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Sir Michael Parkinson has learnt how Anchor Homes has boosted a Government campaign to improve the lives of people living in care homes across the UK.
Accompanied by Care Services Minister Phil Hope, Sir Michael learnt how Anchor Homes’ commitment to quality dementia training for its staff has helped the Department of Health pass its goal of 3,000 Dignity Champions nation-wide.
The DoH Dignity in Care Campaign aims to drive up care standards and encourages people to become Dignity Champions, spreading best practice and giving advice. Anchor Homes’ Managing Director Jane Ashcroft said the not-for-profit organisation now had more than 300 Dignity Champions.
Since becoming a Dignity Ambassador in May, Sir Michael has helped raise the profile of the campaign and the work of Dignity Champions. Mr Hope wanted Sir Michael to hear about the success of Anchor Homes.
Mrs Ashcroft, who is also the Vice-Chair of the English Community Care Association (ECCA), said: “Maintaining the dignity of residents must be at the heart of every residential care service. We at Anchor are aware of how important it is to care for people with dementia with the dignity and respect they deserve.
“The number of people with dementia in the UK will soar from 700,000 today to more than a million by 2025. Anchor has addressed this issue head-on, giving dementia care training to more than 5,000 care staff in Anchor’s 102 residential and nursing homes.
“We also have 309 Dignity Champions who have received advanced dementia training. Anchor now has more Dignity Champions than any other care provider outside of the NHS.”
Sir Michael Parkinson added he had been inspired by the Dignity Champions he had met. He said: "I have had have the great honour of meeting some of our nation’s real unsung heroes, hearing their stories and bringing attention to what they are doing to hopefully inspire many others to follow suit.”
Care Services Minister Phil Hope said: “Dignity is about quality of life and enabling people to live their own lives as they wish, confident that the care and support they receive is of high quality.
“Government alone cannot make this happen. I look forward to continuing to work with the wide range of organisations that provide care services and represent the interests of those using them.”
Starting Jan. 1, the pharmaceutical industry has agreed to a voluntary moratorium on the kind of branded goodies — Viagra pens, Zoloft soap dispensers, Lipitor mugs — that were meant to foster good will and, some would say, encourage doctors to prescribe more of the drugs.
No longer will Merck furnish doctors with purplish adhesive bandages advertising Gardasil, a vaccine against the human papillomavirus. Banished, too, are black T-shirts from Allergan adorned with rhinestones that spell out B-O-T-O-X. So are pens advertising the Sepracor sleep drug Lunesta, in whose barrel floats the brand’s mascot, a somnolent moth.
The new voluntary industry guidelines try to counter the impression that gifts to doctors are intended to unduly influence medicine. The code, drawn up by Pharmaceutical Research and Manufacturers of America, an industry group in Washington, bars drug companies from giving doctors branded pens, staplers, flash drives, paperweights, calculators and the like.
There’s a real lack of understanding in this country of the extent of the problem of medical waste and what I guess you’d have to call doctors’ incompetence. Uwe Reinhardt has a great post laying much of this out including the striking fact that “on average, American patients receive the recommended treatment for their condition only slightly more than 50 percent of the time.”
The structure of Medicare allows us to do pretty solid apples-to-apples comparisons of what different hospitals are spending on treatment, and the evidence is clear that the hospital-to-hospital variance is costs is large, and in quality is also pretty big, but the differences seem uncorrelated:
According to the Dartmouth researchers, if physicians with relatively higher cost preferred practice styles could be induced to embrace the preferred practice styles of their equally effective but lower-cost colleagues, overall per-capita Medicare spending probably could be reduced by at least 30 percent without harming patients, and similarly for commercially insured younger Americans. How can a nation that routinely wails over its high cost of health care ignore such important research?
I’ve been watching a lot of House re-runs lately, and they’re a striking encapsulation of part of what’s wrong with the way Americans think about medicine. Dr House is unfailingly portrayed as a bad person but a fantastic doctor and the medical ideal is seen to be that of the brilliant explorer-hero who does what it takes to solve the most difficult cases. An alternative model would see the doctor as a kind of custodian of public health. A general practitioner who develops an effective method of nudging people toward quitting smoking or exercising more during his brief post-checkup chats would save many more lives at dramatically lower cost than would all of Dr House’s heroics.
And of course most doctors in the real world aren’t like genius television characters — unleash them from concerns about cost-efficacy and imbue them with a heroic self-conception and they don’t even give you costly-but-effective medicine. Almost half the time they don’t even do the right treatment.
"...ethics concerns not only questions of life and death but how one ought to live with and interact with others on a daily basis. The ethics of the ordinary is just as much a part of health care ethics as the ethics of the extraordinary. For the resident, the small decisions of daily life set the boundaries of his or her moral universe."
"One size doesn't fit all," Congressman John Boozman, a strong advocate for improvements to senior care, told a group gathered to celebrate the first shovels of dirt turned for the Green House Assisted Living project in November. "These are the kinds of projects that really do change people's lives."
Now that the finishing touches are being put on the exteriors of the first four Green Houses, a stateof-the-art assisted living environment at Legacy Village, the calls are rolling in. For the past several months, visual progress on the Green Houses has prompted a growing list of seniors and their loved ones to inquire about what will be the first project of its kind in Arkansas.
The Green House model was developed by Dr. Bill Thomas, a nationally recognized geriatrician dedicated to eliminating institutionalstyle nursing homes in America. The Green House success story began with the opening of Thomas' pilot project in Tupelo, Miss., in 2002. There are now 10 such projects across the country.
It’s no secret that adopting culture change principles in a nursing home is the right thing to do. But a new report from the Commonwealth Fund finds that it may be better for business too.
Take staff retention. Researchers found that 59% of nursing homes who implemented seven or more culture change intiatives, like letting residents determine their daily schedule or asking nursing assistants to participate in care planning, had improved their staff retention rate since they implemented these initiatives.
That’s not all. Occupancy rates went up and operating costs fell as nursing homes adopted more programs that empowered direct care staff and focused on residents’ needs and preferences.
That’s not to say these programs aren’t costly. 31% of nursing homes surveyed reported that cost was the biggest barrier to implmenting more culture change programs in their facility. This survey, however, begs the question: does embracing culture change give nursing homes a better “bang for their buck?”
[Editor's Note: Below is a teaser to Dr. Thomas' new health column to be published bimonthly on www.timegoesby.net. Thanks to Ronni Bennett for inviting Bill to become the TGB Geriatrician.]
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