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10 Must Do’s for 2018

A new year is a great time to set goals (both big picture future goals and SMART goals for the current year). Here are DRIVE's top 10 must do’s for creating and sustaining a strong culture in 2018.  (Blog reprinted with permission.)

As you navigate these first few weeks of 2018 we recommend that you sit down with your team and consider what on this list you do really well and what you need to work as a team this year. If you need help getting starting let us know. We have facilitators who can not only help lead this discussion, but they can work with your team throughout the year to help you all achieve your goals.

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Intimacy and Aging

“You’re looking pretty tonight.” Her eyes warm to the compliment. Automatically she checks her hair, newly washed and cut. Even after all these years she is still slightly nervous. But a date is still a date even when you are seventy-and-more. For his part, any tentative feelings are covered with pride and pleasure at being seen out with such a fine woman – much as he felt fifty years and more ago.

“Shall we go?”

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Mislabeling and Aging

Far too often, labeling a person as ‘senile’ is a thoughtless expression steeped in prejudice. ‘Diagnosing’ a person as ‘senile’ is accurate only when we mean there is a continuing pattern of progressively deteriorating thought and behavior coupled with a medically proven diagnosis of an irreversible brain disease. Careless use of this single word (senile/senility) suggests that we think we know what is wrong and there is nothing more to understand or to be done. This attitude is not justified even when the person is, in fact, suffering some form of a progressive cerebral change. But the attitude is particularly destructive when the individual is troubled, yet far from ‘senile’.

Even professionals are capable of making such errors. International mental health teams and researchers in the field of gerontology who have been studying this problem have discovered that many elderly persons who were labeled with the term senile/dementia have come to realize that the problem is, in fact, functional in nature. If this can happen, then people without professional or scientific training may be even more prone to error. Any sign of confusion or mental lapse in an elderly person may be erroneously taken as ‘proof’ of senility.

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Keen-Mindedness and Aging

Definition: keen-minded – “mentally alert” – (Merriam-Webster Dictionary)

Why are some elderly people more keen-minded than others? In youth and middle age some people are more mentally alert and vigorous than others. Keen-mindedness tends to be habit forming: a combination of fortunate genetic endowment and a lifestyle that keeps the intellect well honed.

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The Triumph of Love and Aging

Despite the obstacles, love can triumph for the old as well as for the young. The importance of a sustained love relationship in old age is hard to overestimate. Sex brings more than direct physical gratification, although this by itself is not to be slighted. It also reaffirms each partner’s identity as a person who can offer something worthwhile, and who can be someone worthwhile to another person. The body is still a means of giving and receiving pleasure.

But there is another important function of sexual intimacy in old age. The old person is all too often ‘typecast’ to the outside world. He is the secondary character, belonging on the fringe of the real action.
We tend to remain at an emotional distance from him. Every day we walk past, almost through old people on the street, without clearly registering their existence as individuals.

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Be Prepared: The Administrator’s Leadership Role in Emergency Preparedness

Be Prepared!   The motto of the Boy Scouts of America has never been as true for many Nursing Home Administrators as it has during the recent events of the nursing home tragedies that have occurred in Texas and Florida during Hurricanes Harvey and Irma. For many nursing home Administrators, being prepared for an emergency, or disruptive event, is the ultimate responsibility; a high priority. The CMS final rules of participation on Emergency Preparedness which takes effect on November 15, 2017 will only add another layer of regulations to an already heavily regulated environment for the Administrator.

One certainty that will face all Nursing Home Administrators (in the wake of Florida) will be that the CMS and State surveyors will be reviewing (in detail) a facility’s emergency plan, and in some cases “ripping” it to shreds.  How can Administrators be sure that the emergency plan they have will meet requirements?  Until we begin to see how deficiencies will be cited by surveyors, this question remains to be answered. Regardless of outcomes, the Administrator must have an emergency plan and documented exercises that have tested the plan.

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Wellness and Aging: Learned Dependency and Aging

Several decades ago two prominent psychologists wondered whether giving institutionalized elderly people a tiny amount of control over something in their lives would have a positive influence on their personalities.

What they did was to give a house plant to each resident in a nursing home. Half of the residents were told that the plants would be cared for by the nursing staff. The other half were told that they were responsible for the care of the plants. They were to decide when to water the plant and how much sun it should have. At the beginning of the study, the two groups were similar in physical and mental vigor. Three weeks later, there was no difference in the health of the plants, but there was a lot of difference in the psychological adjustment of the residents who were put in charge of caring for their plants. The group given personal responsibility rated themselves as more alert, active and vigorous.

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Security vs. Dependency, and Aging

A grim choice confronts some people when they face problems associated with advancing age.  Do they have to accept insecurity and deprivation? Must they surrender much of their independence and integrity in order to be helped?

Elderly men and women may prefer to go it alone instead of taking advantage of available resources to which they may appear as stubborn and unrealistic.  But they many feel life would no longer be worthwhile if they were to become too dependent on others for their needs.

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My WHY: #IamACHCA

I believe in the sanctity of those who are older than me, and the significance of supporting them to continue writing their life’s story to the very end, regardless of where they may reside. For post-acute and aging services organizations, this requires enlightened leaders who are amply equipped to adapt their organization to fulfill each of their residents’ narratives.

In this rapidly evolving environment, I know that I can’t be successful by going it alone. I need collaboration, support, quality education and information. I also need a network of like-minded peers, who through formal and informal interactions, afford me the recognition and validation I need to stay inspired.

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Chronology and Aging

Our society will continue to insist on using chronological age for many purposes. We can live with this practice if we recognize that to set up a chronological checkpoint for calling a person ‘old’ is simply a matter of administrative or statistical convenience. It is an unfortunate usage but difficult to avoid. We can, as a society, minimize the negative impact of this practice by making a clear distinction in our own minds between chronological age and the individual’s actual physical, mental and social situation. We can also refuse to be swept along by the implicit relationship between chronological age and human value. ‘Ten years older’ does not mean ‘ten years worse’ or ‘ten years less valuable.’

            Age-grading emphasizes society’s interest; functional age emphasizes the direct facts about the individual.

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Starting with WHY

Lately, I’ve been giving a lot of thought to our profession, post-acute and aging services, and began to wonder if anything we do matters.

With all the challenges from regulators, attorneys, payers, and the press, why do we do it? Not WHAT we do, or even HOW we do it, but WHY? Simon Sinek wrote an entire book on the topic, entitled, Start with Why, and spoke on it in a widely viewed TED Talk several years ago (use this link to view the original “Start with WHY” talk https://www.youtube.com/watch?v=IPYeCltXpxw).

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Creating Culture Candor

“I feel like a mushroom.  They keep me in the dark, so I keep them in the dark.”

A key member of a leadership team muttered these powerful words when we conducted an organizational assessment for his company.  This is what happens when organizations fail to create a culture that embraces open communication.

Consider how damaging it is when an influential member of your leadership team withholds information.  From you. From staff. From residents. The negative impact is tremendous.

Creating culture candor.

Organizations that have a strong culture that focuses on communication will outperform those left “in the dark.”  Transparency allows organizations to run more efficiently and effectively.

It starts with sharing information.  Anytime you have an important message to communicate, we suggest doing so in at least five ways.  Some ideas include:








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Is This Too Extreme?

For some reason, many leaders in healthcare like to equate things in their lobby to person-centered care. Player pianos. Coffee for visitors. Seating areas with plants. Leaders that were eager to tell me about how they are “doing” culture change have proudly presented each of these examples to me.

Pathetic.

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The Effects of Anxiety and Aging

A person who appears demented may be tormented by grief and anxiety. His demented behavior may have been brought about by emotional pain. A grieving person at any age is less able to pay close attention to everything that happens around him. He takes less care in grooming and dress. He has less emotional energy to welcome new opportunities or to respond to challenges. He feels uncomfortable with his body. His mind may be constantly uneasy or tortured.

Loss and grief are common in old age as death removes loved ones. An old person may have suffered other significant losses, of occupation, residence, physical mobility, belonging, or usefulness – all of which produce a grief response.

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Fulfillment and Aging

by Sheldon Ornstein Ed.D, RN, LNHA

             There are many individuals in their later years who question their continued mental functioning with this thought, “Will I become senile?” The fear of growing old casts a shadow over many lives in our society long before the first deep wrinkle announces that old age has arrived. Yet, most people retain resources and powers well into and far beyond what we or they imagine.

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The Intangibles of Professional Association Membership for New Long-Term Care Leaders

As a blossoming leader in long-term care with a specific mission, vision and value for what I want to create for the consumers I serve, my support system is an integral part of developing and enhancing those values and that vision.

The American College of Healthcare Administrators (ACHCA) has been instrumental in the development of my mission and vision for long term care. As a student of St. Joseph’s College of Maine’s Long Term Care Administration program, I was introduced to ACHCA at the beginning of my capstone project. My professor, Philip DuBois, had strongly encouraged my membership as a not merely important part of my education, but a mission critical step in developing myself as a leader within a network of other administrators that share my values and pursuit of excellence in this particular field. 

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ACHCA Group Membership Rate – A Member Benefit that Supports Quality Outcomes!

The ACHCA Group Membership Rate offers a company or facility the opportunity to receive a reduced membership dues rate if they pay for 3 or more individual memberships at one time.

This group rate applies to our Professional, Emerging Professional, and Associate memberships.

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CMS Finalizes Emergency Preparedness Requirements

ACHCA heard today from Mary Elizabeth (Liz) Chesney, Contract Support, National Healthcare Preparedness Programs, HHS/ASPR/OEM. She reported the following information: 

Today, the Centers for Medicare & Medicaid Services (CMS) finalized rules to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and man-made disasters. These new rules will require certain participating providers and suppliers to plan for disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations. The effective date will be November 16, 2016 and the implementation date will be November 16, 2017. [emphasis added]

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Welcome to our new Blog!

Since January of this year, much has happened here at ACHCA!

One of the most exciting things has been the migration to a new Association Management System (AMS) that deepens the connection between members, automates many services, and provides easy access to information using one entry point: the New Member Portal.

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