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Pondering Culture Change…

May 30, 2013



1. the behaviors and beliefs characteristic of a particular social, ethnic, or age group

2. the sum total of ways of living built up by a group of human beings and transmitted from one generation to another

“Culture change” is the frame for a lot of work being done in long-term care these days. When I think about changing a culture, I have to admit, it sounds like a huge undertaking, one that would most likely take more than my lifetime to accomplish. By definition, changing a culture amounts to shifting the “sum total of the ways of living built up by a group of people and transmitted from one generation to another” — now there’s a heavy lift!

To truly change a culture, we must have patience, intention, and endurance. Perhaps it would feel more manageable if we recognized the changes we are making as “culture transitions” as opposed to “culture change.” Using the word change implies that we are replacing one thing with another — like changing your clothes or making a room change. But we are asking people to stop thinking and acting one way and to begin to do so in another way — this is almost never something that occurs quickly. 


In fact, change is almost always accompanied by resistance. We fight against moving away from what is familiar because we are attached to the way we do things. 

Resistance is particularly fierce if changes are being made without our input. If we feel we have no voice, or don’t understand what, how, or why, we will almost assuredly challenge the new way. When our opinion is invited, even if we don’t agree with the outcome, we are more able to live with the change.


However, even when we agree that change is for the better, it takes a measure of time to acclimate. This is the period of transition that follows the change. William Bridges, in his book Managing Transitions, says that every transition begins with an ending. We must let go of something to grasp the new. We have to honor what we’ve already done, build on what has worked, recognize and manage our feelings about what we are losing, and move forward.

During the transition, we often feel discouraged and confused. When we change the look and feel of something, we need time to acclimate to the differences. Once we do, we usually feel good about it — and so do the elders we support.   

More time is required to adjust to some of the more significant internal organizational changes we are trying to implement, changes that rattle the culture that has been in existence in nursing homes for so long. And significantly, we are making these changes in a context that includes external demands for change — requirements for new documentation, shifts in reimbursement, new models for transitions in care. All of these things require organizational adjustments that affect our community. The loss of the familiar throws us off balance, and we all need support through the period of transition. The change may be made, but the transition isn’t over until the new way of doing things feels stable and safe.

Learning how to support each other through not only the changes, but also the transitions, is essential. Take the time to hear one another’s hopes and concerns. Allow time for the adjustment — there is no set time for such transitions to take place. As noted earlier, sustainable change requires patience, assuming good intentions, and endurance on everyone’s part.

— by Kathy McCollett, PHI Organizational Change Consultant

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