Summary Before the present program was initiated, residents on the NHCU were in the same situation as those described by Wolanin. They were forced to take the “whole package” which meant that they were clean, quiet, and totally dependent on the staff to meet their needs. The nursing staff initiated a change in the philosophy of care which resulted in a series of attitudinal, environmental, and programmatic changes. Integration of a theory-based nursing model which parallels the unit philosophy has provided the mechanism for much of the change process. We believe that persons admitted to this nursing home can find a lifestyle suited to them, and they can decide how much or how little help they want in maintaining it.