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Reflections on the Annual Pioneer Network Conference

August 22, 2013

On August 10, the annual Pioneer Network Conference convened in Bellevue, Washington. The 1,100 attendees represented almost every state in the union — and most of the Canadian provinces as well. They included stakeholders from across the spectrum — administrators, nurses, CNAs, educators, social workers, therapists, food service and housekeeping, researchers, architects, and consumers. An all-day workshop for surveyors increased the presence of this critical group among this year’s conference goers.

Programs vs. Purpose

The theme of this year’s conference was, “Hear the Voice, Honor the Choice.” As such, there were more opportunities this year to hear from residents of care homes.

Carter Catlett Williams, a founder of the Pioneer Network and the annual convener, recently moved into an independent elder apartment complex. She convened this year’s conference with an audio hookup from her new home in upstate New York. 

As usual Carter zeroed in on the challenges that face the movement to change the culture of aging. Noting her own defensive reaction to being around a homogenous group of fragile, hunched, gray-haired individuals, Carter questioned the very existence of single-age housing. Her call for intergenerational housing no doubt pushed the boundaries of so many eldercare professionals. 

Carter’s particular concern: These “ghettos” have lots of programs to keep the residents busy during the day, but in Carter’s view, rarely do these programs provide for meaningful living. In our younger years, we live; we don’t go to programs. We have purpose. But where Carter is living, she sees a lot of activity without purpose. 

As she hung up the phone, Carter left the audience contemplating some profound questions: What is the difference between programs and purpose? Does single-age housing provide opportunities to continue living with meaning and purpose? Is it time to throw out the elder ghetto altogether?

Choice vs. Control

Following on the conference’s overall theme of listening to residents, PHI Director of Coaching and Consulting Services, Susan Misiorski, led a session on “What Matters Most to Residents.” 

Using video clips of residents from various nursing homes in the New England region, Misiorski asked participants to listen deeply. When residents talked about what mattered to them, control was high on the list. They wanted more than simple choices like two dinner options. They want a chance to contribute to decisions about their home, from the color of the paint to the brand of personal products; the opportunity to live their day with or without scheduled activities. 

Misiorski made the distinction between choice and control, explaining they are not the same thing. Having control over one’s daily life, just as most of us do every day, is about more than choosing Mahjong or Bridge. Being able to decide how to live your life every day is what it means to be an adult. Elder adults want more than choice — they want privacy (no roommates, please!); they want to have meaningful relationships; they want activities that provide them with purpose and the opportunity to learn and grow.


Over the course of the five-day conference these themes were repeated over and over again. I remembered them as I toured Providence Mount St. Vincent, an assisted living and nursing facility that has been a Pioneer culture change home. The beautiful gardens, library, array of activities, and multiple venues for meals all gave a sense of the involvement of residents in choosing how they want to live. 

But most important was the quality of the staff and their desire to “know” the residents — not just their age and health status, but who that person is: kind, gentle, spiritual, intellectual, funny, quiet and introverted, the life of the party. Knowing their residents allows staff to help each person find purpose and meaning, and live life to the fullest—the ultimate goal for all eldercare communities.

— by Karen Kahn, PHI Communications Director

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