Once admitted into an eldercare facility, it’s usually for life. A criminal who has committed a heinous crime gets a life sentence locked away from society, and a person with dementia who no longer fits into society or family life also gets a life sentence in lockdown.

The challenges the family face and the guilt and emotional pain that comes with the necessity of admitting your loved one to a nursing home are heartbreaking. Usually, the circumstances aren’t conducive to caring for them at home, especially in later stages. The 24/7 care becomes overwhelming, the financial burden is too much, the caregiver is elderly, or the person with dementia’s physical/mental deterioration requires professional help. Nowadays, most younger people in the family must work, and if the elder hasn’t sufficient funds to cover expenses, no one in the family can afford to pick up the financial burden to care for them stay home.

Home care vs. facility placement isn’t the issue of this article. It’s about the environment of the eldercare institution where the seniors will live out their last years. Yes, the larger facilities are institutions. No matter how expensive or how luxurious they appear, they continue to follow the mental hospital model.

Initially, the first poor house was built in New England in 1660, where indigents, mentally ill, orphans, and poor elderly were housed. This was your ultimate destination when you became old without family.

In 1752 the Quakers in Philadelphia created the first mental hospital, which was somewhat of an upgrade from the poor house, but not much. The “senile” elderly usually ended up there.

FDR signed into law the social security act in 1936, and by 1940 seniors were collecting monthly benefits. However, these benefits didn’t apply to those in public institutions. So many closed and sent the residents to “Rest Homes,” where they did qualify. Eventually, these homes grew in size and became more institutionalized, resembling the mental hospital model.

Today’s eldercare is big business, and most of the upscale places are owned by large corporations.

Their architecture resembles expensive hotels, and like the hospital model, they have rooms lined off long hallways with monotone-colored walls. There are activity programs, but because of limited staff, one on one contact is generally limited to physical care. Doors are locked, usually with alarms to alert the staff someone is trying to escape. There are established visiting times, and state privacy laws often prevent non-approved visitors, and during COVID, even families are restricted to seeing loved ones from behind a glass; some using phones like in prison. The nurse dispenses medications from a cart, the diet is a group menu, the routines seldom vary, and some play elevator background music; shades of One flew over the Cuckoos Nest. And the cost ranges from $2,000 to sometimes over $6,000 a month.

There’s a viral story of an elderly lady deciding to live on a cruise ship. There’s medical staff onboard, she gets first-class individual attention, the food is fabulous, the activities Las Vegas-style, and she gets to travel. Good for her.

It’s the family’s responsibility to provide the emotional support the resident usually lacks in the facilities. They also need to become very pro-active advocates ensuring their loved one gets the care the facility supposedly offers. I worked as an advocate, and believe me, you don’t always get what you pay for.

So now that your loved one is in a facility and you are no longer burdened with the 24/7 care, it is your responsibility to ensure their last years are as quality as you can make them.

Try to visit often and take them on outings when possible. Bring little gifts each visit and call them on the phone regularly. Even if they have forgotten you or your visits, remember their lives are restricted to the present, so make those present moments beautiful.


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