There is no doubt that most of us would like to live out our later years in our own homes or apartments. We are all aware that nursing homes and hospitals are necessary for the poor, sick, and lonely, but we assume, as we often do about illness and death, that these are things that happen to others and not to ourselves.
Most of us have had to make numerous decisions in our lives about where we are going to live. Many people have lived in several places, either in one city or town or in many geographic locations. You may be near members of your family, or you may be far removed from them. At some point, you may have to examine whether your living arrangement is the best one for you now and in the future.
Some changes in living arrangements may be precipitated by illnesses, whereas others are made by changes in social, financial, and family needs. The alterations that follow an illness are more difficult to deal with because usually there has been no planning or forethought about them. Other changes may have been considered for many years before the move finally occurs. Usually, you move because you want to, rather than because you have no alternative.
If you are having difficulty maintaining yourself in your own home, you and your children may raise the possibility of moving into a nursing home, retirement community, or even a hospital for long-term care. The latter becomes an issue only if you have become too ill or dependent to look after your most basic needs. The decision to move into a retirement community or nursing home must be based on many factors. You may resist the thought of relocating your life and giving up the comfort, privacy, familiarity, and individuality of your own home, which cannot be supplied even by the best institution.
On the other hand, your home may have become a prison if you feel isolated and are physically or emotionally impaired. Perhaps some of your friends have died or left your neighborhood, and perhaps your family is scattered in distant places. The chores of shopping and housework can become overwhelming if your physical capabilities begin to fail. Your fear of illness or accident may become so great that you might not risk going outdoors. A sudden illness for which no one can be contacted may be so frightening a prospect that you may begin to fear being alone.
Ideally, with close family and friends nearby, you may be able to stay in your home or with a family member. In many cities and towns, community services can assist you at home. Meals on Wheels and visiting nurses, therapists, homemakers, and physicians may be enough to allow you to keep your home. Senior-citizen centers can assist you in remaining social and active and also help your family, who may be looking after you. With this type of care, you will probably be happier at home.
If you feel imprisoned at home, however, moving into a retirement community, home for the aged, or nursing home may be a welcome solution to your problem. The institution may not only satisfy your physical needs, but it may offer also a creative outlet.
In most communities there are more nursing homes than any other type of facility for the older person who can no longer live at home. Some nursing homes divide the type of care required for their residents between those who are more independent and those who are more needy. However, in many instances all the residents are in fairly close quarters, and this has disadvantages, of course.
If you are physically well and active, a retirement home or community may be more suitable. You may have to move from your old neighborhood or town, so the difficulty in maintaining contacts with friends and family has to be weighed against the benefits. Many older people and especially older couples are choosing to move to retirement communities in warmer climates. Here, too, you might be leaving family and friends, although these communities usually foster a strong neighborhood spirit. During times of crises it may be difficult to arrange for assistance and the comfort that a nearby family gives. Children often become disturbed by the thought that should an illness ocur, they will not be able to help their parents. If you choose this type of living arrangement, try it out first if possible without making a firm commitment. Explore the facilities for both recreation and work. Speak to as many residents as you can, and make sure that the medical care is of high quality. When you move, ask your physician to forward your medical records to your new physician. Ask your doctor to keep a copy of your file in his office. If you return for a visit, you may still want or need his medical advice as well.
If you move into a nursing home or retirement home in your vicinity, you or your children should explore the residence as thoroughly as possible. The type and quality of nursing homes vary according to regional, financial, social, and political factors. Unfortunately, some homes are badly supervised and poorly run. Others maintain an exceptionally high quality of care. Municipal homes vary in quality depending on the locale, but they may have more stringent regulations than commercial institutions. Many philanthropic organizations and religious groups support and organize homes for the aged. In my experience, they provide a consistently higher level of care than commercial nursing homes. Because they are sponsored by nonprofit organizations, their degree of commitment and responsibility is frequently greater than nonaffiliated nursing homes.
If you require a great deal of skilled nursing and medical care, you may have to move to a facility capable of supplying long-term care. There are many types of skilled nursing facilities, depending on where you live. They vary in quality but usually give adequate care as well as provide some outlet for emotional needs.
Once you decide to move into a nursing or retirement home, find the best and most suitable one for you. You may need to rely on your family or health care professionals to assist you in making a decision. Depending on where you live, there may be a great deal of choice or little choice at all in finding a suitable home. If many residences are available, inspect them yourself or with a member of your family. Do not be afraid to speak to residents and their families, and ask the medical and nursing supervisors about the care that is given and the attitude of the staff.
It is important to determine the type of medical care you will receive. It is preferable to have a physician whose commitment to the home is permanent and stable, rather than having a “rotating’ physician. You should be assured of the availability of your own physician too. An inspection of the kitchen is important; ask to eat one meal with the residents if possible. Social and recreational facilities are crucial. Ask the residents what programs are available and how often and how well they are arranged.
Your family should not be afraid to ask about the care that you will be given and what kind of access they will have to members of the social service and nursing and medical staff. It is important that at the time of admission you and your family feel comfortable that the decision is the best one for all concerned. This cannot always be achieved, however. Your children may feel guilty and you may feel resentment. You could seek professional assistance to help ease you and your children through this difficult transition period.
Although many people feel that by entering a nursing or retirement home, they are on their last journey in life, the opposite is often the case. In well-run, creative facilities, your life may become more active and interesting than when you were living at home alone. Many good residences provide activities that may rekindle interests that were dormant for many years. I have met many older people who embarked on new paths of expression and creativity after they had moved into such residences. You can make of it what you would like. You may have to work hard to adapt in the beginning, but you can adjust and continue to lead an interesting and satisfying life
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