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On investigative visits to nursing homes across the nation, Beth Baker has witnessed profound changes. Culture change leaders are tearing up everything—the floor plans, the flow charts, the schedules, the lousy menus, the attitudes, the rules—and starting from scratch. They are creating extraordinary places where people live in dignity and greet the day with contentment, assisted by employees who feel valued and appreciated. Perhaps most surprising, these homes prove that a high quality of life does not have to cost more. Some of the best homes in the nation serve primarily low-income people who are on Medicaid.

In Old Age in a New Age, Baker tell the story of a better way to live in old age. Although each home is different, they share common values: respecting individual choices; empowering staff; fostering a strong community of elders, staff, family members, and volunteers; redesigning buildings from a hospital model to a home (where pets and children are part of everyday life); and honoring people when they die. Her visits to more than two dozen facilities include those associated with the Eden Alternative, Green House, Kendal, and the Pioneer Network. Whether these transformational homes become the norm or the domain of a lucky few is the question that faces the next generation of elders, the baby boomers.