The tale starts with a thread of truth.
In the past decade, there have been a handful of instances in which older adults have opted to live on cruise ships instead of paying for traditional senior living communities. Earlier this year, USA Today reported on an 86-year-old Florida widow who has sailed the globe as a permanent cruise liner resident for seven years, similar to a BBC report from 2008 about an elderly New Jersey woman who lived full-time the famous Queen Elizabeth 2 ocean liner. In 2004, The Journal of the American Geriatric Society published “Cruise Ship Care: A proposed alternative to assisted living facilities” that emphasized the similarities between cruise ship and care center living: food, activities, companionship and an on-site physician. Plus, there’s all those ports of call.
That’s how the story grew. And grew. And grew. Now, when senior living experts gather, they tell dramatic tales of lonely seniors constantly sailing the globe on cruise liners — this thread of truth that has morphed over time into an urban myth — as a way of illustrating the expense of senior housing and how neglectful families can be of their aging loved ones.
What the cruise ship urban myth really shows, though, is a gap in understanding between the senior living industry and the seniors it serves, as well as their families.
Experts say families can try to save money by intentionally moving their fragile elders into care facilities that don’t meet their needs — independent living instead of pricier levels of care that provide a greater range of supportive services, including help with bathing, dressing and feeding. And families, who until crisis hits tend to be unfamiliar with the differences between independent and assisted living and nursing homes, can worry that senior care eats up too much money and provides too little in return.
“It costs so much for care,” says Julie Minning, Burger Rehabilitation Systems’ vice president of skilled nursing. “We see families trying to figure out what to do as a result.”
On a personal level, few people like to think they’ll have to move away from their long-time homes as they grow older. Almost 90 percent of Americans say they want to “age in place,” in the familiar surroundings of the homes they’ve inhabited for decades. They don’t want to consider any alternatives. And they insist they’re not old enough to need care, even when they’re in their 90s.
So people wait too long to face the reality of needing care, and they don’t talk about what they want, except for making the kids promise never to put them in a home. Guilt goes a long way in perpetuating family members’ denial in dealing realistically with their aging loved ones’ needs.
And who wants to deal with the rage of an elderly, increasingly frail parent who desperately needs to live in a supportive residence but just as desperately doesn’t want to?
In one recent case, a newcomer to a Carmichael assisted living facility berated her family to such an extent that staff members suggested the relatives leave and allow the situation to cool.
It was the opposite of what care experts call a drive-by drop-off: The family wanted to stay and make sure their mom, diagnosed with dementia, was settled on her first night in her new surroundings. But she felt too betrayed and too furious.
Later, staff members told her children that after they had left, the woman tried to call 911 for hours, certain she’d been kidnapped and was being held hostage. The family was shaken by the whole ordeal — the staff, not at all. One benefit of putting professionals in charge is that they’ve seen it all before, and they’re trained to cope.
A quick primer on senior care: Independent retirement living is intended for older adults who are, well, independent. They’re active and involved, mentally sharp and in decent physical shape. Assisted living serves people who need more help with getting out of bed, taking medications and so on. Memory care is meant for people with acute cognitive decline. And skilled nursing, which most people think of as nursing home care, can be either long- or short-term, for bed-bound people who need assistance.
“Whether you’re talking about dementia or the natural aging process, gathering information before a crisis makes a difference,” says Sally Michael, president of the California Assisted Living Association. “Most people want to do the right thing for their loved ones. But sometimes they really haven’t planned.”
As in so many things, education is the first step toward breaking through denial, busting fears and understanding the difference between myth and fact — even when the myths make for really good stories.
For more on senior living, check out the special section of our August issue which includes Anita Creamer’s feature, “Parent Dumping” — available only in print!