Ever since I read this article about a bingo controversy at a continuing care retirement community (CCRC), the issues surrounding it have been rolling around in my brain.
Just in case you are not aware, a CCRC is a retirement housing option that offers various options from independent living to assisted living to nursing home care. As a person’s health deteriorates, they are able to move to higher levels of skilled care without having to change residences completely. Also, spouses can live within close proximity to each other while still receiving the level of care each one needs. There is usually a pricey fee to enter, but amenities are available such as dining options, housekeeping, social and recreational programs, transportation, 24 hour security and health care services such as memory care.
The article ran last year in the New York Times Science section. “An Unexpected Bingo Call: You Can’t Play” by Paula Span reported on a CCRC facility in Alabama and details the story of Ann Clinton. Ann moved into her CCRC in 2012 with her husband. They took an independent living apartment, but within a year her husband had to be moved to assisted living and then onto nursing care. Through that whole process, she turned to bingo with her friends as a healthy distraction. Unfortunately, Ann is in her 80s and suffers from Parkinson’s disease and had to have back surgery in 2014 after which she had to spend time in the nursing facility to recuperate.
When she was well enough, she wanted to continue playing. However, now, to get into the game as a non-independent living resident, she was told by the activities director that she needed a sponsor. Her friend willingly obliged. However, after a few weeks the staff wanted to bar her from the game and the independent care section altogether and send her back to skilled nursing. When she refused to leave the game, half the women walked out in protest. They felt the rules should be obeyed.
In graduated care facilities, controversies such as this crop up more frequently than you would imagine. Bringing skilled care residents into the dining room of the independent facility, even for married couples, can be a thorny issue. Such acontroversy erupted at a CCRC in Norfolk, Va in 2012 which led to guideline changes after a DOJ investigation.
I am empathetic on both sides. Those who are more independent want to maintain that lifestyle for as long as possible – and they have paid good money to do so. They may want to be unencumbered, and perhaps not even see, those who have unfortunately lost their ability to be on their own. They may dread what is coming and keeping the less fortunate out of sight may be the only way they can cope and keep the all too pervasive geriatric depression at bay. What about the special care and supervision these patients require in facilities unequipped to deal with them?
On the other hand, where is the compassion? Shouldn’t those of higher order abilities empathize with those who are not as strong? Isn’t that what we strive for societally? Wouldn’t they want the same consideration when and if it becomes their turn at that twist of fate? What about the fair housing and disability laws with respect to “reasonable accommodations”? Is it even legal to segregate these patients by restricting entry?
With all this as background, I thought I would try something new and interactive for this newsletter. I would like to invite your thoughts on the subject. I am anxious to hear all points of view. As you can see, medical, legal, values and ethical issues abound. With your permission only, I will publish some of the more interesting responses. If you like, I will be happy to do so anonymously. I am eager to hear your voices!
Best wishes for your continued health and success,
Anita Kamiel, R.N., M.P.S.
Director of Patient Services
Anita Kamiel, R.N, M.P.S. is the founder and owner of David York Home Healthcare Agency and is fully acquainted with all factors related to eldercare services and the latest guidelines for seniors. She holds advanced degrees in gerontological administration and has experience in the field as a Nursing Supervisor in a nursing home. Anita has been in the business of home care for over 40 years starting out in a NYC Medicaid agency. Thirty years ago she realized the need for affordable, quality home health aide services provided and supervised by caring individuals, so she boldly opened David York Home Healthcare Agency in Brooklyn, New York. She is the mother of 4 and the grandmother of many and when she is not on adventures like safaris in Africa, she still works 6 days a week and runs to her workout classes 3 of those nights. You can contact her at 718.376.7755 or at www.davidyorkagency.com where she is happy to share her experience and help you through your home healthcare issues.