Connectedness in CMS Regulations – Did you know?

Connectedness is one of the seven Eden Alternative Domains of Well-being®.  Eden offers a free white paper explaining them as well as Wellbeing Surveys designed for Elder, Family and Employee Care Partners at www.edenalt.org. Dr. Allen Power’s book Dementia beyond Disease: Enhancing Wellbeing, is also a resource dedicated to each of the seven domains.

Connectedness included in CMS Federal Regulations
And to make things even more interesting, did you know CMS included the Eden Domains of Well-being in the new, 2016, regulations? Even more interesting, take a look where…

F679 Activities.

INTENT §483.24(c)

To ensure that facilities implement an ongoing resident centered activities program that incorporates the resident’s interests, hobbies and cultural preferences which is integral to maintaining and/or improving a resident’s physical, mental, and psychosocial well-being and independence. To create opportunities for each resident to have a meaningful life by supporting his/her domains of well-being – security, autonomy, growth, connectedness, identity, joy and meaning.
(emphasis added)

Connectedness Defined
Eden defines connectedness as

State of being connected; alive; belonging; engaged; involved; not detached; connected to the past, present, future; connected to personal possessions; connected to place; connected to nature.

This definition is so rich, let’s look at each portion.

State of Being Connected

Just think if the regulations stated instead of “activities” to provide for each resident in an individualized way to know they experience the state of being connected. Wow. In a way, the regulations now do with the addition of the domains of wellbeing and this being part of the definition of connectedness.

Ask residents what it means to them; individually as well as during groups. When we ask more detailed questions, we get more detailed answers giving us so much more to go on in serving people. You could ask people to rank their state of being connected on a scale, maybe 1 to 3. Regarding those unable to tell you, observe as a team a person’s state of being connected, even ranking what you observe. In fact, it is this group that is most likely to be the least connected and needing you to step into the gap for them. This article may give you some ideas on how.

Alive
Sadly, it could be that some older people particularly living with deep dementia or other hard conditions and unable to communicate may not feel fully alive. The term “slumping” has depicted this. Fortunately, we specialize in preventing slumping and helping people to be more fully alive.

Belonging
What if you were the Belonging Coordinator and your sole job was to ensure people feel they belong somewhere, to some group. A neighborhood identity, well known. A part of a shared interest group like the few who play Bridge or make up the service club.

Engaged
To me the idea of meaningfully engaged is the antithesis to staying busy. What we’ve learned is busy work is boring. The challenge for us is to rise above busy work to discover what creates meaningful engagement for each individual.

Involved
The culture change consultants of Action Pact teach “high involvement” by all. That is key to changing institutional culture and one way to create connectedness.

Not Detached
This is really the opposite to all mentioned thus far. Invite all your fellow team members to take an oath against detachment! Ensure somehow together and with whatever it takes to not let one person feel detached.

Connected to the Past
Make it a point. Help all to know who this person is which includes who they were, their past. Don’t let it happen that new information is learned at the funeral or in the obituary.

Connected to the Present
Give teammates permission to enjoy life, enjoy the here and now, today with those they serve and work with. We all know tomorrow is not promised.

Connected to the Future
The key here is to involve individuals in planning their future: today, later, tomorrow, the week, the next weekend, this month, next month. Did you know some organizations help to make vacations happen for people living in nursing homes? Wow. Did you also know that most people, you and I, have a “future self”? We know what is happening into our future. However, most institutionalized persons do not have a future self. This is sad to me probably because planning has been such a big part of my life as an activity professional, I’m sure you relate. But really, everyone plans, no matter their job. This again is a gift you can give. Involve people in planning events into the future, next month, not only the calendar but then the events within it. Help people to have calendars they can use to plan. If the only calendar residents have is the activity calendar, that is not reflective of their personal future self either. You, of all professionals, have the power to make this connection happen perhaps more than any other.

Connected to Personal Possessions
Lockable curio cabinets and more shelving on walls are easy solutions to help people be connected to more of their personal possessions. They need them and we need them to have them as we then relate to people better, knowing more about them via those special artifacts of their lives.

Connected to Place
It can be very special to help residents remain connected to the home’s community as well as the community at large. Photos and artifacts of the area both past and present are a very meaningful way to help remain connected to place.

Connected to Nature
This does seem important to almost all people. I recommend addressing getting outdoors on every person’s care plan, it is that important and it reaps big benefits. Because of the improvements to health, mood, sleep and even preventing falls, I would place more emphasis on helping people get outside than holding group activities….

Let these various ways of describing connectedness guide you in creative ways to help people have connectedness.

Carmen Bowman, MHS, Regulator turned Educator of Edu-Catering: Catering Education for Compliance and Culture Change, seeks to inspire everyone to chip away at institutional culture by laying a strong foundation of knowing regulatory requirements – blending innovation with regulation.  Activity consulting, personalized continuing education and live instruction also available. “Cutting edge-ucation” nominal pay-per-view training videos at www.patreon.com/educatering, carmen@edu-catering.com 303-981-7228  www.edu-catering.com The Culture Change Minute for free www.facebook.com/Edu-catering