Choosing a Retirement Home

Retirement communities are not all alike. Before making a choice about where to live, you must understand the basic options, how they differ and how these differences affect your lifestyle. The question is: What kind of living situation do you want?

I am writing this just after a disturbing experience. The woman I chose to sit with at dinner, here in the home that I have chosen, had changed since yesterday. An anxious look had replaced her often dazzling smile. Her blue eyes avoided contact with mine, suggesting that she did not know me. She kept bringing up the subject of money, here where everything that happens is paid for by some process determined before we came and cash is useless.

She said. “I don’t know how I am going to pay for my sandwich.” My explanation obviously seemed preposterous.

She said, “I wasn’t raised like this. I can’t just leave and not pay for my dinner.”

Wanting her to feel happy, I told her that nothing was expected except gratitude. “Everything is a gift; all we need to do is say, thank you.”

This did not fit some sense of logic that remained at the core of her confusion.

Then she told me that this was her first time in this city, and she didn’t know where she was going to sleep.

Knowing she did not understand, I explained anyway that a nurse was coming and would take her to her room where she would sleep in her own bed.

Now, with my heart full of sadness for this dear, frightened woman, I will try to explain what you need to consider when you choose a retirement home.

Some homes are designed for “independent living.”  This is for people who are still able to take care of themselves in certain basic ways.

Such a community is meant to provide its inhabitants with the basic needs of home: an apartment (or room), three prepared meals a day, heat, cooling, electricity, television, internet, laundry facilities, trash disposal, etc. (This list varies a bit from place to place.) There should be nurses on duty who will come if you signal, and they will get help for you in an emergency. There may be some transportation to medical appointments, a little shopping, a pleasure trip now and then.

In this kind of facility you will find your own doctors. You may have a car and take yourself wherever you want to go. You will need to be responsible for your bank account, unless you have named someone else to handle your finances.

Then there is “assisted care.” This kind of facility is for people who need help with some basic functions of living. These needs vary greatly. Many elderly people are at risk for falling to the extent that showering and dressing alone are difficult o risky. Some people get their medicines mixed up so can’t be relied on to take the right drug at the right time. Other people can’t walk well enough to get from their apartment to the dining room alone or have problems remembering basic information like which floor they live on. In an “assisted care” facility skilled workers take responsibility for the well-being of all residents, providing very personal assistance.

And then there are other retirement homes that put all of these people and functions together, defining themselves as “Independent Living/Assisted Care.”

In my decision-making process, this arrangement seemed ideal. First of all, it meant that I would never have to move again. My apartment would be my home. I could decorate it, get comfortable in it and consider it mine. If I should decline to the point of helplessness, I would still be at home in it.

And secondly, the pricing was advantageous. Assisted care is very expensive, so the difference between the cost of independent living and the cost of assisted care can be huge. But when the two are combined, you get as much or as little help as you need, maybe off and on, according to your situation, and you only have to pay for the help you need. You can get help after surgery, for instance, get on your feet again and not need it. This seemed to me appropriate to my stage of life.

On my door there is a little sticker to inform anyone who needs to know that I am here in “independent living.” At the same time the nurses’ station is only a few yards from my door. According to a schedule one of these uniformed people takes and records my “vitals” periodically, taking note of abnormalities. And, because of covid, one of them pops into my room and takes my temperature each day. Other than that they leave me alone until I push the help button, which I am encouraged to wear around my neck. The presence of these trained servants adds a lot to my sense of security.

But, as one might expect, I didn’t think about everything before I chose. For instance, it didn’t occur to me that the “independent/assisted” arrangement inevitably results in people with varying physical and mental abilities living all together.

Now I notice that people who walk miles every day are in the same hall with people who creep along behind walkers or spend most of their time in wheelchairs. People who follow the stock market and calculate their own taxes, eat at the table with people who order dinner and forget what they ordered before the waiter brings it.

I don’t intend to say that this way of living is bad. In fact, I find it endlessly fascinating, and challenging. But not everyone here agrees with me.

The bottom line is that when you choose “Independent/Assisted Care,” you need to be ready to live with people you might consider weird, people who are paranoid, for instance, or people who must have an attendant near them always for reasons you may not understand.

In such a facility there will be people who never come out of their rooms, because they are too feeble. You will see only the medical staff going in and out. And there will be scholars with brilliant things to say, old soldiers with stories to tell and witty, fun-loving people who keep you laughing.

At the same time the neighbor you meet in the laundry room could be delusional sometimes, and you will have to figure this out for yourself since she, like you, will be protected by privacy laws. There will be someone who frequently loses things and thinks they have been robbed. The man who sits by the elevator for hours may be waiting for his wife who died years ago.

And, you may have a friend like mine who is lucid and happy one day and lost the next.

How comfortable will you be in such a situation? Consider this carefully.

Of course, you need to determine that the residence is prepared to handle properly the role they have accepted. But those questions come later. The basic debate is with yourself.

What kind of living situation do you want?