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Creating Home Consumer Project

Highlights from Creating Home


"Creating Home: Advocating for Change in How and Where We Age" is a consumer education
pilot funded by the Picker Institute. In collaboration with its partners, the Pioneer Network developed
this project in response to the growing realization that consumer awareness of and advocacy
for culture change are critical to its widespread dissemination. Partners included the American
Association of Homes & Services for the Aging, American College of Health Care Administrators,
American Health Care Association, American Medical Directors Association, The Coalition of
Geriatric Nursing Organizations, and National Consumer Voice for Quality Long-Term Care.
Below are some highlights from the evaluation of the pilot.

Download the Project Handouts

Download the full executive summary. (PDF)

  • Three primary goals of the Creating Home project were to: 1) educate consumers about long-term care and culture change; 2) determine if consumers were interested in the topic and further action; and 3) learn how to best educate consumers about culture change.

  • The Creating Home curriculum provided an overview of long-term care and culture change and was provided to consumers in 2-hour meetings, which were held in small groups of about 9 people. Consumer participants were also given a take home document, which gave additional information on long-term care and culture change.

  • Creating Home meetings were held in Florida, Georgia, Massachusetts, and Oregon. Sixty-one meetings occurred, with 502 consumers and 45 hosts and facilitators in attendance. The meetings were held in diverse locations including private homes, long-term care communities, organization offices, libraries, and senior centers.

  • Participants were asked to complete pre test and post test evaluations. On all questions, participants demonstrated an increase in knowledge. The number of respondents who rated the statement "I understand what culture change in long-term care means" as "strongly agree" or "agree" increased 100% after attending the meetings.

  • All in all, feedback from participants regarding the topic was very positive. In fact, 78% of participants indicated they would like to meet again to further discuss the topic and 84% of participants intended to obtain more information about culture change.

  • Participants wanted more information about what culture change "looks like" and how it is done.

  • Nearly all participants agreed that culture change needs to happen. Ninety-seven percent of consumers strongly agreed or agreed that they would rather live in a culture change community than one that practices a traditional model of nursing care.

  • A frequent comment from participants questioned the cost feasibility of culture change. In other words, there was a prevailing thought that culture change is just for those "high end" homes that could be afforded by wealthy individuals.

  • The majority of participants (79%) indicated the desire to become advocates for culture change.

  • The role of state culture change coalitions in consumer advocacy will continue to grow, as well over a half of participants expressed interest in being part of a coalition.

  • While most consumers in this pilot were appreciative of the information about culture change and generally saw its importance, it was clear that this was not on their radar screen prior to the meetings.

  • The Creating Home program evaluation validated that consumer experiences with long-term care, or lack thereof, is an important consideration in consumer education about long-term care and culture change. Consumers "only know what they know" and may be entirely unaware of institutional routines and the opportunities for change.

  • Continuing to build consumer education partnerships with state coalitions, citizen advocacy groups, the long-term care community, and community organizations not traditionally involved in long-term care will be key to increased outreach.

  • It will be very important for the Pioneer Network, state culture change coalitions, and long-term care partners to support consumers in providing information to long-term care communities about culture change and to be available to consumer advocates as a resource.

  • Increased understanding and involvement of consumers in culture change produces partners who can support providers in advocating for change.

  • When consumers articulate the message that culture change is what they want and that they will not accept traditional models of care, widespread adoption will occur.

  • Pioneer Network has received funding from the Picker Institute to expand efforts to further engage consumers in culture change. "Phase Two" activities include revising the Creating Home consumer education materials and expanding consumer education to at least 20 additional states.

Supported by The Picker Institute, Inc., an international non-profit organization based in Massachusetts that supports research and education in the field of patient-centered care.