A reply to Steve Moran’s full frontal assault on Bill Thomas:
Sixteen years ago, on a small, energy-independent farm in upstate New York, I had the opportunity to visit with a man who was making a name for himself in the long-term care industry — an industry where many had already branded the 40-ish, bearded advocate as “radical” and “misguided.”
The truth? I drove to his farm that afternoon, like others before me, to find out if he was the “real deal.” I knew he could “talk the talk.” But I needed to know if this former Skilled Nursing Facility Medical Director could “walk the walk.”
Ironically, it wasn’t his vision of care for the frail aging that won me over that afternoon, but rather his fascination with and affection for his two infant children – both cursed from birth with Ohtahara Syndrome; a rare and cruel form of epilepsy. I sat mesmerized in Bill and Judith Meyers-Thomas’ modest living room, beginning to understand why the Harvard-educated physician had, by any standard, changed the adult congregate living industry more than any other figure in US history.
As far as the good doctor and abolitionism go, I believe you understand the context in which he uses the term – a word, as you’re well aware, means “to eliminate slavery.”
Finally, I am reminded of Deep Throat’s admonishment to Bob Woodward in All the President’s Men to “Follow the money,” and secretly wonder how much of your enchantment with the nursing home sector is born of quid pro quo generosity.
Janis Deets Nowak says
Oh My!!! I fear for the future of elder care!
If you had asked me yesterday “who are the three folks who care most about: the elderly; the disabled; the cognitively impaired; here in the United States?” – I could not have come up with a better answer than Martin Bayne, Bill Thomas and Steve Moran.
Imagine my surprise when I receive an email this morning from Laura the Nurse who says “This article in the Senior Housing Blog is really interesting. My issue with it seems to be that if I go by what is being written about, I don’t think I understand person directed care. I would really appreciate your take on it.” They are caught up in a discussion about abolitionists and tigers.
Laura hit the nail on the head! This war between our elder-care heroes (Martin, Bill and Steve) has little to do with our residents (or you or me). Elder care should be a battle for individuality. Creating a culture in which each person receives the care they desire is a little scary. Often, it differs from our own opinion about what someone needs. On occasion, it doesn’t meet the requirements of the law. Sometimes, it is not so pretty. This is what person directed care looks like.
Lucky you! If you are not “institutionalized” you can make choices. Maybe you smoke. Maybe you eat too much. Maybe you don’t socialize. No wonder you do not want to enter a long-term care environment!
So what is this argument between Martin, Bill and Steve really after? They are all good men. All extremely well-intentioned. What are they looking for? Here is a thought….
I am going to leave the world of assisted living for a moment because I think there might be some answers outside our silos (Steve Moran, you encouraged us to step outside).
Have you heard of Cynthia Ong and the work that she is doing in the environmental field? Cynthia, is the executive director and CEO of Land Empowerment Animals People (LEAP). Cynthia was frustrated by the development-conservation polarity (the struggle between those who want to develop land and those who want to conserve land). The push-pull, the good guy-bad guy attitude on both sides did not seem productive to her. So she founded LEAP “to facilitate partnerships and projects across sectors and hemispheres based on a core belief that real, robust, and resilient solutions are found in connection and relationship with each other.”
Now I am going to steal her ideas, paraphrase and adapt to the business of assisted living…
• The regulatory/provider arrangement is an old frame, which no longer serves us.
• The regulatory/provider framework pits us against each other, constrains us in us-them dynamics, makes one right or better and the other wrong or bad, and the divide is a chasm. It is a disconnect – which keeps our solutions partial, oftentimes conflicted and always limited.
• Our current mindset is not going to cut it in the world with huge numbers of people over 80, many without the resources to care for themselves.
• Even for those with resources, where are the caregivers going to come from? The proportion of elders to youngers is increasingly tipping toward toppling.
• We need to put our attention and energies into connecting dots, issues, people, groups and sectors. We need to create spaces for conversations about the future that include the elderly, the needy, the carers, the regulators, the payers and the providers of service.
I’m still stealing ideas here….
• We are invested in our constructs, the patterns and formats by which we engage, and their underlying assumptions.
• We roll out the same old processes and get the same results.
• We stay in our corners, interact with people like ourselves, compete amongst each other for finite resources.
• We build campaigns that say if only the other corner would change their ways everything would be fine and the world would be better.
Do you find any of this intriguing? We talk a lot about what we don’t want to have happen: we don’t want people to fall; we don’t want people to be isolated; we don’t want people to run away. Perhaps we should shift our focus and ask what do we want to have happen?
Even my concluding remarks are Cynthia’s words: “The challenge is to get ourselves out of the way, stop thinking it’s all about us, scrutinize, question our assumptions and constructs, and work hard and smart to redesign and recalibrate. Radically different results – which are what we need – are going to take radically different approaches and processes. If we continue on the tracks of business-as-usual, government-as-usual with the elders silently screaming in the margins (ok, elders was a substitution from the words she used). I’m afraid we are not going to make much impact on our own trajectory.”
Let’s start working together and looking for the win-win! We can do this!
Dan Hutson (@dhutson) says
To characterize Steve Moran as “enchanted” with the “nursing home sector” suggests to me that (1) you haven’t really talked to the guy, and (2) you’ve given his blog a superficial read at best. I’d suggest spending a little time talking to Steve. I think you’ll find you have a bit more in common than you think.
Steve Moran says
Kavan, I will be working on that article this week. Be glad to have you post it here, even first, if you are willing. Though in all honestly Bill and I are not really all that far apart in our view of skilled nursing as it exists today.
Kavan Peterson, Editor, ChangingAging.org says
Thanks for dropping a line Steve. Martin is the fiercest advocate I’ve ever met and the most insightful when it comes to living within the confines of long term care. I talk to him as often as possible. I greatly look forward to your next article, which you hinted at in the original post. I also wanted to make sure you caught Bill’s third and final post in that series, which wasn’t linked from your article: https://changingaging.org/blog/two-levers-that-can-move-the-world/
It provides a little more context to what he is talking about.
Steve Moran says
Martin’s post is such an odd thing to me. my article at Seniorhousingforum.net was not meant as a frontal assault and I have received several emails from people in the culture change world who are equally puzzled by your characterization.
There is no need for a “Deep Throat” or Woodward/Bernstein style investigation, to see where my financial support comes from. You can check out my partner page and see who provides the support that pay my bills. I am apologetically a senior living shill. That being said, I recognize the reality that there are some significant problem areas and other areas that are good but could be better. I frequently write about those areas.
More to say, but I think it will come in the form of an article at Senior Housing Forum . . . and maybe Changingaging.org if they are willing . . .
I would close by saying that if Martin had submitted his article at Senior Housing Forum I would most assuredly would have published it.
Kavan Peterson, Editor, ChangingAging.org says
I forgot to say yes, we will gladly publish your follow-up piece on ChangingAging.org!