John* had been living on Mimosa Street* in the desert for nearly 30 years and had grown to love it. He had lived alone since his partner passed away, remaining in the same house, with the same neighbors and the same memories. However, as John aged, it became more and more difficult for him to take care of himself. He no longer drove and hired caregivers for cleaning, grocery-shopping and other errands. After multiple falls, he was transferred from a local hospital to a rehab facility, and the doctor recommended he move to an assisted living facility to get the 24-hour help he needed. As his nurse advocate, I escorted John to visit a few local assisted living facilities until he chose one that suited him. I helped him move most of his belongings, but each time we visited Mimosa Street, I think we both felt a deep sadness as he chose which possessions to take with him and which to donate to a local charity.

He had high hopes for his new living situation, but soon found it wasn’t quite what he had expected or as portrayed in the brochures. He looked forward to learning how to use a computer and other activities, as well as meeting new people since he had lived alone for over 10 years. Unfortunately, computer classes were not available, his cherished painting time was offered as paint-by-numbers and many of the residents living near his room were unable to communicate or interact with him. Although he was deeply disappointed with his new living situation, he was determined to make the best of it. He tried to stay positive and find ways to make the most of his days.

In our later years, our living arrangements play a significant role in our overall well-being. One of the most challenging decisions older adults and their families face is choosing between assisted living and living at home alone with help. Each option has its advantages and drawbacks, and the choice ultimately depends on individual needs and preferences.

Following is a checklist to help you decide if you are ever faced with this challenging decision:

Evaluate your current living situation and determine if is it safe for you to live alone, or have you been advised by health professionals to consider other options?
Consider daily needs such as bathing, dressing, meal preparation, housekeeping and transportation.
Do you require assistance with medication management or medical care?
Assess your social needs. Would you benefit from interaction with others? (*John shared that it is best to develop a “charitable attitude” in assisted living, as you will share space with others who may not be “your type.”)
Can you afford assisted living ($3,500-$5,500+/per mo.) or hired help at home
($25-$39/hr.)?
Research and visit assisted living in your area. Attend some activities as a visitor; eat a meal while you’re visiting.
Evaluate the level of care provided at assisted living and its additional cost to monthly rent (note that the charges are separate).
Consider proximity to where you currently live or close to family and/or friends.
Will the facility offer the level of independence you desire compared to living at home with help?

John still misses his old home on Mimosa Street. In fact, he is hanging on to it “just in case” he changes his mind, which is always an option. However, I notice he is finding joy in decorating his new space at assisted living. I take him out once or twice a week, he’s purchased some new furniture, and all is arranged to his liking. Staff are kind and caring, he has more people to talk with now than when home alone, and he always has a hilarious story to share about his new experience “at the home!” Our visits to the doctor show that his health has improved overall and a recent luncheon with friends revealed, “John is back!” John is back to living, albeit in a new environment, and making the most of this precious time. He makes me smile as I write this, what a gift to share in this life experience.

Dr. Porter is CEO and founder of MyHealth.MyAdvocate in Palm Desert. She is an experienced health care professional with over 30 years of nursing practice dedicated to unraveling the mysteries of health care processes and advocating for patients, families and caregivers. Immediate assistance is available by calling (760) 851.4116. www.myhealthmyadvocate.com.

* Names have been changed for privacy.