Culture Change: Perspectives from Direct Care Workers

Culture Change: Perspectives from Direct Care Workers

There are many variations of person centered care, but all include the idea that the person receiving care is the center of power and decision making.

Quality elder care is essential, because vulnerable older adults are some of the frailest members of our society. Changing organizational culture to person centered care respects the relationships between residents and direct care workers by allowing them to control routines (Ortigara, 2014). This is a dramatic change from traditional long term care settings, where the direct care workers who provide most care have little say in day to day routines (Kostiwa & Meeks, 2009) and outcomes are measured by tasks and assignments, not lives changed. Culture change nursing homes return the power of decision making to residents and direct caregivers.

But how are workers cared for by the organizations for which they work? Each of us has basic human needs that are met or not met in our work environments. Workers whose needs are being met are better able to meet the needs of others. Increasing resident’s choices directly impacts the work expectations and work flow of caregivers, yet little is known about their experiences in implementing and working in a culture change community. This study explores workers’ understanding and experiences of choice, collaboration, trustworthiness, safety, and empowerment in the workplace. It also considers the ways that staff perceive that needs are met or not met. I hope that the results will help all communities implementing culture change to address the needs of their workers, to better enable their workers to address the needs of others.

Dr. Kusmaul is an Assistant Professor at the University of Maryland School of Social Work. Her research interests include healthcare delivery, workforce, and culture change in long-term care.

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