What the movies got right, and wrong

Some of us may remember a certain 1989 movie, the one with John Cusack holding a boom box over his head outside a girl’s bedroom window, blasting “In Your Eyes” by Peter Gabriel. It’s an iconic scene. What most people forget is the subplot: The girl’s father, played by John Mahoney, runs a nursing home and is under federal investigation for defrauding his residents.

That subplot has stuck around in the culture longer than anyone in senior living would like to admit. Nearly 40 years on, the fear it named is still the first fear a family raises, sometimes out loud and more often not. Are these people just after my money? Are they going to talk me into services I don’t need? Is my inheritance safe?
Those questions deserve straight answers, not reassurance.

Yes, there are bad actors

Senior living is a large industry, and like any large industry, it includes operators who do not deserve trust. Pretending otherwise is insulting to anyone who has read the news. The wariness families bring to this decision is not paranoia. It is reasonable caution, and any community worth choosing will respect a family for showing up with it.

The good news is that the industry is also among the most heavily regulated in American health care, with federal and state oversight, mandatory financial disclosures, resident rights protections and public inspection reports available to anyone who asks. LeadingAge, the national association of nonprofit senior living providers, and AARP both publish consumer guidance on what to look for and what questions to ask. That guidance exists precisely because the industry knows the fear is real and knows that the honest members of it are held to a standard the bad actors aren’t.

Cost should be transparent, full stop

The cost of senior living is not small. It shouldn’t pretend to be. What it should be is clear, itemized and explained in language a prospective resident and their family can competently follow. Fees, what they include, what they don’t, how they can change and under what circumstances, all of it should be on the table before anyone signs anything.

A community that gets vague when the conversation turns to money is telling you something. A community that hands you a clear document, sits down with you and answers hard questions without flinching is telling you something else.

When needs change, an honest conversation follows

Here is the part that gets misread most often. Independent living can be a wonderful arrangement for a long period of many people’s lives. But needs sometimes grow, and when they do, an honest community will notice and start a conversation.

Additional support with medication, help with a few activities of daily living or, in some cases, memory support may make life safer and more comfortable and may extend a resident’s ability to remain in independent living longer than they otherwise could.

That conversation is not about extracting more money. If anything, it’s the harder path. A less scrupulous operation may let a resident struggle quietly in a setting that no longer supports the resident’s needs and keep collecting the same fees.

Suggesting an honest plan of support, which would include an appropriate increase in fees, and letting the resident and family weigh it against outside opinions and their own judgment is what an ethical community does. It is also, incidentally, what the good ones will invite you to hold them to. They should invite you into that process.

Ask hard questions. Ask for the numbers in writing. Ask your own doctor, your own attorney and your own children to look over what you’re being told. The right community will hand you the pen and welcome all of it.

That, and not the boom box, is the scene worth remembering.
Although Lloyd Dobler was epic.

Matt Uppenbrink, MS Gerontology, is the Executive Director of The Seabrook of Hilton Head. Interested in learning more about The Seabrook of Hilton Head or to schedule a tour: https://www.theseabrook.com/ or call 843-842-3747.