Beruflich Dokumente
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Organizational Change:
Alzheimers Disease and Dementia Resources for Bellingham Senior Activity Center
Christen Bowman and Celestinna Davidson
Western Washington University
Alzheimers Disease and Dementia Resources for Bellingham Senior Activity Center
Older adults are at risk for multiple chronic illnesses due to the normal aging process. As
their needs for healthcare increases, their need for psychosocial support also increases. Older
adults must learn to learn to cope with changes in their health and their role in the community.
Healthcare professionals, especially nurses, are in a unique position to help this population
maintain their wellness. Originally, Bellingham Senior Activity Center (BSAC)'s manager, Heidi
Wilson, requested that we survey BSAC members to determine what type of health educational
topics could be used to develop a support group. After a thorough organizational assessment of
BSAC, we found that management is not ready to implement a health and wellness support
group. Based on the survey results of BSAC members knowledge(?), a list of
dementia/Alzheimers Disease resources would be more relevant to the communitys needs at
this time.
In order to meet the needs of BSAC members and the agency most effectively, it is
important to conduct a thorough organizational assessment. An organizational assessment
analyzes an organizations readiness for change and willingness to adopt the proposed
intervention. Included in this paper is a description of Prochaska and DiClementes change
theory, which guided the evaluation of the agency. The agency was analyzed within each
category of this theory. Additionally, a force field analysis of the agencys readiness and a
summary of the recommendations for the next steps for BSAC to adopt the proposed intervention
are also included. Lastly, a Logic Model (see Appendix A for the Logic Model) and Focus
PDCA (see Appendix B for the Focus PDCA) are incorporated to provide a clearly formulated
plan for implementing the intended intervention at BSAC.
Change Theory
Prochaska and DiClementes change theory is best suited for BSACs needs. This
concept focuses on the agencys readiness for change. According to Sare & Oglive (2010),
Prochaska and DiClementes Five Stages of Change is a series of stages in which the agency
moves between the stages freely. The five stages are pre-contemplation, contemplation,
preparation, action, and maintenance. In the pre-contemplation stage, the agency is unaware of
the need for change; they may not have the education or understanding of the need. In the
contemplative stage, the agency is aware of the need for change, however is not actively
implementing change. In the preparation stage the agency is planning on change and may have
already started to implement change. During the action phase, the change has been implemented
for several months; during this stage, it is not uncommon for regression. After the completion of
the action phase the agency moves into the maintenance phase, in which they are committed to
the change.
Based on our organizational assessment BSAC is currently in the preparation stage of
Prochaska and DiClementes change theory. The manager and program director are well aware
of the need for change and have collaborated with Western Washington University (WWU)
students on identifying BSAC members needs. A resource list has already been created and
BSAC is preparing to utilize it. Identifying BSAC members needs has given the manager and
program director great confidence in implementing the resource list. Tailoring the intervention
to this agency will overall benefit both the members and the key stakeholders such as the
manager, program director, advisory council, Whatcom Council on Aging, members, volunteers
and staff. Based on the results of our assessment, BSAC intends to make changes in the future.
In regards to a support group, BSAC is in the contemplation stage because they are ambivalent
about any major changes right now. BSAC management needs to see a greater need for an
organizations strategic plan for support services. We believe that the amount of power behind
the enabling forces is much greater than the restraining forces, making the proposed change less
difficult to implement in the future.
Lewins Force Field Analysis best suited this type of change because it allows for open
communication within the organization (Sare & Oglive, 2010). It looks at all aspects of the
change including restraining forces or barriers to the plan. Once the barriers are identified, the
agency is able to decide on interventions and plan how they will overcome the barriers. The
restraining force that the agency can influence the most would be volunteers and staff not
knowing how to use the resource list. Therefore, the agency can overcome this barrier by
educating staff and volunteers on how to use the resource list. The manager and the program
director are already aware of the need for the resource list and are willing to implement its use
within the agency. The enthusiasm of the manager and program director is an enabling force that
has the most impact on bringing about change within this organization.
Our recommendations for the agency are to:
Implement the use of the compiled resource list (see Appendix D for the Alzheimer's
disease/dementia resource list). This resource list includes various community agencies that
provides support for both caregivers and patients with the disease.
If the request for Alzheimers disease/dementia information is popular, then the agency could
consider implementing or hosting support groups, seminars and other various support at BSAC.
Consider networking with doctors offices, clinics, and other organizations within the
community, requesting they refer patients to BSAC.
Consider partnering with the Alzheimers Society of Washington. This is an important resource
that can educate and provide support to members. They can also provide education to the staff
and volunteers.
Conclusion
As evidenced through the organizational assessment, this agency is ready for change, but
has yet to implement the end goal of a support group. Implementing a resource list is the first
step towards this goal. We believe that if enough members request resources for Alzheimers
disease/dementia, then BSAC will recognize the need for a support group at the facility. Even if
a support group is not implemented in the near future, having the resource list can assist
members with navigating community resources by referring them to other support groups or
informational sessions, thus enhancing the quality of care they need overall and providing them
with education to cope with the dementia or Alzheimers disease.
References
Sare, M. & Oglive, L. (2010). Strategic planning for nurses: Change management in health care.
Burlington, MA: Jones and Bartlett Learning.
Appendix A
Logic Model
StatementofNeed:Chronicillnessesaffectolderadults65+,theseadultsneedsresourcestohelpthem
manageandcopewiththeirdisease.BSAChasidentifiedaneedforthedevelopmentofaresourcelist
thatcanbeutilizedbystaffandvolunteersthatputsmembersintocontactwithlocalAlzheimers
disease/dementiaresources.
Appendix B
Focus PDCA
Find a Process to Improve
Through the community survey and assessment, it was determined there was a need for a dementia/Alzheimers
resource list. This need was determined through the survey as well as a request by the manager and activities
director.
Organize a Team that knows the process
Heidi Wilson BSAC manager. Oversees the support group, coordinates with Eric, volunteers, employees, and
outside resources.
Eric BSAC program coordinator. He is knowledgeable about the center and the many different programs that it
offers. He will be scheduling when and where the support groups will be held.
Volunteers of BSAC Will be important to maintain and update the resource list.
Birchview Memory Care Currently conduct a dementia/Alzheimers seminar at BSAC that is held for 4 months.
Birchview may influence the potential for a support group and would be a good resource to add to the list.
Alzheimers society of Washington Provides support and education for caregivers and those with Alzheimers
disease. This would be another good resource to add to the list.
Family Health Associates Physicians WWU students will survey this group of physicians and determine their list
of resources that BSAC can utilize. Surveying and showing this group that BSAC has interest in the resources they
refer their patients may create a partnership between the clinic and BSAC. Physicians can refer older adult patients
to BSAC.
Clarify current knowledge of the process
Identify health topics of interest for this population by gathering data and conducting a survey.
BSAC does not currently have a comprehensive resource list for staff to utilize.
Understand causes of process variation
Availability of staff or volunteers to maintain and update the resource list.
Level of financial support from advisory council.
Whatcom council on aging does not currently offer support services for Alzheimers/Dementia.
Lack of staff knowledge on how to utilize resource list.
Select the Process Improvement
To compile a comprehensive resource list.
BSAC to partner with Alzheimers Society of Washington.
BSAC to partner with other health organizations in the community such as Birchview Memory Care, various clinics,
and PeaceHealth Medical Center.
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Appendix B continued
Focus PDCA
Act
o BSAC staff and members utilize
resource list
o Volunteers and staff maintain and
Plan
o Consult with BSAC mentors
weekly and via email.
o Collect data to compare to the
survey that is to be conducted.
o Conduct survey to
determine health disparity
the community is most
interested in having a
support group for.
Check
Do
Appendix C
Lewins Force Field Analysis
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Appendix D
Alzheimers disease and Dementia Resources
Early Stages of Dementia:
Northwest Adult Day Health
Address:
Address:
Alzheimers Society of Washington Office
1308 Meador Avenue, Suite C-1
Bellingham, WA
Phone: (360) 671-3316
Website: http://www.alzsociety.org
Contact person:
Beverly Brownrigg or Leslie Jackson
Hours: 11:00am to 2:00pm
Every Tuesday
Address:
Locations varies monthly
Next location is at
Blaine Senior Center
763 G St
Blaine, WA
Phone: (360) 671-3316
Website: http://www.alzsociety.org
Hours: 10:30am to 12:30 pm
Every third Tuesday of each month
Appendix D continued
13
Address:
Christian Healthcare Center
855 Aaron Drive
Lynden, WA
Phone: (360) 354-4434
Website:
http://chcclynden.org/services/dementiacare/
Contact person:
Steve Wallace or Sarah Thomas
Hours: Sunday through Saturday 8:00am to
9:00pm
Address:
848 West Orchard Drive
Bellingham, WA 98225
Phone: (360) 715-1338
Website:
http://thebellinghamatorchard.com/index.asp?T=11
Hours:
Open 24 hours
Address:
155 East Kellogg Rd
Bellingham, WA
Phone: (360) 671-1459
Website: http://www.highgateseniorliving.com/
Hours:
Open 24 hours
Appendix D continued
14
Address:
2400 Samish Way
Bellingham, WA
Phone: (360) 734) 4800
Website:
http://www.highlandrehabilitation.com/services.html
For more information on elder care or long term care
in Bellingham WA, please
email:ED_148@empres.com
Hours:
Open 24 hours
Appendix D continued
Bellingham:
Grace Church
1815 Cornwall Ave.
Bellingham, WA
Hours: 1:30om to 3:00pm
Second Thursday of each month
Blaine:
Blaine Senior Center
763 G St
Blaine, WA
Hours: 1:30pm to 3:00pm
First Tuesday of each month
Ferndale:
Louisa Place
2240 Main St
Ferndale, WA
Hours: 10:00am to 12:00pm
First Thursday of each month
Lynden:
Lynden Manor
905 Aaron Dr.
Lynden, WA
Hours: 10:00am to 12:00pm
First Tuesday of each month
Phone: (360) 671-3316
Website: http://www.alzsociety.org
Appendix D continued
15
Address:
Bellingham:
First Congregational Church of Bellingham
2401 Cornwall Ave
Bellingham, WA
Hours: 1:00pm to 3:00pm
First and third Thursday of each month
Lynden:
Lynden Manor
905 Aaron Drive
Lynden, WA
Hours: 11:00am to 1:00pm
Every Monday
Ferndale:
Ferndale Senior Center
1998 Cherry St
Ferndale, WA
Hours: 1:00pm to 2:00pm
Date TBD
Phone: (360) 671-3316
Website: http://www.alzsociety.org
**Please call in advance to confidentially
discuss your appropriate placement into
this group.**
Appendix D continued
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Address:
PeaceHealth St. Josephs South Campus Rehab
Conference Room
809 E Chestnut St.
Bellingham, WA
Phone: (360) 676-6749
Website:
http://www.peacehealth.org/stjoseph/services/adultday-health-services/Pages/Default
Contact person:
Julie Johnson
Hours: 2:00pm to 3:30pm
Every second and fourth Tuesday of each month
Address:
PeaceHealth St. Josephs Adult Day Health Center
809 E Chestnut St.
Bellingham, WA
Phone: (360) 676-6749
Website:
http://www.peacehealth.org/stjoseph/services/adultday-health-services/Pages/Default
Contact person:
Julie Johnson
Hours: 6:00pm to 7:30pm
Every second Wednesday of every month