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Culture change continues to evolve

October 9, 2013
by Judah L. Ronch, PhD
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Health Professions Press has just launched its new series Leading Principles and Practices in Elder Care, for which Audrey Weiner and I will serve as series editors. Our first two volumes in the series, Culture Change in Elder Care  and Models and Pathways for Person-Centered Elder Care were released this year, ten years after the publication of our initial edited volume, Culture Change in Long-Term Care. That was a decade that saw significant changes in the cultural landscape of aging services.

But as two contributors in our first book have observed, there is still much left to do. In fact, they ask, why have we only come this far?

What can we point to as the difference in ten years? First of all, the language we use has changed. The definition of “culture change” still not been clarified enough so that people in the field who are not a regular part of the culture change conversation are able to define it. At a recent state association conference, I did a presentation that clarified the point that “culture change” was not synonymous with Green House or Eden homes.

There are many other expressions of changed cultures of elder services that provide person-centered, or as some say, person-directed, care. Many nursing homes or assisted living models are not well known. Some culture change innovations are acute-care oriented, like Seniors Emergency Departments. Or they are not set in or sponsored by bricks-and-mortar care organizations such as the Village Movement and other approaches that are not part of the traditional LTC community environment. There are models in other parts of the world that are relatively unknown in the United States, as well as what families do every day to care for their relatives and friends.

What we found in preparing the new series is that the term is in part defining itself as a result of how creative and dedicated people understand what needs to be changed and the importance of developing forward-looking models in elder services. Some changes are small and accomplished with modest cost; some are huge and require large budgets and a great deal of time and patience.

Looking back at our first book, where there was much advocacy and passion but little data, it’s easy to see that the past ten years have brought an appreciation of the need for not only creative ideas, but outcome measures with which to make the case for culture change. We are encouraged by the research that has taken place to help innovators make decisions based on outcomes, and by the sound knowledge that has been gained about the operations side of culture change.

The conversation now includes a new generation of younger innovators from more diverse fields, locations and organizations, and has led to solutions we could not have predicted ten years ago.

The new series provides a place for practitioners and researchers to have a “home field advantage” when they want to share their work with others interested in new service models. We envision the series as a practical guide that will inspire providers, policy makers, students, scholars and entrepreneurs to be creative and share evidence of their success.


Judah Ronch

Dean, Erickson School, University of Maryland Baltimore County

Judah Ronch

Judah L. Ronch, PhD, is the dean of and a professor at the Erickson School, University of...