Page 66 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
WHAT MAKES NEW IDEAS DIFFICULT?
It is essential that long term care providers continue to provide quality care as identified by nationally recognized standards, but these standards must be integrated into OBRA ’87 as guidance, not as law, and with respect for resident satisfaction, self-determination and quality of life in their home.
In summary, the thoughts of Audrey Weiner and Judah Ronch are particularly relevant, as expressed in the forward to Culture Change in Long Term Care:
It is not without some irony that Cohen and Eisdorfer (2001) see models for the future in earlier models of charity and compassionate care (beginning with the poorhouses of the 17th and 18th centuries) whose evolution toward medical models of care and reimbursement subordinated care of the person to care of an illness. As the articles in this collection demonstrate, some of the best attributes found in earlier years and other cultures are at the heart of contemporary innovations. But the intellectual, regulatory, economic and attitudinal barriers that have arisen over time still confront innovators from all stake holder groups as they contemplate issues of culture change for the future.” (Weiner and Ronch, 2003 p xiii)
Recommendation: National workgroup with representatives from all stakeholders address modifications needed in application of Food Code 2009 to bridge the gap of home and institutional applications, and that future modifications be incorporated only
through a similar workgroup.
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