Fireworks, grilling, time with friends and family. These are all hallmarks of a July 4 holiday weekend. As we started preparing for it, I started to think more about “independence” and what it means to the people we serve.
Freedom and the ability to choose how you want to live are things many of us take for granted. Rules and regulations certainly have a place in long-term care; there must be “order,” after all. I worry, though, that there are times when “order” takes a front seat to “choice.”
Last month I wrote about the “F” word (“Stop using the F word already!”), and the very week I wrote it, I gathered with leaders in our field and was reminded again of how common it is to say “facility” when referencing our communities.
So here we are at another Independence Day, and my thoughts are with the seniors we serve. Not only the people we serve in our communities but those who are a couple or three decades older than me. At what age does independence vanish? Is it a certain age, or is it a location?
We work where people live and choice changes in our communities. Safety many times trumps choice. As leaders in this field, are we doing enough?
Personally, I know I’m not. I see and feel independence disappear. Shared living does make it difficult to have all the freedoms you may want, but I’m talking about the little things. The freedom to express yourself any way you choose without being labeled. The freedom to sit outside without an escort. The freedom to do something you know is bad for you, but you decide to do it anyway.
Leadership takes courage and boldness. We talk about reform often, and yet true reform in long-term care has not happened. A mandate won’t propel reform. We are constantly fighting when we should be completely and totally focused on revolutionizing long-term care to be able to offer more people true independence. This feels like an enormous task because we need to break down stereotypes that have taken on a life of their own.
In many ways, institutionalization has robbed older adults of their ability to make choices for themselves. The re-institutionalization that happened during the pandemic pushed us back even further.
This starts in each community by noticing and making people aware of the common words and phrases that hurt our efforts to change. Those are the small steps; the big steps still need to happen. What I’m talking about is bigger than resident-centered care. What I’m talking about is ageism, and we in the field sometimes (myself included) are our own worst enemies.
A quick example: I often hear phrases like “non-compliant” used when a resident doesn’t follow their “orders.” The jump from making your own decisions to being non-compliant shouldn’t change because of geography.
This Independence Day feels like the right time to remind myself, and fellow leaders, that we all need to do more. Our field is necessary and honorable, and we have been told what we can and can’t do for years. We rarely take risks and challenge the regulations because the consequences are potentially disastrous.
I know there are trailblazers out there. Leaders who are tuned in, leaders who are making a difference in the lives of those we serve every single day. My wish is that we would see more of those stories in the headlines. More personal testimonies from young people on why they are excited about our field.
And more resident-focused accounts of how they want to live and the choices they want to make for their lives, regardless of their address.
Julie Thorson was the 2018 recipient of the LeadingAge Dr. Herbert Shore Outstanding Mentor of the Year award. She currently facilitates LeadingAge Iowa’s Leadership Academy. She is a LeadingAge Academy fellow and former coach. The Head Coach (president and CEO) of Friendship Haven, a life plan community in Fort Dodge, IA, Thorson is a coach’s daughter at heart. A former part-time nursing home social worker, she is a licensed nursing home administrator and an alumna of LeadingAge’s Leadership Educator Program.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
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