Aging in Place versus Assisted Living

aging in place vs. assisted living

If you’re an aging baby boomer or an adult child of a senior, there’s an epic battle shaping up in your life. You may not yet realize that it’s coming—and if you do you certainly don’t fully understand it—but if you (or your parent) live to your life expectancy or beyond, there are very few ways to avoid it.

That epic battle, of course, is the one between choosing to age in place or to move to a senior living community. I use the word “choosing” with the sincere hope that you (and I) will be able to choose, and actually have options available that are not solely dictated by either financial considerations or health conditions. Some people theorize that if you eat the right foods, exercise religiously, stay active socially and continue to “train your brain” with new activities and information, you’ll hardly age at all, and never even have to face this decision. As long as your money holds out. We live in hope.

Time and again, we read and agree that most people would prefer to age in place, to live out their years in the comfort of familiar surroundings, with family and friends nearby willing to offer occasional help with errands, home maintenance, meals and other routine daily activities. (For more thoughts on this, read our related article, “Nine Reasons Aging in Place May Not Be Right for You.”)

Recently, however, some thought leaders, including Stephen Golant, a professor of Gerontology at the University of Florida, have contended that “proponents of aging in place groupthink are doing a great disservice to millions of older Americans now occupying inappropriate residential environments.”

So, what’s “inappropriate” about remaining in your own home? Surely nothing could be more natural, but people may be so attached to the familiarity and comfort of their surroundings and routines that they ignore the factors that are increasingly making their homes less than ideal.

To successfully age in place, you should consider the following:

Home Modifications

Most older homes need to be modified to make them more convenient and accessible. These modifications range from installing grab bars for toilets and tubs (or installing a walk-in tub) in the bathroom; replacing old doorknobs with lever handles; replacing flip light switches and elevating power outlets; installing safer, more accessible kitchen appliances; clearing away clutter and removing throw rugs; widening doorways to accommodate walkers and wheelchairs; and even installing ramps, chairlifts or an elevator.

Home Maintenance

Aside from the modifications, all homes, and especially older homes, need constant maintenance to keep them safe and habitable. That includes everything from changing smoke alarm batteries to painting, landscaping, washing windows, vacuuming, unstopping drains and cleaning bathrooms. Anything that you can’t do may have to be done by an outside professional, which can be very expensive.

Location

Your once-friendly neighborhood has probably changed over the years in several ways. Do you still know the neighbors? Are the grocery and drug stores still convenient? Are the homes in your neighborhood increasing or decreasing in value?

Not all of these factors will figure in to your decision-making, and there are ways to successfully manage each of them so they’re not deal breakers. In fact, now that Medicaid will fund some in-home services, there is added incentive to stay put. And if you’re fortunate enough to live in a thriving neighborhood with many of your contemporaries, the village model—in which neighbors band together to help each other age in place—may be a workable, enjoyable alternative to moving to a senior living community.

So, let’s look at the pros and cons of moving to a senior living community:

Home Modifications

There are none. You will be moving into an “apartment” that usually will be designed to be age-appropriate, accessible and safe. But, it will no doubt be smaller than your home. You will have to downsize your furniture and all your possessions. This can be extremely stressful for some people, and extremely liberating for others. There is no need to modify your kitchen because meals are usually included or available.

Home Maintenance

This is included in your monthly payment, and is one of the major tipping points when people are making the “stay or move” decision. Toilet clogged? Call maintenance. Carpet need vacuuming? Housekeeping is included. The bathroom gets cleaned, and often the bed gets made.

Location

Will anyone ever come to visit? Will I know anyone that lives here? There is a period of adjustment or “resocializing" when moving to a senior living community, and for some people, it’s not easy. You will meet new people, some of whom will become your friends and others whom you will choose to avoid. Studies have shown this increased socialization is healthy for you, however, and as you become assimilated into this new “neighborhood,” you may find renewed energy and purpose. Shopping and appointments are not a problem; there is transportation if you don’t drive, and varying services available on the premises. And, most importantly, you will probably find your family and friends will love visiting your new home and participating in this new chapter of your life.

Which is the right choice for you or your loved one?

If you’re leaning toward aging in place have you considered what it would be like to live within the walls of your home for many years, will there always be someone to call in an emergency, or even if you need help with daily activities and simple tasks around your home, or shopping or meal preparation? Have you projected the costs to determine if you can afford to stay in your home?

If you’re leaning toward moving to a senior living community, have you considered what you're leaving behind? Are there some things you can’t live without and can’t take with you? Are you leaving a neighborhood of friends for a building full of strangers? Will you miss the morning sun shining on your back patio? Have you projected the costs to determine if you can afford to move to an assisted living community?

There are pluses and minuses to both aging in place and assisted living. The choice is not always black and white. But the good news is that as the aging population increases, the options are increasing, too. Advanced technologies will enable you to live and thrive longer in your home. New senior living design will make communities even more accommodating and nurturing. And, new thinking by both entrepreneurs and civic leaders will enable older people at every income level to have viable choices available that will help them live longer, healthier, more fulfilling lives.

Until then, the battle rages on. May you choose your side wisely.

Access The Senior Living Manual here.