To the Editor:

Re “How Not to Grow Old in America” (Sunday Review, Sept. 1):

Geeta Anand is dismayed by poor options for elder care. Fair enough. As with families, some assisted living facilities are dysfunctional, but that doesn’t mean we should ditch them altogether.

Ms. Anand prefers to help older people stay home longer, which works well for some and is the thrust of many current policies. However, this shift can burden family caregivers, leading to loss of work, health and safety for all. And what about the roughly 11 million elders in America who live alone? Many do not qualify for nursing homes, yet are at risk and cannot live with family. For this group, assisted living might be just the right choice.

We need better options for where and how to live as we age. The author labels assisted living’s attempts to balance support with independence as “ a lie ”; this is inaccurate and unhelpful. What we need is to build a range of high-quality services for different people with different needs .

Tia Powell

Bronx

The writer, a psychiatrist, is director of Montefiore Einstein Center for Bioethics and author of “Dementia Reimagined: Building a Life of Joy and Dignity From Beginning to End.”