More About Resident-Directed Communities: Findings from a Conversation with Colleagues

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Verna Cavey

Moriah Bernhardt

Verna Cavey, Advocate, Independent Living Resident, Clermont Park
Moriah Bernhardt, Senior Director Programs, Christian Living Communities

PREFACE: In the article, “Can We Talk,” August of 2021, Verna and Moriah started a conversation with our readers on Resident-Directed Care, introducing the Citizenship model and asking for feedback regarding where organizations are on the Continuum of Resident-Directed Culture. As promised, they are back with Part II of continue the conversation to share what they learned.

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Yes, we did talk! During the last few months, we heard you at state and national conferences, in blog discussions and in participants’ responses to panelists and symposium presenters. Your input has shaped and reshaped our thinking and it’s been exciting to watch the evolution in such a short time.

And you taught us a lesson.  In spite of our positive experiences with resident-directed and citizen-based communities, our first article in August may have had a pessimistic tinge to it. For example, we asked, “What are the obstacles which get in the way of resident-directed communities?” This came from our listening to folks at conferences telling us that resident-directed communities were too difficult to create and just plain scary.

What we heard from you instead was a resounding call for change and a strong statement that you were ready to get started. For example, when we did polling and asked where team members and residents were along the continuum (see graph), a large percentage said that they were already resident-directed communities.

This stunned us as the evidence isn’t there. In fact, percentiles are small.  The question is “Why?” these results. We can mumble about the fallacy of self-reporting. Or, we can acknowledge that we are often preaching to the choir. Many of you are already invested in compassionate, progressive communities; others are curious in a positive way — not exactly a group of resisters.

However, we would be very remiss if we didn’t talk about Covid as a critical variable. Where years of trying to convince have failed, Covid has opened minds at incredible speed. Here are some of the insights that you have offered:

The resident-directed and citizenship models are all about disrupting the status quo. Covid made it clear that status quo isn’t working and a radical transformation is needed.

  • New and more effective housing models are available to us — let’s use them.
  • Residents asked that they be educated about these new models and their role in them. Help them see their own capacities and combat learned dependency. They want to come aboard and show the external community too, so that we can finally rid our society of ageism.
  • All members of the community — leadership, team members, residents and their families — are participants in community with obligations toward each other. We are all accountable in treating each other with dignity.
  • Do a serious study of national and international models and incorporate their best practices into our communities.
  • Understand that all communities have some aspects of conflict. With a new collaborative model, we can discuss and resolve them rationally and put away the “scary.”

Probably the best contribution was the addition of the Citizenship model to the continuum. Not surprising, Jill Vitale-Aussem, in her book, Disrupting the Status Quo of Senior Living:  A Mindshift, stressed the importance of the citizenship model. We were also able to bring people together for a very open discussion — one that was very much needed. Respected movers and shakers for decades in the aging field joined newcomers and residents to talk about this.

Singular voices have been calling out in the dark for years for a resident-directed community model. Now we are seeing organizations standing behind those voices: Pioneer Network, for example, with their symposium on purpose and meaning and The Beryl Institute with their recent White Paper.

We are walking away from this experience with a far more positive outlook about the future. You did that. We only asked if you could come and talk with us. You came from far and wide and offered a resounding response.

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Verna and Moriah will be back in 2022 with Part III, in which they will share the three main steps they have identified to take in initiating a resident-directed community.






5 comments on “More About Resident-Directed Communities: Findings from a Conversation with Colleagues

  1. Verna M. Cavey on

    Oh, I hear you, Donna. It takes a lot of hard work by good people for it to happen.
    I have worked in many disciplines over the decades. I choose to labor in my autumn years with the folks in the aging field because they are amazing people who aren’t afraid to work hard. Some of them have been at it for decades and they still haven’t given up.
    And, it really is happening. I see the evidence in front of me every day. It is spreading to other communities and to people who want it in their community. But I’m not Suzy Sunshine. Not everyone in my community will participate. I don’t expect everyone to do so. But we have enough “live wires” who want to be a contributing, meaningful part of their community and that percentage of the population is sufficient for it to happen.

    The truth is that resident-directed communities wouldn’t happen if the person-centered model wasn’t already in place as a foundation. I remember feeling pessimistic as to whether even that would get off the ground. It has…

    You are right. Administrators and others must be willing to give up their power to residents, their families and to team members. Many of these people are convinced, however, but only when they see positive evidence of the “bottom line.” We know that occupancy, marketability and retention all improve under this model. Others have been convinced when they saw residents taking some of the weight off of their shoulders when decision making and work is shared.

    Thank you so much for your honesty, Donna. Yours is a critical contribution and both sides must be heard. And, Moriah and I aren’t going anywhere…give a yell if you want to bounce ideas around. Verna

    • donna k woodward on

      Verna, thank you for your reply. Yes, change is a life-long commitment and the residents of your community are lucky to have you and Moriah. I don’t at all think you’re a Suzy Sunshine, Verna! I see you, as well as Joan and Cathy and Penny, as taking graceful positions on the spectrum running between justified optimism and constructive (I hope) contrarianism. I would love to give you a ‘yell’ sometime.

  2. donna k woodward on

    Resident-directed? I’d be happy if long-term care homes became just resident-responsive! (If you think LTC homes are resident-responsive, become a fly-on-the-wall during food council meetings.)

    I fear that this wonderful concept—resident-directed LTC—may go the way of ‘person-centered’ LTC, animating the rhetoric more than the reality. I fear this because resident-directed care implies that residents participate in decision-making. For residents to become decision-makers means convincing current owners, investors, and administrators to share their decision-making authority, including financial information and decision-making authority, with residents, with families of residents living with cognitive loss, and with staff. I hope we’ll more about the blueprints this group comes up for bringing about these needed innovations.

    • Joan Devine on

      Based on the work being done by the many organizations and individuals who are part of the Pioneer Network, I do not believe that resident-centered care has gone away, and it won’t as long as we are willing to keep the vision alive and continue the hard work needed to support the vision. I agree that for all too many residents, being involved in decision-making is not happening. But we need to keep that vision alive, and it is encouraging to see that organizations, like CLC where Verna lives, are making that vision a reality and finding ways to honor and respect residents – and all stakeholders – in the decision-making process. Communities like CLC may not yet be the majority, but they are out there. In the December 8 symposium, in addition to the session, “Growing the Team of the Future to Drive Cultural Transformation Toward a Person-Directed & Citizenship Approach to Senior Living” session with the team from CLC, the session “Resident Voice: From Token Voice to Powerful Driver”, not only reinforces this vision, but will be sharing examples of how resident voices are being raised with meaningful involvement at the resident council level, and even the board of trustees.

      • donna k woodward on

        Thank you as always, Joan, for reinforcing the glass-half-full side of LTC. 🙂 Yes. There are many people keeping working to keep person-centered care alive and well. Still more is needed.

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