But a distressing thing happened along the way. The
concept of assisted living became so popular that
developers began slapping the name on just about
anything.Theideamutatedfromaradicalalternativeto
nursing homes into a menagerie of watered-down
versions with fewer services. Wilson testified before
Congress and spoke across the country about her
increasing alarm at the way the idea was evolving.
“With a general desire to adopt the name, suddenly
assisted living was a redecorated wing of a nursing
facility,orasixteen-bedboardinghouselookingtoattract
private-pay clients,” she reported. However much she
attemptedtoupholdherfoundingphilosophy,fewothers
were as committed.
Assistedlivingmostoftenbecameamerelayoveronthe
way from independent living to a nursing home. It
becamepartofthenowwidespreadideaofa“continuum
of care,” which sounds perfectly nice and logical but
manages to perpetuate conditionsthat treat the elderly
like preschool children. Concern about safety and
lawsuitsincreasinglylimitedwhatpeoplecouldhavein
theirassistedlivingapartments,mandatedwhatactivities
theywere expectedto participatein, and definedever
more stringent move-out conditions that would trigger
“discharge” to a nursing facility. The language of
medicine,withits prioritiesofsafetyandsurvival,was
takingover,again.Wilsonpointedoutangrilythateven
childrenarepermittedtotakemorerisksthantheelderly.
They at least get to have swings and jungle gyms.
A survey of fifteen hundred assisting living facilities
publishedin 2003 foundthatonly 11 percentofferedboth