Coffee heat rising

How to Age in Place…

As you know, my dear friends from church have moved into the Beatitudes, one of those old-folkeries presently dubbed “life-care communities,” where you take up residence in an apartment, eat in the institution’s chow line, get first dibs on space in the nursing home should you need it, and are generally watched and entertained 24/7. Sorta like a prison for old people. Or a rabbit warren.

It looks like Nirvana – just think! Never have to change your own sheets again! Never have to mow another lawn! Never have to wrangle a repairman to fix the plumbing! Never have to cook another meal! Wooohoooo!

Yeah. Freedom’s just another word for….

Not that I don’t understand where Mrs. Friend was coming from in deciding that they would make this move: they’re both in their mid-90s, Mr. F has fallen three times, he has glaucoma that soon will render him pretty much blind, and he has serious heart problems. She has a bad hip and is now too old to get it replaced, meaning she’s in pain all the time. And they had a bat-sh!t crazy neighbor who was bound and determined that they would not use the common walkway between their houses to roll out the weekly trash pickup. Even though most of the exterior work was covered by the HOA and most of the housekeeping was done by a cleaning lady, taking care of the house was getting to be a bit much.


Yesterday we all went out for lunch with Connie the Long-Haul Trucker. Mr. F ordered a bowl of chili, apparently something he orders with some frequency at the Institute. Along it comes. When he sees it, he remarks, “This bowl contains three times as much chili as we get at the Bistro” — which is what the old-folkerie calls one of its three chow lines. We eat and yak and carry on. Some time later, we’re about to settle up for the lunch, and he remarks again, “I got a lot more chili, and the quality is far better than the Bistro’s. And the meal was cheaper than what we’re paying.”

Mr. F is not a whiny guy…he’s a retired nuclear engineer with a lot of common sense. I’ll tell you, I was unimpressed with the quality of the Bistro’s food, myself. They had me over for breakfast…not my favorite restaurant meal, since I can’t eat eggs and I don’t care for cereal and I detest pancakes with sweet gooey gunk slopped over them. So I order an alleged “Belgian waffle.” Out comes a little waffle-shaped thing, about four or five inches in diameter, no powdered sugar on it. Looks like one of those things that you take out of a box and pop into a toaster.

I asked for extra butter (because lots of butter is the only way to gag down pancakes and waffles made from a mix, if you dislike syrup), and they brought me four or five tiny individually wrapped packets. The waffle thing wasn’t hot enough to melt the butter — would’ve done better to have ordered a couple pieces of toast. But more to the point: on the way out I realized my mouth was puckered-up parched, so salty was this fake waffle.

Ugh. Four years of bad student union food at the University of Arizona was enough for me. I sure don’t want to spend my dotage eating that junk.

This is the trouble with institutional life: it’s not life.

For three to seven grand a month, they could provide you with decent food. REALLY decent food. And more to the point, what the hell are they doing, serving up packaged foodoid that is so oversalted it leaves your mouth puckered up half the day to freaking old folks, most of whom presumably have cardiac issues?


Yesterday afternoon I started calculating how on earth I can stay in my house until I croak over… Checking out a price comparison, it seems to me that even if you have to hire a 24-hour caregiver, it may be cheaper to stay in your home than to move into a storage bin for the elderly.

One person told me the Friends are paying 7 grand a month to stay in the cramped two-bedroom apartment they’ve landed in. The house wasn’t large, but it was one helluva lot more comfortable than four small rooms and a kitchenette. Actually three rooms: the dining and living rooms are separated by a sort of partition that doesn’t quite make them separate spaces.

The Beatitudes works hard to keep its rates off the Internet. One site says the place charges 5 grand a month…but that’s for a studio or one-bedroom apartment. For one person. So $7,000 for the two of them in a two-bedroom suite is probably about right.

Even hiring someone to come in and take care of them 24/7 in their house would not have cost $7,000/month. Even if it did, they’d still be in their home.

The Institute gave them each one of those electronic dog tags to wear around the neck, to summon help if they fall or have a heart attack. But forgodsake! You can get those for free at Amazon. The best of them, which summon the EMTs or police as needed and come with a lockbox for emergency workers to retrieve the house keys, have a subscription rate that’s only about $20 or $30 a month…again, a far cry from 7 grand.

That’s 7 grand a month plus all the return on the sale of your house: they had to pay ALL that they netted on the house sale to buy into the place. They got about 360 thou, from what I can tell.

Uhm…let’s think on that….

I figure that if, like me, you have nursing home insurance (one reason to buy into the place is that you’re guaranteed a bed in the nursing home, when the time comes), all of your living expenses and all the services they’re getting would run you around $2292 to $2323 a month if you stayed in your home:

They didn’t have a pool at their house…nor did they care to use one. So knock $240 a month off those totals for a person who lives pool-free.

As for transportation: they’ve kept the car, even though driving has become a challenge for them. But let’s say you used taxis or Uber to get around. Everything they needed was very close to where they lived. If they were like me, they could keep the driving junkets to one every two or three days.

Take the cost of your vehicle (about 28 grand. paid in cash) and prorate it plus the taxes, insurance, and routine care over 12 or 15 years: you get a monthly cost of $797 to $836. With that bracing calculation in mind (it doesn’t even include gas!), judicious use of taxicabs would be significantly cheaper. Let us say that on the low end they actually are paying $5,000/month to live in the warehouse. Five grand would buy you one helluva lot of taxi rides!

If a typical taxi trip cost you $50, that would be a hundred rides per month! If you went out twice a day (!!), the junketing would run you $3,000/month, significantly less than the rent at the old-folkerie; if you even went out once a day (which would be about three times more often, on average, than I drive anywhere), at $50 a trip it would cost you $1500 a month. While that’s more than owning and driving your own car, it’s a far cry from living in that place, where the transportation is a shuttle-style jitney ride to the doctor’s office or a grocery store. A-n-n-d…$827 a month to own and operate your own car — which doesn’t include gasoline) — is not that much less than $1500 a month for chauffeured rides…I spend about $60 a month on gasoline, which would bring the total to around $887 a month. And I think that’s pretty conservative. It assumes you paid for the car in cash — if you didn’t, your monthly cost would be a great deal more than the proposed taxi rides.

With grocery stores and Amazon now delivering orders, including whole ready-too-cook meals of fresh food, I think you could stay in your home and live better — and no less safely — for a lot less than it would cost to institutionalize yourself.

Got a thought? Am I nuts?

6 thoughts on “How to Age in Place…”

  1. Aging in place really is the way to go, if you live in a manageable to maintain, single story house (I’d say under 1600 square feet). Part time visits from a home health aide (2-3 times a week is plenty usually unless dementia or severely ill), plus grocery delivery, meals on wheels, yard and home cleaning services, and ubering make aging in place doable and often cheaper than assisted living. I work with a large number of older women (religious congregation) and it really is cheaper to put people together in the same apartment building (own apartments) and pay for them to have the needed services than pay for each person to go to assisted living.

    My grandmother paid $6,000 month for her single room in assisted living facility in central Jersey before passing away, and they nickle and dimed her for everything, including outgoing telephone calls (something like 20 cents a minute) and the nurses service for family medication dosing ($5/day). She had to be put in the facility as her home was two story and she couldn’t move in with family (plus she really did need assistance after a while— she was in late 80s when she moved in).

    It really is all about planning though… too often people are waiting too long for these decisions and they end up rushed in the end. Always good to move/downsize while one still has the physical and mental ability to do so.

    Plus, having ones independence taken away has been shown to shorten longevity. So even if they cant drive, showing them how to uber (if no dementia) keeps the sense of independence and spirit alive. If a person can safely age in the comfort of their own home and it’s more fiscally prudent and emotionally satisfactory to do so, it’s silly to move to assisted living.

    Also, a lot of these assisted living facilities know they are on borrowed time. In about 20-30 years a lot won’t be open any more as each generation after the baby boomers is smaller and smaller.

    • That is truly interesting. The idea of having folks together in an apartment building so as to deliver services more efficiently — yet NOT have it be an “assisted living” facility per se — sounds pretty constructive. Personally, I happen to like the presence of young couples and children. That’s one of the things I love about my home: as the neighborhood gentrifies, more and more young people with kids are moving in. I so much enjoy the sounds of children playing and young adults going about their business…can’t imagine living in an age-segregated community.

      One of my other coreligionists and her (now late) husband moved into the same facility, and shortly moved out. Among other complaints, she remarked, in exactly the same terms, that they were nickeled-and-dimed every time they turned around.

      Holy mackerel! They gouged the woman for making phone calls? That is…criminal. And one suspects it’s a strategy to discourage communicating one’s dissatisfaction to family members, eh?

      My house is 1680 square feet, on one story, no basement. Though it’s a little large, I use two of the bedrooms for storage, and so they don’t need a lot of cleaning or other maintenance. The yard is desert-landscaped; upkeep entails monthly blowering and some minor trimming, easily handled once a month by Gerardo and friends. The pool is easy to care for, but if I get to the point where I can’t or don’t want to deal with it, a pool dude will come in once a week to cope with it, for about $80 a month…again, a far cry from the cost of life-care accommodations.

      For my friends, in their 90s and also in the throes of encroaching ailments of old age, it may have made sense to move to assisted living. The demented neighbor was a problem — she tried to run down Mr. F in her car (tried that with a couple other residents, too, including the vice-mayor of the city…), and I think they were kind of afraid of her. And in the fear department, Mrs. F frankly said that the prospect of one of them falling and not being able to get help scared the bedoodles out of her.

      These, IMHO, are reasonable concerns. You could probably cope with the risk of falling with one of those emergency call buttons. Food, as you point out, can be delivered, and cleaning help can be hired. But a bad — and possibly dangerous — neighbor poses a serious problem and definitely curtails your pleasure in your home.

  2. I will share, falling is the biggest fear in the elderly and for good reason. I know from experience that Dear Father would fall and sometimes he and Dear Mother couldn’t get him up. One morning DM called at 4:30 am … Dad had fallen out of bed. I got down there and he had “bump” on his head but appeared fine and was sound a sleep on the floor. We got him up and back in bed. He remembered nothing the next day. I agree aging in place is the way to go.

    • Wow! That must have been worrying for all concerned…except maybe for Dad himself, who seems to have suffered no ill effects.

      At the Beatitudes, Mr. & Mrs. Friends have been taking balance classes. She says it’s helped them to feel more sure-footed and confident. Also — this is apparently huge — their apartment is on the far end of the building that’s furthest from the chow lines. So…. to get to their meals, they have to go out, hike down the hallway to the elevator (their place is also as far from the elevator as you can get), and then walk over to whichever building houses the “restaurant” they wish to visit for that meal. It’s not very far — a couple hundred yards at most. But she says that twice-daily stroll has made them both feel a lot better.

      At least, that’s what she attributes it to. Of course, they COULD be feeling better simply because they feel more secure in their housing — no maniac next door, no HOA, no yard to have to care for, no housecleaning to speak of…and they don’t even have to go to a grocery store if they don’t want to.

      At any rate, I was startled to realize that our occasional Costco junkets — maybe once every three or four weeks — provided the most exercise they’d been getting. Now with the balance classes and the de rigueur hikes to the chow lines, they’re at least getting up and moving around every day, which has got to be good for their health.

  3. I don’t think you’re nuts, but I do think that your “age in place” scenarios assume a level of physical and cognitive ability that not everyone possesses. And some people (like your friends) may currently have a good level of physical/cognitive ability, but may be feeling declines that have them concerned about what’s to come.

    My mother needs someone to be present with her 24/7 because she had a stroke and her mobility issues are bad enough that she cannot use the bathroom without help. She also has cognition issues that I think would make it dangerous for her to use a stove without someone else around, and her hands don’t work well enough for her to open containers.

    Right now, she is still in her home because her sister lives with her and also because a rota of paid caregivers come some days/nights to help my mother take showers and so that my aunt can get a couple of uninterrupted nights of sleep each week. My aunt is the only reason my mother is still in her home, and I continue to worry that my aunt is giving too much for her own health and safety. I would worry less about both of them if my mother was in a nursing home or assisted living. Her needs are just so high, and paying someone to be present 24/7, even at minimum wage, is beyond what we could sustain for very long.

    I think that living on your own is great for as long as you can do it. And it’s great if you can find solutions that allow it to last longer. But I also think that it’s worth it to recognize that not everyone is in the same position that you’re in right now, and to allow some space for that in what you’re saying. You’re expressing yourself so strongly in your posts on this topic that it feels like you’re ignoring some hard realities that may or may not happen to you, but have happened to others.

  4. Yes, right on. I think that was my father’s concern when he consigned himself to Orangewood Baptist Estates at a relatively young age: he wanted to get care lined up should he need it, which he figured he would sooner or later. In his case it was later: he didn’t have his heart attack until he was 80, though he moved into the place at the age of 68. But one never knows. Also, the fact was he did not want to be bothered with taking care of a house and yard.

    Your situation sounds like my neighbor’s. Her mom lived to advanced old age. The family did the best they could to care for her in her home, but the true workhorse was neighbor’s sister, who lived with the mom and cared for her exactly as you describe. Sister had a job off and on — she did the kind of work that could be done either in the office or from home — so the old gal was left alone for a few hours a day. But she managed all right until she finally did have to go into a nursing home, right at the end. Still…there was a worrisome period before she reached that point, as she did not remain in possession of all her marbles.

    It seems to me this decision is very much like rolling the dice. Moving yourself to a lifecare community in advance of pressing need is betting that you will not drop dead at the kitchen sink and that you will indeed develop chronic, long-term, disabling health and cognition problems. And that is a very good bet, indeed. Deciding to stay in your home is betting that you will stay healthy right up to the bitter end, that you will have enough money to hire someone to help you when you need assistance AND you can find someone who won’t rob you blind or abuse you, and that somehow you’ll be able to get into a decent nursing home at the very end…or that you will drop dead at the kitchen sink.

    In 21st-century America, given our healthcare system and the quality of nutrition and protection from disease the Baby Boom generation has had, the odds are that you’ll live to advanced old age and at some point need maintenance care.

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