Here comes the latest horror story from the ragged frontier of care for the elderly. Like a lot of aging baby boomers struggling with ailing parents, Peter Levang fretted 2 1/2 years ago when his mother Dolores, already plagued with mild dementia, became incontinent. He considered a nursing home--the classic option for those too sick to live alone and too needy to live with family. It seemed a dreary choice. Then Peter heard about a center just 15 minutes from his house. It was an assisted-living facility, part of a new way to live--and die--with dignity and freedom. These facilities, designed to help residents with daily tasks but not to provide skilled medical care (you still need a nursing home for that), are free of many of the safety and sanitary regulations that make nursing homes seem so much like mortuaries. By providing warm, inviting decor and individually tailored care, these centers can take much of the pain out of the awful decision to move a loved one from her home.
So Peter brought his mother to Alterra Clare Bridge in Eagan, Minn. Designed for people with memory difficulties, the center promised to allow Dolores, then 78, to live independently while it provided the extra support she needed. Staff members trained in memory impairment would help her eat and bathe; a "life-enrichment coordinator" would keep her active. The facility was stunning: from the outside, it looked more like a resort than a hospital. Inside, residents could gather in the "town square," with its beauty salon and ice-cream parlor, or relax by the fire in the living room, or skim through stacks of old National Geographic magazines. "You walk in and say, 'This is a place I would love to have my parent,'" says Peter.
Now he wishes he had looked a little more closely. Shortly after Dolores moved into the Eagan center in March 1999, at a cost of $3,450 a month, Peter's wife Bonnie, who visited regularly, noticed that Dolores' only "life enrichment" was watching television in her rocking chair. Nor was Dolores receiving the help she needed in visiting the toilet. On several visits, Bonnie found her mother-in-law's feces smeared on the bedroom floor and walls, in Dolores' hair, on her face, on her toothbrush. Then Dolores began to fuss incessantly with her feet. The Levangs thought they had arranged, through the center, for an outside service called Happy Feet to provide pedicures. But Happy Feet never received the contract. (The center's operator, Alterra, based in Milwaukee, Wis., insists that its manager did fax it in.) For eight months no one cut Dolores' nails, which grew so long that they curled over the tops of her toes and began to dig into the skin underneath.
The Levangs then began to hear alarming stories from other residents' families. Tina Sowells' grandmother Freda Trimble, then 89, had to be hospitalized after an anxiety attack because for several days she hadn't been given her necessary dose of Xanax. Fran Firth complained that her mother, Grace, then 74, had been left lying in her feces for several hours until her skin peeled; the company says her diaper was changed regularly. "We could not have been more disappointed," says Bonnie Levang.