The Washington PostDemocracy Dies in Darkness

Even in midlife, it’s smart to start thinking about where you’ll live when you’re old

(Pep Montserrat for The Washington Post)

As soon as my parents became eligible for Medicare, my siblings and I started nudging them about planning for their future. They were healthy at the time, but we found ourselves looking at their house with a fearful eye. It had lots of steps, narrow door frames and uneven floors, and it was a hundred miles from my sister, their nearest child. We could easily imagine a nightmare unfolding.

What if one or both of them became disabled or seriously ill? What if one died first, leaving the other? There were so many worrisome scenarios, but our parents stuck with their plan for “aging in place.” After all, they had witnessed my father’s aunt live out her final days unhappily in a dreary nursing home.

It turns out we three were the realistic ones. My dad did become disabled. My mother was diagnosed with lung cancer. A generous long-term care policy covered a great deal of the in-home services they received, but their living situation became the predicted nightmare. When a blizzard isolated them for days without power, it was the first time I truly heard fear in my dad’s voice.

After my parents died in 2017, and as I approached 60, I vowed to do things differently. According to AARP, people turning 65 these days will probably live another 20 years — and 70 percent will need some level of long-term care. I needed a plan — actually a revised plan, because until then I’d expected my husband to be part of my plan. But we divorced. And so, with no guarantee that I’d find another partner and — like many LGBTQ people — no kids, I had to think about an aging plan for just me.

Since my contemporaries are now approaching (or passing) Medicare age, I asked for their thoughts on senior living. My former work colleague, Paul Boutin, 58, told me: “Denial, Steven. Sheer denial.” A high school friend, Michael Shapot, 62, hit the nail on the proverbial head: “Call me Peter Pan. My plan is to never grow up and need senior living.” I empathized with both.

Like 90 percent of older Americans, I had hoped to “age in place” — until I saw up close how difficult it was for my parents (and worrisome for their kids). And expensive: premiums for long-term care policies like my parents had now average $2,700 a year, according to the industry research firm LifePlans, which AARP reports “puts the coverage out of reach for many Americans.”

Even worse, premiums skyrocket as people get older, and once you develop a medical condition you may be rejected. As for Medicare coverage, forget it. It doesn’t cover nursing homes, assisted living or in-home care.

Fortunately, I live in an area with many options, including continuing care communities (where residents live independently until they need assisted living or skilled nursing care), nursing homes for those who need more medical care, memory units for people with dementia or Alzheimer’s, and cohousing (independent units with shared kitchens and other common areas). I wondered which, if any, might feel right for a gray guy like me.

I first visited a continuing care community that a friend had recently moved to — which also has a waiting list of up to 12 years, depending on the type of unit.

I kept in mind what Rodney Harrell, AARP’s vice president of livable communities and long-term services and support, told me during a recent interview: “What are our possible needs for ourselves and our families, 10, 20 years [from now]?” In other words, it was important for me to look at the options through the lens not of whom I am today, but of my 74-year-old future self.

I really didn’t want to do that, but that is the nature of denial.

I started at the two-bedroom cottage that my friend, Debbie Finn, a former teacher, now lived in with her husband, Arthur, a retired doctor. They miss their old neighborhood, where they lived for three decades, but at age 85, Debbie says they did the right thing.

“Aging in place is not convenient if one has to go to the hospital and the spouse has to transport him/her,” she says. “Reliable help in the home is not easy to come by consistently. Our children are relieved of all concerns regarding our health needs.”

Before the tour, Debbie and I had lunch in the community dining room, which is bright and airy, with choices from shrimp scampi to pizza to a salad and sandwich bar. But as I looked around, I couldn’t help but think, “Jeez, there are all these old people here!”

Sure, some were like Debbie, in great shape, stylishly dressed and engaged in conversation. Others relied on wheelchairs, canes, walkers and rollators. (Residents range in age from 62 to 105.)

“This is my future,” I thought with a pang.

I persevered and went on to see the rest of the place, with a group of about 20. Daughters with their mothers. Couples in their 70s, and a handful older. A friend, in his early 80s, happened to be on the tour and whispered to me, “I’d rather kill myself than be here.”

We visited several units, all clean and well kept. Some were large and open, others small and claustrophobic, none of them cheap.

Continuing care communities are among the most expensive options, with entry fees that can reach into several hundred thousand dollars, with additional monthly fees from $2,000 to $4,000, reports myLifeSite, which provides a wealth of information about these communities.

My anxiety rose proportionately as my Peter Pan syndrome dissolved: Yes, I would be one of these old people one day. Would that fear inspire me to plan — or to adopt my parents’ denial? Before the tour continued on to the skilled nursing facility I had my answer: I bailed.

That evening I emailed Debbie. Her advice: “Write the [deposit] check and forget about it.” The next morning I sent a $1,300 check that added my name to the waiting list. Maybe when I’m 74 those other residents won’t seem quite that old if I decide to go. And if I change my mind I can get a refund of $1,000.

Next I looked into a “cohousing” community not far from where I live. Cohousing communities feature private homes, or condos, that share common spaces (kitchen, dining, and entertainment areas). Charles Durrett, 64, an architect who coined the phrase (with Kathryn McCamant) and who has written “The Senior Cohousing Handbook,” explained that participation among residents is fundamental to cohousing.

“There’s no hierarchy among the residents,” he said, adding that the facilities are designed to foster community. “It’s not just about independence and care — it’s about the all-important emotional well-being of each and every one.” In many of these communities, fellow residents do much of the day-to-day caregiving, but those seriously ill or disabled will need to get in-home medical care, or transfer to a nursing home or skilled-nursing facility.

Advertising itself as an “urban, intentional community,” the cohousing community I visited features a modern, stylish building designed primarily for seniors and, according to its website, is home to 36 “lively and creative” individuals. It’s beautiful, with gardens and terraces and units with tons of light.

Alice Alexander, 62, a self-described “happy resident” and former executive director of the Cohousing Association of the United States, told me, “it’s an excellent choice for seniors to house themselves with dignity, independence, safety, mutual concern — and fun.” She made a point of adding that “a strong social environment contributes to better health.”

I watched one of the residents prepare a Tex-Mex dinner in the common space and thought, “I like this option.” But I also learned that on a per-square-foot basis, cohousing units are often more expensive than similar homes in the same ‘hood. (You’ve got to pay for those common areas, gardens, and more.) Was it worth the extra cost to have the communal atmosphere knowing that I might also need to pay for extra care at some point?

I understand better now why my parents couldn’t make a plan: It’s scary to contemplate one’s own old age. I love my current house (with a ground-floor master, making it feasible for aging in place), but I’m glad to have a Plan B with that deposit check as my safety net. Without a spouse (at least for now), I’m guessing my three 20-something nieces will be pleased, too.