Abstract
SUMMARY Sustaining “culture change” in long-term care or any other social system requires change in the underlying social structures that support a given culture. Due to the “medicalization” of contemporary long-term care, the cultural meanings of aging and disability have been increasingly defined and maintained through social structures associated with the medical professions. The “culture change” movement in long-term care is seeking to balance the power of the medical professions with more consumer empowerment. Over the next two decades, consumer empowerment will be supported by important demographic and socio-economic changes in the older population. Demographic empowerment will come from relatively small cohorts of older persons, declining disability rates, and stronger supports from informal caregivers. Socio-economic empowerment will come from higher levels of income, wealth, and educational attainment. Together these trends should provide powerful support to a more consumer-driven culture of long...
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