lightbulbs going on

My conversation with Linda today sparked some new ideas about defining my research topic. I think my research question needs to change.

"How can design support Culture Change in Memory Support environments?"

I know that I will need to define Culture Change as well as Memory Support as being a part of the larger senior care community.

My hypothesis will change too.

"Residents in Memory Support environments can benefit from the principles of Culture Change, despite their cognitive challenges."

I have a lot of work to do tonight to get this presentation ready in 2 days!

community contacts

I had a great conversation over lunch today with Linda Gabel of NBBJ (thanks, Liz) about research directions and her thoughts on senior care. One of her concerns in the healthcare market is the issue of bariatrics as an underserved and underresearched population.

Some of the questions that came out of that discussion are:
How are blended units working with Alzheimers/Parkinsons/mental health issues?
What is comforting or means home to residents vs. family members? (facilities are really marketing to families)
How are the concepts of culture change going to apply to dementia care residents?

She had great contacts for me too, such as Jane Rhoady and Betsey Brawley, Donna Mullins, and Lisa Cini of Mosaic. I will definitely be following up with these people as I go.

expressions of love

Nursing Home
by Lillian Morrison

My mother is all bones
and eyes.
She doesn't notice
her clothes anymore
who had loved beads and bright colors
or glance at the racketing dayroom TV
who had watched her "stories" every day.
"These are my company."
Just people she wants
to greet and joke with,
to cry a little.
She wants them to smile
and to love her.
She asks for her father and mother.
I touch the baby skin,
the meaningful face
and look in the eyes that say
"I'm still fighting
in this narrow place."
and I hug
the fragile bones.

more hmmmmmm

"Old age is not the source of our problems; it is where we will find the answers we need. Indeed, it has been the source of all our answers from the moment we first learned to grow old."

- Dr. Bill Thomas, founder of the Eden Alternative

a little rework is in order

I'm still concerned that my research question "How can design best support the evolving senior care market?" is the weak spot in my presentation. And since it is the cornerstone of everything I do from here, that is a little disconcerting.

After some encouragement from my fellow students and a little tweaking, I am feeling better about it. But the main response I got when we were going over our presentations for next week was that the contextual rationale for a senior care overhaul is where my strength is. So I may want to move that to the front and really emphasize it, get people involved and caring about my topic right up front. So I will spend tonight moving some things around and seeing where this goes.

But my question may go something like "How can design best support skilled nursing care in the senior living environment?"

things that make you go "hmmmm"

"We would never purposely design a nursing home system like we have if we imagine ourselves in its care." - Steve Shields

changing my key words

Old key words:
senior living
medical model
culture change
person-centered care
Greenhouse model
Household model
Eden Alternative

New key words:
health care
senior living
nursing homes/skilled nursing
evidence-based design
culture change
person-centered care
post-occupancy evaluations

aging with humor

things are a-changin'

enough said

conversation of the day

The conversation of the day centered around the use of my final slide, the one I affectionately entitled, "Lady Bird." (an elderly lady giving the camera the finger). I wanted to upload the photo here, but it says it can't load because of an internal error. It doesn't say what the error is or how I should fix it, so I'm not sure what to do about that.

Anyway, I asked my fellow students if the slide should stay or go for the final presentation. I love it, because I think it conveys a powerful message about how the elderly feel about nursing home care. But I am a little worried about looking unprofessional during the final, considering the number of faculty who will be in attendance.

The general consensus was that the slide should stay. But Bruno had an excellent idea to move it to the first slide, instead of the last one. It sets a mood, gets people's attention, and I have an opportunity to explain its context while everyone is listening. Last time I was trying to talk about it while we were transitioning to the next presenter, so the conversation may have gotten lost.

So that's it. Lady Bird stays, AND gets an upgraded seat. Not bad for someone her age.

Musings about POEs and the definition of healthcare

So, I'm having a thought here... I think I need to take a look at current Post Occupancy Evaluations as they are being used in senior care. Who is creating them? What kinds of things are being studied? How far "post-occupancy" are we talking about? Who is conducting them? How is the information being collected? Where does the information go? Are there holes or gaps? Do we need to take another look at them from the standpoint of person-centered care to make sure we are measuring the appropriate things?

Which lead me to another thought... senior care is generally considered a subset of the healthcare industry. Many of the standards being set forth in research and legislation of senior care facilities are based on the larger healthcare model. But healthcare, more often than not, is referring to hospitals and medical management, based on the "sick-patient" concept. It's goals are institutionally based.

By definition, the culture change movement in senior living is anti-institutional. The entire concept is to get away from the "sick-patient" concept and get to a "whole-person" concept. These residents may also have ailments that need to be treated, but that is not the focus of their daily lives.

So how can the goals and models developed for the larger healthcare system really be addressing the needs of the senior care community. I have a feeling we are working at cross-purposes here. Which is why a larger review of something like post-occupancy evaluations may be in order.

some people design with words

On Aging

When you see me sitting quietly,
Like a sack left on the shelf,
Don't think I need your chattering.
I'm listening to myself.
Hold! Stop! Don't pity me!
Hold! Stop your sympathy!
Understanding if you got it,
Otherwise I'll do without it!

When my bones are stiff and aching
and my feet won't climb the stair,
I will only ask one favor:
Don't bring me no rocking chair.

When you see me walking, stumbling,
Don't study and get it wrong.
'Cause tired don't mean lazy
And every goodbye ain't gone.
I'm the same person I was back then,
A little less hair, a little less chin,
A lot less lungs and much less wind.
But ain't I lucky I can still breathe in.

-Maya Angelou

can we try that one more time?

http://www.myinnerview.com/_media/doc/general/CultureChange123105.pdf

let's see if this one works...

link to research somebody else already did for me

http://http://www.myinnerview.com/_media/doc/general/CultureChange123105.pdf

Why didn't that link in the last post?

a place to start

So, I tried to post my entire powerpoint presentation on my Statement of Intent, but clearly I have more to learn about this whole blogging thing.

Instead, let's just dive right in to my research question...

"How can design best support the evolving senior care market?"

I know, I know. It's broad. But it will be narrowed as I do more research and talk to more people.

How about my hypothesis...

"Culture Change itself needs to be more clearly defined in terms of management structure, facilities, goals, etc."

But guess what I found today? Somebody already did that.

http://www.myinnerview.com/_media/doc/general/CultureChange123105.pdf



So where do I go from here?

Onward and Upward

Ok, so I opened this blog way back when as an experiment, which clearly didn't go very far.

But while I have one, and now that I need one, I may as well use it.

So here goes.... I am going to attempt to turn this into a design blog related to my master's thesis in design. Wish me luck.