• My mother lives in one of those places – not a “home”, but a closely managed assisted living facility. My mother-in-law lived in one of those places for about 3 years, until she died. They are very nice, like an upper level hotel with LOTS of concierge services always looking out for the interests of the residents.

    Both of them were unhappy that they were not living in their own houses, or with their oldest daughter (my sister and my wife, respectively). But they could not live alone in their houses, because of (1) physical problems and (2) dementia.

    Neither of them was capable of living with their oldest daughters, and doing so would have just generated enormous amounts of hatred and discontent and fights and family discord. My mother-in-law actually wanted my wife to move in with her, while my wife was holding down a managerial job. And my sister tried it for 3 months, before I had to step in and do a “rescue”, to take her away.

    So, should I, the eldest child, take my mother into my house? She would require 24/7 supervision, because her dementia might cause her to leave a stove on, or doors open, or some other physical catastrophe in the house. Without close supervision she might also fall, and without someone around 24/7, she doesn’t know how to push the button to summon help.

    My mother actually says, out loud, that she does not want to burden her children with her care, even though it is clear from her face and body language that she would really love to move in with one of us. She is terribly conflicted. She wants to be taken care of, but she does not want to be a burden. How to resolve that conflict?

    She has enough money from the sale of her house to pay for assisted living. I could have her come live with me, and hire a caretaker. That would cause all sorts of problems with my wife.

    I think that people who talk about this “problem” have never been thru it, and think that a bit of family communitarianism would just do the trick. Unless you have actually been in this situation you have no idea of the range of conflicting human emotions that swirl around and make any decision very difficult for the various participants to accept.

    I, personally, do not wish to end up in a facility like this, but the difficulty is being able to determine an exit date and strategy while I still have the capability to carry it out. Our society is only starting to try to deal with this problem, but not very well, and not very quickly.

    We are lucky to live in a society that is rich enough to be able to afford to take care of elders like this. I think that in the old days, the family would take care of the elders as long as they did not become too divisive or difficult to care for, and then, one night, an accident would happen, and the problem would be solved. We should be happy that we don’t live that way any more.

  • RXC, one thing about the article referenced is that it does not deal with the pros and cons of institutional care. Rather, it concerns whether facilities are removing choices that the resident can, and should, be making for himself in order to comply with regulations or corporate decisionmaking, and the negative impact that has on a resident’s quality of life. Assisted living facilities are much less regulated, and provide care to less dependent residents. As a result, the issues raised by the article are less prevalent.