In Why Is Grandma Screaming?, Barbara Speedling opens a provocative conversation on the impact of the changing demographics in long term care on quality of life for those being served. Access to mental health facilities, homeless shelters and other public or residential services for people of all ages with mental illness, substance abuse issues, complicated social circumstances and other complex needs has dwindled in a wounded economy. The nursing home environment is fast becoming an uncomfortable mix of ages, circumstances, and medical and psychiatric needs. Advances in medicine have added years to the average life span, with little attention given to ensuring that those added years are worth living for those who live dependently in our nation's nursing homes. After many years of observing and interacting with dependent people, Speedling offers practical guidance for transforming a one-size-fits-all nursing home into a quality living environment for every individual.