The National Center for Assisted Living reports that the average age of individuals in assisted living facilities in the US is 86.9 years. The average length of stay is about 28 months. Martin Bayne is an exception to the typical assisted living patient, both because of his age (he’s only 63), and, most remarkably, because of the time he has spent in assisted living. Bayne, whose movements are severely limited by early-onset Parkinson’s Disease, recently completed his 10th year in an assisted living facility.
According to an article by ChangingAging.org editor Kevan Peterson, Bayne has recently been reflecting on what matters most for residents of assisted living facilities. For him, it isn’t the reputation of the facility, the dedication of the staff, or the excellence of the programs. What matters most is whether residents find a purpose for their lives. As he put it in a phone conversation with Peterson, “Without purpose, nothing gets done, everything stays the same. People don’t move, they don’t have new ideas, they don’t grow and eventually they just give up and die.”
Bayne’s point was made decades earlier by another observer of people living in institutions. Victor Frankl wrote about his experiences in a German concentration camp during World War II. He observed that the key factor determining whether prisoners survived was whether they had a reason to struggle for survival, some purpose outside themselves giving meaning to their lives. Though concentration camps and assisted living facilities are vastly different institutions, both are highly structured systems that exert control over their residents. It is easy to see how each could sap the will to live of those inhabiting them. Though all humans wither in the absence of purpose, the withering may be especially rapid and severe in residents of tightly organized institutions.
Bayne thinks that one of the things that assisted living facilities do that interferes with a sense of purpose is that they encourage selfishness among the residents. Specifically, the focus is on entertaining residents, not on challenging them. He told Peterson, “We put people here and give them no responsibilities an [sic] that is a big mistake. It leads people to only think of themselves.” Bayne wants residents to be interested in the welfare of the community they are a part of, not just in their own comfort. He suggests the way to foster this change is to expose residents to “incremental compassion.”
I looked at Bayne’s blog for more information about incremental compassion, but didn’t find anything. I like the idea of it, though. I suspect that he’s referring to experiences that would evoke feelings of compassion for others. The Eden Alternative, which changes the culture of nursing homes to reduce loneliness, helplessness, and boredom, does this in part by providing “close and continuing contact with plants, animals, and children.” Some assisted living residents have a sense of purpose having to do with family, friends, or community. It can be as simple as praying for a troubled grandchild or sending birthday cards to friends. For those who haven’t found a purpose via such connections, though, watering a plant or feeding a puppy may be sufficient motivation to redirect attention from self to the world outside one’s skin. It can be reason enough to look forward to the next day.