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CW 95: Jane Rohde

Systematic and instrumental change or incremental change? Jane Rohde discusses the importance of the call to action she feels is necessary for us to start the rebuilding of a broken system that has been in place for way too many decades. When it comes to person-centered care and workforce opportunities, there’s a lot to discuss!

Welcome to Bridge the Gap Contributor Wednesday, I’m Jane Rohde, Principal of JSR Associates and founder and president of Live Together, a nonprofit focusing on person-centered care through development and operation of an intergenerational community model. Hello and welcome. I thought today we could talk about systematic and instrumental change, or is that incremental change? Over the weekend, I was listening to NPR and a fascinating interview with Sarah Schulman, participant in Act Up New York, and the recent author of Let The Record Show: A Political History of Act Up New York 1987 to 1993. Act Up stands for Aids Coalition to Unleash Power, a collaborative yet extremely diverse group of activists that came together in response to the aids epidemic in crisis. When mainstream America was not listening and acting. As I listened to the story, one thing stood out clearly to me, the adversity of the group was part of the power of the messaging and reaching the goal of getting assistance and access to services without stigma to those suffering with aids.

And this was the overarching goal for all participants in act up. This coming to thinking about COVID as a pandemic that has impacted everyone’s lives, particularly older adults being isolated and further exacerbating the lack of access to housing, services, amenities, and care for approximately 90% of older Americans. Why doesn’t America stand up and take notice? What would it take to get regulatory and reimbursement changes? What are we doing for those without a voice? And who’s going to carry the banner forward with the messaging for needed change and implementation of those changes in our systems for caring for elders. How do we unleash our collective power? Although we may not all agree on the how, this is for consideration for all of us that have voice as we all see the challenges every day. I think most of us working in the senior living and long-term care world would agree that providing person-centered care and opportunities for a staff to thrive and grow would be an overarching agreed upon premise for the senior living industry as a whole.

The means and the approach may be completely different. My experience in trying to reach a tipping point for person-centered care, led me down a path that identifies workforce development and research as a part of reaching the tipping point for a community to be restructured, and then that improves quality of life outcomes over time. My life includes my two girls both grew up in the system in a local children’s home, seeing their ongoing challenges in adult life and be immersed in the evaluation of a multitude of different types of models and settings for older adults work in both in-house and outside as a consultant. These two populations often do not have a voice in many commonalities that could be inter supportive within an intentional community. Through my work I’ve witnessed shifts and thought and planning that supported staff, residents, and families when opening a new product by focusing on the day to day operations, saw, heard, and know the value of talking with frontline staff, residents, including those with dementia and very amazing opinions and discussions on what their needs are. And families about their worries, desires and recommendations for improvement through focus groups and post occupancy discussions.

And constantly looking at the new models that are around us or that are being developed. The Eden alternative, the greenhouse project culture change now models, pioneer network concepts, household models, co-living opportunities, cooperative living, European and Asian models. Not only for older adults, but children aging out of foster care, students graduating from college, communal living based upon affinities, provision of freedom for those with cognitive impairment, and the list goes on. The new models we are evaluating are intended for living, and that’s like a capital L I V I N G. At some point, living became the exception to the focus for senior living and healthcare became the primary focus. That’s not for all settings, but for many. Individualized care and services became my passion. And that was the beginning of taking 30 years of my collective experience and focusing on intergenerational models, housing, access to very combinations of services, amenities, and care to provide a continuum of care while living in community, coupled with workforce development opportunities for staff, seeking out staff concerns of childcare, transportation, workforce, housing, living, wage, and benefits, and other issues that help formulate potential community based solutions to support our staff all the way around.

This is the base of our Live Together model, a grassroots approach to understanding the needs of a community and finding the intersections with underserved populations, older adults, youth, children, and families, connecting them into an intentional community. Breaking down silos is essential and existing beliefs to be examined, to move things forward. That is my approach and what I work for each day to bring about shift and change that supports person-centered care and support to staff. We are working within a collective mindset. If everyone, no matter what aspect you are involved in, or type of community or project, that could be caregiving, finance operations development, design, regulatory, could be in a non-profit, for-profit or governmental entity, independent living, assisted living nursing homes, daycare, home healthcare, or combination. I think we could all agree on the need for focus on resident access to care services and amenities with supported staff. 

As an industry, we are stronger together than as a single voice. If we can bring these voices together over one concept, think of the change that can occur, the stories that can be shared and the quality of life that can be improved. We are the movement and the opportunity for change. Particularly now with the pandemic seemingly continuing onward and exacerbating all of the ever present issues within our industry. And I have from all the conversations that I’ve had with different providers, and different colleagues, and different, we are all feeling it. And all of our residents are as well.

Everyone has a different approach; philosophy, cause or direction. But if we don’t all speak out for sorely needed change in reimbursement practices, delivery of care models, regulations, and access to housing services and amenities, we’re missing the largest opportunity in our lifetimes to start the rebuilding of a broken system that has been in disrepair for way too many decades, and that supports residents, families, and staff.

This is a call to action that every day you look through the lens of person-centered care and supporting staff to be their best selves. Everyone for a year, please try to take on this challenge. Start your day with this lens and premise and start, continue or develop just one thing, one thing that reaches this goal. It could be a small action like hearing frontline staff and providing a solution that benefits both staff and residents as an incremental change. Or it could be bold and audacious such as telling a board of directors, “the time for change is now,” and we’re going to shift our care model from a disease focus to a preventative wellness focus as a systematic change. 

There’s so much work to be done. Everyone of you are a part of the solution. Let’s join together is that collective voice that provides opportunities for improvement for those without a voice and for our own futures. Reaching a tipping point for person-centered care in ways to continue to support staff. I want to thank you for listening to this week’s Bridge the Gap Contributor Wednesday, please connect with me at Have a wonderful day, stay safe, take care of one another and go get ’em.


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CW 95: Jane Rohde