No longer home alone

For more than five years Donald Kruse, a retired bank officer in Whittier, Calif., considered the pros and cons of moving into a retirement center. But his wife, Anna, opposed

the move, preferring to stay in their home of 45 years.

"We talked about it a lot, and we investigated a lot of different places," says Mr. Kruse. "But to give up your house, that's something else."

Finally their daughter and son-in-law, Lynda and Richard Patton, aware that the couple needed assistance, stepped in. "I was pretty much the prime mover," Mr. Patton says. They found a large, efficiency apartment in Stanton, Calif. - a nonprofit facility where options range from independent living to assisted living and nursing care. Last June the Kruses moved in.

"Actually we waited too long," Kruse says, explaining that his wife died a month later. "We didn't realize my wife was as ill as she was." Now in particular he relies on services the center provides, such as meals.

Where to live in retirement is a question that looms large as the ranks of the elderly increase. Those 85 and older, like Kruse, make up the fastest-growing group in the US. For people hoping to "age in place" and avoid a succession of moves as their needs change, choosing the right facility becomes increasingly important.

The decision centers around three "W's" - whether to move, and if so, where and when. It can also involve adult children. Patton, of Pasadena, Calif., calls the role he and his wife played in arranging the Kruses' move "not untypical," adding, "Some of our friends have just gone through the same thing."

A roof and support

For many people like Kruse, assisted living ranks as an appealing option. Residents live in their own apartments and maintain as much independence as they want. But they also have access to support services such as meals, transportation, and personal care - bathing, dressing, grooming. Many facilities offer a range of activities - lectures, discussions of current events, music, local outings.

Not surprisingly, such amenities come with widely varying price tags. In the middle range, Kruse bought his apartment for about $100,000 and pays $1,800 a month for food, assisted care, and medication. At Edina Park Plaza in Edina, Minn., a typical one-bedroom rental apartment averages $1,900 a month. That includes 45 meals, housekeeping, and transportation. Home-care services cost an additional $6.30 for each 15-minute increment.

Typically, says Toby Mullenger, marketing director at Edina Park Plaza, women make up 70 percent of residents in these facilities and men, 30 percent.

Housing is, in fact, a central issue for older women. Ruth Harriet Jacobs, a gerontologist at the Wellesley College Center for Research on Women in Wellesley, Mass., notes that 46 percent of women over age 65 are widows, 70 percent of whom live alone. "Surveys show the last option most women want is to move in with adult children," she says.

Irene Wechsler, president of Elderlink Referral Service in Santa Monica, Calif., a free service that matches older people with appropriate facilities, receives 20 percent of her calls from retirees themselves. "They don't want to live in their big old house, and they want someone to cook and do the driving," Ms. Wechsler says. "Widows decide they don't want to be home alone, they want good meals, and they want people around."

How to help mom or dad?

The remaining 80 percent of calls come from adult children. "Usually they're at a loss to know what to do," she explains. "They suddenly realize their folks aren't safe with the stove or are malnourished or need help. For kids it's really hard, because they look at their parents with respect and don't want to go against their wishes. But keeping parents at home may be putting them in danger." In such cases, she says, "you have to look at this as a gift to your parent."

Yet Wechsler cautions, "Any time kids intervene and try to make decisions for a parent who is clear-minded and healthy, that parent will not move."

When clients call, Wechsler assesses their need, then gives referrals based on the family's preferred location and ability to pay.

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