They are based on the values of acute care hospitals where one needs to do precisely what doctors and nurses say. When that approach is applied to people living indefinitely in a nursing home, it robs them of their self-respect, removes them from decision making roles, denies them the opportunity to take risks or to have a seat at the table where policies and procedures are made. Ms. Williams describes a Swedish nursing home where everyone awakens on his or her own schedule. Schedules are worked out around the residents' needs and requirements. It was a touchstone for people feeling good about the day and, in the long run, was also more efficient.
Humans are highly adaptive creatures.
As we become physically less robust, it is plausible that we may become more spiritually and mentally robust, as our five senses often compensate for each other. It does identify residents as the people who can make things better. We must allow people to take risks. Life is full of risks. Playing parent to a parent often plays out dreadfully.