Living Arrangements at End-of-Life

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Coming to terms with the inescapable reality of our departure from this life is, for far too many people, an unthinkable, unimaginable concern.

Not wanting to accept eternal truths like “no one lives forever,” we too often avoid planning ahead for our demise.

While many people diligently complete Living Wills, Health Proxies, POLST forms, etc., preparing for their demise, what often doesn’t get as much attention are the years just prior to that end.

This topic is very near and dear to my professional AND personal heart and is born out of experience.

Many fail to deal with the issues of where and how will they spend their “twilight” years.

While many people emphatically say that they want to stay in their homes, that is frequently a misguided idea.

There are so many What-Ifs:

  1. What if a husband needs health care for which his wife is unable to assist?
  2. If it becomes a burden on her, she could become emotionally drained 
  3. If she should become emotionally drained, he will not get the assistance he needs,
  4. If both are ill, neither spouse’s needs are being addressed adequately.
  5. We pray the wife remains in good health – mentally and physically. If something drastic should occur to either of them, like a stroke, most people do not make good decisions in a crisis.
  6. If someone lives alone and has an issue, they probably are not in a sound position to make decisions, or get help.
  7. If one chooses to stay in their own house, that means keeping up with schlepping the garbage out, daily maintenance like replacing a light bulb, fixing stopped-up drains, and general outdoor maintenance, 
  8. If you have to stop driving — losing your independence — that means no leaving the house alone. You can’t go where and when you want, you’ll always need a shadow, and your life schedule now is determined by who is available to drive.
  9. Is your home near public transportation? 
  10. The independence issue is probably the most destructive to a person’s ego, and it bears repeating: Relying on friends — or a car service or even a community bus — means your freedom to come and go is limited by THEIR schedule.
  11. Expenses now to accomplish the many chores that you or a spouse USED to be able to do now will add up significantly.
  12. The pressure and responsibilities add up significantly.
  13. If you have reached “senior” status — it’s likely most of your friends have too. Some of them have died. Some of them have moved away. Some of them are in facilities.
  14. Your social life has become nonexistent and you find yourself alone.
  15. If family lives nearby, family dynamics are always interesting. Who — if anyone — is willing to do what? This is a HUGE question.
  1. You can’t rely on: I’ll be there for you” 
    1. Their job requirements change
    1. They relocate for a job
    1. Disagreements
    1. Finances,
    1. Personal schedules and, while they may live near you now, people follow their kids.
    1. Hiring help for a few hours a day or 24/7 can be expensive.


Many people who choose to remain at home while they are fine neglect to consider they may not remain fine and will be up the proverbial creek without the necessary paddle.

That can mean expenses and Isolation, health issues and boredom.

Consider alternatives such as established communities, which we really should rebrand as “Camp.” 

Think about it.

Every day has a full calendar of social activities, speakers, community rooms, maintenance, housekeeping, dining rooms, a nurse on premises, no car needed. No need to hire a plumber, or driver. This might be a paradise if you let it. 

Established communities most often address all these issues in a timely and satisfactory way. Adult communities afford one the opportunity to relax, socialize, have privacy — AND — many offer a golf course, a pool and a gym. 


How we choose to perceive something can make all the difference.

Everything we do is a choice. Making smart choices — that are in our own best interest — is key to a more positive and productive life.

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