Wherever we live, we’ll want to stay as independent as possible for as long as possible.
What does being independent mean? Clinicians and insurance companies characterize it as the ability to manage “Activities of Daily Living” (ADLs): bathing, dressing, eating, toileting, transferring (getting into and out of bed, chairs, etc.), and staying continent. The more of these you can manage unassisted, the more “independent” you are.
Independence also requires functional abilities like housekeeping, managing money and driving. In most of the United States, it’s hard to stay independent if you can’t drive. Not being able to drive is a primary motivator for moving to independent and assisted living facilities.
Most basically, the key to independence is staying healthy (Aspects of Health Under Our Control). But we can extend our abilities by using assistive devices, retrofitting our living spaces, and developing a network of support.
Of course there’s a continuum of independence from needing occasional help to being unable to survive without daily assistance. The transition through this continuum may be gradual or abrupt. In either case, the older we get, the more important it is to plan for the end of independence. This means identifying future surrogates and facilities and pre-planning the transition as much as possible (Preparing for the Inevitable).
It also means accepting when the time has come. This is far from easy. It’s among the most contentious issues between elders and adult children. While we’re spared having our kids take away our car keys or whisk us from familiar settings, we may be more at risk for losing independence by triggering an auto accident, letting an unattended pan start a fire, or being found wandering in the night.