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by J. Kevin Eckert, et al
Johns Hopkins University Press, 2009
Review by Leo Uzych, J.D., M.P.H. on Aug 31st 2010

Inside Assisted Living

Inside Assisted Living is an ethnographic study of assisted living.  The text is multi authored; Eckert et al. are (or have been) affiliated with the Center for Aging Studies at the Erickson School and the Department of Sociology and Anthropology, at the University Maryland.  As explained in introductory Chapter 1, the research technique of ethnography is used to study assisted living at six actual assisted living facilities in Maryland.  The research process used by Eckert et al. is described, in considerable detail, in an "Appendix" joined to the text.

The pages of the book are suffused with a profusion of informative details garnered from the six profiled assisted living facilities.  Pseudonyms are used for these facilities, and also for interviewed persons.  The specific information presented, culled from these six facilities, raises a great many issues of general pertinence to assisted living.  Readers interested in information, and insights, regarding assisted living should be especially pleased with the research efforts of Eckert et al., which pry open a window enabling readers to see some of the real life promising aspects as well as challenges of assisted living.

The substantive contents are research referenced.  Citations for referenced research materials (alphabetized by author last name) are presented in the "References" section, adjoining the text.

Also affixed to the text are some instructively annotated "Notes".

The book's substance is comprised in part of quoted material, prominently featuring numerous quotes attributed to residents of (and their family members), and to persons who work at or own, the six profiled facilities.  The quotes, individually and collectively, breathe animating life into the nostrils of the text, and contribute significantly to its edifying substance.

Separate book chapters are devoted to each of the six facilities.  Detail laden descriptions, of the respective facilities, are embodied in Chapters 2 to 7.  Across the substantive length and breadth of these chapters, Eckert et al., in detailed fashion, describe assisted living at the six facilities as experienced by residents, their family members, staff, and owners.

In Chapter 8, Eckert et al. endeavor to synthesize their research findings regarding  the realities of everyday life in assisted living.  Particular topics broached, in this regard, encompass:  serving meals, relative autonomy and privacy (of residents), and some medical related aspects of assisted living.

The reader is presented, in Chapter 9, with expert discourse across a wide spanning gamut of issues associated with assisted living.  Tentacles of discerning discourse reach to disparate issues, including:  how older adults regard the prospect of assisted living; factors which may prompt a move, to assisted living; assisted living "consumers"; considerations affecting the choice of an assisted living facility; how information about assisted living is obtained; "settling in" (to assisted living); and the departure of residents from assisted living.

In concluding Chapter 10, Eckert et al. expound pithily on some of the perceived core realities of assisted living.  There is, as well, forward looking commentary, including comment pertaining to:  unfolding regulatory control, the evolving relationship between assisted living and nursing homes, staffing concerns, and assisted living affordability.

Although the research roots of this book are planted in six specific facilities, a multitude of issues of broad interest, regarding assisted living, branch out from its trunk. 

In the first instance, what, exactly, is "assisted living"?  What are indications for assisted living?  How is assisted living distinguishable from nursing home care?  Is assisted living appropriate for a person with dementia?

Some branches are financial in composition.  How, for example, is assisted living financed?  And how affordable is it?

Other branches evince regulatory concern.  What regulations are assisted living facilities subject to?  Is there presently adequate regulatory oversight of assisted living?

Still other branches raise questions relating to the quality of life for assisted living residents.  How much autonomy and privacy do assisted living residents have?  Are residents burdened often by onerous "house" rules?  How safe are assisted living facilities?  Are they staffed adequately?  And is there proper medical oversight of residents?

Critics may caution readers to be properly mindful of the uniqueness of each person in assisted living; and to be alert critically, as well, to the overall unique nature of each assisted living facility.

Additionally, it should be kept in mind that assisted living is affected by complex, and unpredictably evolving, legal, regulatory, political, economic, and financial circumstances.

But for the reader attempting to gain access to information, and insights, germane to assisted living, the revealing research efforts of Eckert et al. open the door to helpful scrutiny of this area.

The expansive range of professionals who may be considerably enriched professionally by the unlocking of this door extends to:  owners, operators, and administrators of assisted living facilities, nursing homes and hospices, specialists in dementia care, chronic illness, aging, long term care and elder law, gerontologists, primary care physicians, geriatric psychiatrists and nurses, neurologists, social workers, psychologists, health policy makers, legislators, social scientists, sociologists, and cultural anthropologists.

 

© 2010 Leo Uzych

 

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University.  His area of special professional interest is healthcare.