As promised, this will be a continuation from the talk given by Connie Michaelis, lifestyle consultant at The Piper.  Hopefully, it will help you think about "what", "when", and "why".
The #1 threat to a person as they age is loneliness caused by being isolated.  It threatens one's physical health as much as mental health, and is as detrimental to older people as smoking and high blood pressure.  We need to hang out with people and be social, but too often children and grandchildren are too busy with their own lives.  All through life, people plan for the future.  They plan where they will go to school, they plan for their jobs, they plan for their families.  So as one ages, it is also important to have a strategy for the future.  After you retire is when you are just old enough to find purpose and a passion in life, and have time to do it (ha, ha!)  But until you face your own mortality and the fact that you will someday die, you cannot live.  Planning for the future and preparing for all circumstances can lead to a life of peace, happiness and satisfaction.  You need to start early in making decisions.  86% of people will need help as they age, so it is important to get a plan--and then hope you die in your sleep and don't have to use it!  But so saying, everything you do in life is a gamble.  So at the same time, older people need to have a sense of autonomy, and their wishes and decisions need to be respected.
Retirement used to look much different from it does today.  Social Security was born August 14, 1935.  The monthly payment in 1963 was about $22.  There were poor houses.  There were mental institutions--(believe me, I worked at one during my psychiatric rotation in nursing school.) The nursing homes looked just like hospitals, giving the inference that the people living there were sick.
So let's talk about the different options available now.  It is so important to think about this while you still have the option to choose, so you can have strategies (maybe several) in place, so you won't be unprepared or surprised.
The first I will talk about is remaining in your own home.  Your home is your place of safety and security.  It is the place where memories are made. As we talked about last time, we are surrounded by our "treasures".  But when Bob and I moved into our present home 28 years ago (really?) we didn't even think about the stairs being a problem.  It was nice to have all the bedrooms upstairs!  But in the end, that was the factor that led to Bob having to move to a safer place.  He WAS going to fall down the stairs.  So how your home is set up isn't always conducive to having home health care come in to help in the home.
Becoming more and more popular, at least in this area, are the CCRCs--continuing care retirement communities.  They are typically operated with a buy-in plan, though some are now offering monthly rent in their communities--to compete with other newer facilities, I imagine!  The buy in plan covers your care from the time you move in independently, through assisted living, and nursing home care.  Some also have dementia care and rehab.  And now I think they are more apt to help you set up a plan that would leave assets to your heirs upon your death than they used to be.  The ones I have toured typically want you to live in independent living for at least 2 years before you move to more care, so they will assess your mobility etc. before you move in.  They are very social, with a lot of amenities and activities and have meal plans.  You also pay a monthly fee to cover utilities, cleaning, food, etc.  Be careful though!  Some stay at the monthly rate you sign in with though out your life there, with only cost of living increases.  Others, you start at one rate, and then the rate increases as your level of care increases.  So there is a lot to think about.  If you should put down a deposit while you are on a waiting list or while you are thinking about it, be sure to ask if the deposit is refundable.
Also hugely popular are the independent living facilities which may or may not have assisted living available that are month-to-month rent and there is no continuum of care.  They usually have meal plans, but there is also a facility right down the street from me that is called Village Co-operative, that
does not.  These facilities all have beautiful amenities, opportunities for socialization, and come in all different price ranges.  (And NO housework, as they do the cleaning!) Also, home health agencies can come in these facilities and help with medical care for the short term, or even long term, I imagine.  A thought about these facilities is that you can put a deposit down while you are on the waiting list, or just want to wait awhile until you make your final decision, and typically you would get the deposit (usually about $500) back if you decide you don't want to move in, or it would be applied to your first months rent if you do move in.  So you could conceivably have deposits down in more than one place.  This is an overwhelming thing to think about, but probably a year in advance of moving in is a good timeline to start thinking about it.  As I have helped my friend tour these places, I am pleased to see that different agencies are working together, and are making helpful suggestions.
I am just so glad I found The Piper for Bob, after touring many others.  It is a household model, and other facilities come to see it.  Instead of long halls with closed doors the majority of the residents are out in the common areas.  The food is cooked in the kitchen right there and they all are served and eat at a common table (a few spill over to tables in the sunroom.)  It is a bright and cheery place and Bob seems so content there, and that makes me happy.
I would like to close with a paragraph from Guiding Light Ministries International:
"There IS a place in which we can abide, whatever external circumstances may come, where we can maintain a sense of peace and joy throughout whatever events may be unfolding in our lives.  And it is within each and every one of us.  You must find that place...for there is nothing else that can compare, and nothing else that will ever satisfy the soul of man!"
I am heading back to Israel in a few days.  I solicit your prayers as I again walk where Jesus walked.
This summer will be very busy with grandkids here, but I will try to give updates on Bob.  (They may be much shorter than this post, as he seems to be on a plateau at present.)
Betty