By Sarah White
I met some neighbors for beers last weekend. The topic turned to where we might live when we could no longer manage our old two-story homes or afford the property taxes in our gentrifying neighborhood. One had been motorcycling in Wisconsin’s Northwoods, and proposed her idea. “I see all these closed motel-supper clubs. We should buy one, rehab the units for efficiency apartments, and run the supper club for income to support us.” The idea aligned with something I’ve been thinking about—the hippie commune reimagined with senior care included.
I’ve been interested in what becomes of us in old age since I first began to sense my mother’s increasing fragility. Three years of serving as her aide de camp in assisted living before she died only intensified my concern: How are we preparing for the wave of Baby Boomers who will sooner or later need care? We have re-imagined every life stage we’ve encountered: can we revolutionize this one, too? From this mindset, I was delighted to discover Happily Ever Older: Revolutionary Approaches to Long-Term Care by Moira Welsh.
This may seem like an odd choice to review for a blog focused on true life stories. But look at it this way: Our decisions as individuals, in groups, and as societies, create the context for our life stories. What we decide about how and where we live our last chapters impacts everything about those stories. Our degree of hope or despair about the conditions we are likely to live in at the end affect us long before we move into that assisted living facility.
Moira Welsh profiles eight initiatives—call them projects, or thought leaders, or prototypes—held together with a common thread of hope and a common focus on dementia. She writes in her introduction, “The focus of my research turned toward people with memory loss, although the intention was not to overlook stories of those who are frail but still mentally sharp. In many ways, it is in the field of dementia care where innovation is happening.” (While I resent that the lion’s share of government funding for aging research has gone to dementia studies, starving research on the cognitively-healthy elderly, I believe that when the frailest among us are well cared for, everyone is likely to be well cared for. So okay, let’s see what’s up with dementia care in assisted living.)
Moira Welsh is an investigative reporter at the Toronto Star who has spent nearly two decades writing about nursing homes. Her book is curiously personal; her own problems concerning her aging parents’ wellbeing threads through it. If a reader doesn’t bring her own backstory of worry, Welsh’s personal story provides a ready-made one. But most of us do have concerns about an elder or two, and of course there’s always future-you to worry about. As a child-free person, it’s on me to plan my last chapter.
Welsh’s book grew out of writing about the Butterfly Effect, and that is the topic of the first chapter. This approach, which began in the UK and is spreading across the globe, lives the promise of person-centered care. It’s a culture shift that replaces the institution as the primary metaphor with a home-like model where boundaries and barriers are removed. Routines are relaxed, feelings are prioritized, and “herding” of people from one place or activity to another is replaced with freedom and flexibility. All good, so far!
Chapter Two cover Dr. Bill Thomas’s work with The Eden Alternative and the Greenhouse Project, similar initiatives that focus on de-institutionalizing eldercare. I’ve been following Dr. Thomas’s work in anti-ageism for some time, and was pleased to see the work he and his colleagues are doing accurately represented.
Subsequent chapters examine various approaches to making dementia care more humane, with some interesting probing of the ethics of creating “fake” environments like an idealized 1950s town square to help the memory-challenged feel more at home. A chapter explores the uses of virtual reality in senior care settings, where the confluence of technology and Boomer buying power is driving some fascinating developments. These include virtual exposure to natural environments that people could not otherwise access. This is music to my ears. (See this article I wrote for Next Avenue earlier this year.)
As a person of white privilege, I am squarely in the target of the senior care industry. We are the people paying the assisted living facilities—not the elderly poor, who are often nonwhite, and whose care is provided by family, often at great personal cost to women. Cyberpunk author William Gibson famously said, ““The future is already here–it’s just not evenly distributed.” Let’s hope the future that is already here, described in Happily Ever Older, is distributed with greater equity than now exists.
But now, back to the problem of facility and program design. What would YOU like your penultimate resting place to be like?
Me, I’m moving to the Northwood Retirement Lodge and having a Brandy Old Fashioned before supper. You’ll find me under the taxidermy moose head, enjoying the view of “the land of sky-blue waters.”
© 2021 Sarah White