Lessons in Senior Living from the Book: “Bed Number Ten”

Institutional Practices, along with loneliness, helplessness, and boredom, diminish well-being and dignity. What we can all learn from one person’s story.

Last year a team member from The Eden Alternative recommended the book Bed Number Ten, written by Sue Baier and Mary Zimmeth Schomaker. The book recounts Sue’s experience in a Houston hospital over 10 months when she battled Guillain-Barre syndrome. The disease left her paralyzed except for her eyelids, but she remained mentally alert. She could only communicate by blinking. She was entirely dependent on tube feedings for nourishment and a respirator to breathe.

Her journey included some wonderful caregivers who became family but also included many horrible experiences that highlight the impacts of institutional practices on well-being. As The Eden Alternative teaches, it is not the people but the processes that are broken, and that was very true in this story.

In the book she draws parallels to her father’s experience in a nursing home while living with dementia. She wondered how his care-or lack thereof-affected his well-being in ways she never knew. Her story serves as a cautionary tale, reminding us of the need to push for continued change in our healthcare system.

While things have improved greatly since 1980, many institutional models remain in place. She was often frustrated by the same issues we see today-fragmented care, high costs and poor communication across doctors and disciplines. However, the greatest impact on her well-being came from the day-to-day care she received.  which caused her to experience the three plagues -loneliness, helplessness and boredom. The purpose of this blog is to demonstrate the effects of her care on her well-being using some of The Eden Alternative Domains of Well-Being®.

Deep Desire for Meaning

Many people assumed Sue could not have meaning in her life due to her incapacitation. How could she, given her condition? Yet she yearned for meaning constantly. She was allowed visitors only three times a day, for fifteen minutes each. The rest of the time she described as empty, spent watching the clock on the wall.

Her husband helped to provide meaning by including her in decisions and asking her opinions about their daughters and family activities. A visit from her pastor gave her another sense of purpose. He told her about a sick member of their congregation and suggested she pray for them. She wrote, “He gave me a new, positive sense of responsibility.”Many residents in senior living communities likely feel the same way. Due to cognitive or physical deficits, others assume they cannot contribute meaningfully. This is especially true for people living with dementia. Too often, we assume cognitive impairment eliminates the possibility of meaningful engagement, but meaning is essential to well-being and aging well.

Sue also noted how death lacked meaning in the hospital. When a patient passed away, the staff would close all the curtains so others couldn’t see the body being taken away. This made her depressed and anxious. Even today, some nursing homes close doors when a resident dies so others won’t see their friend leave. Removing meaning from death also removes meaning from life. At Clermont Park Senior Living in Denver, CO, when a resident passes away, staff and fellow residents line the hallway to sing Amazing Grace or another song the resident had chosen. The deceased leaves through the front door, creating a powerful and meaningful farewell.

Loss of Identity and Security

During her hospital stay, Sue experienced a profound loss of identity and security. Staff often referred to her as “Bed Number Ten” rather than by name. Some senior living communities still refer to residents by their room numbers, likely making them feel the same way Sue did—like they are no longer individuals.

As Eden teaches in Principle 7: “We are more than our medical diagnoses. Medical treatment should support and empower us to experience a life worth living.” Unfortunately, that was not Sue’s experience. Many staff members saw her only as a diagnosis in need of treatment rather than as a human being. She wrote, “…no one asked if I needed anything. I had become fused into the inanimateness of that huge wooden chair that held me.”

Staff provided medical treatment without explaining what they were doing, which often caused Sue fear and pain. We see similar situations in senior living communities. When care partners fail to explain procedures to a person living with dementia, it can lead to fear, frustration, or even agitation. Providing a sense of security is essential for the well-being of those who cannot fully advocate for themselves.

Eden Alternative Principle Seven: We are more than our medical diagnoses. Medical treatment should support and empower us to experience a life worth living. 

No Autonomy

Sue had no autonomy. She could do nothing physically for herself, and everything was done on the hospital’s schedule, not hers. Her preferences were disregarded, as staff made decisions for her, assuming they knew what was best. We see this in senior living as well. Well-intentioned staff often dismiss residents’ preferences in favor of what medical guidelines dictate.

At one point, as Sue began recovering, therapy staff felt she took too long to eat breakfast, which cut into her therapy time. However, she knew that eating was crucial for maintaining the energy she needed for therapy. Rather than listening to her, the therapists reported to her husband that she was being “non compliant” with treatment. How often do we see similar care plans in nursing homes or assisted livings? A resident is labeled as “non compliant” simply because they have a different opinion about what’s best for their own care.

Need for Connection

Some hospital staff were cold and mechanical in their approach, performing treatments with no personal connection. Sue longed for human interaction, even in her paralyzed state. Her best memories involved staff who connected with her on a personal level. One nurse shared the news of her pregnancy with Sue before telling anyone else. Another sought her advice on planning a wedding. A third would tell her stories about her cats. Sue described these moments as “bright spots.”

This is a powerful reminder of the importance of relationships in senior living. Residents thrive when staff members truly know them, and vice versa. It’s always touching when staff bring their spouses or children to visit, allowing residents to get to know their families. These moments build a greater sense of community and break down the barriers between staff and residents.

Connections with family were equally vital to Sue. Visits from her husband and children were essential to her mental well-being. The same is true for residents in our communities—family visits provide a deep sense of comfort and belonging.

Final Thoughts

There is so much more that could be explored from this book. It is a must-read for anyone working in healthcare. Sue’s experience is a powerful example of the negative impacts of institutional practices and the toll they take on patients. That is why the work of organizations like The Eden Alternative is so crucial. They strive to change these practices and shift the focus toward well-being, dignity, and person-directed care.

About The Eden Alternative

Our Mission: To improve the well-being of Elders and their care partners by transforming the communities in which they live and work. 

The Eden Alternative offers educational opportunities, consultation and a proven approach to honoring Elderhood – with resources for Elders and their care partners to elevate well-being.