NaCCRA Forum: General

I think it is clear that if a person is a danger to themselves or others they should not be admitted or allowed to stay (although there can be a debate over whether there is a danger). Another problem is people who are not a danger but are seen as annoying by other residents. Some people argue that these people spoil the culture of the community and should not be admitted or allowed to stay. But it can be argued, especially in "faith based" communities, that these are our brothers and sisters and we should welcome the opportunity to comfort them. We knew after all that we were moving into a community of old people.

I also think there is a legal issue here. I believe that the Fair Housing Act prohibits discrimination against people with disabilities and requires the housing provider to provide "reasonable accommodations" for people with disabilities.

I see this as a difficult issue but one that is rarely discussed openly.

There is not a hard and fast line marking when a person is or is not appropriate for Independent Living. It can be a hard call to make. Generally, it will only come up if the resident or the resident's family bring it up, or if staff are made aware of problems with the resident's behavior when outside their residence. There is a continuum, a 3-dimensional one, not a clear cutoff point.

At our community (Ingleside at King Farm, Rockville, Maryland), there is a staff committee that meets weekly to discuss residents about whom there are questions that may relate to their appropriate level of care, or whether they need to have aides help them in IL. Reports from other residents may be helpful to them, but there has never been any effort to let residents know they can report issues with other residents and where these should be reported. The committee uses incident reports that are generated from input by staff or residents. They work to determine whether an IL resident would be better in a different level of care or other adjustments, and what level of care would suit the person's needs best.

At Wind Crest, an Erickson Senior Living Community, we have this problem. They often permit entry to Independent Living if there is a spouse caretaker, but they do permit some with cognitive problems without a spouse. The reason given is that the LAW forbids them from keeping them out. As a lawyer I know that is nonsense. And someday there will be an incident, where they allowed someone in who goes violent and harms someone. There was a resident at a community who had a gun and killed a staff person.

At Wind Crest there was a woman who slashed postings on a bulletin board with a knife and then threatened to kill her neighbor with a knife. It took around six months for the Executive Director to get her out. The neighbor had to live in another part of the community before she could go back to her unit. Sometimes they use HIPAA or invasion of privacy as an excuse. That is laughable.

I sometimes hear a complaint that there are people in Independent Living who because, cognitive limitations, shouldn't be in Independent Living. The argument go that management should not admit these people or should require them to move on when they get to a certain point. I am wondering how common a complaint this is. Is this an issue in a lot of retirement communities?