Lifeline, a publication of the National Continuing Care Residents Association, Volume 2, 2025, By Charles F. Finley
Charlie Finley has lived in independent living at a CCRC near Richmond, Virginia, for the last five years. Email: charfinley@mindspring.com.
Doubtless, there has never been a book like this written expressly for us senior citizens. Jill Vitale-Aussem’s Disrupting the Status Quo of Senior Living is not an anti-management diatribe—far from it. It’s a wake-up call, a challenge to the deeply ingrained paternalism in Continuing Care Retirement Communities (CCRCs) that treats independent residents more like clients than community members. The book’s message is simple but profound; It’s our life, after all.
Vitale-Aussem writes from experience—having spent over 20 years in senior living leadership—and she’s a former president and CEO of The Eden Alternative, a nonprofit organization focused on improving the culture of elder care. Her central argument is that most CCRCs are stuck in an outdated “service” model, where safety and risk avoidance are prioritized over autonomy and community engagement. She calls it “surplus safety”—the idea that so much effort goes into protecting residents from risk that it erodes their independence and personal choice.
Paternalism and Surplus Safety
Chapter 8 tackles the heart of the problem: paternalism disguised as care.
The examples are maddeningly familiar to anyone living in a CCRC:
- Bird feeders are forbidden because they might attract squirrels—and, theoretically, a rabid squirrel could bite a slow-moving resident.
- Residents are not allowed to move tables together so that a group of eight can sit together. You must call for service, as if you were in a hotel, not your own home.
- Staff insists on handling every minor issue “for your own good.”
One forum contributor summed it up well:
“Our Residents Council is structured to make us feel like we have a voice. In reality, management listens politely, thanks us for our input, and then does exactly what they had already decided to do.”
This overprotective, service-oriented model might be understandable if residents were truly frail and dependent. However, in independent living, it can be infantilizing. As Vitale-Aussem puts it, “After the management began to let go a bit, we went from an institutional disjointed culture to one of inclusivity and empowerment”.
Token Resident Involvement
Many CCRCs have ad hoc task forces where residents are invited to “contribute.” But as the book points out— and as many residents can confirm—the input from these groups is frequently ignored or dismissed.
One forum participant wrote:“Our board president claims that any resident who is a board member has a conflict of interest and must not participate in financial discussions. Seriously? Residents have given CCRC corporations an unsecured and non-interest-bearing loan—we carry all the financial risk. That’s not a conflict of interest; it’s a stakeholder interest.”
This mindset reflects a deep structural flaw: management holds the decision-making power while residents are treated as customers, not community members. It creates a culture of dependency where the executive director is seen as the one who must fix all problems. That dynamic leads to both entitlement and frustration. As Vitale-Aussem argues, real change will happen only if management lets go, when residents are treated as partners, not dependents. One of the recurring messages is that management must be willing to share power and decision-making with residents.
Financial Transparency and Governance
Vitale-Aussem’s book doesn’t just call out cultural issues, it points to serious structural flaws in how CCRCs are governed. Financial transparency is a significant issue. Too often, residents are kept in the dark about the financial health of their community—until it’s too late.
One CCRC in a southern state was praised in the local press for its management and happy residents, right up until it declared bankruptcy in 2024. Will residents be made whole for their entry fees? That still is unclear. This lack of transparency is baked into the governance model. Many CCRC boards are composed of volunteer, non-paid members who rely almost entirely on the CEO’s reports. As one forum contributor wrote:
“Dysfunction happens when boards become isolated from residents and rely solely upon management to report and interpret the state of the community.”
Vitale-Aussem argues that residents should have the same access to financial information as bondholders. After all, residents’ entrance fees and monthly payments are the financial foundation of the community. Yet in many CCRCs, residents are treated as customers rather than stakeholders.
Pennsylvania resident described the problem clearly:
“Our board president claims that residents are not
entitled to financial data. The problem isn’t the law—it’s that boards don’t take their accountability to residents seriously.”
Empowerment Through Partnership
Vitale-Aussem calls for a fundamental shift from a service model to a partnership model. Residents have vast professional and life experience, but in many CCRCs that expertise goes untapped. One example from the book stands out: a presentation by a CCRC board to a group of 200 residents included a question about whether they understood the concept of compound interest. Seriously? As the author notes, this kind of condescension reflects the underlying assumption that seniors are no longer capable of independent thinking.
But there’s another way. Clermont Park, a CCRC where Vitale-Aussem works, underwent a transformation when management began to trust residents to help solve problems and make decisions. The result was not chaos—it was a more connected, vibrant, and engaged community. As Roger Landry, author of Live Long, Die Short, writes on the back cover:
“This book is not a wrecking ball. It is a tough love guide to doing the magnificent things we all do in senior living, in a better way.”
A Call to Action
Vitale-Aussem’s message is clear: If residents want to reclaim agency, they must be willing to push back. She offers practical advice on how to organize, how to advocate for board representation, and how to demand greater transparency and accountability.
Some questions to ask yourself:
- Do you know if your board members ever question the CEO?
- Are residents allowed to attend board meetings, or are they permitted only to observe?
- Do you have access to the CPA audit of your community’s financials?
- Does your CCRC have resident representation on the Board of Directors?
If not, why doesn’t your CCRC have resident representation on the board?