A couple of months ago I wrote about the efforts under way across the country to spread the practices of culture change in nursing facilities. I have continued to explore what this term means through conversations with those kind readers who contacted me with their personal stories as well as professionals engaged in the efforts in their community.I am motivated in this process of self-education from my personal experience of being with a family member who spent a week in a local nursing facility after a stroke. During that week, we experienced a wild ride of emotions, partly because of medical issues and partly because of our need to quickly learn the “culture” of the facility.What I mean by this is that we needed to figure out who to talk to for medications, who to talk to for food, who to talk to for an update on medical concerns and who to talk to when we needed an assist for a trip to the bathroom.We learned about the hierarchy of which staff will respond to a call button and which would not. We learned that sometimes it is easier to just find the snack or transfer someone to a wheelchair by ourselves. We learned how to intrude on personal staff conversations in order to get a response for our family member.All of this in just a week. I cannot imagine the experience for those of you who have spent months or years in a relationship with a facility on behalf of a family member.