The bright side.

Nothing says "holiday season" like looking at the bright side of things. I think the principal theme of this issue--wellness in long-term care--represents our best shot at this. For a while, let's stop focusing on the image of financially strapped facilities struggling heroically to provide quality care to severely ill residents. Let's adopt instead the wellness mantra: It's not what they can't do, it's what they can do.

The article and sidebars in this issue offer examples of facilities making major investments of time, energy, and money in bringing life to residents, and vice versa. Although lively and engaging activities programs and recreational therapies have been with us for decades, it seems that only since the turn of the 21st century have long-term care providers focused with depth and commitment on what's become known as The Wellness Philosophy. Maybe you've already created programs, hired staff, and even built specialized facilities to enhance the wellness of your residents in all six dimensions of that philosophy: emotional, intellectual, physical, social, spiritual, and vocational. If so, what you'll see here will validate that you're part of the trend. If not, perhaps you will begin to glimpse the beginnings of a sea change in the concept of long-term care--and an important new marketing reality.

What the wellness movement is doing is taking an activist stance toward meeting what is, in fact, a long-standing goal of OBRA '87 and the survey system it spawned: keeping residents active and engaged with life to the extent practicable. It has reached the point where facilities committed to this are forswearing calling themselves "nursing facilities" or their residents "elderly." They are now, in so many words, centers for "vital aging."

I have been personally impressed by how vigorously some of the vital aging centers I've dealt with deny having anything to do with sickness, dependency, or medical care. All of these are built into their offerings, to be sure, but these facilities just don't talk about them. The way they see it, more and more seniors these days want to know how they can continue living life to the fullest, whatever their current stage in life. They want to embrace new intellectual challenges, physical activities, and social engagement. To the extent this new concept of long-term care holds true, the more medically oriented traditionalists in the field are in some trouble, from a marketing standpoint--unless, that is, they take the opposite tack and offer themselves as exemplars of clinical excellence.

But this is getting back to our worry wart mode, isn't it? It is heartening, rather, to think of our aging contemporaries pushing through life's vicissitudes with such a positive, even joyful attitude. Maybe when we're ready for its services, long-term care's offerings will be eagerly anticipated by everyone. That's a bright thought to hang on to throughout the holiday season and beyond.

BY RICHARD L. PECK, EDITOR-IN-CHIEF

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