Diselderly Conduct: The Flawed Business of Assisted Living and Hospice

The book is a personal account of unmet needs in assisted living and hospice aiming to spark discussions about new approaches for America’s aging population and family decision makers. There are 30 thousand assisted living facilities in the US, but most are unaffordable for middleclass Americans and fraught with staffing deficiencies and mismanagement. Chapters on the author’s experience helping her mother move from an age-restricted community in Florida to independent living in Wisconsin to assisted living will interest seniors and their family members who know the struggle of finding long term affordable care. The chapter on hospice care distinguishes it from assisted living through the author’s experiences and misconceptions, then moves to a broader discussion of Medicare spending, and finally a meditation on dying of old age. The author strikes an effective balance between the personal, political, and cultural aspects of aging. Karofsky dedicates the last chapter of the book to a discussion of recent failures to protect long term care patients during the COVID19 pandemic.

Judy Karofsky was a city council member and one of Wisconsin’s first women mayors (Middleton). During her term of office, she established a now-thriving senior center and emergency medical services. She served on the executive staff of a governor and held multiple roles in housing and economic development for a state agency, a nonprofit housing development organization, and her own research firm. Before organizing and providing care for her mother, Judy filled interim positions for a statewide women’s network - focusing on elder economic security - and for a coalition of state aging groups. Serving on nonprofit and municipal boards, she participates in policy discussions and comments publicly on demographic trends and urban growth.

Judy has authored numerous op-eds, articles, and papers on affordable housing, historic preservation, and regional growth. More recently she has written on institutional investing in seniors housing. delivered keynote speeches, public meeting testimonies, and conference introductions, and she’s participated on panels on a range of issues for women’s networks and service organizations. In her role with the Wisconsin Elder Economic Security Initiative, she led discussions with labor union retirees.

Judy holds an AB cum laude from Bryn Mawr College (economics) and master’s degrees at Brandeis University (American history) and the University of Wisconsin-Madison (business). She’s taught both corporate and personal finance.