In the wake of 98-year-old S.F. woman's death, questions swirl about independent living

Apr. 4—During the two years Ann Strong lived at Las Soleras Senior Living center, she assembled jigsaw puzzles in her free time.

Sometimes, she said, another resident of the facility joined in.

The woman was "the sweetest friend," Strong recalled, but she repeated things. She often wandered. And she had a propensity to jam puzzle pieces into the wrong places, into spots where they didn't fit.

Strong said she worried her friend's medical needs weren't being met at Las Soleras — a facility located just off Beckner Road that bills itself as independent living — designed for seniors who don't need help performing daily tasks.

"She really shouldn't have been there," Strong said of her friend. "Maybe it was bordering on irresponsible."

It's a familiar story among current and former residents: Several claimed Las Soleras accepted new residents whose needs exceeded the bounds of independent living.

Their concerns gained added heft following the death of Esther Barnes, a 98-year-old resident of Las Soleras whose body was found March 17 after she apparently wandered away from the facility two days earlier. At the time, Barnes had lived at Las Soleras for only a matter of weeks, one fellow resident said.

Barnes' death casts a spotlight on one of the central challenges of independent living: Who's to say whether someone can live on their own?

The question weighs on a rapidly growing segment of the state's population — people considering how they will live, where they will live, as they age.

In the wake of Barnes' death last month, her family is in the early stages of a wrongful death lawsuit, said Brian Egolf, their attorney.

Family members described Barnes — a longtime teacher with a master's degree from the University of California, Berkeley — as intelligent and adventurous but experiencing cognitive decline. Egolf declined to comment on whether Las Soleras was an appropriate facility for Barnes, stating factual allegations pertaining to the case will appear in future legal filings.

"Their job is to keep the promises that they make to residents and to families about services provided and whether or not Las Soleras is an appropriate place for each and every one of their residents," Egolf said.

William Swearingen, a spokesman for Las Soleras Senior Living, wrote in an email Las Soleras is designed for seniors looking to live independently, with residents "free to come and go as they see fit."

"Please know that we continue to value the trust put into our community by our residents and their families and are devastated by this tragic loss," Swearingen added.

Officials with New Mexico's Aging and Long-Term Services Department declined to comment on Barnes' case specifically. In general, determining the most appropriate living situation and care for elders is a complex and emotional process, said Kris Winterowd, a director at the department.

What's clear, however, is this: Appropriate care for elders who live largely on their own, whether in congregate situations, with family or even in their own homes, is largely a matter of chance and choice. For myriad reasons — financial, personal, emotional, familial — experts say seniors who seemingly shouldn't live independently often do.

"Making that decision about what is the least restrictive environment for someone — can they handle being in their home? Is it time to move to a different level of care? — it is excruciating. It is excruciating for people," Winterowd said.

"Unfortunately, sometimes it takes a terrible event for people to even realize how bad things have gotten."

'A complicated, individual negotiation'

Senior living centers — an umbrella term that includes at least a dozen facilities in Santa Fe County, according to New Mexico Department of Health records — exist on a ladder of increasing care needs.

Independent living is the first rung of that ladder. Residents of independent living facilities manage their own affairs, though they may use facility amenities for meals and entertainment, said Sheri Jones, ombudsman supervisor at the Aging and Long-Term Services Department.

"Whenever you think of independent living, I want you to think of it the same way as you would just living in your home," Jones said. "You don't need any type of assistance; you conduct all your own business."

A copy of one Las Soleras lease agreement obtained by The New Mexican says as much. Though residents can contract caregiving services on their own, the lease discloses Las Soleras staff will not supervise resident activities or care. In contrast to other independent living centers in the state, Las Soleras does not offer step-up options to higher levels of care on-site, according to the facility's website.

"The Resident understands and agrees that the Community is not licensed to provide and will not provide the Resident with assisted living services or skilled nursing services of any kind," the lease states.

Beyond independent living, Jones said there are several rungs higher on the ladder of elder care, including:

* Assisted living, in which residents need help with daily, largely nonmedical tasks like bathing or preparing meals.

* Skilled nursing facilities, which are staffed with professionals 24/7 to provide medical care — like administering IV antibiotics or providing physical and occupational therapy — directly after a hospital stay.

* Intermediate or long-term care facilities, which provide skilled nursing care for extended periods of time.

* Memory care, a type of specialized care for people with some form of dementia that can take the form of either assisted living or skilled nursing care.

Though the state Department of Health regulates a variety of health care facilities — including assisted living centers and nursing homes — it does not license independent living facilities, spokesman David Morgan confirmed.

That's because, Winterowd said, "There's no care component at all in independent living."

There is one more complicating factor in this ladder of senior care: insurance. Short periods of skilled nursing — after a qualifying hospital stay — are covered by Medicare, and there are Medicaid programs in place to assist seniors with home- or community-based services and long-term care needs, Winterowd said.

But insurance won't pay for independent living.

Jones cited one of the primary reasons why elders choose independent living facilities: cost.

An apartment at Las Soleras isn't cheap — but it is more affordable than the monthly rate for assisted living. According to its website, rent in the community averages around $2,600 per month, a price that includes utilities and breakfast each day.

Jones estimated the going monthly rate for assisted living is about triple that cost — somewhere between $7,000 and $8,000 per month.

"Individuals are probably using their retirement checks ... to pay for their independent living facility, and they don't have the $3,000 to $4,000 extra that [they] might need to pay for assisted living," Jones said.

Cost, combined with the difficulty of leaving one's home and aging adults' entitlement to autonomy, make determining the appropriate level of care a sticky and emotional process.

"Somebody can clearly be living in substandard conditions and making bad decisions — objectively bad decisions — but if they have the capacity to choose for themselves, then they are allowed to do so," Winterowd said.

"So that makes how much care a person is getting just a complicated, individual negotiation."

'It's just not designed for it'

While Linda Gonzalez lived at Las Soleras, she often encountered a woman who wandered the facility in pajamas and without shoes. The woman didn't sit with or speak to anyone.

And because she didn't swing her arms while she walked, the woman received a nickname from fellow residents, Gonzalez recalled: "The Zombie."

Gonzalez, who lived at Las Soleras for two years before moving out earlier this year, worried the woman — and other residents like her — weren't suited to an independent living facility.

The New Mexican spoke with seven current and former residents of Las Soleras; all lived there within the last three years.

Though some declined to be named, all said the facility housed residents who they believe needed assistance with daily tasks but had no caregiver.

Las Soleras spokesman Swearingen reiterated the center "caters to residents who want to live independently" and does not provide any supportive care, rehabilitation or skilled nursing services.

The coup de grâce of Annie Johns' experience at Las Soleras was a pile of feces on the hallway floor, a few doors down from her apartment.

It was late 2023, and Johns had lived at Las Soleras for about a year. At that time, Johns said, her dog was the only animal living in that wing of the building.

She worried the feces came from another resident — one of many in the facility, she claimed, who couldn't independently care for themselves.

Johns said it remained on the floor for four days before it was cleaned up.

"In a million years, I wouldn't put a loved one who was handicapped in any way there," Johns said. "It's just not designed for it."

Linda Flatt, who worked as a concierge at Las Soleras for six months in 2022 and 2023, said she was instructed by management not to assist residents with daily tasks, like retrieving packages, or in the event of a medical emergency, like a fall.

The facility may have changed since she worked there, Flatt noted, but she said she worried Las Soleras was welcoming new residents without regard to their their care needs.

"Many seniors cannot afford the expensive places that are really nice for assisted living," Flatt said. "So they are opting to do something like Las Soleras — where it's supposed to be independent."

She added, "This is a deeper, deeper problem that is going to happen with seniors everywhere because there are so many more seniors who are now living longer."

'You should know if the people can live independently'

Several current and former residents argue there's more Las Soleras could do to ensure residents are safe, especially in the aftermath of Barnes' death.

Some suggested Las Soleras officials should ask prospective clients if they are, in fact, independent.

It's common for independent living facilities to visit with would-be residents, typically offering them a tour and asking some questions to determine whether the facility is appropriate for their needs, Jones said.

Still, she added, prospective residents are allowed to make their own decisions, based on their own circumstances.

When she moved into Las Soleras, Strong said no one asked her about her independence. She wouldn't have minded answering questions; she said she would have been willing to complete an entire survey.

"Doesn't it make sense that if you're advertising something — 'We're an independent living community' — you should know if the people can live independently?" Strong asked.

Part of that question will play out in court as Barnes' family moves forward with a wrongful death lawsuit, Egolf said.

"Accountability and justice are the absolute foremost concerns of Esther's family," he said. "The family wants to also make sure that every resident at Las Soleras is there only if it's an appropriate place."