By Mark Friedman
Having a personalized plan – as we discussed in last month’s article – is one of the most important steps you can take to age well. Once you’ve outlined your priorities, values, and preferences, you’ll find it much easier to navigate the four key factors that truly drive care decisions.
Most people don’t start this process until something major happens – a fall, a new diagnosis, the loss of a spouse, or a noticeable change in daily capabilities. But whether you’re planning ahead or responding to change, these four factors will help you build a clear, holistic path forward that adapts as your needs evolve.
Factor 1: What type of care do I need?
Start by asking what kind of help you truly need – and want. Do my current needs affect my lifestyle or the people I depend on? Can my family or others in my circle of care safely meet those needs, or is professional support required? If professional care is needed, what kind? Home care, adult day services, assisted living, or skilled nursing? Each option offers different benefits, costs, and levels of support.
Factor 2: Where will I live, and what are the tradeoffs?
Your living environment plays a major role in quality of life and safety. What are my options for aging in place, and what modifications might make my home safer? If I move, which settings – independent living, assisted living, or another model – fit my lifestyle and budget? Should I plan based on today’s needs or anticipate future changes? If I have a partner and we have different abilities, how do we plan together?
Factor 3: What do my options cost?
Finances often shape care decisions more than anything else. What is my realistic time horizon – how long do I expect to need support? What does each option actually include, and what’s billed separately? What will my insurance cover, and where might I need private funds? How do I protect assets for my spouse or heirs while ensuring I receive the care I need?
Factor 4: What resources are available?
You don’t have to do this alone. Who in your personal network or circle of care can help coordinate or deliver support? Which professional or public programs might be available? Do benefits or services vary by town or state?
Six steps for making confident care decisions
Even if you find yourself in the middle of a crisis, you can still take control by following these six practical steps:
Step 1: Do an honest assessment of needs.
- Physical health: Do I need help with personal care, medical tasks, or daily routines?
- Cognitive health: Have I noticed changes in memory or decision-making that affect safety or independence?
- Emotional well-being: Am I socially connected or beginning to withdraw?
- Safety and home environment: Can I manage household tasks safely and comfortably?
Step 2: Reflect on wants, priorities, and tradeoffs from your plan.
Step 3: Assess what’s already in place.
Step 4: Identify gaps and constraints.
Step 5: Weigh your options.
Step 6: Make your choices and revisit them over time
For many, the hardest part of the decision is place – where to live and receive care. Essentially, you’re comparing current place vs. different place and asking, “Based on my needs and wants, what is the right place for me?” If you stay where you are, what changes or support would make your home safer and more functional? If you move elsewhere, what type of community or residence best fits your balance of needs, lifestyle, and budget? As life evolves, your definition of the “right place” may change. Keep your plan flexible. Do your homework: Learn what “OK,” “good,” and “great” options look like for your situation. There will always be tradeoffs between comfort, cost, and availability.
Making care decisions is deeply personal and often emotional, but preparation brings confidence. When you’ve done your homework, reflected on what truly matters, and built a supportive network, you’ll be ready to take your next step with clarity and peace of mind. Aging well isn’t about perfection; it’s about planning ahead, adjusting along the way, and staying true to what matters.
