The Negative Effects Of Standardized Tests On Students And Teachers Sample Essay

America is currently involved in a continuing controversy about how to best measure the education of high school students. According to P. Thomas, the country is “currently in the midst of a 20 year [education] movement toward statewide and national standards and high-stakes testing” (63). The increase in test-driven approaches to school reform has created an uproar between students, educators, test advocates, and many other education professionals. These new testing practices have also resulted in a greatly expanded set of testing requirements for most schools that has ultimately initiated a national debate regarding the validity and value of traditional standardized tests and their negative effects on students and teachers.

Extensive research raise questions about whether improvements in test performance significantly signal an improvement in student’s learning. Recent studies, such as those of Herman and Golan, as well as Madaus and Clarke, show that rather than being a positive influence, testing, may, in fact, trivialize learning and instructional time. Similarly, there are many resources, primarily from Kohn, Henning, and McCracken and McCracken that demonstrate the repercussions testing has on teachers. As standardized testing becomes an increasingly popular assessment tool, it is critical to look at such applications and their overall effects.

The history of standardized tests lies in the recent past. Over the past thirty-five years, the American education system has experienced many changes in the area of testing, mostly as a result of the change in political climate. The idea of mandated testing began in 1983 when Ronald Regan articulated his view on the quality of public education in a radio broadcast. He proclaimed that “our education system, once the finest in the world, is in a sorry state of disrepair” (qtd. in Kornhaber & Orfield 2). He also asserted that “the quality of learning in our classrooms has been declining for the last two decades” (qtd. in Kornhaber & Orfield 2).

In addition to his assessment of the nation’s education system, Reagan demanded that higher goals and tougher standards be introduced to improve the quality and effectiveness of public schools. His administration solidified this initiative when they developed A Nation at Risk, a report presenting the state of America’s education position and the threat such a poorly managed system had on national security.

Mindy Kornhaber and Gary Orfield, in their article High-Stakes Policies, assert that “this report ultimately created a widespread perception of an educational crisis so severe as to undermine America’s economy and future” (3). The response to A Nation at Risk was eminent; 54 state-level commissions formed during the year and 26 states raised gradation requirements (Levin 47). Within 3 years, 35 states had taken the measures to emphasize increased course enrollment and testing; testing became a way to impose standards on schools and students while holding them accountable for achieving results (Miner 17).

This trend of accountability continued when politicians George Bush and Bill Clinton continued the push for standards and test-driven reform. As a promise to support state tests for grade promotion and graduation, George Bush held an Education Summit during his first year in office as vice-president. This initiative led way to America 2000, a major education proposal to produce educational gains by the beginning of the new millennium. An important objective of this program was to develop tougher tests to produce more intelligent and highly capable citizens (Miner 17; Hauser 153).

Although significant changes have occurred throughout the past three decades, the most dramatic modification in education occurred in 1998 in Texas. At this time, Governor George W. Bush proposed that standardized reading tests be used for grade promotion for Texas public school children. The Texas Assessment of Academic Skills (TAAS) became the very first test to become state-mandated and to determine whether a student is able to be promoted from grade to grade.

Texas’ success, sometimes termed a miracle, began the testing craze and once George W. Bush became President, he employed similar laws across the country through the No Child Left Behind Act (NCLB). This act ultimately redefines and introduces concepts in an attempt to improve the education in public schools. It mandates that states eliminate the achievement gap between students, as well as focus on the needs of those who are typically disadvantaged through a number of tests. Among many of the repercussions of this act, the increase of nation-wide testing is, by far, the most significant and controversial (Massad 2).

Standardized testing has become prevalent in high school districts across the nation, including Michigan. The Michigan Educational Assessment Program (MEAP) test is the state’s K-12 standardized testing system. The MEAP test was designed in 1969 to measure how well students master the state’s curriculum and how well teachers teach it. The test was first introduced in 1978 to high schoolers and includes five testing areas: Reading, Mathematics, Science, Writing, and Social Studies. There are four categories of achievement that students fall into, depending on their test scores, from highest to lowest they are Exceeding Standards, Meeting Standards, Basic Performance, and Not Endorsed (see Table 1 in Appendix).

Test score results from last year show that the number of 2004 graduates who met or exceeded state standards increased in all testing areas. The most dramatic increase of these two categories was seen in the Reading test scores, which jumped from 66.8% to 76.2% (See Figure 1 in Appendix). Similar, but not so significant, results were also seen in Writing scores; the number of students who met or exceeded state standards increased from 60,066 to 60,979 (See Figure 2 in Appendix). These results show that Michigan schools are headed in the right direction (United States).

Although test scores are rising, there are still a number of controversial issues that are the focus of many state-wide debates. One of the most important issues relating to the MEAP test is that colleges do not consider a student’s MEAP scores for entrance; instead, they weigh heavily on the ACT. This, in turn, affects the attitudes of many students taking the test. For example, earlier this year, seven seniors at Lake Shore High School in St. Clair Shores intentionally failed the MEAP test. Already having passed the test the year before, these students felt that it was unnecessary to take the test seriously and proceeded to circle random answers.

This scenario created an uproar throughout Michigan and many politicians, as well as numerous educators, had mixed feelings about the state’s standardized testing methods. Senator Michael Switalski, D-Roseville, in an article by Lori Higgins, stated that the Lake Shore incident “is a symptom of what’s wrong with the MEAP. With students not seeing the relevance of it [the MEAP test], it causes us to go through all kinds of hoops to try and make it important. We have to offer them [the students] free pizza to take it. Now you have some schools saying it is required for graduation” (1).

Parents are also frustrated with the MEAP test. Dearborn Height mom Peggy Lenart believes the MEAP Scholarship Program, a benefit that awards successful students extra funds for college, favors students who are good at taking tests. Her 17 year old daughter will take her 11th grade MEAP test this year, but probably won’t score high enough to earn a scholarship. Lenart says that, “some of these kids really try, but they don’t get the scholarship because they are not good test takers.” She suggests an alternative test be implemented in place of the MEAP test, or possibly having the state insist that each student complete the ACT or SAT as a graduation requirement as an alternative (Hornbeck 1-2).

Despite negative attitudes toward standardized tests, such as the MEAP, many policymakers believe that the tests are a good idea and a satisfactory indicator of the success and efficiency of schools as an academic institution. Joan Herman and Shari Golan suggest that there are a few arguments test advocates believe in regarding the use of standardized tests. According to these researchers, “testing sets meaningful standards to which school districts, schools, teachers, and students can aspire”(2). It is beneficial to have a goal to focus all efforts on in an attempt to attain an ultimate endpoint. Having standardized tests in the high school classroom motivate both students and teachers. They encourage qualities of well-rounded students: hard work, academic habits, and success while also encouraging teachers to focus course curriculum so that the most important concepts are taught.

A second argument Herman and Golan proposed is that test data acts as feedback to attempt to shape classroom instruction. Standardized test scores allow educators, administrators, and policymakers to evaluate the efficiency of schools. From this data, they are able to meet the needs of students, primarily focusing on weaknesses demonstrated from test results. Educators are notified of the major issues students are having with the curriculum and are able to adjust classroom instruction accordingly. This annual feedback allows test advocates to reflect on the efficiency of schools and determine what changes can be made at the classroom level to improve test scores.

The third and final argument Herman and Golan feel best typifies the average testing advocate’s support for standardized tests is the fact that “testing, coupled with incentives…can be used to promote fast and broad changes within schools and can stimulate major educational reform” (3). Because test results illustrate so much information, they allow test advocates to make critical decisions regarding the school system. They are able to recognize weaknesses in the curriculum and implement or alter programs to ensure that test scores improve. It is a quick and easy way to monitor the progress of education across the state and even the nation. Ultimately, there are a number of advantages, as proposed by Herman and Golan, of the integration of standardized tests in the high school classroom.

Although some testing advocates believe that the MEAP test is effective in portraying the true state of education in Michigan, other professionals are not convinced. Because many Michigan students, parents, teachers, and administrators are unhappy with the current state of Michigan education, the state legislature is in the process of replacing the controversial MEAP test with a college entrance-type exam which will be put in place in all high schools by 2007.

Although the specifics of the new Michigan Merit Exam (MME) are still unknown to the public, discussion of it since last year has been centered on the test combining a number of tests like the ACT and the ACTWorkKeys that will ultimately assess a student’s academic and workplace skills. Another big difference between the two exams is that results from the MME will be used by colleges as an entrance requirement, much like the ACT or SAT, but will also meet state graduation requirements. Proponents believe that this will be the main selling point of the test and will encourage students to take it more seriously. Many details still need to be worked through, but, if the MME test is received as well as it is anticipated in 2007, it would mark the biggest change to happen to the MEAP test in over 30 years (Higgins 1).

Although the testing scene is set to change in the near future, the effect of the MEAP test, and similar assessments are evident across the nation. The effort to improve the American education system through standardized testing comes at a high expense to both students and teachers. Teresa Henning, in her article Beyond Standardized Testing: A Case Study in Assessment’s Transformative Power argues that “at the secondary level, the focus on assessment is often the result of the state government’s desires to hold schools and teachers accountable for the successes and failures of their students” (3). Thomas agrees that the current movement portrays a negative impact on the learning and teaching of high school students (63). Many educators and researchers feel that there are three major effects of standardized testing on Michigan students: retention rates, dropout rates, and student learning.

Grade retention, as a result of poor standardized test scores, is pervasive in Michigan secondary schools and schools across the nation. In his article, Should We End Social Promotion, Robert Hauser states that “part of the drive to raise standards and hold students and teachers accountable, are using standardized tests as a tool to determine whether students should be promoted or not” (177). Instead of using the student’s academic success through the school’s curriculum, policymakers are now using mandated test scores to determine whether students are competent enough to move onto the next grade.

Although this decision, in essence, seems practical and logical, there are some negative effects of retaining high school students. In a study by George Madaus and Marguerite Clarke, it was observed that “when students are overage for their grade (an end product of grade retention), it eats away at their sense of efficacy” (103). In addition, being held back a grade has been a determining factor as to whether or not a student will be retained again. Madaus and Clarke, in the same study and using the same data, discovered that compared to on-age students, those individuals who are overage for their grade, as a result of not being promoted, are twice as likely to be retained again. Further research showed that individuals who are held back a grade are also more likely to become disengaged and drop out of school earlier than their classmates: an effect that hold no benefit to students.

Additional research has been conducted to determine the relationship between grade retention and dropout rates. There have been many individuals over the past two decades who have gathered data and made a number of conclusions regarding this relationship. Douglas Anderson proved, in his 1994 study, that grade retention dos lead to higher dropout rates in secondary schools. From the 5500 students whose school attendance was followed for seven years, those individuals who repeated a grade were seventy percent more likely to drop out of high school than students who did not repeat a grade. In a similar, but more recent study, Haney studied the impact of state exit exams and found that the integration of such tests into the curriculum was associated to an increase in dropout rates, particularly among African American and Hispanics (Horn 33). It is obvious, from these studies, that retaining students for achieving poor results on standardized tests is purely detrimental and does not help the student in the long-run.

Not only are retention and dropout rates affected, but student learning is also greatly influenced by the integration of standardized tests into the curriculum. Numerous English students in Michigan are experiencing the pressure of increased high-stakes testing as more studies show that the incorporation of such assessments are more harmful to the student’s learning than they are beneficial. Wayne Au, a professional editorial associate for an online periodical and a former high school teacher, believes that “standardized tests generally leave no room for understanding process because they tend to focus only on rote memorization and knowledge that is decontextualized away from practice.”

He clarifies his point by adding that “we make sense of our knowledge in context, and standardized tests ignore this relationship” (Au interview). This concept of promoting underachievement has swept the nation within the last few years. Students now learn to memorize stock responses that would be acceptable to any writing prompt, instead of focusing on understanding the material and retaining valuable information. As a result, students learn low-order skills that are inapplicable to higher education and the workforce, while also disregarding the skills and abilities needed to function in a complex society (Meier 15-16).

Many other notable educators feel that standardized tests ignore some of the most important concepts and characteristics of a good learner. Bill Ayers, a notable educator’s opinion is that:

Standardized tests can’t measure initiative, creativity, imagination, conceptual thinking, curiosity, effort, irony, judgment, commitment, nuance, good will, ethical reflection, or a host of other valuable dispositions and attributes. What they can measure and count are isolated skills, specific facts and functions, the least interesting and least significant aspects of learning. (Kohn 17)

Mastering only the competencies covered on the exam is the primary focus of today’s students; however, this concentration does not equate to increased learning. In fact, Amrein and Berliner gathered sufficient evidence to suggest that student learning remains at the same level before standardized tests were implemented, and in some cases, deteriorated after the education policies were instituted (Horn 33). From these examples, it is clear that standardized testing has no increased benefit to retention rates, dropout rates, or student learning.

Although it would seem so, students are not the only ones affected by an increase in state-mandated testing; many teachers are also feeling the pressure. The integration of standardized tests also forces teachers to narrow their curricula and instruction, while, at the same time, decreasing their preparation time. Increased accountability, a result of the increased pressure of higher test scores, causes many teachers to neglect material that does not relate to state tests; the main focus of all courses is to prepare students for mandated tests so that the school can be represented well. In English high school classrooms this ultimately means that reading real books, writing in authentic context, and conducting creative projects are disregarded and not integrated into the classroom curriculum (Henning 3; Herman & Golan 8-9). National Writing Project fellow and high school teacher Vivian Axiots describes what she has lost as a result of the current testing craze:

As a teacher, I have lost faith in the value of tests, faith in my ability to succeed, faith in the educational system-the system that once worked so well for me…As a teacher I have lost time to write, especially creatively, time to find, then share a poem alongside a short story, time to integrate other disciplines, ideas-even though I know this is far more important (McCracken and McCracken 30-31).

A teacher’s sense of professionalism and their overall attitude regarding testing, as mentioned by Vivian Axiots, is also influenced by the increased accountability associated with high-stakes tests. The pressure teachers feel to raise test scores negatively relates to their professional self-images (Herman & Golan 10). Teachers across the nation agree with this opinion and are pessimistic about what scores truly reveal. Many teachers are frustrated with trying to teach students concepts that, as shown by test scores, are just not doing any good. Another high school teacher speaks for many high school teachers who are perturbed with the significance of standardized tests in the classroom:

We [educators] believe in a standard, and I think there are ways of making this, but not [through] one long test, and certainly not one this challenging…Why is it the teachers or the students [who are at fault]? Why is it nobody is really coming out full force at the school level and saying, “Take a look at this test? Maybe there’s something wrong with it.” Heaven knows, if I give a test and everybody in my class fails, I might start thinking, “Gee, maybe it’s a little above their level.” (Luna and Turner 86)

It is clear, from these two examples, that there are a number of teachers who believe that standardized tests are doing more harm than good in the classroom. As they are forced to implement a curriculum largely determined by the content of standardized tests, teachers are beginning to tire of the skewed priorities and the disrespectful treatment they are receiving from policymakers, as well as administrators, who are desperately trying to raise school scores.

Increased pressure is put on teachers who work at schools that have poor test results; they are put on even tighter ropes by administrators and are unable to have much freedom in the way that they teach (Henning 3; Kohn 27). This ultimately leads to the altered type of instruction that is being offered in American schools: teaching to the test. Many educators feel obligated to focus only on raising test scores and set aside other subjects for days, weeks, or even months.

Because the test essentially becomes the curriculum, both the content and the format of instruction are affected. For example, if students are to be tested with multiple choice questions on a standardized test, teachers may have students practice multiple-choice exercises beforehand. Similarly, teachers may skip a certain segment of a classroom lesson, while spending more time on a different section that is thought to be more significant and more likely to appear on the test. In the same way, educators may cut back on reading to make room for writing; it all depends on what they think will be emphasized on the test (Herman and Golan 9; Kohn 29).

Many educators, test advocates, and similar professionals suggest a number of different alternatives to standardized testing. Specifically, Gary Natriello and Aaron Pallas discuss four of these solutions in their article The Development and Impact of High Stakes Testing. First, to understand more fully the consequences of high-stakes testing and the general assessment process on students and their performance, more research programs can be developed. Although many studies have been conducted to date, there are still areas of standardized testing that need to be explored. Perhaps implementing additional programs to monitor the success of mandated tests would be good solution to the nationwide debate.

The second action that can be taken, they suggest, is to “explore more aggressively the capacity of high-stakes and other tests and assessments to reflect the full range of human capabilities” (38). Further research and studies are needed to assess the effects of such tests and determine what the best course of action is regarding testing students’ knowledge and measuring their success. Another possibility to solve the standardized testing debate, according to Natriello and Pallas, is to expand the human capacity conceptions beyond those typical of mainstream tests. This means that not only should tests be more focused, but they should also reflect the student as an individual, while, at the same time, incorporating workplace skills that are necessary in the world outside of high school.

The final solution Natriello and Pallas have developed, in regards to standardized testing, is to “continue to use the results of high-stakes tests to reflect back on the system and its obligations to provide equal opportunity for learning, in effect making the stakes for policymakers no less high than we make them for eighteen-year-old high school students” (38). This alternative would allow policymakers to understand the consequences of state-mandated tests and would, more importantly, make them accountable for the success of students and teachers alike. The four solutions proposed by Natriello and Pallas are a mere guideline to what could happen in the future to ensure that standardized tests do not become the entire curriculum and the be-all and end-all of education.

Through extensive research, Herman and Golan assert that “standardized testing has assumed a prominent role in recent efforts to improve the quality of education” (2). The history of these high-stakes tests gives way to a new era of testing and provides information for researchers to discover the true effects of such tests on students and teachers. Many studies, particularly those of Herman and Golan, and Madaus and Clarke have concluded that, as a result of poor test results, grade retention, dropout rates, and student learning are all influenced by the new testing craze.

Similarly, research conducted by Kohn and McCracken and McCracken show that more teachers are experiencing frustrations while trying to narrow their curricula and instruction, while still teaching to the test. At this point, there are a number of alternatives to standardized testing and solutions to the current controversy, including understanding the consequences oh high-stakes testing. However, there is no easy answer when deciding what the future will hold for state-mandated testing, but the fact remains that tests, such as the MEAP test, have adverse effects on both students and teachers on a statewide and national scale.

Works Cited

Au, Wayne. Email Interview. 13 Feb. 2005.

Hauser, Robert. “Should We End Social Promotion?” Raising Standards or Raising Barriers?: Inequality and High-Stakes Testing in Public Education. Ed. Gary Orfield and Mindy Kornhaber. New York: Century Foundation Press, 2001. 167-174.

Henning, Teresa. “Beyond Standardized Testing: A Case Study in Assessment’s Transformative Power.” English Leadership 24.3 (2002): 3-8.

Herman, Joan, and Shari Golan. “Effects of Standardized Testing on Teachers and Learning- Another Look.” Diss. UCLA, 2003.

“High Schoolers’ Apathy Could Help Kill the MEAP.” Detroit Free Press [Detroit]

3 May 2004.

Hornbeck, Mark. “State to Ax High School MEAP: Legislature Replaces Controversial Test with College Entrance-Type Exam.” Detroit News (10 Dec. 2004).

Horn, Catherine. “High-stakes Testing and Students: Stopping or Perpetuating a Cycle of Failure?” Theory Into Practice 42.1 (Winter 2003): 30-41.

Kohn, Alfie. The Case Against Standardized Testing: Raising the Scores, Ruining the Schools. New Hampshire: Heinemann, 2000.

Kornahaber, Mindy, and Gary Orfield. “High-Stakes testing Policies.” Raising Standards or Raising Barriers?: Inequality and High-Stakes Testing in Public Education. Ed. Gary Orfield and Mindy Kornhaber. New York: Century Foundation Press, 2001. 1-5, 12-18.

Levin, Henry. “High-Stakes testing and Economic Productivity.” Raising Standards or Raising Barriers?: Inequality and High-Stakes Testing in Public Education. Ed. Gary Orfield and Mindy Kornhaber. New York: Century Foundation Press, 2001. 47.

Madaus, George, and Marguerite Clarke. “The Impact of High-Stakes Testing on Minority Students.” Raising Standards or Raising Barriers?: Inequality and High-Stakes Testing in Public Education. Ed. Gary Orfield and Mindy Kornhaber. New York: Century Foundation Press, 2001. 96-104.

Massad, Carolyn. “Maximizing Equity and Access in Test Construction.” Harcourt Technical Report (2003): 2.

McCraken, Nancy M., and Hugh T. McCracken. “Teaching in the Time of Testing: What Have You Lost?” English Journal 91.1 (2001): 30-35.

Meier, Terry. “Why Standardized Tests Are Bad.” Failing our Kids: Why the Testing Craze Won’t Fix Our Schools. Ed. Kathy Swope and Barbara Miner. Milwaukee: Rethinking Schools, 2000. 14-16.

Miner, Barbara. “Origins of the Latest Testing Craze.” Failing our Kids: Why the Testing Craze Won’t Fix Our Schools. Ed. Kathy Swope and Barbara Miner. Milwaukee: Rethinking Schools, 2000. 17.

Natriello, Gary, and Aarom M. Pallas. “The Development and Impact of High-Stakes Testing.” Raising Standards or Raising Barriers?: Inequality and High-Stakes Testing in Public Education. Ed. Gary Orfield and Mindy Kornhaber. New York: Century Foundation Press, 2001. 19-22, 38.

Thomas, P. “Standards, Standards Everywhere, and Not a Spot to Think.” English Journal 91.1 (2001): 63-67.

United States. Department of Education. High School MEAP Test Scores Improve Across the Board. Lansing: GPO, 2004.

Theory Of Personality Change

A central idea in this theory is the life structure, defined as the “underlying pattern or design of a person’s life at any given time.” The life structure changes over a lifespan and we build it primarily around our relationships and work. From the interviews Levinson was able to illustrate life structure evolves through a series of alternating stable (structure building) and transitional (structure changing or crisis) phases. These were dubbed “the seasons of a man’s life” (outlined by figure20.1). The lifespan covers four eras: pre-, early, middle and late adulthood. Where the eras over lap, we experience transitions, which last roughly five years each.

At the Pre-adulthood stage the individual grows from a baby to early adulthood. The individual then moves to early adult transition; this is where the person moves towards independence, both emotionally and financially. A person can explore life’s possibilities without making firm commitments.

Early adulthood is then reached; the individual forges firmer links between themselves and the adult world. More choices and commitments are made and life becomes more structured. Here it might be conceivable to start thinking about and/or starting a family and setting up a home. The individual will settle a few key choices and find a position in the adult world to grow comfortably and happily contributing to aspects of personal, home and working life. The later stage of this phase has been called BOOM – becoming one’s own man.

BOOM is completed and individuals are wiser and more experienced in the next stage. However, the sense of passing time and one’s own life become more illustrated in this transition, which is into midlife. Physical signs of ageing appear more obvious and deaths of older relatives arise. Initial dreams and plans may or may not be realized and for some this can be a period of midlife crisis, in which to avoid disappointment, changes are made.

During middle adulthood people build on choices from the earlier transition. This could be a new occupation/partner… or a change in attitude to a previous occupation or partner… The people in this stage are less ethnocentric and look out for the next generation. They have more authority and more experience to make impressions on others around them, therefore may become mentors or more involved with the family.

In the last transition put forward by Levinson, physical decline is obvious to the individual and to the culture. A final acceptance that life is finite is accepted, and either goes into another crisis or a period of calm reflection and making the most of time.

A key feature in this theory is that of a midlife transition/crisis, which has essential validity for some, especially for those following the traditional pattern of adult life. Levinson viewed this crisis as essential/inevitable and claimed 80% of his sample had experienced similar sorts of circumstances, and those who didn’t saw the repercussions later.


There is not a lot of quantitative data to support the ideas put forward, because it was collected in the form of clinical reports.

The evidence for the later eras can’t be generalised vastly, as it was collected from only 15 people over the age of 45.

The research was androcentric and ethnocentric, only being carried out on males from western culture, therefore is it fair to generalise this theory to females and people from other cultures?

However, the theory realises the importance of others in development and it takes into account sociocultural and historical setting when describing development.

May Sarton’s Novel, As We Are Now – Summary

May Sarton’s novel, As We Are Now, tells the story of 76 year old Caroline (Caro) Spencer who has been placed in a nursing home by her family to live. However, Caro feels she has been dumped, abandoned, and left to die in what she refers to as a “concentration camp for the old.1” To pass time and retain sanity, Caro begins recording her past and present experiences in a journal. It is her hope that this so-called “Book of the Dead” will help prepare her for her death.1

Caroline’s journal helps us to see why long-term care is so heavily regulated today. Many administrators would agree that state and federal regulations have, in some areas, reached and even exceed their maximum utility. However, after reading of the poor quality of care and life Caro experienced at Twin Elms Nursing Home, most would agree upon the deep seeded purpose of such regulations.

While today’s heavily regulated long term care facilities are far from being perfect, they are also a far cry from those of yesterday. Caro was only provided the basic necessities of life (food, clothing, and shelter). Today Caroline would have experienced the highest possible quality of care and ultimately better quality of life. She would have received, at the bare minimum, the necessary care and services needed to attain and maintain the highest practicable level of physical, mental, and psychosocial well-being.3

Unfortunately for Caro, she had to live in what she referred to as “Hell.1” She was treated like a prisoner in what was to be considered her new home and was forced to constantly live in fear of punishment. She lost all rights to individuality, relationships, and privacy. Each time Caro spoke out on her fellow inmates or her behalf, she was punished by being drugged, restrained, and confined.2 Presently, such poor treatment would result in state or federal sanctions.

Today Caroline would most likely become an active participant in choosing the facility in which she would live. Many resources are available today to help individuals choose a suitable home. One resource tool, which has increased in popularity in past years, is to perform an online search. For instance, the DIA has a website listing report cards for all Iowa long-term care facilities. It should also be considered a standard to perform a physical assessment of the facility and to interview staff.

Some of the most popular facilities for the elderly are introducing a concept known as resident (patient) centered care. Caro would have benefited greatly from this type of facility. She would be able to receive help physically and at the same time be able to maintain her mental and psychosocial well-being. The most important benefit Caroline would have received from person centered care would have been the quality of life she had grown accustomed to over the years.

With resident centered care, Caroline would once again be allowed to enjoy some of the basic freedoms of life most elderly are forced to give up when they enter into a long-term care facility. This increased quality of life would be a direct reflection of the facilities attitude toward supporting individual dignity, allowing individual choices, and meeting individual needs. Resident centered care allows individuals to make daily living choices like when to get up and go to bed, when to bath, what to do, and when and what to eat. With resident centered care, Caro could make the long-term care facility a home and not just a place to end her life in.

If Caroline were to increase her physical well-being in a nursing facility, she would be an excellent candidate for a number of services such as home health care, adult day care, and independent living. It is very possible that Caroline would have been able to keep her own home and have daily assistance with her housekeeping, laundry, and dietary needs.2 For instance, many physically frail individuals take advantage of the local meals on wheels program which provides individuals at least one meal a day for a small fee.

In conclusion, while the past of long-term care was unfortunate, the present is looking up. With regulations guiding quality of care, the conception of resident centered care, and the inception of alternative personal care options, individuals like May Sarton’s Caroline Spencer can be assured of the highest practicable quality of life when faced with the long-term care decision.


1 Sarton, May. As We Are Now. New York: W. W. Norton & Company, 1973.

2 Selsor, Selena. Personal Interview. February 12, 2004.

3 Gordon, George K. and Leslie A. Grant, and Ruth Stryker. Creative Long-Term Care Administration, 4th Edition. Springfield, IL: Charles C. Thomas, 2003.

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