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Beginning of article

For more than two decades, proponents of culture change in longterm care have worked on transforming the institutional nursing home model. More recently, the focus has turned to assisted living and even independent community housing.

What we see is that America falls short in all living environments when it comes to older adults engaging in diverse communities. How can we optimize the quality of life, across a multitude of settings, for our nation's elders?

In long-term care, most frail elders are housed in hospital-like institutions, where life revolves around medical and nursing interventions. Even in assisted and independent elder housing, the trend has been to …