A couple of weeks ago I published an article titled “Bill Thomas Says I Am an Abolitionist”. This article spawned an almost immediate response/rebuttal, “All The President’s Men” by Martin Bayne at the Bill Thomas Changingaging.org website.
In that article Martin accuses me of two things:
- Launching a ‘full frontal attack’ on Bill Thomas. You be the judge, but I don’t see it as a frontal attack and it wasn’t intended to be that.
- He then suggests that I have some sort of secret backroom relationship with the industry that makes everything I write suspect and that somehow I should be “investigated” Watergate fashion. Really a pretty funny assertion because the partner sponsors of Senior Housing Forum are easy to spot. In addition I am openly pro senior living. No investigation needed. I admit it.
This all leads to an article on what I like about the person-centered care movement and what bothers me.
What I Love About Person-Centered Care
As a concept, person-centered care has become main stream. You find it in CMS regulations and guidelines; you find it referenced at most senior living conferences. Most senior living providers, in one form or another, say they are doing person-centered care.
How can you not love the idea that residents should be in control of their own destiny; That they should be able to choose how they live their lives in skilled nursing facilities and assisted living communities.
And yet . . . if you were to talk to just about any person-centered care advocate, their own assessment is that after 20 plus years of flying the flag, true adoption of person-centered care is low, which brings me to my struggles with the Pioneer Network/Person-Centered Care movement as it exists today.
Their Own Worst Enemy
In my view, the person-centered care movement as it exists today is their own worst enemy. Here is why:
- My Way or The Highway – At last year’s Pioneer Network, one of the keynote speakers (not Bill Thomas) delivered up one of the harshest, mean-spirited presentations I have ever heard at a senior living conference. He attacked every single provider/person who was not doing person-centered care they way he thought it ought to be done. He had zero grace for people who were doing some things but not everything.It played well to the audience, but at the end of the day served to create an “us and them” mentality that is not, helpful in moving the bar. I found this attitude to be common (though far from universal) as I interacted with people at the two Pioneer conferences I attended.
- Smugness – I want to be very careful here. I have a number of friends who are deeply embedded in the person-centered care movement that are in no way smug. But overall there is a sense of superiority that turns people off. Martin’s article is a great example of this. He attacked me because I suggested that Bill Thomas did not have it entirely right. I probed, asking him to explain what part of my thinking he actually disagreed with. So far, he has not answered that question.I am not sure he actually even considered what I wrote. As near as I can tell once he decided I was the enemy, he quit considering my point of view. The person-centered care people may be 100% right, but no one likes smugness. It is one of the surest ways to make sure no one will take you seriously.
- They Don’t Really Want Change – The worst thing that can happen to a crusader is getting what they want. Crusaders love an audience. They love being riled up and riling up like-minded individuals. The problem is that if they get what they want, the crusade is gone and their reason for being evaporates. This requires finding another good cause or retiring, both of which are hard to do.
- It Doesn’t Go Far Enough – I have no problem at all with the fundamental principal of self-determination for elders in senior living setting. The problem with it is that it is still a cruise ship mentality. You move into my senior living community and whatever you want you get . . . unless of course it is to do something for someone else.Sounds good at first, but there is much data that elders do better when they are provided opportunities to continue giving. It can be in the form of volunteering or continuing to work. It is not in being entertained until they die.
Now waiting for Martin’s Rebuttal Part Two.