Recently, I was working with The Edward King House Senior Center, The Senior Agenda Coalition of Rhode Island (SACRI) and Age-Friendly Rhode Island to bring an invitation-only screening of the film Involuntary and a panel discussion to Newport. While this screening has been postponed, one thing became clear to me: many people don’t know what an involuntary discharge is. If you’re aging yourself or helping to care for an aging parent, this is something worth understanding.
For the filmmakers, Dana White and Chris Knoblock the film represents a piece of art, a telling of a story that while extreme, is not impossible. It represents one end of the spectrum of what an involuntary discharge can look like and can be difficult to watch for that reason. White and Knoblock were scheduled to be a part of our panel discussion and when I asked why they chose to tell this story, White shared:
“We use cinema not simply to tell our stories, but to invite reflection, empathy, and awareness. Many of the films we write focus on themes of aging and the treatment of older adults. We hope that Involuntary can help encourage thoughtful conversations about how best to care for older adults in our communities. It’s an important conversation to have and one that touches all of us at some point in our lives.”
While the screening offers a powerful starting point for conversation, it represents just one point on a much broader spectrum. Involuntary discharges happen daily across our state and the country with effects that range from temporary disruption to profound displacement.
Let’s start with a basic description of how this can happen.
An involuntary discharge occurs when a person’s care needs exceed what a particular care setting – such as a hospital, nursing home or assisted living facility – is designed, licensed or reimbursed to provide. When that limit is reached, an involuntary discharge may follow. Patients and families don’t fully understand what is happening until they’re facing it, which can leave them feeling caught off guard.
The word involuntary is important to you and me, and to the healthcare system. When something is involuntary, it means you didn’t choose it and often didn’t plan for the next step the system, by design, presents. That next step may involve a move to a place that is unfamiliar, and isn’t ready or equipped to support evolving care needs. In some cases, that step may be a return home; in others, particularly in behavioral health, the question becomes: what’s the next step?
I asked Carol Anne Costa, Executive Director of SACRI, why awareness of involuntary discharges and starting a conversation across every level, needs to start now.
“From an advocacy standpoint, involuntary discharges represent a challenge for Rhode Island families, caregivers, and long-term care facilities and hospitals. At the same time, the mere awareness of this issue offers a path forward toward meaningful policy reform. It will take common-sense regulation, a commitment to workforce training and development, public education and outreach, keen policy analysis and a concerted effort to better understand the mechanisms which help to create these unfortunate situations to begin to forge progress. SACRI is dedicated to advancing a balanced, informed strategy that protects patients while ensuring our long-term care system remains robust, healthy, and accountable.”
In my work helping older adults, I have supported many families navigating involuntary discharges from hospitals, nursing homes, and assisted living communities in real time. These situations typically involve established protocols that come into play when certain thresholds are reached. This is something local organizations that people in our community rely on every day understand all too well.
I asked Carmela Geer, Executive Director of The Edward King House Senior Center why bridging the gap between being caught off guard and building awareness needs to start now.
“At Edward King House, we see firsthand how destabilizing involuntary discharge can be. Raising awareness helps older adults and families ask better questions earlier—before choices become emergencies.”
There is concern across multiple perspectives and layers of the system. It’s clear that building awareness, and eventually addressing the issue, starts with an inclusive conversation and a willingness to examine what’s happening together.
I asked James Connell, Executive Director, of Age-Friendly Rhode Island how involuntary discharge fits into age-friendly work at the community level. He shared this perspective:
“Understanding, discussing, and being prepared for Involuntary discharges, and their deep impact on communities, should be part of age-friendly discussions across sectors. For communities embracing age-friendly principles and developing multi-sector plans on aging, it’s important to consider the potential of involuntary discharges and the ripple effects they can have on resources, services, and well-being of older residents. Creating space to proactively brainstorm potential ways to minimize disruptions, strain on services, and impacts on healthy aging is a critical part of the work.”
That perspective reflects why awareness matters, not as a solution but a starting point.
This piece is not meant to offer a solution. It’s meant to build awareness and a shared understanding of the human experience on all sides. By doing so, we can begin to have more meaningful conversations about aging and care, and better understand how and why people can be caught off guard.
Ultimately, this is about serving one another better and recognizing that involuntary discharge is a conversation already unfolding–and one we all need to understand.
Plans to reschedule the screening are underway.
Helen Hames is an Aging Advisor and Founder of Age Ambassador, based in Rhode Island. She works with older adults and their families to navigate decisions around aging at home or transitioning to senior living, recognizing the needs and priorities of today’s older adults continue to evolve with each generation. Helen’s approach centers on understanding what matters most to each individual and helping families plan with intention, clarity and compassion. Helen was honored with the 2025 Senior Champion of the Year Award for her advocacy and personalized guidance that supports older adults in living fully through every season of life.