As I'm describing my new book to folks, I always say something like "It tells the story of a movement of people trying to transform nursing homes from the old institutional model to places that really look and feel like home." If I have time, I go on to say that the movement is really taking on the culture of aging, with nursing homes being the most egregious example of how we marginalize elders (or something like that). Anyway, I keep getting asked what the movement is called. For those who have never heard of this, I'm finding that "culture change" is too jargony and vague and could be used to refer to all sorts of enterprises, not just long-term care. And the "Pioneer Network" doesn't really capture the essence of what this movement is. One friend who is a long-time public relations sort, suggested it be called "the elder home movement" meaning, everywhere elders live should be "home." I wondered if others had wrestled with this.

On investigative visits to nursing homes across the nation, Beth Baker has witnessed profound changes. Culture change leaders are tearing up everything -- the floor plans, the flow charts, the schedules, the lousy menus, the attitudes, the rules -- and starting from scratch. They are creating extraordinary places where people live in dignity and greet the day with contentment, assisted by employees who feel valued and appreciated. Perhaps most surprising, these homes prove that a high quality of life does not have to cost more. Some of the best homes in the nation serve primarily low-income people who are on Medicaid.

In this new book, Baker tell the story of a better way to live in old age. Although each home is different, they share common values: respecting individual choices; empowering staff; fostering a strong community of elders, staff, family members, and volunteers; redesigning buildings from a hospital model to a home (where pets and children are part of everyday life); and honoring people when they die. Her visits to more than two dozen facilities include those associatd with the Eden Alternative, Green House, Kendal, and the Pioneer Network. Whether these transformational homes become the norm or the domain of a lucky few is the question that faces the next generation of elders, the baby boomers.