The old woman in the attic

Failing elderly women in America

A week ago, last Monday, my mother fell in her apartment at her assisted living facility. She pushed her call button, and no one came. She laid on the floor, maybe 20 minutes, she said, until an aide came in who was bringing her medication. The aide helped her up, and called an ambulance because she was short of breath and dizzy.

My mother was admitted to the hospital with a massive double pulmonary embolism and two additional blood clots in her legs. Her glucose was also 379.

The facility staff said that the wifi was down, which was why her call button, which she wears on a lanyard around her neck (and is also her room key) didn’t work. Just now, the director told me that they tested the button, and that it worked, and that miscommunication was common among the staff and she would talk to them about it. She said it was so lucky the aide happened to be bringing my mom her medication, and in the same breath, the director told me that the aide was also responding to the call button while bringing her meds. When I asked how could be it a lucky coincidence and also a planned intervention, the director ignored the question. I reminded her that I had requested a record of when my mother had been receiving her insulin and her glucose tests. She promised she would email me those (she still hasn’t).

I had been trying to call the director about the call button since yesterday. I left her a message, reminding her about the conversation when had we my mother fell (during this conversation I was also told that the wifi might have been down). Today, when I called the facility multiple times, no one answered. This is important, because my mom is getting discharged tomorrow, and the social worker has been calling the facility for the past two days trying to make arrangements for my mother’s discharge. No one called the social worker back. So finally, after I called multiple times and it wasn’t answered, I looked into the management company that bought my mother’s facility (the third buyout in about 18 months), and called the VP of the transition team. I left a very angry voicemail.

The facility is now called The Barclay and is owned by QSL Management. Previously, it was The Brandywine, owned by RUI. Before that, it was Anthology, and I’m not sure who owned it. That’s what it was when my mother moved in. Anthology. That’s who she signed her original contract with. That’s who she expected to be assisting her for the rest of her life. Or at least the rest of the year.

The Barclay is an assisted living facility with different tiers of assistance. Each new management has redefined the tiers and the charging packages. My mother is on the lowest tier. She uses a walker and needs help with her many medications.

She pays about $7,500 a month for this “assistance.” Her current amenities include not having her trash emptied on a regular basis. She wears Depends, so her apartment reeks.

Because she doesn’t drive anymore, she orders things she needs online, including groceries. These are brought upstairs and left in their boxes in her apartment. No one assists her in putting them away, despite her arthritis and her use of a walker. She pays $7,500 a month for this help.

There are two elevators in the building, and the one nearest her apartment has been broken for weeks at a time. She pays $7,500 a month to walk across the facility, with her walker, while suffering under several medical conditions, to use the one working elevator because she cannot take the stairs.

My mother’s medication has gone unrefilled at least twice, causing a delay in receiving her meds. She has multiple health conditions that require medication. She pays an extra $500 a month for her medication service. She has had to correct the tech on the amount of insulin she should be receiving.

The average ambulance response time, Google tells me, is under eight minutes. According to the director of The Barclay, they try to respond to a call button press in under 15 minutes. It takes them longer to respond, from within the building, than it does for an ambulance to arrive. My mother pays $7,500 a month for this.

There is a famous work of feminist literary criticism called The Madwoman in the Attic, by Sandra Gilbert and Susan Gubar. They argue that women in Victorian literature are reduced to two stereotypes, the angel or the monster. Among the works they examine is Jane Eyre, where Mr. Rochester locks his first wife, Bertha Mason, in the attic when she goes “mad.” This wasn’t uncommon. Psychiatry was young and sexist, and women who were “hysterical” were often locked in attics for their own good. “The Yellow Wallpaper” by Charlotte Perkins Gilman is a stellar short story that comments on this practice. Books like Preventing Misdiagnosis in Women by Elizabeth Klonoff and Hope Landrine address this history of women’s healthcare and try to remedy some of those issues. There is an extensive amount of literature on how poorly healthcare treats women.

It should come as no surprise, then, that the majority of the residents at The Barclay are women. In fact, so many assisted living facilities are dominated by women residents that the recent Netflix show, starring Ted Danson, called A Man on the Inside, joked about it. The senior living community he infiltrates is made up largely of women.

And these women aren’t “angels” or “monsters.” Gilbert and Gubar published their foundational work in 1979, after all, and we’ve progressed (somewhat), and we don’t lock “hysterical” women away. By these women in assisted living are all old, and we are not above locking old people away. Our society can’t abide aging, and especially not aging women (how many creams and serums and treatments and hair dye and Botoxes and blah blah blah are all targeted at women?). So instead of enclosing them in attics, we enclose them in fancy looking assisted living facilities. Essentially removing our elderly women from society, and putting them out of sight. While profiting on them by draining their life savings at the same time. Instead of angels or monsters, we treat elderly women as aging dowagers, loaded with cash, ripe for the taking. And these assisted living companies have no qualms about taking it. After all, these old women are going to die. What do women need with money or property anyway? Historically, women have been denied both, so it’s no surprise to see predatory practices against elderly women.

But why not kill two birds with one stone? Assisted living facilities are notoriously underpaid workplaces with high turnover rates. Aides, techs, nurses, management, cleaning crews, cooks, front desk help—most of these positions, if not all, are filled by women. And The Barclay is no exception. And again, it’s common enough that A Man on the Inside is cast accordingly. The vast majority of the staff are women. Women who work on the inside are also less visible. For the staff at my mother’s facility, the ones who have stayed through three management changes have lost healthcare benefits, retirement benefits, and savings opportunities with each new company. Because who cares if women suffer when profits can be made?

I wish I lived in the same state as my mother and could take care of her. But I don’t. My job is here. My home is here. And I drive across four states every single month to go help out (I’ve missed two months in the past year and a half). But she doesn’t want to move her and give up her friends and her city and her doctors, and I agree with her. But that means her only option is assisted living because she cannot live on her own. Her health and her mobility are too poor. And she was diligent when she chose her facility. She shopped around. She took tours, as hard as that was for her to do. And she chose. She put her trust in a company that she thought would do its best to take care of her.

And they sold her to the highest bidder.

And then they turned around and sold her again.

My mother worked in healthcare for over 40 years. She worked in a hospital; she was the director of the laboratory. She saved people’s lives. And now, when it’s her turn, the nursing director can’t be bothered to coordinate her hospital discharge with her social worker. That’s what $7,500 a month gets her.

And while this is a systemic failure on multiple levels (because I would like to live in a society where I could get the support I needed to take care of my mother. And I’m VERY lucky, because my job understands and supports my travel and monthly teleworking to caregive.), it’s also a failure of intersectional feminism. We have not done enough, or written enough, or studied enough, or advocated enough about assisted living predation, about aging, about our elders. We have not specifically looked at the concerns and challenges of women over 70. And we certainly haven’t looked at them for women who are marginalized further. Because the women residents at my mother’s facility? The vast majority of them are white. The management? Mostly white. The staff? Mostly Black and Hispanic.

But as much as we need to do this CRUCIAL work, we also need change, and we need reform, NOW. There is no excuse for profiteering on our elderly population. And that’s what this is. These facilities need to be held accountable. They need higher safety standards. Higher response time standards. Higher care standards. Higher training standards for staff. Higher pay for staff. Regulations that prevent flipping the purchase of the facility. Residents of assisted living facilities often can’t just pack up and move, and usually have no where else to go.

I am so beyond angry at what my mother has to go through. At how she’s treated. At how she’s disregarded and ignored. Fuck the capitalist assholes who suck the literal life out of elderly women who need help. Fuck exploitative labor practices. Fuck the entire system of leeches who profit from other people’s need.

I don’t know how to change this. And even if I could move my mom to a new place, it would be the same shit. She told me yesterday that she’s worried that if she complains too much (like about her call button not working properly), she’ll get kicked out and she doesn’t have anywhere else to go. So I spend half of my time advocating for my mother, calling directors and management, in between talking to doctors and pharmacists, instead of doing what I really want to be doing in my mom’s remaining time here: spending it with her, sharing stories, watching TV, and stockpiling memories while I can.

My mother is 80 years old. She turns 81 in a few months. She has metastatic cancer and several other health problems. She’s in the hospital every few months. Yes, she’s an old woman. Yes, she’s eventually going to die. Yes, this is her literal life savings that she’s spending on the mediocrity and overpriced shitshow that is assisted living.

She deserves better. And so I will make every phone call, I will berate and chastise and demand to see records and hold people accountable, I will write emails and call corporate and follow up, and I will persist every fucking day, even if it means that instead of spending time with my mother, I’m spending my time asking some puppet for a profiteer why her fucking call bell doesn’t work and getting mixed stories and half-truths because they’re desperate to cover their liability. I will continue to do this because she is more than an old lady.

She’s my mom.