The author of Being Mortal, Atul Gawande, identified the three plagues of old age as #1 Loneliness, #2 Dependency, and #3 Boredom. Much could be done to alleviate those three plagues! See if you agree with me.

Consider Plague #2—DEPENDENCY

It is possible to delay physical decline for decades with good nutrition and exercise. Eventually, the wear and tear of longevity takes its toll on the human body. Most older adults will experience some loss of mobility, strength, and balance. At some point, many will need assistance with activities of daily living (ADLs). However, Dr. Gawande encourages us to ask, Does the need for assistance  necessarily mean the end of all choices? 

In residential care facilities, one’s autonomy can be subject to the schedules, routines, and menus set by the staff. There are many benefits to living in a place designed to meet the needs of the elderly: prepared meals and housekeeping services, social interaction, transportation, and planned outings. When comparing potential residences that include such ongoing services, however, one would be wise to consider how much autonomy is allowed. Not all such institutions are the same. Assisted living differs from skilled nursing in offering several levels of care depending upon one’s needs. While some residents welcome the opportunity to minister to their new neighbors in a retirement community, others are passionate about “aging in place” (continuing to live in one’s own home) to preserve their choices, existing relationships, and the comfort of familiarity.

How might we maintain the privilege of choice after we have reached the point of needing some assistance? There are several options outside of residential care facilities, but they each require some research, planning, and cooperation.

HIRE ASSISTANCE with yard work, housework, finances and your personal care or purchase a condo or townhome that includes landscaping and exterior maintenance in its monthly fees. With such assistance, you can remain in your own home where you choose your schedule and the menus. Some long term care insurance policies cover this assistance once you are diagnosed with a chronic disease. The downside to this arrangement is twofold—the  cost and the need for supervision of the folks you have hired. To avoid elder abuse and/or elder fraud, it is advisable to involve a trusted third party.

THE VILLAGE MOVEMENT is driven by the desire of many to “age in place.” This is a network of folks organized to pool their talents and resources with the goal of helping one another maintain their independence as they age. This arrangement greatly reduces the cost of hiring assistance, and sharing such resources lessens one’s vulnerability in the marketplace. If you are interested, explore the following websites:

Whether or not there is a Village Movement is your area, you can become more interdependent by connecting with your own community. If you are not already, try becoming aware of your neighbors’ needs. Read your local newspaper and church bulletin to find ways to volunteer that you may enjoy. Consider joining the local food bank, a community garden or mentoring in the schools. Keep trolling for opportunities to participate while you are able to give and share in group projects that will benefit others. When it is your turn to receive, it will be much easier because you have been contributing. You will not be a dependent person but part of a local caring adult network.

MULTI-GENERATIONAL LIVING ARRANGEMENTS can address the needs of the aging at the same time they facilitate the unique contributions an older family member is able to make to the household. Consider this solution while you are capable of assisting the younger generations in a significant way. Strong, mutually beneficial relationships are necessary, but there is such a movement afoot. Many families are adopting this age-old solution to the need for some assistance in the fourth quarter of life. Together Again by Niederhaus and Graham and When Your Parent Moves In by Horgan and Block address the unique concerns of multi-generational living.

PRESERVE YOUR POWER OF CHOICE BY EXERCISING IT NOW. It only makes sense to choose where and how you live now with a look at future transitions and possible limitations. At some point down the road, for example, you will no longer be able to drive. Why not select a home or condo that is within walking distance of your basic needs—the post office, the library, a restaurant or two, the movie theater, the grocery store? Get familiar with Uber and Lyft. As one moves through the decades, options become fewer, but we always have the option of looking to Jesus Christ—our Creator, Savior, Brother, Wonderful Counselor, Friend, Hope, High Priest, and our finish line.

Trust in the Lord with all your heart; do not depend on your own understanding. Seek his will in all you do, and he will show you which path to take. Proverbs 3:5-6 

Humble yourselves, therefore, under God’s mighty hand, that he may lift you up in due time. I Peter 5:6 

A person standing alone can be attacked and defeated, but two can stand back-to-back and conquer. Three are even better, for a triple-braided cord is not easily broken. Ecclesiastes 4:12

Keep your eyes on Jesus, who both began and finished this race we’re in. Study how he did it. Because he never lost sight of where he was headed—that exhilarating finish in and with God—he could put up with anything along the way: Cross, shame, whatever. And now he’s there, in the place of honor, right alongside God. When you find yourselves flagging in your faith, go over that story again, item by item, that long litany of hostility he plowed through. That will shoot adrenaline into your souls! Hebrews 12:1-3 MSG