As a teenager I visited my Aunt Karla who lived in Berlin. I had been there before but was too young to really understand what the city was all about and how significant it was to my life.

It was in Berlin that my parents met and married. My father was an honor guard at the famous JFK speech. My brother was born there. I loved the city with its busy business district, restaurants, and shops, all of which exuded an energy that felt good. But there was some ugliness to it as well with its reminders of the war and the thought of how isolated the people were in the worst of times. And that wall…

We took a bus tour through Checkpoint Charlie and into East Berlin. The energy there was different – it did not feel good. No bustling streets (although the postcards at the shop where we were allowed to stop showed bustling, busy streets). I commented on the hypocrisy of it all and my mother quickly hushed me, but not like she usually hushed me. This time there was fear in her eyes and urgency in her voice, and I quickly shut up as I realized her urgency.

I was used to living where silly teenage rants are ok and the right to speak my mind was taken for granted. Clearly, life was very different here on the other side of the wall. I felt smaller, weaker, and vulnerable. My mother told me about her cousins and distant relatives who were stuck on the east side and unable to communicate with each other. As the wall went up, families were torn apart. Life changed literally overnight, and most thought it changed forever.

Many years later I went back to Berlin, took a tight grip on a sledgehammer, and let loose on that damn wall. It was a tough battle, that old concrete was hard and determined to stay put. Before running out of breath I was able to punch a hole as East German soldiers, still carrying their assault rifles and walking with their German Shepherds, cheered me on. The wall came down, and normal life once again began to flourish.

When I started my new job as a nursing home administrator I felt a familiar energy – an uncomfortable twinge that reminded me of my experiences in East Berlin. Indeed, entering the nursing home was a bit like crossing a wall that separates freedom from despair.  I think the discomfort I felt came from the spirits of all those who felt lost and trapped in an environment that controlled them. That was true in East Germany, and it was true in the traditional nursing home. Overnight, life changed forever for the elders moving into the facility. Families were torn apart. They felt smaller, weaker, and vulnerable.

Before long I realized that working to sustain a system that degrades and tortures the human spirit makes no sense. There has to be a better way. Our team started looking for it.

The search was long for me, and eventually I joined the culture change movement. Fortunately I crossed paths with Action Pact and began to see a better way. With much team effort, things began to change.  Eventually I was working to help others break away from the institutional model of care and build households.

Those who try to change the systems know someone is watching. Much like the East Berlin guards cheering me on, the regulators seem to support change, but their weapons still threaten our efforts. With a one-word command, the guards’ dogs and guns could have prevented me from tearing down the wall and destroyed me in the process.
Similarly, many in long-term care consider the risks that come with pushing the limits to be too much to bear. Regulations and rumors of others getting tagged in surveys for their culture change efforts is enough to push some into perpetuating an old, broken system. Many choose to maintain the status quo. The perceived, ensuing imprisonment crushes human spirits around the world. Many will not speak up out of fear – much like the fear I saw in my mother’s eyes in East Berlin all those years ago.

The Household Model works to defeat all these problems. Putting residents back in control of creating their own lifestyle in a setting that offers the degree of privacy our homes should provide sparks new hope. As the walls begin to come down, the human spirit arises with renewed energy and purpose. People start to believe in the possibilities. Staff, residents, and families begin to see that true choice is possible. Life does not need to be driven by staff schedules and task lists; you can live life your own way.

See institutional care for what it is – an oppressive wall that crushes the human spirit. And when you see this I say to you: Tear Down That Wall!