Ever since I read this article about a bingo controversy at a continuing care retirement community (CCRC), the issues surrounding it have been rolling around in my brain.

Just in case you are not aware, a CCRC is a retirement housing option that offers various options from Independent living to assisted living to Nursing home care. As a person’s health deteriorates, they are able to move to higher levels of skilled care without having to change residences completely. Also, spouses can live within close proximity to each other while still receiving the level of care each one needs. There is usually a pricey fee to enter, but amenities are available such as dining options, housekeeping, social and recreational programs, transportation, 24 hour security and health care services such as memory care.

When she was well enough, she wanted to continue playing.  However, now, to get into the game as a non-independent living resident, she was told by the activities director that she needed a sponsor.  Her friend willingly obliged.  However, after a few weeks the staff wanted to bar her from the game and the independent care section altogether and send her back to skilled nursing.  When she refused to leave the game, half the women walked out in protest.  They felt the rules should be obeyed.

In graduated care facilities, controversies such as this crop up more frequently than you would imagine.  Bringing skilled care residents into the dining room of the independent facility, even for married couples, can be a thorny issue. Such acontroversy erupted at a CCRC in Norfolk, Va in 2012 which led to guideline changes after a DOJ investigation.

I am empathetic on both sides.  Those who are more independent want to maintain that lifestyle for as long as possible – and they have paid good money to do so.  They may want to be unencumbered, and perhaps not even see, those who have unfortunately lost their ability to be on their own.  They may dread what is coming and keeping the less fortunate out of sight may be the only way they can cope and keep the all too pervasive geriatric depression at bay.  What about the special care and supervision these patients require in facilities unequipped to deal with them?

On the other hand, where is the compassion?  Shouldn’t those of higher order abilities empathize with those who are not as strong?  Isn’t that what we strive for societally?  Wouldn’t they want the same consideration when and if it becomes their turn at that twist of fate?  What about the fair housing and disability laws with respect to “reasonable accommodations”?  Is it even legal to segregate these patients by restricting entry?

With all this as background, I thought I would try something new and interactive for this newsletter.  I would like to invite your thoughts on the subject. I am anxious to hear all points of view.  As you can see, medical, legal, values and ethical issues abound. With your permission only, I will publish some of the more interesting responses.  If you like, I will be happy to do so anonymously.  I am eager to hear your voices!