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The Importance of Constant Renewal

Posted: April 18, 2013

This coming weekend, Dr. Hans Becker from Rotterdam, The Netherlands is visiting JCHE to talk about his bold experiment of creating a new form of elder care.  His “apartments for life” are “age-proof” meaning they are physically suitable for any material limitations created by an aging body.  In addition, he marries this architectural accommodation with a psychological one—the staff have adopted a “yes culture” whereby the first response to all residents, staff and family members is “yes” and from there the conversation is a negotiation about how to effectively implement the idea.  In addition, all members of the “extended family” are encouraged to “see it and do it” meaning they should take initiative and make things better.  Moreover the organization has embraced a “use it or lose it” philosophy of care where residents are pushed to care for themselves as much as possible, even until it hurts, and to take control of their lives, making their own care decisions.

Dr. Becker recognizes that along with the benefits of this approach, there are limitations.  With more experimentation and empowerment, there are more failures and errors.  Without extensive rules and rigid protocols, there are moments of chaos.  With people remaining in housing at extreme old age, there are those who question their desire to live in the complex.  And there are times when people’s self-determination bumps up against their own well-being.  Dr. Becker urges the staff to use common sense in all of these cases and wants managers to back up staff in their desire to try new things.  He further pushes managers to remove “creativity barriers” such as perceived lack of time or money.

Despite the challenges, Dr. Becker’s PhD dissertation proved through academic research methodology that the benefits deeply outweigh the costs.  The mistakes and false starts are far less expensive and time-consuming than the endless meetings and time spent analyzing and dismissing new ideas.  People’s ability to do for themselves often reduces demands on staff.  And increased staff morale due to being trusted and valued reduces absenteeism.

JCHE is sponsoring Dr. Becker’s visit because we are an organization committed to reflective practice.  In reading Dr. Becker’s dissertation to prepare for his visit, I was encouraged to discover how many elements from his practice we have already adopted:

  • He argues for non-hierarchical management practices.  We are one year into our culture change process, where the primary philosophy is “mutual respect, mutual accountability” and we have been working collectively to create an open, respectful environment.
  • He believes in shared “one-liners” to tell the story internally.  Our “principles of practice” posted in all common areas are 12 one-sentence imperatives derived from democratic, inclusive staff participation sessions.  [Admittedly, ours are wordy and could benefit from modeling from the simple language of Dr. Becker’s principles.]
  • He says telling stories is critical to help stakeholders and the public understand the importance of the work.  For the past 3 months, we’ve been posting one story/day, written by anyone from the JCHE community who chooses to participate.
  • He argues that attractive, engaging public spaces are essential to continued stimulation of mind and body.  We have more of these public spaces than I’ve seen in any other affordable housing development.
  • He advocates extensive offerings to engage mind, body and spirit with cultural sensitivity.  We work hard to be culturally competent and employ staff from diverse backgrounds and raise money annually to continue art, music, intellectual and community programs.

Nonetheless, the Humanitas complexes take our achievements one step further in the ability to provide nursing home and assisted living care right in people’s apartments, and in the way they welcome the public into their common areas for dining, culture and entertainment—and extend their care offerings beyond their 4 walls.

We’re always trying to improve and learn, and we hope Dr. Becker will help us advance the cause.


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