In Rhode Island, 29% of people age 65 and older live alone (American Community Survey; U.S Census Bureau 2021). Many are facing complex and urgent health or life events with no clear guidance or support. Each lives with the risk that life as they knew it could change in an instant–with the possibility of calling a nursing home home. Here is one story.
Alice is 88. She worked for decades in retail starting out as a clerk in a chain store and worked her way up to management. She was secure in her finances in retirement, and proud of the home she made for herself and her daughter. She bought her small home in a quiet neighborhood over 50 years ago, where she was able to live comfortably and looked forward to creating new and simple meals, “with lots of cheese and vegetables.”
With no family nearby, Alice formed tight bonds with her neighbors who have known her for years. “My neighbors are my family,” she said.
For years, Alice mowed her own lawn and tended to her flowers. But as the decades passed, as they do for all of us, things began to shift. One summer, a neighbor noticed that the grass was growing very tall and stepped in to take over, he helped with shoveling too. Another neighbor took the time to visit regularly for coffee and conversation. Others were always stopping by. Alice felt connected, supported and at home. Life in her neighborhood was familiar and nourishing.
Alice was fortunate. The old-fashioned neighbor-helping-neighbor spirit, often ignored today, lifted not only Alice but the whole neighborhood.
Last summer was a tough one for Alice. After a fall, it was a revolving door of four emergency room visits combined with rehab, then back home again. In the fourth round, last fall, she landed at a nursing home and has been there ever since. Her daughter lives “far away and I don’t want to bother her with this.” Her daughter hasn’t visited since December. Neighbors visit regularly to brighten her day, “but they have lives.” Alice was told by the social worker that “you can’t go home” with no advice on how she can. Resourcefully, from her nursing home bed, Alice, who is proudly independent, started making plans. She recruited the help of a neighbor, Janice, who helped her find the right realtor to sell her home. With the neighbor as her advocate, Alice was able to locate an apartment with wheelchair accessibility. It’s now furnished and ready to go. Two months ago, her Medicare coverage ended and she has been paying over $10,000 a month privately.
I had the privilege to meet Alice a few weeks ago at the nursing home and what was supposed to be a 30-minute consultation turned into a nearly 3 hour visit. Pleasure would not be the right word to describe meeting Alice. Her energy, determination for advocating for herself, feistiness and compassion for others put me in a mesmerized state of pure joy.
When I arrived to visit Alice, I was greeted by the receptionist. It was on the weekend and aside from one staff member walking by, the building felt empty. I walked a long corridor to the elevator, then another stretch to Alice’s room. If I hadn’t peeked into rooms on the path to Alice’s, I would have thought I was alone in the building. It was about 1:30 pm. I saw one resident reading, another resting in bed, one watching TV, another in a wheelchair staring out the window. They had one thing in common: each was alone. When I got to Alice’s room, she was napping.
“Hi, I’m Helen. Your neighbor Janice called me and said you may like to talk with me. She said you’re planning to move to an apartment and you may need help with setting up services.”
“Oh, hi Helen, sorry, I was taking a nap” Alice said, adjusting herself in bed.
“I heard you’re unhappy with the food here, so I brought you some chicken soup.” I said.
“Yes, I have been losing weight, I’m missing my food. I’ll have this for dinner–thank you.”
Talking with Alice was like having coffee with a friend in need of a friend.
I told her what a pleasure it was to meet Janice. Her eyes welled up “I can’t believe how much my neighbors have done for me. I don’t know what I would have done, she always smiles and is happy to help me. She is like a daughter to me. I’m sorry I’m emotional.”
Alice sits up tall. She has a fun, no-nonsense way with words–she’s outspoken and well–just cool. She asked me to shut the door of her private room. She didn’t want anyone to overhear what she was about to say. I went to the door, looked left and right–not a person in sight–and I closed the door.
“There is no one here. I hardly see anyone. There is not enough staff, and–except for five people–Alice puts her hand up to show the number five– “everyone is abrupt and impatient. They need to get to the next person.”
“I was in the bathroom, on the toilet, the door was closed and an aide walked in with my pills in hand and said ‘time to take your pills.’ I couldn’t believe it. Another time, I refused to take my pills–I knew they didn’t have the right ones. I never took a yellow pill. I challenged the head nurse who was not kind in return. When I demanded she double check, she came back and apologized.” Alice was clearly appalled.
As we talked more, Alice told me she is afraid–afraid of the uncertainty of her future, and afraid she wouldn’t be able to leave the nursing home. “I did have rehab but there is not a lot they can do anymore. Since my fall, I am strong enough to walk with a walker and make sure I walk the halls a few times a day. I’m in a lot of pain and I’m trying to manage that. I’m afraid to take strong pain medication. When I asked the social worker about going home he said ‘there is no home for you. It’s unsafe there. You need to stay here.’ I don’t understand why I need to stay here. That’s why I got my neighbor to help. There’s no one I can talk to here.”
Alice understands she can’t live without support and may need assisted living. She’s open to that and financially able to pay privately, but would like to try the apartment with home support to see if it’s something that can work.
When I asked what matters most to Alice, the whole person, as she approaches her 90th birthday, she didn’t hesitate.
“I want to cook a simple meal in my new apartment and I want to live as close to my neighbors as possible.”
Let’s try to get Alice home.
There are details of Alice’s experience that I haven’t shared. Some are too painful, others too complex for a single story. And I want to protect her privacy. But what matters most is this: we can’t fix what we don’t face. How do we uncover the good and hard stories so we can face them and fix them together? The system doesn’t consider what matters to Alice, to you, or to me.
Transparency isn’t about blame–it’s about listening to voices like Alice’s and recognizing the role each of us plays as fellow neighbors. Not just neighbors who live nearby but as fellow humans united by humanity and not separated by age. If we want better–and I do–let’s walk the road forward together. Let’s start the conversation.
To protect the privacy of those involved, names or specific places have been changed or omitted. This account is based on a recent visit to a nursing home in Rhode Island. While there are many positive stories in nursing homes, this piece focuses on what’s not working and how shortcomings impact the quality of life for one individual whose voice deserves to be heard.