One issue not often mentioned these days, among the many political issues talked about in 2024, is the challenge faced by older adults who need to reside in assisted living facilities.

The issue is not a new one. I can remember as a kid 70 years ago hearing about “old age homes,” which since then have been referred to as “nursing homes,” “convalescent homes,” “assisted living facilities” and/or “residential care” places.

Over the past seven decades nursing homes haven’t often made the news, unless something really bad happens. A few years ago, a nursing home in Texas made the news because, when flood waters came, the residents were essentially abandoned, with some stranded in waist-deep water.

Last month a nursing home in Missouri was in the news because one day it suddenly closed without explanation and a man was lost in the ensuing confusion for three weeks before he was found wandering the streets.

Closer to home, an assisted living facility in Dos Palos that didn’t make the news a few years ago had to close because of financial difficulties. This was particularly disheartening because it was a well-run facility that cared for its residents as though they were family members. It just couldn’t afford to stay open.

Assisted living facilities today face many challenges. Their residents are usually fragile and need compassionate and professional care. Meanwhile, in many assisted living facilities, the staff is not paid particularly well, especially if the facilities are owned by for-profit companies trying to make big bucks.

These for-profit corporations often increase profits by hiring insufficient staff and reducing residents’ care to a minimum. A few years ago, I visited my father-in-law in a nursing home in another city run by a for-profit corporation, and the lack of care and attention paid to him was appalling.

From my experience the best assisted living facilities are run by nonprofit organizations. Their goal is not to make money for distant shareholders but to simply break even.

Over the years in America the best examples of compassionate nursing homes were those run by Catholic nuns who believed their job was a vocation, a calling to serve those in need. It also helped that the nuns had taken the vow of poverty; they weren’t paid much and that helped the facilities break even.

I’m not naïve enough to believe all Catholic nursing homes have been ideal places. There are enough examples of these homes over the past century treating residents poorly–not surprising, since all people are capable of misdeeds, often explained by Christians as original sin.

I don’t envy administrators of assisted living facilities. They operate on a very tight budget, and they have to be well versed in governmental and insurance procedures.

These administrators are bound by many governmental rules and regulations, created mainly to protect residents, many of whom are vulnerable to inappropriate acts, whether by omission or commission.

This brings me back to the opening of this column. Why isn’t there more discussion on both the state and national level about assisted living facilities? Every year this becomes a bigger problem because each year the number of older adults who need assisted living increases, some of which can be attributed to the aging of baby boomers.

The reasons why older persons may need assisted living care are many and diverse. Perhaps the most common is that they can no longer live independently or be taken care of by family members. Often these older adults have problems like decreasing balance or increasing incontinence.

One of the positive aspects of American life is that people live much longer than they used to. The life expectancy of a person in 1924 was 60; in 2024 it’s 75. A challenging consequence of this good news, however, is that more people need assisted living than ever before.

I haven’t heard any politician lately discussing this issue, maybe because it’s so complex or maybe because politicians don’t care about folks in assisted living facilities because they think these residents don’t vote. That wouldn’t surprise me, because so often assisted living residents are “invisible” to the rest of the world.

In the complexity of assisted living challenges, the first issue is financing. What can and should be done to help well-run assisted living places stay open, places like the one in Dos Palos that had to close?

Another issue is that for-profit companies are trying to make a bunch of money off vulnerable and fragile senior citizens. Is there enough government oversight of these facilities?

Another issue is determining the right about of regulation for assisted living places, not being burdened with so much regulation that the facilities become bogged down and overwhelmed with paperwork, but having enough regulation to ensure that each resident within the facility is consistently treated with the dignity and the respect they deserve and get the professional care they need.

I hope this issue gets much more attention. Maybe the reason assisted living facilities are so important to me, at age 78, is that one day I may need to live in one.

If I do, I would want to live in one that puts the care, dignity and human rights of each individual over money, prestige and reputation.