Dining decision brings discrimination issues in aging to forefront; lessons for reporters

Judith Graham

About Judith Graham

Judith Graham (@judith_graham), is a freelance journalist based in Denver and former topic leader on aging for AHCJ. She haswritten for the New York Times, Kaiser Health News, the Washington Post, the Journal of the American Medical Association, STAT News, the Chicago Tribune, and other publications.

Paula Span of The New York Times clearly struck a nerve with her recent story about an upscale retirement community’s decision to exclude certain residents from its country-club style dining room.

The residents in question lived in assisted living apartments or a nursing home that are part of the Norfolk, Va., continuing care retirement community (CCRC).

For years, some had eaten in the main dining room, with its white-clothed tables, fancy food and nice views, without a fuss.

But last year, management at the complex decided that only people residing in independent living apartments could take their meals there.

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

Residents of assisted living would have to eat in their own dining room, as would nursing home residents, management declared.

Yes, it’s a form of segregation, based on older peoples’ relative health.

And yes, it speaks to a little-discussed hierarchy often found among the old, with those who are “well” – active, mobile, without significant impairments – on top and those who are sick or disabled on the bottom.

We might not like to acknowledge this aspect of aging, but it’s a reality in all kinds of settings, including nursing homes where more “with it” residents often look down on those with significant cognitive or physical problems.

More than 150 people wrote in to comment on Span’s article, which appeared in the paper and on the Times‘ New Old Age blog. Many said they had experiences of the same sort.

MJ of New York City wrote, “A similar issue came up in my mother’s CCRC. Some residents wanted people who used wheelchairs to be barred from sitting in the spacious front lobby because they thought it was ‘depressing’ to see fellow residents in wheelchairs.”

An East Coast reader using the pseudonym DemocracyNow noted:

“When my father was in assisted living, I saw this kind of discrimination practiced not by the facility, but by the residents themselves. Healthier patients would form cliques, like the cool kids in high school, and would sit at their own tables. Those who were perfectly healthy enough to engage in lively conversation, but were saddled with walkers or a wheelchair or an oxygen tank, would be banished to the outer reaches of the dining room, sometimes left to eat alone. It was a sad sight.”

Many readers called the practice of segregating CCRC residents at meals “appalling,” “disgusting,” “mean spirited” and noted that the practice appeared driven by fear.

Kate in Boston commented, “The residents in independent-living situations are looking at what can and very likely will happen to them over the next several years and it terrifies them.”

Curtis Selden Cone of Berkeley observed that the story spoke of “prejudice against the process of aging itself, which often involves physical frailty. The irony of the exclusion is that the individuals who are supporting this, may find themselves being excluded in the near future due to some disability.”

Others suggested that some kind of compromise was probably necessary.   When people are seriously disabled, unable to eat on their own, and require extra assistance, it’s probably appropriate for them to eat in a separate space, several said.  In this the case, dining rooms for more disabled residents should be similarly comfortable and inviting, they added.

Indeed, the CCRC that Span wrote about eventually let assisted living residents eat in the main dining room if they passed a functional assessment and if they had transitioned to assisted living from independent living. But nursing home residents remain excluded, as do people who move directly into assisted living when they enter the facility.

This story holds important lessons for reporters writing about aging and health:

  • Don’t assume that negative attitudes about being old and frail are held only by the young. Deeply ingrained cultural values favoring youth and vigor often remain with people through their own latter years.
  • Don’t think of the elderly as being a monolithic population. They’re not. The kinds of divisions that characterize people throughout their lives – differences of wealth, health, education, temperament and more – remain as people age and shape their preferences and experiences.
  • When you write about senior housing, be alert to the culture of senior housing facilities as well as health or safety concerns. Are these facilities inclusive? Or are healthier residents treated differently than more disabled residents? What do the people who live in these facilities say about their own situations?

Update: Elizabeth Simpson of The Virginian-Pilot published her own take on this CCRC’s controversial dining policies today.

Watch for a tip sheet with detailed information about senior housing on this site in the months to come.

2 thoughts on “Dining decision brings discrimination issues in aging to forefront; lessons for reporters

  1. Pingback: Retirement center modifies dining policy following media coverage : Covering Health

  2. claire robertson

    Interesting piece. More info.: Meadowood Retirement Community in Bloomington, IN, goes even further. It has no assisted living facility on the property, although it has independent living and nursing home facilities, and seniors must buy into it for the future to stay there (this might have changed). Meanwhile, the independent living facilities are not equipped for those with disabilities, and people with wheelchairs or walkers are not allowed in the communal dining room, I understand. So, if someone needs assisted living, they must leave the facility. It’s a very strange arrangement that caused us to turn it down as a hospitable place for my mother’s last years. They would not take her, in any case, because she needed assisted living.

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