An unusually large and passionate group of readers responded to Martin Bayne’s story “They call it assisted living, but it can take the life out of you” [July 10]. Bayne, an eight-year resident in an assisted living facility, described his frustration with the management, the pain of watching friends decline and die, and the low-paid “heroes” who are the caregivers. Excerpts from some of the letters follow.

My father died in March at the age of 91. He lived the last three years of his life in an assisted living facility in Louisiana. I spent many days and weeks over those three years visiting my dad and, as a result, got to know and become friends with many of the other residents. As assisted living facilities go, I think Dad’s was pretty good — clean and attractive with a caring staff. (You’re right, those front-line staff are the real angels.) But . . . there’s a certain loneliness to the existence, to the regimentation, to the deaths that keep occurring, to the fragility of the residents’ existence that each resident feels — knowing that they, too, could at any moment be sent to “the back” (as the dementia/nursing home part of this facility was known).

I don’t know what the answers are, but I agree that changes can and should be made.

Karen Clark McManus, Chevy Chase

Our society must find ways to make it financially possible for families to have adequate home care for our fragile and often confused family member at this difficult end stage of life. Otherwise we will have to continue taking our loved one out for a ride that ends at this cold, cold winter place, where loneliness is the prevailing final experience.

I remain tormented two years after my mother’s death by her despair at the two facilities where she lived for the last years of her life. Though I visited almost daily each week and phoned usually three times a day, I could never clear away the reality of her constant agonizing loneliness. What she needed and wanted most was to be in her home with her family, or what was left of it — only me. I did not have the financial means to give this to her.

Worse than this was the fact that she was so vulnerable, physically and emotionally, to inconsistent handling by a variety of overworked and sometimes under-trained care workers. There were serious falls and injuries, and many bad “skin tears,” as they are called. Most of the time I did not get what I felt were honest explanations for causes of injuries.

The public needs to know more about “assisted living” and “total care” facilities, looking beyond the pretty porches and the sparkling-clean but empty white rocking chairs. Beware: Inside there is deep despair, isolation and danger for these dependent residents.

Elizabeth Richter, Alexandria

Mr. Bayne referenced residents who facilitate their own demise with a “willed death.”

I think constantly about my own father, who suffered a stroke on his 79th birthday. When the hospital said that Dad’s insurance was running out and we needed to move him, we began looking for an alternate facility in which to place him. My mother decided to bring Dad home until we could find an affordable facility to care for him, because my mom lived alone and was incapable of taking care of Dad. Dad appeared to be happy on the day that the ambulance brought him home, but after being there for only a few short hours, he began having difficulty breathing and we had him transported to a second hospital.

Days later, according to a nursing attendant, Dad took a deep breath while he was being bathed and left this world. That occasion replays itself constantly in my mind. I know that my dad did not want to be an invalid, dependent on others to take care of him, or a burden to his family, and I will always believe that, aware and obviously unhappy with his situation, Dad willed himself to die.

Loretta Parker-Brown, Washington

I will send Mr. Bayne the address where I live and he will be able to see that every one of his negatives become positive, including his attitude. He has done a disservice to the continuing care campuses where we absolutely do have a voice in “our” home.

Fran Stockdale, Lake Ridge

My mother and mother-in-law are both in assisted living facilities. I couldn’t figure out why, with such lovely facilities, dedicated activity directors, well-planned meals and mostly kind and friendly aides, the residents never seem to appear happy.

The lobbies are always full of older people who try to smile and be friendly, but their smiles and their eyes do not match. I witnessed residents not wanting to join activities and not speaking to the people at their own small dining tables. Perhaps they did not want to get too close to someone who might not be there the next day. Another loss is too painful.

Mr. Bayne explained what is going on so clearly — it is the “ambient despair that is a permanent component of life in assisted living. It is the result of months or years of loneliness and isolation. It is also the result of burying our feelings and emotions about being surrounded by many demented and disabled neighbors and by frequent death.”

With the aging of baby boomers, more and more assisted living facilities and nursing homes will be built. We can easily improve the facilities, but how do we fix the broken hearts of the residents?

Josephine Selepak, Dumfries

My father was a resident in assisted living for six years, and he knew like the rest that he would never leave alive. The constant loss of fellow residents, the lack of intellectual stimulation and no real physical fitness facility took its toll. His dementia increased and his good nature and willingness to even try to engage with others dissipated.

The nurses always told me when they observed the daily flow of visitors at my father’s residence, “If you ever have children, you better have daughters,” because repeatedly, it was the daughter who regularly visited while many sons who lived only blocks away from the home never came; the facility’s despair hit too close to home.

The author is correct when he applauds the caregivers, those underpaid angels of mercy who give their jobs their all in spite of ridiculous edicts issued by the facilities’ administrators and owners.

Kathy Megyeri, Washington