Moving to a retirement community: What goes into a physician’s decision


Part of a series.

I put down my blogging pen last fall to focus on two things. One was completing a new book: Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor. The second was preparing to move to a retirement community.

We live in a pleasant neighborhood with nice neighbors who mostly all moved in here about the same time. It seems that the Grim Reaper has stationed himself nearby. There have been recent deaths from complications of diabetes, breast cancer, autoimmune disease and lung cancer with others dealing with lymphoma, Alzheimer’s disease, arrhythmias and a bleeding ulcer — plus multiple joint replacements.

Most people move to a continuing care retirement community (CCRC) after a life altering event such as the death of a spouse, an illness or some other major challenge. My wife and I decided to do it now — in our early 70s — while we have good health. Our daughter suggested that we were not “old enough.” We looked in the mirror and disagreed. When visiting CCRCs, we do of course immediately notice those with walkers and wheelchairs. But we’ve also met many individuals with sharp minds who are vigorous and engaged.

There will be help when or if we need it — a van to the grocery store, the mall, the movies or the symphony; multiple in-house restaurants; indoor swimming and gym; walking trails and more. And there is very good medical care, assisted living (hopefully not needed) and long-term care (very hopefully not needed). In order to “age gracefully” there are some key actions to keep our bodies functioning: good diet (and not too much of it), exercise, reduce stress, and no tobacco. Our brains need these four plus intellectual challenges and social engagement. CCRCs are designed to offer opportunities to work on all of these. It is sort of like returning to a college campus, “senior campus living.”

We made our choice of those available for some of the obvious reasons – location, appearance, perceptions of management and staff, options and quality primary care. The latter was important as I am a strong believer that primary care is the backbone of medicine, and a good PCP is essential to good health. We will keep our current PCPs (both with one form or another of direct primary care) but will get to know the PCPs at our new home.

It all sounds great. But our apartment will be about one-half the size of our current home with very little storage (i.e., no attic, basement or garage.) We have lived here for nearly forty years, so there has been a lot of accumulation. Much of it is not that important, indeed probably not that important at all. But it seemed important to us at the time and still does. There is some nice antique furniture that we have used and loved for many years that has to go. So too some collections that will simply not fit.

We have found that doing a room at a time makes the process less overwhelming. Allowing it to be iterative also helps. What today seems essential to save seems to become much less important a few weeks or months later. That box that houses some stressful old memories maybe just doesn’t have to be opened at all.

It’s been an interesting process and journey so far, and we imagine it will be even more so once we complete the move. But it has created its own anxieties as well: Is this the right decision? Is it the right time? Is it the right CCRC? What if we don’t like it? And most of all — this is a marker of a new phase of life just like going to college, getting married, starting a career, starting a family or beginning retirement. We need to remind ourselves that this is not “the last phase” but rather a “new phase.” We’re exciting, but the anxiety is just under the surface.

Like all of life’s transitions, we won’t really know what it is like until we experience it. Hopefully, it will last a lengthy time and with good health so we can evade that inevitable final transition for long while.

Crisis-2 jpegStephen C. Schimpff is a quasi-retired internist, professor of medicine and public policy, former CEO, University of Maryland Medical Center, and senior advisor, Sage Growth Partners.  He is the author of Fixing the Primary Care Crisis: Reclaiming the Patient-Doctor Relationship and Returning Healthcare Decisions to You and Your Doctor.

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