Not everyone moves though the spectrum of needs at the same pace, or even goes through all the same stages. The needs of a person with mild cognitive impairment, for instance, are very different from the needs of a person with advanced dementia. As another example, someone diagnosed with diabetes needs chronic care — that is, doctor or nurse visits; ongoing monitoring, including blood tests; medications; and foot and vision exams. If the diabetic condition deteriorates to the point where the person is unable to walk or perform daily activities independently, then significant changes need to be made.
Some future needs can be anticipated, and others cannot. The goal is not to have a detailed plan for every possible contingency but a general idea of what can reasonably be anticipated and planned for.
Location, location, location
The well-worn real estate adage of choosing a home based on location applies to this stage of your life as well. In this case, location is not so much an economic asset (although in some cases it can be) as a symbol of personal comfort and satisfaction and, often, being near family and close friends. Consider how you will meet all your needs — including the social and emotional aspects.Many people just say, “I want to stay in my own home!” And indeed, that’s a reasonable short-term goal, but it may not be feasible in the long run. Beyond their initial statement, many people just stop thinking about it or assume that their children (or more likely, a particular child) will say, “I’ll move in with you so you can stay at home.” Maybe that will happen, and maybe it won’t. But it certainly requires an explicit understanding, not just an assumption.
In thinking about location, you want to consider:
- Family: Moving to another community to be nearer children, often at their urging, may be an option. You should consider what you may lose and what you may gain. Someone with strong ties to a particular community — for example, a faith community or club or other group — may miss that connection. On the other hand, you may be able to re-create those ties in another setting. A lot depends on the type of community you would move to, whether you have spent enough time there to be confident you would like it, and whether you will have to depend on your children for transportation and other needs. Visiting your children as a guest and participating in their activities is different from being a permanent resident. Some social groups welcome newcomers, but others closed their ranks a long time ago.
- Climate: It’s almost a stereotype that older people want to move to warmer places, but in fact that is one main reason people do relocate. There may be health reasons to move to a different climate, or the upkeep on a house and car in a winter zone may be too onerous to sustain. But not everyone adjusts easily to a more or less constant temperature, especially if it’s very hot. And although blizzards can create dangerous situations for someone living alone, so can hurricanes and tornados, which generally occur in warmer areas.
- Cost of living: Different regions of the country are more or less expensive places to live. This applies to costs of housing, medical care, food, personal care services, transportation, and other items that will figure into your plan as well as independent or assisted living.
An extended visit to a community you’re considering is a good way to find out whether you like it or not. Before or after your visit, you can look online to get an idea of prices for everything from groceries to rentals. You’ll also see what social, sporting, and cultural events are featured. Think about what you most like to do now and what you would like to be able to do in a new location.
Timing and flexibility
If you’re going to make a change, when is the best time to do it? I can’t give you the perfect answer. Still, if you’re planning to stay where you are for the immediate future, you should start now to reassess your home for safety and accessibility. The mostly minor modifications you can make now will help prevent falls, which are the most common reason for a need for more intense long-term care services. Even if you don’t expect to stay in this location permanently, the modifications will add value to your home because they will also make it safer for others, including families with young children.At the same time, you should begin to investigate alternatives. Without the pressure of family members or doctors insisting that you make a change, you can think about what matters most to you and what you have become used to but can live without.
If a change does fit into your plan, allow enough time to make all the arrangements and consider all the pieces that need to be reassembled in a new location, whether that is independent living, assisted living, or another option. Downsizing and moving is one of life’s most stressful events, even if it is well-planned and desired. Take your time.
You may not have enough space in your new location for the lifetime of memorabilia and objects you have collected. You may have to donate or sell some possessions. If you’re moving from a big house to a smaller house, apartment, or condo, you may have to decide what furniture to keep and what won’t work in the new setting. This process — with the emotional impact of dealing with so many memories at once — stops many people from moving forward. But if you enlist help from family, friends, and, if need be, from professional organizers, it can be liberating.Be flexible. Even if you aren’t moving to a different location or a different community, you’re entering a new stage of life. Change can be stimulating but also disorienting.
Paradoxically, remaining independent often means asking for help. Asking for and accepting help is often a major hurdle in any future plan. Being willing to acknowledge that you can’t do everything alone (and probably you never really did) is the first step toward a person-centered plan. Family and friends are your first sources of help, but they are not the only ones. Neighbors, volunteers from community groups, building contractors, home care aides, and transportation services can all play a part in helping you achieve your goals.