SACRAMENTO — "Daily throughout this state, residents of community care facilities are being severely abused, beaten, fed spoiled food, forced to live with toilets that don't work, generally subjected to a demeaning existence and left unattended. In fact, some residents are actually killed."
The dramatic words echoed those of turn-of-the-century muckrakers, but in fact they described life in contemporary America. In a 1983 report to Gov. George Deukmejian and the California Legislature, the watchdog Little Hoover Commission was commenting on some of the state's "board-and-care" homes--refuges for the elderly where the residents are guaranteed three meals a day and some help with the routine tasks of life.
As more people live into their 80s and beyond, board and care is becoming an attractive alternative for elderly persons who do not need the round-the-clock care of nursing homes but can no longer get along at home. Usually more homelike than nursing homes, they are also considerably cheaper.
Types Vary Widely
Hundreds of thousands of the elderly live in the facilities, which range from one-bed "mom-and-pop" operations in private houses to large homes with 100 residents or more. Some homes promise little in the way of care, while others make sure residents take their medicine, help them out of bed and even assist with bathing.
"We are the answer to the population that needs supervision," declared Charles W. Skoien Jr., vice president of the California Assn. of Residential Care Homes. "I'll take you through one of our homes and I'll take you through a nursing home--then you tell me where you want your parents."
Yet some board-and-care homes operate in the shadows where the law scarcely reaches. Like nursing homes of a generation ago, board and care in many states is largely unregulated. Many of them are unlicensed, and some of them are anything but homelike.
"There are some really good homes, and I've been in some excellent ones," said Bill Benson, a staff member of the U.S. Senate Special Committee on Aging and former long-term-care ombudsman of California's Department of Aging. "But for the bad ones, you could not fictionalize them, you could not write a horror story to match what goes on there."
Last October, a man was discovered dead in a South-Central Los Angeles board-and-care home, his body locked in a closet that had been nailed shut. The manager of the Heaven's Crest home later pleaded guilty to involuntary manslaughter.
Just last month, the California Department of Social Services shut the Hilton Retirement Center in Lynwood and threatened to close Waldorf Manor in Gardena, alleging fire hazards, filth and inadequate supervision of residents. Both are owned by Los Angeles businessman Sam Menlo.
And problems extend far beyond California. Firefighters near New Orleans responded in June to an alarm at the Villa Angela Retirement Center in Metairie, La., and discovered "deplorable and uninhabitable conditions," including toilets hanging loose from the walls and rooms infested with fleas, according to a report by the governor's office. Fire inspectors shut down the converted motel, but the home's operator reportedly loaded 28 of his 45 residents into vans and moved them 120 miles north across the Mississippi state line to a former church camp he owned. One of the relocated residents wandered away and was later found dead.
For every horror story, however, there are homes where the residents live comfortably and get all the care they need. One such is Epworth Manor in Ocean Grove, N.J., walking distance from the boardwalk, where many of the 46 boarders relax on the porch under gray-and-white awnings.
"I'm very grateful for the protection of this home and the very active fellowship here," said Enola Wragg, 86, who moved there earlier this year after the death of her husband. Crab casserole and ambrosia salad were on the lunch menu that day, and a resident provided piano music for the diners.
Government Helps Pay
Residents pay $720 a month if they can. If they cannot, they can get help from government welfare programs for the elderly and from the United Methodist Church, which operates Epworth and seven other New Jersey board-and-care homes.
Similarly, in Los Angeles, the 100-bed New Garden of Roses home resembles a well-maintained garden apartment building. Saul Bernstein, the home's owner, said his family eats the same kosher food he serves the residents.
"We have our integrity," he said, "and we run a pretty good operation here. In general, I think people expect a lot worse than what they see when they get here."
Nobody knows exactly how many such homes operate nationally because tens of thousands of them are unlicensed. In California, there are 3,523 board-and-care homes for the elderly certified by the Social Services Department, up from 3,150 four years ago.