Senior Living Innovator Carle: Safety of Assisted Living Versus At-Home Memory Care Must Be Weighed in Light of WaPo Reports

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A recent Washington Post investigation highlighting elopements among residents with memory care needs may be missing the forest for the trees, including the relative safety of communal living versus people with dementia residing in single-family homes.

That is the opinion of Andrew Carle, a longtime senior living innovator, adjunct lecturer at Georgetown University and former executive director of The Virginian, a CCRC in Fairfax, Virginia, managed by Life Care Services.

To Carle, the situations described in the recent articles from The Washington Post are no doubt tragic. But he also thinks the articles, and others like it in the past, miss “vital context,” chiefly the impact that assisted living and memory care providers have on millions of older adults every day.

Carle shared his thoughts in a response also published in the Washington Post last week.

“Tragic but rare incidents that happen in hospitals, nursing homes or any care services reliant on human beings should not be dismissed, and those found guilty of neglect or worse should be held responsible,” Carle wrote in the Dec. 27 letter. “But the needed services they provide should not be depicted as dangerous simply for the sake of a headline.”

In an interview on Tuesday with Memory Care Business, Carle said this is the third time in recent memory he has seen such an article highlighting “the horrors of assisted living.” In his view, the stories unfairly portray an industry that houses and cares for an average of 1 million seniors every day.

Specifically, he is worried that the articles will turn older adults and their families off from using senior housing when they really need it. Carle said that there are many older adults who would be safer in assisted living communities than in their own homes, given the care those communities can provide on a regular basis.


On the flip side, he worries that older adults may stay in homes that aren’t suited for them too long, and as a result, face some of the same negative outcomes they were looking to avoid in the first place.

“The number-one reason people put their mom or dad in a memory care environment and senior living is because they’re terrified they’re going to wander out of the house,” Carle said. “I hope that families don’t avoid memory care assisted living now.”

His comments echo those of Argentum CEO James Balda, who said in December that “even taking [the Post data] at face value, fatalities due to wandering are 0.0015% of the more than 6.2 million assisted living residents served in the last five years.”

The industry should now take a more proactive approach toward educating the public about the benefits of senior living, Carle said.

“We’re a people business when you’re taking care of a million people a year 365 days a year,” he said. “We need to educate the public on the real numbers, which are just how safe people are, and how much more safe they are versus being at home.”

Among the ways the industry can be proactive with messaging is highlighting satisfaction rates and the percentage of residents that say they feel safer in assisted living at home, he noted.

Studies are also being conducted at the moment, such as the Mather Institute’s “Age Well Study” which revealed residents in life plan communities reported higher scores in five out of six domains of wellness, including physical, emotional, social, intellectual and vocational.

“We need to be sharing this information constantly,” Carle said.

Training could also help prepare the industry for the estimated 12 million people projected to live with dementia by the year 2040, based on predictions from The Journals of Gerontology.

Looking ahead, Carle said the information needs to not just come from the corporate level, and for the time being, the industry needs to focus on highlighting the safety of communities. Sharing this kind of information could potentially help change public perception as a whole compared to the low perceptions the industry as a whole faces.

“We’re too busy trying to compete with each other, instead of boosting the entire industry,” he said.

Senior living operators should take several lessons away in the aftermath of the Post’s reporting, according to a recent column in SHN+, which is part of MCB’s sister publication, Senior Housing News. Among them is the fact that nearly every assisted living community is now a memory care community in some way, given the scope of cognitive changes among residents. Training and education are also of utmost importance in 2024. Overall, operators will certainly face more scrutiny in the years to come, and they must be prepared to meet criticism not from a posture of self defense, but from a place of self-reflection and strategic thinking.

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