How Community Meetings and the Definition of an Elder create Compliance and a Shift to Normal Life

We have been studying the culture change practice of community meetings as developed by the Barkans along with those who lived in the Live Oak home in the 1970s.

Additionally, this passionate community developed the Live Oak Project Definition of an Elder.

Please read this imagining it is you who lives in a nursing home or assisted living. How would it make you feel?

The Live Oak Project Definition of an Elder

An elder is a person who is still growing, still a learner, still with potential and whose life continues to have within it promise for, and connection to the future.  An elder is still in pursuit of happiness, joy and pleasure, and her or his birthright to these remains intact.  Moreover, an elder is a person who deserves respect and honor and whose work it is to synthesize wisdom from long life experience and formulate this into a legacy for future generations.                  Copyright 1977, The Live Oak Project.

Retired administrator and culture change leader in Colorado, Beth Irtz was inspired by this and used it as a path to teach changing institutional culture.  She tells the story about a man who lived in the nursing home who was very angry toward team members not accepting offers of care in hateful ways. Beth thought that this may be because no one had shown kindness to him and he had become bitter. He came to a community meeting where Beth projected the Definition of an Elder and noticed his eyes followed her the whole time. She said although she had never heard him say one intelligent thing, he said, “That is the most wonderful thing I have ever heard, that I’m still learning and growing.” It brought tears to team members that day. And to Beth it brought home that we must listen to the elders. She is not wrong.

In the original Live Oak home, The Definition of an Elder was read each day. “Our Rights Go Marching On” was sung to every newcomer. From this, new neighbors (those who live there) and new team members alike learned from their first day that the nursing home was a home and community, not an institution (2014). The Barkans purposefully did this believing that rituals would bind the community together (2002). The Eden Alternative continues to suggest this to its members.

Consider together rituals for your community. First of all, consider the ritual of the community meeting itself. This is the third article explaining the possibilities. It does so much to create beautiful community. And in the community meeting, consider reading the Definition of an Elder. Watch what happens. Then together create your own rituals which do wonders to knit a community closer and closer together.

Definition of the Community Meeting
The community meeting is a coming together to build community, create connection, explore meaning, gather as a community to discuss things of mutual interest and concern, to celebrate, to remember and to mourn.

I just am astonished at the same language of the regulations, notice compliance everywhere when we honor those who live there and build strong community bonds.

CMS Tag F679 §483.24(c) Activities.

The facility must provide, based on the comprehensive assessment and care plan and the preferences of each resident, an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, encouraging both independence and interaction in the community.

CMS Tag F679 Intent.

To create opportunities for each resident to have a meaningful life by supporting his/her domains of wellness/wellbeing security, autonomy, growth, connectedness, identity, joy and meaning.

F550 Resident rights.

The facility must treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident’s individuality.

Tag F675 Quality of Life.

Quality of life is a fundamental principle that applies to all care and services provided to facility residents. Each resident must receive and the facility must provide the  necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, consistent with the resident’s comprehensive assessment and plan of care.

CMS F584 Safe, Clean, Comfortable, Homelike Environment

A “homelike environment” is one that de-emphasizes the institutional character of the setting, to the extent possible, and allows the resident to use those personal belongings that support a homelike environment. A determination of “homelike” should include the resident’s opinion of the living environment.

CMS F565 The resident has a right to organize and participate in resident groups in the facility.

The facility must consider the views of a resident or family group and act promptly upon the grievances and recommendations of such groups concerning issues of resident care and life in the facility.

Please consider community meetings as a community. Don’t be the only one to promote or hold them, it must be done by your whole community/administration/management team otherwise it ends up being viewed in the old institutional lens of just another group activity. Strategically share these articles with your wider team with all the advantages the community meeting brings. Experiment. Have fun. Let it morph into your own.

Barkan, Barry. (2002). The Way of the Champion. New York: Pioneer Network and El

                  Sobrante: Live Oak Group.

Barkan, Barry. (2014). “The Live Oak Regenerative Community” chapter in Models and Pathways for Person-Centered Elder Care. Baltimore: Health Professions Press.

For more information, look for Live Oak Regenerative Community YouTube videos thanks to a three-year CMP grant in Colorado.

Carmen Bowman, MHS, Regulator turned Educator of Edu-Catering: Catering Education for Compliance and Changing Institutional Culture is an activities/engagement/community life, regulatory compliance and culture change consultant.  She offers new or not-yet-qualified activity director consultation and personalized continuing education for professionals/teams/associations. Also, a new blog and eResource GUARDIANS OF NORMAL LIFE: How Activity/ Recreation/ Engagement/Community Life Professionals can Save the World of LTC at  www.edu-catering.com. At the Edu-Catering YouTube channel, see how turning rigid schedules into flexible ones creates all the outcomes everyone wants!