Harvard Health Letter

Retiring? What about your health?

You’re ready to head for sunnier climes. But have you thought through your evolving health needs? Here’s a checklist.

When we get close to retirement age, we’re all a little guilty of deluding ourselves into thinking how rosy it’ll be — long walks on the beach at sunset, meaningful volunteering to engage the mind, the warmth and conviviality of friends and family.

It’s great to approach retirement in a positive state of mind. But it’s also a good idea to consider your future health needs when it comes time to select a community where you can live out your golden years.

“Some people move to a place where they spent vacations and have great memories,” says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center. “But often these places are remote and not close to medical care. People have to realize that, as they age, there may be medical problems they didn’t anticipate. Being close to a good hospital can make the difference between a good or bad outcome.”

A simple way to plan

Dr. Helen Chen, a geriatrician at Harvard-affiliated Hebrew Rehabilitation Center, promotes a way of looking at this challenge called “The Five Ms.” The idea was first advanced by researcher Mary Tinetti of Yale University.

Mind. How are you going to stay intellectually active and manage your mood in your new retirement community? Will you find enough mental stimulation?

Move. Will you be part of a community that provides transportation to key places (like a grocery store)? If you have to drive everywhere, how will you manage that?

Mingle. Will you be socially connected in your new environment? Is moving really in your best interests if you’ll be far from friends or family?

Meaning. What will be your purpose as you enter life’s so-called third act? Purpose and meaning contribute to one’s mental well-being (and there’s only so much golf you can play). Another way to frame this M is as what “matters most” to you in your retirement years. Maybe it’s giving back by volunteering. Maybe it’s checking in more frequently with grandkids.

Multicomplexity . The fifth M is perhaps the most difficult. It pertains to the myriad health challenges of getting older, from managing medications and procedures, to keeping doctor appointments, to arranging for lab tests and routine screenings.

The Five Ms in practice

How do we translate the message of the Five Ms into practical steps? When you’re thinking about where to live in retirement, consider the qualities of a community that are important for health at an older age:

  • medical services
  • nonprofit health services, like meal delivery
  • transportation services
  • affordable housing options
  • recreation opportunities
  • volunteering opportunities
  • private-duty services (such as a companion or certified nursing assistant).

For example, these days, walkable city centers are getting more consideration as retirement destinations, as are college towns that offer robust learning opportunities or entertainment.

Home is more than a house

According to Jennifer Molinsky, senior researcher with Harvard’s Joint Center for Housing Studies, there are several challenges in making a home suitable for retirement living. Affordability is very high on her list. “If it’s not affordable, you’ll cut back on other necessities like food and health care. Affordability problems only get worse as you get older.”

And while access to groceries and medical care become crucial, safety and accessibility inside the home are also paramount. “Stairs can be a problem, so it can be beneficial to have all the rooms on one floor. Even having steps to reach the front door can cause problems later. Imagine the challenges of having the washer and dryer in the basement and the shower and bath on the second floor,” says Dr. Salamon.

In fact, a whole new field of urban design caters to the needs of older people. Ann Forsyth, professor of urban planning at Harvard University Graduate School of Design, has a unique window on the latest trends: “There are a lot of fantastic housing options. Some mix middle-age and older people. Others cluster people into social groups, or introduce animals people can befriend and take care of.” The “greenhouse model” has a nursing home broken into various pods where people live in private studio apartments but share a kitchen and other amenities.

Our experts agree on one vital factor. Don’t overlook staying right where you are if your existing house and community checks all your boxes. For many of us, there’s no place like home.

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