Many of us encounter the same people every day as we go about our lives. And though we may not consider these individuals friends, or even acquaintances, they are still a part of our daily existence, and over time, we like to think that some human connection is made.  Whether it's a series of mundane exchanges, or at times a more profound connection, we feel on some level, "This person knows me." They can make us feel that we're special and brighten our day. Or they can make us feel insignificant, like we don't matter. Every human connection, no matter how small, can enhance or detract from our well-being. It is our nature to want to feel that we matter to those whose lives we touch in some way every day. Imagine your world if these connections were denied to you.

 

In many of today's traditional long-term care settings, these basic human connections are often lost. As a resident of one of these institutions, you are separated from those who love you and know you best, and removed from familiar surroundings and the simple joys and comforts that have made your life meaningful. You become a diagnosis or the sum of your ailments or impairments, stripped of your personhood.  In such an environment, your confidence, and your trust in those who are supposed to be there to support you suffers. You may feel devalued and that your needs and preferences are dismissed because you are a physical body to be cared for, not a human being with thoughts and feelings, and a story to tell. It would make for a rather hollow existence, wouldn't it? Sometimes you might even feel that life is not worth enduring.

 

When we talk about Culture Change in long-term care, we're talking about a holistic approach to care that focuses on the person and creates a partnership between the caregiver and patient/resident rather than a one-way relationship. In 2004 the Eden Alternative® and the Jefferson Area Board of Aging convened a task force that defined the ultimate outcome of person-directed care as well-being. The task force identified seven domains of well-being, one of which is "identity," which includes the concept of being well-known by others. Communication is fundamental to this concept. Because we can't expect an individual with a cognitive disability, for example, to always know what he needs from us, it's our responsibility as long-term care professionals to try and discern that. We know that validating an individual's uniqueness, his agency and personal story enhances well-being, while being dismissive or provoking feelings of alienation diminishes well-being. Knowing the "patient" is definitely important, but knowing the "person" is essential. We cannot replace friends and family. But we must also acknowledge that we are, for many of our residents, the primary relationships in their lives and as such, we have to develop that trust, instill confidence and hope, and nurture those very special connections because they matter.