When I began to complain about care centers that do not respect the personal, social and spiritual needs of residents, I was given a packet of materials sent to my editor by Providence Mount St. Vincent, called the Mount.

Writer Beth Baker had been offered the opportunity to live at the Mount while researching her new book "Old Age in a New Age: The Promise of Transformative Nursing Homes." She was given free reign in interviewing residents without someone at her elbow. As a result of her visits to care centers around the country she found that the Mount met the criteria for resident involvement in community.

She was invited to the Mount recently to read from her book, which included her interaction with many of the residents. They had shared with her their experiences of happiness and joy in a setting that affords dignity, respect, freedom to make decisions and warm loving relationships.

When asked why she wrote the book she revealed that she had memories of her grandmother in a traditional nursing home, which was a place where residents waited to die. I once wrote a mini-book about dying in which I contended that one is not ever dying but lives until one is declared dead. No matter what age or condition, life is to be cherished and honored until taking one's last breath.

Author Baker began to research the whole field of nursing home care and learned about resident directive care affording freedom and choice. I could relate to her story of the changes needed from the usual atmosphere of the medical model in which the staff hangs around the nurse's station while residents wait for care. Can you visualize a woman sleeping soundly in a room where the early morning light has not dawned and being wakened by someone there to take your blood pressure? Baker's own mother, age 87, and without a trace of high blood pressure was this very woman. No wonder that this book became a reality.

Baker was no neophyte when she began researching patient care in long-term care facilities. She was a winner of two media awards for reporting and had once been a dialysis technician in hospital care for kidney patients. After contacting Charlene Boyd, who had researched resident directive care resulting in freedom of choice, and seeing this in action at the Mount, she was on her way to exploring new ways to provide homelike surroundings for those facing their aging years.

Previously at the Mount lights were on at 6:45 a.m. and from then on the clock determined the schedule. Now, with staff empowerment and resident choice a new day has dawned without the constant interruptions of the resident's own internal clock. Leadership is crucial in making cultural change. Even though the Mount is a very old building, the innovations for resident well being, enjoyment and spiritual connection has made the difference. One aide said that the staff works like a family, showing compassion to residents and feeling supported in their efforts.

After returning to the Mount, which had served my own husband for a month over two years ago after he suffered a brain hemorrhage, I sat in a room filled with Mount representatives and residents waiting to meet the author. There I heard in the author's own words about the delight and enjoyment of residents as they recounted taking part in celebrations and activities they engaged in. Baker describes one example of total involvement.

"The highlight of Mardi Gras week was a parade of staff, family members and residents each with a dog in costume, a shih tzu dressed as a nun, a Yorkshire terrier in red plaid, a miniature dachshund with a red feathered mask, a homely old mutt with a big under-bite and a baseball cap, another dachshund in a baby bonnet, cocooned in a quilt."

When I asked Beth Baker about the present health care system with its emphasis on profit making she said that service and empowerment of residents needs to be the bottom line. She went on to say that the so-called Baby Boomers, who are now faced with elder care of their own parents, might be the driving force in change. After all, a recent survey found that a majority of these 60-somethings were sure that they would need to be responsible for their parents' care at some point. Change in the system to make such care available for all is still on the drawing board.

For those presently seeking out retirement and elder care in a nursing home go to Beth Baker's website at www.bethbaker.net and click on information about her book which lists the following issues as crucial: Community That Cares, Autonomy and Privacy, Rich Environment, Life of Meaning, Individualized Care of Residents with Dementia, and Death with Dignity.

Personally I hope that there will eventually be care centers where one needing nursing care can live together with a spouse. No wife wants to visit a husband in a fishbowl and have to leave to go home alone at night. With the 60-somethings now in the majority this may eventually come about.

Georgie Bright Kunkel is a freelance writer who can be reached at gnkunkel@comcast.net or 935.8663.