The JOY Domain of Wellbeing part of CMS Regulations

The Eden Alternative? developed what are called the seven Domains of Well-being®.

If you want to learn them, Eden has a white paper at www.edenalt.org.

Another highly recommended resource is Dr. Allen Power’s book Dementia beyond Disease: Enhancing Wellbeing. Each chapter is dedicated to each of the seven domains.

Did you know CMS included the Eden Domains of Well-being in the new, 2016, regulations?

And, do you know where…? At the Activities tag!

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)

Since we started this series CMS added this to its guidance referencing the Eden Alternative,

GUIDANCE §483.24(c)

Opportunities for each resident to have a meaningful life may be created by supporting his/her domains of well-being (e.g., security, autonomy, growth, connectedness, identity, joy and meaning) as identified by the Eden Alternative philosophy of care. More information may be found at: http://www.edenalt.org/about-the-eden-alternative/theeden-alternative-domains-of-well-being/ ) (10-21-22)

We have been working through each of the seven domains and now turn to JOY.

The Eden Alternative? definition of JOY is

JOY

Happiness; pleasure; delight; contentment; enjoyment

Joy is such a big deal I honestly feel inadequate in trying to write about it.

Perhaps I struggle because it is so personal to each of us.

Therefore, I just suggest turning each of those powerful descriptions into questions.

Ask them of all. Ask all of them. Ask some new questions. Give people something different to think about. Give them homework, ask them to ponder and tell you later. Or, ask one at a time. Have a Question of the Month and seek to ask each person who lives where you work.

What brings you joy?

What brings you happiness?

What gives you pleasure?

What delights you?

What makes you feel content?

What do you enjoy?

Even think of your own answers for yourself. Here are some answers I have heard to What brings you joy?:

Having a place that entices grandchildren to come and be with grandparents, i.e. playground or corner for kids
A dog, or more than one.
Friendship with those who live and work here and from my life, to not be forgotten and not to lose all control of my life.
To be outside as much as possible.
Being with other people, especially family, I don’t like to be alone.
Music, all of it, listening and playing, my joy ever since I was little when I whistled up and down the cow barn.
Chemistry and astronomy, I love hands on learning and did experiments ever since I was a kid when we had a telescope as well.
Gathering with other people and talking about similar things.
When son comes, doesn’t see him often, bowling as well.

Recently I was getting to coach a team and shared the seven domains of wellbeing and that they are in CMS regulations. I asked, “Imagine living in nursing home and being asked, ‘What brings you joy?’” Get this, one of the team members was the organization’s general counsel and he quicky replied, “It would be amazing and so much better than seeing my mom alone in a corner in the dining room.” He even became teary.

Asking individuals what brings them joy may change institutional culture just by the asking and then coordinating for those things to happen. What if our new job title was Joy Coordinator? How would you organize your time differently? Someone do it and write an article about it! Go change institutional culture my fellow Joy Coordinators!

Carmen Bowman, MHS, is a former activity director, the first certified activity professional to be a surveyor, worked at CMS Central Office trainings surveyors and is an Eden Alternative Associate and Mentor. She has fun calling herself a Regulator turned Educator as owner of Edu-Catering: Catering Education for Compliance and Culture Change. She hopes to inspire chipping away at institutional culture with a strong foundation of regulatory requirements – moving away from traditional activity programing to offering real life. Activity consulting, personalized continuing education. Compliance and culture change workbooks at www.actionpact.com. “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