There was something about large institutions that in itself is depersonalizing, but it doesn't have to be dehumanizing. Buildings don't dehumanize, people do.

And if you have the right kind of staff and the right kind of training, the right kind of leadership, and the right kind of expectations, then you don't have to have a dehumanizing environment. And you can have a dehumanizing environment in a local community in a home that houses only four people, if you have the wrong kind of staff.

And I think that's something that people have to understand, that a big institution is not good only because the size makes it depersonalized. It's hard to personalize people when you have large masses of people in large congregate areas.

But the fact is that you can have a very humane program in a large place if you've got staff that are trained and leadership that expects it.