The problems associated with institutionalized care of the frail elderly are complicated and require interdisciplinary problem solving. This paper explains the conceptual framework and initial implementation of the Lazarus Project, a pilot project in a nursing home that offers an alternative governing philosophy for residential living. The framework is a community model based on democratic governance, which empowers those who work and live within the nursing home facility. Implementing a community model in an institution is a political process that requires an awareness of power relationships and structures. Strategies for institutional change are directed at alteration of the hierarchical power structures so that power is shared and decision making collaborative.

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