Inside Assisted Living: The Search for Home

8 Everyday Life in Assisted Living

149` EIGHT Everyday Life in Assisted Living Acolleague who heard about our study asked us, “What’s a typical day like in assisted living?” The heterogeneity of people and places necessarily affects the answer. For many people who reside in assisted living facilities, a typical day might not be very different from a day spent at their previous home. They have meals, watch television, nap, read, take care of personal care needs, go shopping, work on hobbies, and visit with family and friends. Some continue to do their own housekeeping, while others are thrilled to have a housekeeper for the first time in their lives. For others, assisted living could not be more different from home. Living in an apartment-style setting is new to many, as is having a roommate (something that a small number of our participants reported), or living in one small room as opposed to a house. For some, the daily schedule varies substantially from the one they had followed or would prefer to follow. As a result, some older adults residing in assisted living find themselves awakened or put to bed at unaccustomed times, eating meals earlier or later than they desire, or taking a shower only twice a week when they are accustomed to a daily bath. Nearly every resident receives basic services such as housekeeping, laundry, and meals, but many require help from a staff member to complete personal needs like bathing, dressing, using the toilet, moving around the residence, and taking medications. A few need almost total care. While many residents express gratitude at receiving support in myriad personal care tasks, some express annoyance at the loss of independence, resenting that they need help or that they are not given the choice to do some things on their own. Some residents find the assisted living environment provides much 150 INSIDE ASSISTED LIVING more activity than their prior situations, in both positive and negative ways. Individuals who want social interaction often enjoy sharing in conversation and having something to do. Whereas the assisted living residences in our study structured their activities in the daytime, one group of women at the Chesapeake created an informal social club that met late in the evening to chat and munch on snacks. But for those who prefer privacy or solitary pursuits, the constant presence of others and the encouragement at some assisted living residences to participate in the scheduled activities (prompted by a belief that social engagement is necessary for well-being) is an annoyance. When an interviewer asked her to describe a “good day” at the Chesapeake, Mrs. Mitchell said, “Well, actually they have too many things—that you have to pick and choose. They’d have you running every single day. . . . I don’t seem to have much time on my hands [for] writing notes or letters, or buying cards—and your time is taken up.” This contrasts with Opal’s experience at the much smaller Franciscan House, which she repeatedly described as “boring.” Despite a daily timetable structured by meals and planned social activities, residents also kept to their own schedules, such as watching a favorite television show: Mrs. Koehler didn’t miss Law and Order, and Dr. Phil was popular at Huntington Inn. The preceding chapters provide in-depth stories about six residents of assisted living facilities. In this chapter we synthesize some of what we learned about everyday life in assisted living during the course of this research. In many ways, assisted living is a study in contrasts, due in part to the realities of group living. In actuality, many assisted living staff members and managers want to accommodate resident preferences, but they must also restrict some choices that residents make. Residents experience varying levels of contentment and resentment associated with life in assisted living. We observed similarities and differences across these places that went beyond the size of the facility or the type of care provided. For example, assisted living operators vary in the degree to which they are either rigid or accommodating of resident needs and preferences. Some of the contrasts and apparent contradictions we observed result from the unique perspectives of the beholder: assisted living represents different places for different people because it is simultaneously a residence, a work environment, and a regulated entity. It is a place where residents experience their own and others’ illnesses and disabilities, make new friends, EVERYDAY LIFE IN ASSISTED LIVING 151...