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Nurturing Cultural Change in Care for Older People: Seeing the Cherry Tree Blossom

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Abstract

There is a need for person-centred approaches and empowerment of staff within the residential care for older people; a movement called ‘culture change’. There is however no single path for achieving culture change. With the aim of increasing understandings about cultural change processes and the promotion of cultural values and norms associated with person-centred practices, this article presents an action research project set on a unit in the Netherlands providing care for older people with dementia. The project is presented as a case study. This study examines what has contributed to the improvement of participation of older people with dementia in daily occupational and leisure activities according to practitioners. Data was collected by participant observation, interviews and focus groups. The results show that simultaneous to the improvement of the older people’s involvement in daily activities a cultural transformation took place and that the care became more person-centred. Spontaneous interactions and responses rather than planned interventions, analysis and reflection contributed to this. Furthermore, it proved to be beneficial that the process of change and the facilitation of that process reflected the same values as those underlying the cultural change. It is concluded that changes arise from dynamic, interactive and non-linear processes which are complex in nature and difficult to predict and to control. Nevertheless, managers and facilitators can facilitate such change by generating movement through the introduction of small focused projects that meet the stakeholders’ needs, by creating conditions for interaction and sense making, and by promoting the new desired cultural values.

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Acknowledgments

We would like to thank George Vink for visualising the case in some nice drawings and Donna Frost for her feedback and willingness to check and correct the English language.

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Authors and Affiliations

  1. School of Nursing, Fontys University of Applied Sciences, Box 347, 5600 AH, Eindhoven, The Netherlands

    Miranda M. W. C. Snoeren, Bienke M. Janssen & Theo J. H. Niessen

  2. VU University Medical Center, Medical Humanities, Amsterdam, The Netherlands

    Tineke A. Abma

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  1. Miranda M. W. C. Snoeren
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  2. Bienke M. Janssen
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  3. Theo J. H. Niessen
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  4. Tineke A. Abma
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Correspondence to Miranda M. W. C. Snoeren.

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Snoeren, M.M.W.C., Janssen, B.M., Niessen, T.J.H. et al. Nurturing Cultural Change in Care for Older People: Seeing the Cherry Tree Blossom. Health Care Anal 24, 349–373 (2016). https://doi.org/10.1007/s10728-014-0280-9

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