Culture Change at the Friendly Home: A Historical Continuum of Reform

The recent initiative undertaken by the Friendly Home to educate its entire staff about the intricacies of person-centered care (also known as Culture Change) exemplifies the continuation of the historic trajectory of medical institutions, and represents the next stage in the Reform Movement that initiated the creation of the Home. The values associated with Culture Change (friendship, teamwork/collaboration, compassion, excellence, integrity and customer focus) have been embraced by the Friendly Home, and embody some of the original intentions of the institution’s founders. This movement away from traditional institutional care and towards person-centered care is representative of the most recent step forward in the reform of nursing facilities which accounted for the establishment of this institution in the 1800’s. 

Culture can be defined in various ways. Webster’s dictionary defines culture as “the beliefs, customs, arts, etc., of a particular society, group, place, or time.” An anthropologist or social scientist might identify culture as “the system of shared beliefs, values, customs, behaviors, and artifacts that the members of society use to cope with their world and with one another, and that are transmitted from generation to generation through learning.” Really, both imply the same idea: culture is the means by which we give value to our lives and interactions, and interpret our surroundings in a way that provides us with the most beneficial relationships with the people around us.

The Culture Change initiative happening within the Friendly Home community right now is a continuation of the values instilled in the institution by the Rochester Female Charitable Society, as well as the ideologies shared by all Rochester institutions that participated in Reform-era modifications to senior care and living.

Founded in 1849 by the Rochester Female Charitable Society, the Friendly Home (the fourth oldest existing private not-for-profit nursing home in New York State), continues to exemplify values rooted in kindness, charitableness, exceptional care, and most importantly, friendship. Originally located at 33 Edinburgh Street in the city of Rochester, the Home was established as a reprieve for elderly and impoverished women. As with many reform-era institutions, the “Rochester Home for the Friendless” was a female-run institution that was predicated on social improvement for the unfortunate and downtrodden.

In 1855, the Home was relocated to its second location on the corner of East Avenue and Alexander. “Eventually the Home came to specialize exclusively in the care of the aged. In 1918, the Home became the Rochester Friendly Home and began to accept married couples and single men as well as women. In the same year, the Home relocated to its present ten-acre site at 3156 East Avenue in Brighton. This structure was extensively remodeled and enlarged in 1966.” Today, the Home continues to provide nursing care, rehabilitation and related services that enhance the quality of life for older adults.

Prior to the nineteenth-century establishment of institutions for the care of the elderly, home care was considered the norm. Society provided family members (particularly women) with the availability to remain within the home and care for their loved ones, should they be wealthy enough (in possessions, or kin), to afford this luxury. Often, a large number of children would indicate a comfortable old-age for the head of a family. During the nineteenth century, the increased emphasis on the work-force and labor requirements reduced the ability of family members to stay in the home and care for the elderly, who could no long work or care solely for themselves. This led to the establishment of institutions in which the elderly were housed, these often likened to poorhouses, workhouses and asylums.

Referred to as ‘almshouses,’ these institutions provided lodging for what was considered the lowest rungs of society – the poor, disabled, criminal, orphaned, and elderly. Oftentimes religious groups (generally female-run) and immigrant communities attempted to provide more ‘respectful living conditions’ for the elderly, as the almshouse was generally the only option for the aging. These charitable institutions provided marginally better residences, but were often costly and available only to the upper crust. Many catered specifically to only their own religious or ethnic group, leaving a large section of the elderly population in the almshouse system.

The Reform Movement spanned across the United States in the mid to late nineteenth century, leaving a particularly large impact on Rochester and its local institutions. The health care industry was at the forefront of the reforms, focusing on the care of children, the impoverished and elderly females, who were the main priority of the Friendly Home’s founders. Contemporaneous with the early beginnings of the Friendly Home was the movement towards suffrage lead by Susan B. Anthony and Frederick Douglass in Rochester, empowering females in society and further substantiating the efforts of the reformers who took on the task of caring for Rochester’s elderly female population.

Throughout the twentieth century, the Friendly Home underwent continued changes for the better, always looking forward to ensure improved care in the lives of its Members. The grounds of the new East Avenue residence were ornately landscaped to provide a beautiful and natural setting in which residents could draw inspiration from their naturalistic surroundings, a common conception amongst landscape architects of the early twentieth century. Improvements to the Home throughout the twentieth century foster a home-like feel, and establish an aesthetic of comfort and excellence. The most recent renovations to the Friendly Home in the late 2000 have continued to embrace this momentum of historical reform.

Similarly to these historic Reform Movements, Culture Change can be considered a social movement unto itself. The Friendly Home adopted this movement in 2010 with the goal in mind of bringing added meaning and purpose to the lives of the Members who live here. The establishment of the Friends Care Committee ensured the dissemination of these ideas to all of the staff, as well as the public. When examined within the context of the Reform movement of the nineteenth and twentieth centuries, Culture Change at the Friendly Home takes on a historic character, embracing the initiative of society to provide excellent care for an aging population and elevating that goal to the forefront of its mission and vision.

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