This month, the much beloved 88-year-old comedienne Betty White of
Golden Girls fame will appear on NBC's
Saturday Night Live. She is sure to be funny; I'm waiting to see if the writers present her as witless and forgetful (reflecting the ageism that pervades contemporary society) or as independent and intelligent-a person deserving our respect and admiration.
Ageism, a patronizing and condescending view of seniors, contributed to the birth of the assisted living movement almost 30 years ago and the formation of the Assisted Living Federation of America (ALFA) 20 years ago. In those days when a senior could no longer live safely at home, the only options were institutional forms of care such as skilled nursing and boarding homes. Frail elders were the antithesis of a culture which celebrated youth and vitality.
AL preserves ‘choice’
The assisted living movement evolved from the idea that seniors who could no longer live at home but didn't need full-time nursing care could still live independently and make their own decisions about their lives. It deemed that seniors should be able to choose where to live, live independently as long as they were physically and mentally able, be treated with dignity and respect in all cases, and receive quality care.
The ALFA proudly celebrates the 20th anniversary of our founding this year and we look back with enormous pride on the role our members played and continue to play in helping to create positive and popular lifestyle options characterized by their inherent respect for the individual resident.
To this end, assisted living eschews any and all association with institutional forms of care. Assisted living is resident-centered and the assisted living terminology reflects the reality of the experience. Seniors choose to move into assisted living-they aren't “placed” and they aren't “housed.” They live in communities, not “facilities.” They are residents, not “patients.” They move in or move out, they are not “admitted” or “discharged.” Because it is their home, an assisted living resident makes his or her own decisions about bedtime, social activities, and meals. And today, there are many, many options for seniors to consider.
For the past 20 years, ALFA members have remained adroit, flexible, attentive, and responsive to the needs and wishes of the aging consumer. We have clearly seen changes. Thanks to advances in pharmacology, seniors are living longer and able to manage chronic health conditions with medication. As a result, assisted living residents are growing older and the acuity level is increasing. Many of our members now offer hospice services so residents can remain in their assisted living community surrounded by friends and loving caregivers during their final days.
But some things never change. Our members remain the entrepreneurs and innovators of senior living. And the basic philosophy of care that guides and inspires our industry remains the same: Seniors deserve the best resident-centered care in whatever place they call home. It is telling that our industry weathered the economic recession so well and the fundamentals of assisted living operations remained strong in the face of the worst economy in generations.
“For the past 20 years, ALFA members have remained adroit, flexible, attentive, and responsive to the needs and wishes of the aging consumer.”
We have much work to do. There are still onerous, if well-intended, state regulations that perpetuate the idea that seniors lack the capacity to make good choices and need the paternalistic protection of the state. For example, in some states, seniors who may have lived for years in an assisted living community are forced to move to a skilled nursing facility if they need hospice. In other states, despite what the resident wants and even if the family, physician, provider all agree with the resident, the resident is forced to move when the state decides it is time to go.
As boomers age and seek assistance for their parents, they see the ageist attitudes of the people around their parents and they are reflecting on their own attitudes about aging. When they need some assistance in the future, they will be far less tolerant of the state's imposition of its bureaucratic will upon them because they will want to make their own choices. We are convinced they will embrace the assisted living philosophy-a philosophy that transcends artificial distinctions imposed by business and government between home care, independent living, assisted living, and skilled nursing and, instead, works against ageism by respecting the aging senior-seniors like Betty White and millions of her peers in the nation's fastest-growing age demographic.
Richard Grimes has been President/CEO of the Assisted Living Federation of America (ALFA) since 2003. He completed his undergraduate degree at the Texas A&M University and his graduate work at the University of Illinois at the Medical Center, Chicago. Mr. Grimes has served the healthcare industry all his professional life. He can be reached at (703) 894-1805.
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Long-Term Living 2010 May;59(5):26-27