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200   Chapter 13 Baby Boomers’ Legacy? Building a Movement The biggest force for change would be the market. If consumers really get on to what the difference is in these places, they won’t want to go to the old unchanged places. Every blow for creating a demand for change is all to the good. —Carter Catlett Williams, nursing home reform leader Together we can create a culture in which it’s easier to do the right thing. —Mary Pipher, Another Country Cultural transformation is an idea whose time has come. What began as a dream of a handful of radical reformers is rapidly gaining acceptance as the way life should be for people in nursing homes. This is especially remarkable given how truly radical that vision is. In his best-selling book The Tipping Point, Malcolm Gladwell compares the spread of social phenomena to that of an epidemic: “What must underlie successful epidemics, in the end, is a bedrock belief that change is possible, that people can radically transform their behavior or beliefs in the face of the right kind of impetus.” Within the field of long-term care, many have worked hard to create that impetus. Steve Shields recognized early on that transformation cannot be sustained as long as nursing homes such as Meadowlark Hills are islands in a sea of institutional mediocrity. “This thing will not survive if it doesn’t become normal ,” he said. “That’s when I started taking every speaking engagement that came my way. I knew I needed to influence regulators, our associations, pro- Baby Boomers’ Legacy? 201 viders. I told myself that I was going to just speak the truth as I experienced it, and so I did.” He, Bill Thomas, and other leaders dedicate more and more time to going on the road, preaching the gospel of transformative change. I called Richard Peck, long-time editor of Nursing Homes magazine, to see if their voices were being heard. Peck’s magazine goes to fifty thousand long-term care managers and directors of nursing. “Culture change is a hot topic—not an easy topic,” he said, especially for administrators who must lead the change. He shared an anecdote he thought was revealing. He had recently attended a culture-change seminar in Ohio. A week before the event, only twenty people had signed up. But the day of the event, more than three hundred people descended from around the state. Although many expressed disbelief that such change could really happen, Peck said he sensed an openness unlike anything he’d witnessed in his fifteen years of covering the field. “In the past, they have been in a very reactive and defensive mode,” he said. “Now, people are stepping up, just stepping up and doing it the way it’s supposed to be done. It’s a different philosophic mindset. This is new.” There are no hard numbers, yet only a fraction of the nation’s nursing homes have committed themselves to fundamentally change. But the two main trade associations—the American Health Care Association/National Assisted Living Center (AHCA), representing primarily for-profits, and the American Association of Homes and Services for the Aging, representing not-for-profits, both enthusiastically endorse the tenets of culture change. “We definitely support systemic change, and we do not support it just being a marketing effort,” said Sandy Fitzler, AHCA senior director of clinical services. AHCA’s Provider magazine regularly runs features on transformative homes, encouraging members to follow their lead. At AHCA’s annual conventions , culture change is now a regular workshop topic, and in 2006, two of its four preconvention sessions were devoted to culture change. Although many reform advocates and nonprofit leaders are skeptical that for-profit nursing homes, especially corporate-owned chains, will have the long-term commitment needed to transform, others say that the business case may be strong enough to prompt action. Golden Gate National Senior Care (formerly Beverly Enterprises), one of the nation’s largest corporate chains, is piloting small culture-change pilot projects at 23 of its 342 nursing homes. But as the new name implies, corporations are bought and sold, and such projects can lose the support of new owners. “We went through a change of ownership this year,” said Patrice Acosta, senior vice president for quality of life programs. “There is a learning curve for our new executives to learn what this whole resident-centered [18.191.189.85] Project MUSE (2024-04-26 05:15 GMT...

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