It might be you, it might be a parent, or it might be someone else you care about or feel responsible for. The time comes when living alone at home just doesn’t work any more. Maybe it was a long time coming, and some incident makes it clear that this is no longer sustainable. Or maybe it’s a stroke, or a fall, or some other health problem that comes out of the blue.
Suddenly, you’ve got a lot of really big decisions to make, and maybe not much time to make them.
Assuming that death is not an immediate prospect, you have five main choices:
#1: You can stay where you are and enlist outside help.
If only a modest amount of help is needed, this can be the best plan. Almost all of us want to stay in our homes if we can, and most people say they prefer to die in their homes, rather than in a hospital or other facility. It can also be the cheapest. Maybe family can provide enough help. Or if not, outside services – for healthcare, or just for non-health-related assistance – are available. You might also need to make some changes to the structure or furnishings of the home to make it safer or otherwise more livable.
One possibility that can work sometimes, if you have a spare room, and the need for assistance is not too severe, is to advertise for a live-in companion willing to help out – probably in return for your waiving or reducing rent.
#2: You can move to another home that would be easier.
Maybe all that’s needed is a smaller space requiring less care (e.g., a modest apartment or condo instead of a big house with a yard), or living all on one level instead of with stairs. Or if driving is the issue, maybe a place that is closer to downtown, or to public transportation. Although such moves are a nuisance, they can reduce monthly expenses and, if you are moving from a larger house to a smaller house or apartment, the transaction might generate cash that can be saved for future medical or other needs. And, as in #1 above, you still may have the option of sharing space with someone else who can provide at least modest help with caregiving.
#3: Moving in with a child, or someone else.
This is the old-fashioned way, and it can still work. Of course, it probably won’t work unless there is already a strong and positive relationship. And even then, there are obstacles to be overcome. But again, outside services can provide assistance of all kinds, which could be cheaper and easier for everyone than making other arrangements. Your (or your parent, or whoever is moving in) can often repay the favor in other ways – perhaps by paying rent, which might help the other person/family not just to cover the additional costs but to have something extra to save or to spend in ways that add to his/her/their lifestyle, or perhaps by babysitting for grandchildren, or by helping around the house in some other fashion.
#4: Moving into an assisted living facility.
If ongoing medical needs are not too serious, assisted living housing might be just the ticket. It’s a pretty expensive ticket, and neither private medical insurance nor Medicare will pay for it (though long-term care insurance typically does) – but if you can afford it, you are just the sort of person it was designed for. There are some very good assisted living facilities within an easy drive of Harvard.
#5: Entering a nursing home.
If you (or your parent or other person) has a serious physical or mental condition that requires expert care or 24/7 attention, and that is not likely to ever get much better, a nursing home is usually the best choice. It is very expensive, even more so than assisted living, but it is still much less expensive that staying home and hiring round-the-clock attendants (usually an option only for the wealthy, or for those who expect to live only a very short time).
Obviously, not all these options are really suitable for everyone. It depends on one’s current health, one’s medical prognosis, one’s financial condition, and the availability of family and/or community support.
Unfortunately, this is a lot to figure out, especially on short notice. But help is out there. For more (general) information about these options, read “When You or a Loved One Can No Longer Live Alone,” which will also link you to additional, more detailed resources.
Chuck Yanikoski is a retirement adviser who lives and works in Harvard. For more about him, or to contact him directly, visit www.ChuckYRetirement.com.