Supporting Independence: Dorothy's Story

Older Adult


To age successfully everyone needs a place to live. Dorothy Brown is one of these individuals.  

Her backstory demonstrates how low-income adults with a little support can avoid less desirable housing placements. Without functional support many older adults end up in places that are expensive and compromise autonomy. Independence is especially valued by older adults. Pain, anxiety, depression, breathing challenges, frequent hospitalization, poor nutrition, inability to navigate outpatient care are all factors which push individuals to higher levels of care. While the price of independence is unmeasurable, the cost of living in facilities with skilled care is not negligible. These places include nursing home care ($100K/year), out of pocket assisted living ($60K/year), hospital stays ($5-10K/visit), homeless shelters ($40K/year for barracks style accommodation).

A few years ago, Dorothy Brown was dealt an unfair blow. After living independently, she contracted double pneumonia, got really sick, was hospitalized, intubated, and had a small stroke. She was discharged after a full month of being kept in a medically induced coma while her lungs healed. Recovery was challenging. Her lungs returned to normal function but cognitively she was initially not the same. Temporary confusion resulted in questionable risky behavior and poor choices which to this day she states that she cannot fathom why she did them. The family rallied and she cleared all symptoms except for forgetfulness that resulted in her taking too much medication sometimes or not enough other times. Her daughter provided her with a room in her home and asked her to not smoke. While her daughter was at work, Dorothy went into the fire stairwell to sneak a cigarette. She doesn’t remember falling but found herself upside down, against the wall, at the bottom of the stairs with a broken hip. It was decided that Dorothy could not live there safely.

Recovery has been hard but Dorothy is an optimist and on-the-mend following a stint in a rehab facility. With no financial reserves and care needs exceeding what her family could provide she was fortunate to find placement in a Medicaid-funded assisted living facility. There, they provide support for low-income older adults with functional needs. The support provided to Dorothy allows her to live independently. She maintains a tastefully decorated single room apartment adorned with crayon-colored pictures from grandchildren and polaroid pictures of herself from the 70’s when she was a younger, stylish, and hip African American woman. She attends physical therapy and medical appointments as an outpatient. While at her home she does extra work to build strength and heal. She is a regular at chair aerobics and music appreciation/dancing in the community dining hall. It’s been challenging since she moved in due to social distancing and other COVID measures. With the improvement of COVID vaccination in the city, newly opened recreational opportunities are allowing her the ability to socialize with other individuals who found themselves in this unique lower cost environment in the Bronx. Aside from the administration of scheduled medications, Dorothy continues to live an independent and active life. Each day of independent living is a bonus to her and a financial savings to society that does not need to pay for higher levels of care.


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