Aging in Place or Assisted Living: It's About Choices

It's not hard to understand why 60-year-olds would say that they want to remain in their home for life rather than move to assisted living or a nursing home. These are generally people who are relatively healthy and feel that they can hire help for whatever they need down the road.

Indeed, aging in place sounds like a wonderful concept. What could possibly be wrong with it? The Washington Post interviewed Stephen M. Golant, a University of Florida professor of gerontology about the trend. Golant views the current. He feels that people should have choices and that aging in place is just one of them. Golant said in the interview that aging in place may prevent older adults from seeking "healthier, more holistic alternatives."

A tale of two elders

Years ago, I became the primary caregiver for an elderly neighbor, Joe, who was 100 percent deaf and was losing his eyesight. Joe's only son lived across the country. Joe was one of those people who would not have thrived in assisted living so I'm grateful I was there for him. But I often wonder what would have happened to him if I hadn't been.

The neighborhood had changed during the half-century Joe had lived there. The people he'd known had moved on or died. He wouldn't allow in-home health workers into his home, nor would he accept food from Meals On Wheels. When it came to care, it was me or no one.

Likely, had I not insisted on the personal alarm that I placed around his neck daily, Joe would have died alone after one of the falls from which I rescued him - many due to alcohol. Would Joe have preferred assisted living to that kind of death? Knowing Joe, probably not. He'd have still said that he wanted to die at home.

However, there are many people who, once they adjust to the change that a move to a facility brings, thrive. My mother-in-law was an example. Even though I visited her daily in her condo, bought her groceries and fixed her meals, she steadily went downhill, especially cognitively. Once she moved to a nearby nursing home she soaked up the feeling of safety and caring. She was rejuvenated by the social atmosphere of the facility and was utterly transformed.

I think that people should be able to receive the help in their homes that they need so that they can age in place if they choose to do so. However, I'm not yet convinced that this is best for everyone. Loneliness is a threat to mental and physical health, and loneliness can be difficult to avoid if one is elderly, living alone and in poor health.

Not every elder has a family member who can step in and provide in-home care. Not all elders have friends who can stop in to visit or take them out to events. As much as I want to see more funding that will allow people to stay in their homes should they want to, I'd hate to see resources become only focused on helping people age in place while good facilities dry up.

Note that I'm not against aging in place. In fact I'm for the concept if that's the person's choice and there is hope for some quality of life. However, I do agree with Golant that aging in place is not the solution for everyone. It was right for Joe. It was wrong for my mother-in-law. People are different and, as Golant says, they should have choices.

Carol Bradley Bursack
Meet Our Writer
Carol Bradley Bursack

Carol Bradley Bursack is a veteran family caregiver who spent more than two decades caring for a total of seven elders. This experience provided her with her foundation upon which she built her reputation as a columnist, author, blogger, and consultant. Carol is as passionate about supporting caregivers work through the diverse challenges in their often confusing role as she is about preserving the dignity of the person needing care. Find out much more about Carol at