In Iowa, Moves to Regulate Facilities Spark Controversy
Listen to Joseph Shapiro's report.
"You grasp that she worries about facing her own death. I dread it myself. I love my mother. I felt like to give her this extra little jolt would be unkind. This is her home. She's staying right here."
"Some of these assisted living programs are morphing into uncertified nursing homes, and that's not permitted within the state."
Most people move into assisted living when they need just a little care, or simply don't want to manage a house. But then people age, they get more frail, they develop Alzheimer's disease. And that's a problem for state regulators, who now are struggling to figure out how to set rules for who can live safely in assisted living, and who should leave -- most likely, into a nursing home.
As NPR's Joseph Shapiro reports from Iowa, a controversy there has pitted government officials against assisted living residents and their families.
Doreen Sparks, 92, is a resident of the Sunset Park Place assisted living facility in Dubuque. Her daughter, Carolyn McCoy, says assisted living allows her mother to live with a degree of comfort she could not find in a nursing home. "It's dignity. It's independence. It's freedom to shape your own lifestyle. That's what assisted living is supposed to be about. It's not a nursing home," she tells Shapiro.
McCoy agonizes over how to break the news to her mother that she's being evicted. Sparks has Alzheimer's disease, and the facility's administration recently informed McCoy, Sparks' only child, that the elderly woman's medical needs "exceeds the level of care we can provide as an assisted living community."
"This is a nightmare," McCoy says. "This can't be happening to my mother in Iowa. Iowa."
Nursing homes are heavily regulated in the state, but assisted living facilities aren't. And earlier this year, after a series of newspaper articles implied that poor care in assisted living facilities was going uncorrected, the governor moved to put the facilities under stricter scrutiny.
"Some of these assisted living programs are morphing into uncertified nursing homes, and that's not permitted within the state," says Steve Young of the Iowa Department of Inspections and Appeals.
Young has come under fire from angry family members at public meetings. And Dana Petrowsky of the Iowa Association of Homes and Services for the Aging -- a trade group of non-profit nursing homes and assisted living facilities -- says the inspectors overreacted.
"They interpreted what they were doing as rescuing these people, because they were inappropriately placed," Petrowsky says. "I think the people didn't want to be rescued."
Mark Haverland of Iowa's Department of Elder Affairs thinks that eventually, assisted living and nursing homes will merge. "I think the assisted living programs will be everything -- people will move into an assisted living facility and be allowed to stay there and age in place."
But until the state sorts out the details, McCoy is faced with a tough decision. Still, she avoids telling her mother the news about the eviction. "You grasp that she worries about facing her own death," she tells Shapiro. "I dread it myself. I love my mother. I felt like to give her this extra little jolt would be unkind. This is her home. She's staying right here."
"There are similar battles across the country," Shapiro concludes. "How they get resolved will determine whether assisted living can keep its promise to be both safe and homelike."
Assisted Living Federation of America
Consumer Consortium on Assisted Living
National Center for Assisted Living
American Association for Homes and Services for the Aging