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The long-term care field has had a rich history, full of ups, downs, hair-raising regulation and heartwarming innovations. It is a story encompassing many decades, featuring a cast of heroes and, yes, villains whose impacts long-term care providers experience virtually every day of their working lives. I've composed my own idiosyncratic “Top 10” list of these people, based on my nearly three decades of experience in geriatric publishing, including 18 years as editor-in-chief of this publication. I take full responsibility for my choices. Perhaps not everyone will agree with them, but I'll do my level best to make the case for each and every one.
Diane Carter, RN, President and CEO, American Association of Nurse Assessment Coordination (AANAC)
Sen. Frank Moss (D-Utah)
Photo: Courtesy of UMBC Erickson School of Aging Studies
William H. Thomas, MD
Known universally as “Bill” Thomas, it's hard to know of anyone who's had more impact on the quality of the nursing home experience than he. Thomas is known for not one, but two major innovations in long-term care delivery: the Eden Alternative and the Green House Project. People who write off the Eden Alternative as “plants, fur and feathers”-alluding to Thomas's advocacy of on-premises pets and vegetation in the nursing home environment-are missing the fundamental point: to help residents stay in touch with and enjoy the real world around them despite isolating circumstances. Similarly, the Green House is more than a cottage with 12 bedrooms surrounding a family room/kitchen. It's a way of reducing the scale of institutional care to very personal levels-important for anyone residing in such an environment 24/7/365. Both innovations pose significant challenges to administrators adopting them, but they point to a way out of the nightmares that quality-of-care advocates have railed about for 40 years. And Thomas himself is a most entertaining advocate, as anyone who has attended his lively and inspiring presentations can attest.
Photo: Courtesy of The Heinz Awards/photographer Jim Harrison
Elma Holder, Founder, the National Citizens' Coalition for Nursing Home Reform (NCCNHR, currently the National Consumer Voice for Quality Long-Term Care)