Responsiveness and accountability in long-term care: strategies for policy development and empowerment

This paper presents a model for engaging planners, service providers and consumers in a collaborative process of improving quality of life in long-term care facilities, discussing the implications of this approach for standards of care and policy development. This empowerment model was refined and tested in a large system of skilled-nursing-care facilities using a matched-pair comparison group design. The rationale, theory base and the relationship of the empowerment model to current concepts of health promotion are shown. Subsequent follow-up indicated examples of the impact of the model on broader aspects of public policy.