Seniors in Assisted Living: One Man’s View

An article, “A Room With A Grim View: The ‘Ambient Despair’ That Marks Life In Assisted Living,” authored by Martin Bayne and published by Health Affairs was republished in the Health & Science section of The Washington Post, July 10, under the headline, “They call it assisted living, but it can take the life out of you.”

Mr. Bayne, now 62, entered an assisted living facility at age 53 because of young-onset Parkinson’s. In his article, Mr. Bayne makes several compelling points:

  • The notion that this is a resident’s new home is not shared between residents and assisted living management;
  • Just because it’s assisted living doesn’t mean it’s compliant with the Americans with Disabilities Act;
  • You understand when you go there, that you have checked in ‘for life’; this is most likely where you will die.

The article generated much comment from The Washington Post readers. Most wanted to share their own experiences with a loved one, although some complained that Mr. Bayne was “guilt tripping” them. But let’s examine each of his points.

This is a resident’s new home. As professionals in the field, we have encountered the statement quoted by Mr. Bayne, “This is NOT your home. You lease space here just like everyone else.” Yes, this happens. In our case, it was a conference with assisted living management, the resident (our client), and her three daughters. It is indeed unfortunate that certain administrators will go to extreme lengths to disenfranchise the residents to achieve even greater control and to keep the residents in a continual state of dependency.

In the interest of full reporting, my aunt and uncle spent 13 years in a continuing care retirement community, progressing from independent living to the nursing unit. The care at the intense end of that continuum was incredible. For starters, the facility was carpeted throughout and the staffing ratio was outstanding. When the facility wanted to move my aunt into the nursing wing, she and my uncle refused until they could both go and continue living and sleeping together in the same room. They died in their nineties within six months of one another, but for 13 years they considered the facility their home and no one contradicted them.

ADA compliant. Based our experience, Mr. Bayne’s observations about handicap and wheelchair accessibility, are valid in a majority of assisted living facilities. In fact, many hospitals’ patient rooms are not compliant either. It’s fair to ask, how expensive would it be to have certain rooms with lower sink height for example. Regardless of cost, wheelchair accessibility should exist throughout the facility.

The oppression of watching people die. Like it or not, senior living facilities are, by and large, ghettos, containing a very narrow cohort of the population defined by old age. Yet, just because this is the market the facilities serve, the services do not have to be devoid of energy. Some have experimented with having a pet in residence, and many offer programs of dance, music or other activities. But once a week or once a month is not enough. Activities need to be provided daily.

Tapping into high school community service requirements might be another way to bring youthful energy into the facilities. Sharing stories, playing cards or Scrabble, looking at pictures; the visits would be beneficial to both student and assisted living resident.

Home care is another option that more and more people are choosing. But there will always be some for whom assisted living will be a preferred choice when they can no longer manage on their own at home.