A Community of Care

Seven years ago, Mr. and Mrs. Johnson, like so many older adults today, moved into an assisted living community. The two had drastically different experiences.

From the beginning, Mr. Johnson ate in the dining room and participated in activities at his new home. His wife, however, arrived that first day “kicking and screaming,” according to staff. She ate all her meals in her room and stayed there most of the time.

When Mr. Johnson noticed his wife wasn’t adjusting well, he told staff she seemed unhappy, but they insisted she would eventually settle in. They’d seen this before, they said. Until, one day something terrible happened.

Mr. Johnson returned from lunch to find his wife lying on the floor with cuts to her wrist.

He had arrived just in time. And to his relief—Mrs. Johnson survived.

However, Mrs. Johnson’s suicide attempt was a wake-up call to the staff at the assisted living facility, who shared the story with EDC for a new project titled A Toolkit for Senior Living Communities. It reinforced to the Substance Abuse and Mental Health Services Administration (SAMHSA) that older adults—now with one of the highest suicide rates of any age group—should be the lead-off subject for a set of suicide prevention toolkits targeted to specific populations. Funded by SAMHSA, the toolkit teaches personnel at senior living communities how to recognize and take steps to help an older adult at risk of suicide.

Today in the United States, there are more older adults at senior living communities than ever before. As the baby-boom generation ages, their access to improved standards of health care are contributing to a longer life expectancy. According to the U.S. Census Bureau, while the growth rate of the world’s population is expected to continue to steadily decline, the older adult population is increasing. Those over 65 are projected to make up 17 percent of the global population by 2020, up from 12 percent in 2000.

And EDC has risen to the challenge of supporting older adults through the suicide prevention toolkit and another program called Chronic Care Community Corps, which supports those providing end-of-life care.

A good quality of life

Of course, not all older adults choose assisted living.

“The institutions of care are not the main place where elderly receive care in today’s society,” points out EDC’s Ned Rimer. “More often, it’s home.”

Rimer has developed the Chronic Care Community Corps, which prepares and mobilizes groups with an existing sense of community—such as local churches, neighborhood associations, and workplaces—to assist families dealing with chronic illness and end-of-life care at home and, on occasion, at assisted living facilities.

Rimer developed a series of short seminars on how to meaningfully support families caring for a loved one with chronic illness.

“Just a few years ago, there was not even a certified medical discipline of palliative medicine,” says Rimer, who leads the series alongside EDC’s Loring Conant. “Assisted living facilities have been growing out of necessity, due to the complexity of illnesses today and a demographic trend for humans to live longer with tough, comorbid conditions.”

Today, a total of 80 percent of the elderly population lives at home—and those who don’t are entering facilities that look and feel more like home.

Senior living communities are shying away from the traditional institutional nursing home approach toward more home-like settings. Residents are actively participating, creating newsletters, and serving on policymaking boards. This improved sense of community is especially important knowing that increased social connections and a sense of purpose in life can help reduce the risk of suicide, according to research highlighted by EDC for the toolkit.

“People started to realize that depression isn’t a part of aging,” says EDC’s Chris Miara, who directs the senior living communities’ toolkit project. “No matter what age people are, they deserve a good quality of life.”

Mrs. Johnson is no exception. After her brush with death, she received inpatient psychiatric treatment. Now, seven years later, she is 93 years old. Even after her husband passed away two years ago, she is still residing at the assisted living facility. Only now, she eats all her meals in the dining room.