Free Being Mortal by Atul Gawande

just have to figure out how to deal with her.
    Their apartment was only a floor away. But somehow that made all the difference. Exactly why can be hard to pinpoint. Felix still ended up hiring an around-the-clock staff of nurses and aides. And the remaining six weeks until the casts could come off were physically exhausting for him. Yet he was relieved.He and Bella felt more control over her life. She was in her own place, in her own bed, with him beside her. And that mattered tremendously to him. Because four days after the casts came off, four days after she’d begun walking again, she died.
    They’d sat down to lunch. She turned to him and said, “I don’t feel well.” Then she collapsed. An ambulance whisked her to the local hospital. He didn’t want to slow the medics down. So he let them go and followed after in his car. She died in the short time between her arrival and his.
    When I saw him three months later, he was still despondent. “I feel as if a part of my body is missing. I feel as if I have been dismembered,” he told me. His voice cracked and his eyes were rimmed red. He had one great solace, however: that she hadn’t suffered, that she’d got to spend her last few weeks in peace at home in the warmth of their long love, instead of up on a nursing floor, a lost and disoriented patient.
    ALICE HOBSON HAD something very much like the same dread of leaving her home. It was the one place where she felt she belonged and remained in charge of her life. But after the incident with the men who had victimized her, it was apparent that she wasn’t safe living on her own anymore. My father-in-law organized a few visits to senior living residences for her. “She didn’t care for this process,” Jim said, but she reconciled herself to it. He was determined to find a place she would like and thrive in. But it was not to be. As I watched the aftermath, I gradually began to understand the reasons why—and they were reasons that bring into question our entire system of care for the dependent and debilitated.
    Jim looked for a place that was within a reasonable driving distance for the family and within a price range she could affordwith the proceeds of selling her house. He also wanted a community that offered a “continuum of care”—much like Orchard Cove, where I visited Felix and Bella—with apartments for independent living and a floor with the around-the-clock nursing capabilities that she might someday need. He came up with a variety of places for them to visit—nearer ones and farther ones, for-profit and not-for-profit.
    The place Alice ultimately chose was a high-rise senior-living complex that I will call Longwood House, a nonprofit facility affiliated with the Episcopal Church. Some of her friends from church lived there. The drive to and from Jim’s home was barely ten minutes. The community was active and thriving. To Alice and the family, it had by far the greatest appeal.
    “Most of the others were too commercial,” Jim said.
    She moved in during the fall of 1992. Her one-bedroom independent-living apartment was more spacious than I’d expected. It had a full kitchen, enough room for her dining set, and plenty of light. My mother-in law, Nan, made sure it got a fresh coat of paint and arranged for a decorator Alice had used before to help place furniture and hang pictures.
    “It means something when you can move in and see all your things in their own places—your own silver in your kitchen drawer,” Nan said.
    But when I saw Alice a few weeks after her move, she didn’t seem at all happy or adjusted. Never one to complain, she didn’t say anything angry or sad or bitter, but she was withdrawn in a way I hadn’t seen before. She remained recognizably herself, but the light had gone out from behind her eyes.
    At first I thought that this had to do with the loss of her car and the freedom that came with it. When she moved into Longwood House, she’d brought her Chevy Impala and fully