LTC Bullet:  The Tarnished Name of Assisted Living

Friday, September 27, 2013

Seattle, WA—

LTC Comment:  Our guest columnist for today’s LTC Bullet is Liz Taylor.  No, not that one.  Rather, the Liz Taylor who has raised the standards and written wisely about long-term care for decades.  After the ***news.***

*** AALTCI:  The American Association for Long-Term Care Insurance recently announced their 11th National Long-Term Care Solutions Sales Summit will be held May 18-20, 2014 at the Westin Hotel in Kansas City, MO.  Over the past decade we’ve attended many of these conferences and have always found them to be of high value in terms of professional development through educational content and networking opportunities.  Early registration is only $69 and ends October 31st.  See for further details and to register. *** 

*** IN THE MEANTIME, don’t forget about the Fourteenth Annual Intercompany LTCI Conference scheduled for March 16 to March 19, 2014 at the Rosen Centre Hotel in Orlando, FL.  Check out the details here:  And if you’re contemplating an Exhibit Booth and/or a Corporate Sponsorship, act now!  The early bird deadline for those applications is October 4, 2013.  Contact Jim Glickman for that. ***

*** ANNOUNCING:  CLTCR Premium Membership  --  Center for Long-Term Care Reform premium members receive our full suite of individual membership benefits including:  our LTC Bullets and E-Alerts; access to our Members-Only Zone website and Almanac of Long-Term Care; subscription to our Clipping Service; and email/phone access to Steve Moses for 24-hour turnaround queries.  Our Premium Membership is designed to give you a competitive advantage in your long-term care profession. Your increased knowledge of the critical issues and challenges we face in the field of long-term care service delivery and financing equals improved professional success for you and better LTC services for your clients and for those who have no choice but to rely on scarce public resources.  Premium Membership is $250 per year, paid up front or monthly by automatically recurring credit card payments.  Contact Damon at 206-283-7036 / to start your Premium Membership immediately or go directly to our secure online subscription page and sign up for as little as $21 per month. ***


LTC BULLET:  The Tarnished Name of Assisted Living


LTC Comment:  Today’s guest columnist, Liz Taylor, has worked almost 40 years in the aging field.  As an author, former Seattle Times columnist, and public speaker, she advocates for “aging deliberately,” having coined this phrase to express the importance of planning ahead and maintaining control of our lives as we age. She can be reached at

“The Tarnished Name of Assisted Living,”
Liz Taylor

The Frontline PBS television program about assisted living communities that ran July 30 promised to be a barn burner. The media is at its best or worst (depending on your point of view) when it shows blood and gore. From advance clips, this was its intent.

I hate to sound jaded, but where has the media been lo these last 50 years? In 1976, when I headed up a federal investigation of the nursing home industry, images of horrible bed sores, people tied in their wheelchairs screaming, and lack of warm blankets and heat in winter were a dime a dozen – in nursing homes. There were no other care options then; nursing homes were all we had.

Levels of care…

The same poor care exists today (though usually more muted). Then, and now, there are exceptions to the rule — some nursing homes and some assisted livings do extraordinarily good jobs. Further, some older people don’t need the kind of extensive care that invites abuse.  The less care you need, the less you’re likely to run into trouble.

But the rule remains the same: mediocre to poor care exists in far too many care facilities, similar to a half century ago. The culprit is also the same: the government says it’s in charge and tries to control quality from “the top down” – through regulations.  Over the years, nursing homes have become one of the most highly-regulated industries in this country. We’ve seen some quality improvement, but not nearly enough.

During my nursing home inquiry four decades ago, we looked at the very best providers. We figured, if we could find a few excellent nursing homes — when the country was rife with awful ones — it was possible to do better. Since then I’ve seen exceptional care providers at all levels — home care, retirement communities, adult family homes, assisted livings and nursing homes. Most providers don’t hold a candle to the good ones, though all are operating under the same regulations and conditions.

Conditions Can be Better

For at least ten years, we’ve known how to make care better, a lot better.  I wrote about this in a dozen or so of my Seattle Times columns, giving real life examples. If you’d like to receive a summary of their links, email me.

I believe that the only way we’re going to get better eldercare is “from the bottom up” – arming consumers with the information to help us make informed decisions, showing us how to “kick tires” to get the care we need, alerting us to pay attention and do our homework before there’s a crisis, and providing the tools to do the job – with regulations as a back-up.

Imagine if the computer industry had operated in lock-step to the dictates of the federal government and 50 states for the last 30 years – where would it be today? Well, that’s what we’ve done in eldercare. As consumers, WE have to become educated and demand better services – the government will never be able to do it for us.

So what happened to my 1970s nursing home investigation? The knee-jerk reaction then, as now, was to demand more regulations. Instead we called for consumer education and information to help consumers choose care wisely – to give older people and their families huge amounts of information about their choices – management track records, inspection reports, staffing ratios, consumer complaints, staff turnover, and other important facts.

The reaction: thunderous, widespread yawns. Consumer education? How boring!

Selecting good quality eldercare is one of the most complicated, expensive and emotional decisions most of us will ever make.  As the PBS documentary made clear, relying on lofty advertising promises is foolish. As is choosing a place based on how pretty it is. We have to do our homework, as we would for anything important – with tools that don’t exist now.  As 80 million baby boomers grow old, we need an entirely new way to deal with the entire care industry.