How do you like it there - The Thin Edge of Dignity

 

 

 

 

 

 

 

 

 

 

 

By Dick Weinman, AARP Volunteer and Assisted Living Guru

I’m frequently asked, “How do you like it there?” “There” referencing the Assisted Living Facility (ALF) in which I live – which for me means “here.”

My answer depends on what the questioner means. I assume that s/he wants simply to know about the specific ALF where I live. My answer is not so simple. I like to broaden the Q&A by tilting my answer toward the subject of Long Term Care (LTC) for elders and the disabled. I fit both categories - at 83, I’m in a wheelchair and have non-functioning hands. But I stretch my reply further, by suggesting the questioner consider society’s attitude toward the old and the cultural change that is needed in DEALT (Disabled Elder Adult Long-Term Care.) - I just made up the acronym to be in solidarity with the rest of the profession.

As it has turned out, I feel I was dealt a hard hand to deal with, so I have to hedge my answer how I like living here in my ALF. My answer would be the same wherever here is.

To explain: search the PioneerNetwork ( www.pioneer network.net/AboutUs/values.) When your read about the PN mission you’ll discover what I mean by that paradox.

For me, the fundamental factor in “liking it” is (are) the Caregivers – now called Resident Assistants (RAs). Whatever the nomenclature these are the “hands-on,” front line people who share residents’ lives. They give the showers, wipe the asses, do the dressing, share life stories, and join the journey to life’s end. (If they stay till then.)

You’ll get the idea of the delicate relationship between resident and whatever appellation you choose, in my blog, “You’ll Never Walk Alone.” https://states.aarp.org/you’ll-never-walk-alone-the-thin-edge-of-dignity/.

In that respect, living here is good: most of the Caregivers are friendly, caring, respectful, and concerned about helping those who can’t help themselves. Of course, for some it’s just a job. And the Caregivers, themselves, are aware of the discrepancy: as one of my Caregivers said about a colleague, “She doesn’t give a rat’s ass.” But that kind of person is in the minority.

My problem with assisted living is Assisted Living. Today’s model doesn’t live up to the vision of its creator. Dr. Keren Brown Wilson’s concept of elder living began in Portland, Oregon, in 1981. Dr. Wilson, acting upon the urging of her nursing home-ridden mother, sought to give elders who were unable to live in their own home, a home-like atmosphere in which to live out their lives. But the degradation of Dr. Wilson’s original concept prompted her, according to author Dr. Atul Gawande, in his widely-read, influential book, Being Mortal, to disclaim her relationship to what Assisted Living Facilities had become. They were less of a home, serving residents (“person-centered”) and more of a facility serving themselves (“provider-centered.)
What the Pioneer Network, and similar organizations, advocate, is” culture change,” which transforms society’s perspective of elders. “Culture change” values the elder – as in many non-Western cultures – respecting their individuality, wisdom, and independence – even though their lives have to be dependent. As Dr. Gawande says, culture change lets elders  write their (our) own narratives.

So, I guess my answer is, “I like it here, but not here.

 

[photo: Istock wildpixel]

 

 

 

 

 

 

 

 

 

 

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