“Families see a real deterioration of their loved ones when they’re ALC."  No question. However, let's not blame ALC. It's a problem even when the individual--like my 93 year old mother-in-law-- is fortunate enough to have very good Long Term Care.

Earlier this week, we picked her up from the home and brought her into our own for the day (no steps to the main floor).  She fell. Again.  Almost preordained.  She feel 8 times  the final year she lived in her own house. No injury this time, but a realization that it is simply too risky for her to be anywhere but the long term care facility. Family will pick her up for Xmas dinner at son's home.  We have our fingers crossed.  So, her opportunities to be "outside" the home are really diminished--after only a few months in LTC. 

Deterioration comes with age. It's that deterioration that diminishes the circle of influence and narrows experience, not necessarily the places they live.  All ALC may do is speed up the inevitable process.