Improving care in nursing homes using community advocacy

Community organizations have often focused their campaigns for social change on the health care system. While the techniques of Saul Alinsky and to a lesser extent Paulo Friere have provided the theoretical backbone for most community organizing efforts, these campaigns frequently are characterized by a rather eclectic synthesis of different methodologies. The nursing home industry has been one of the most severely publicly criticized components of the American health care system, and during the last decade consumer groups have sought to achieve fundamental improvements in the quality of life and care available to nursing home residents. However, the standard Alinsky and Friere techniques have limitations in organizing efforts directed toward nursing home reform. One case study is presented which describes a relatively successful community organizing project for better care in a San Francisco Bay Area nursing home. The organizing method used in this project was one of community advocacy. This method is described in detail, and the limitations and potentials of community advocacy are analyzed.