Creating Homelike Environment Per Federal Mandate
For AGNG 600
May 20, 2012
I recently learned that CMS/DHHS revised regulations on environment in 2009: “The intent of the word “homelike” in this regulation is that the nursing home should provide an environment as close to that of the environment of a private home as possible.” If ‘homelike’ is a goal: preferred view, the press and the power of language to create culture are three things that stand to help nursing home staff to maximize an elder resident’s autonomy and quality of life.,, A conscious effort to understand these things gives clinically trained staff more of the requisite thought processes required to care for the person, instead of just the patient. With the explicit revisions to the regulations regarding environment, the consummate clinician has been given a directive that serves to open pathways toward de-institutionalizing the nursing home environment simultaneously providing opportunities for elders to achieve their utmost capabilities. Preferred view, and its goal to “bring out the best when people are at their worst,” by focusing on the “constellation of ideas” that relate to people’s “strong preferences with regard to how they would like to behave, see themselves and be seen by others,” is a great starting point. A starting point from which individual clinicians and elders can openly relate to perceived/preferred perceptions about self and each other. Candid conversations that stand to help break down barriers placed by perceived notions of professionalism or filling one’s ‘role’ as a resident in a nursing home. Then growing from that point, using the product of such conversations from which to foster caring relationships. Awareness of “the press:” how the physical environment represents just part of “the transaction between a person and the environment” where light, smells, sounds, proximity to others, etc. must be also considered. The entire milieu of any...
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