Gary Tetz

From now on when I ponder the future of long-term care, I’ll think about Uncle Jimmy. 

For those paying more attention than you should to my periodic ramblings, you’ll recall he’s a Betta fish given to me by a well-intended but misguided friend, and he floats oblivious as my chaotic life unfolds all around his peaceful glass cathedral. 

Sometimes when the typical human craving for permanence and stability takes hold, I wish our situations were reversed — that I could become the prisoner/watcher safe in my bowl, and he the one flailing about in the infinite, ever-changing universe. 

But he’s not saddled with concern about something as insignificant as future survival. He just waits for another food pellet to fall from my fingers — like it always has, so always will.

Recently, Uncle Jimmy and I moved across town. I don’t mean to sound resentful, but he didn’t lift a fin to help. I just picked up his bowl in our old place, and set it down safe in the new one. His world stayed exactly the same, every rock and fake plastic plant, while everything about mine had to change. It hardly seems fair. 

Unfortunately, as we face a similar transitional moment of incredible complexity and uncertainty in long-term care, nobody’s going to pick us up and set us down safely in our new environment, and no one will feed us a pellet every day just because we’re pretty. 

We’ll have to adapt — and providers are already dividing into proactive adventurers or passive Uncle Jimmys, between those content to float with their mouths open and those determined to demonstrate value and adjust to new payment models.

W. Edwards Deming, the renowned guru of quality assurance and process improvement, is alleged to have said, “It is not necessary to change. Survival is optional.” Just a little something for all the Uncle Jimmys to think about while the last payment pellet falls.