Are you thriving at home— or just surviving?
Over the past eleven years in practice, I’ve developed a handful of questions I keep asking my clients, and the most common one is this:
Do you think you’re thriving at home—or just barely surviving?
I know that question can bring a little discomfort. In some ways, it’s supposed to. Self-reflection can be tricky, but let’s be honest: the art of aging isn’t always consistent.
Some of the things we often associate with success—like staying in our own homes at 92 and getting by with a little help—can be impressive. But they aren’t always a sign that someone is truly thriving.
Here are a few questions I ask to help me gauge if someone might be struggling:
Do you have a first-floor setup at home?
What kind of meals do you usually prepare?
How often do you get up in the middle of the night to go to the bathroom?
Who takes care of cleaning, medications, appointments, and bills?
How often do you shower?
How long does it take you to get ready in the morning?
Do you drive?
What are some of your hobbies?
When we plan for aging and life after retirement, we often picture living in our own home, maybe with no mortgage. Our expenses might include medical costs, food, and some basic help with cleaning or lawn care. As we get older, maybe we hire someone to drive us to appointments or help with household tasks like laundry.
It’s a luxury to remain in our own home and have the care we need there—or family support to help manage those daily and weekly needs.
How can that be bad, right?
Well, maybe.
Allow me to walk through some common situations I hear about in practice.
When Everyday Tasks Start Taking More FROM US
Are we waking up multiple times during the night to use the bathroom? If someone is waking up four times a night, that interrupted sleep can affect how rested and alert they feel the next day. Combine fatigue with getting out of bed repeatedly in the dark, and it may also create additional safety concerns.
Then morning comes.
Getting ready for the day might mean using the bathroom, managing basic hygiene, showering, choosing clothes, and getting dressed. It may also include preparing something to eat and taking medications.
That can be a lot.
How long does all of this take? And perhaps more importantly, how much energy does it require?
I often hear during interviews that it takes someone two hours to get ready in the morning—and that doesn't include a shower.
Showering may feel scary or exhausting, leading someone to bathe less frequently. Preparing meals may also become difficult, so breakfast becomes a piece of toast and dinner becomes whatever is easiest to heat in the microwave. For some people, that may meet their needs. For others, it may mean they aren't getting the quality or quantity of nutrition that would benefit them.
Now imagine having an appointment at 8 a.m. If it takes two hours to get yourself ready, being dressed, fed, medicated, and out the door by 7:30 can make that appointment incredibly taxing before the day has really even started. I often hear that my clients have no desire to take that first appointment of the day because it feels impossible!
When Staying Home Means Staying Home
Another elephant in the room: leaving the house itself can become exhausting.
That may mean fewer trips to the golf course, fewer lunches with friends, or deciding that the items on the shopping list can wait another day. It can affect time with family, too. Maybe you turn down a dinner invitation or decide not to be picked up for your grandchild's soccer game because getting ready and getting out of the house simply feels like too much.
Driving is another major piece of independence that can change as we age. When driving is no longer an option, activities and errands that were once part of everyday life can become much harder to access.
And what about falls?
After a few falls, someone may decide the safest option is simply to move less. If I don't get up, I can't fall. It makes sense—but over time, that can create an entirely different set of problems.
Stairs may become difficult, so perhaps someone hasn't been upstairs in years. Getting outside may require family assistance because even the entrance with fewer steps is challenging. Eventually, leaving home becomes such an undertaking that staying home feels easier.
As a physical therapist, I hear several things in these scenarios: deconditioning, isolation from people and enjoyable hobbies, possible nutritional concerns, changes in hygiene routines, fear of falling, and difficulty moving safely throughout the entire home.
Planning Before There’s a Crisis
These examples aren't meant to create fear around losing independence. They're meant to encourage us to look at independence a little differently.
In healthcare, we often see people seek additional help when something has already become an emergency. A fall happens. Someone is hospitalized. A caregiver becomes overwhelmed. Suddenly, decisions have to be made quickly, and everyone feels stressed and frazzled.
Planning ahead gives us more choices.
If any of these examples describe something you or a loved one is experiencing, maybe it's time to get some help. And importantly, getting help does not automatically mean you can no longer remain in your home.
Redefining Independence
We sometimes prioritize staying at home over asking whether the lifestyle we're maintaining there is fulfilling.
We can overlook isolation, exhaustion, and survival mode and still consider the situation a success because someone has maintained some independence in their own home.
But what is that independence costing them?
Life may actually become bigger by downsizing and conserving energy each day. Consistent support could reduce the time and effort spent on morning tasks. Help with transportation could make lunch with friends possible again. Assistance with meals, laundry, or medications could leave more energy for the things someone actually enjoys.
Socializing throughout the week is a normal and meaningful part of life. That may mean golfing with friends, attending a group fitness class, going to a grandchild's game, grabbing lunch with family, attending church, gardening, or simply getting out of the house because you want to.
If you can get yourself ready for the day without feeling exhausted, shower regularly, prepare your meals, manage your medications, get to appointments, enjoy your hobbies, and maintain the relationships that matter to you—that's amazing.
But needing help with some of those things doesn't mean you've failed at aging independently.
Reducing the physical demands of laundry, medication management, meal preparation, and self-care can free up time and energy to actually enjoy retirement. For some people, that may mean hiring an in-home caregiver. For others, it may mean modifying or downsizing their home. Some may have the right family situation for an in-law suite. And for others, moving to a community with different levels of support may provide opportunities they no longer have at home.
We've spent time in past articles discussing the art of aging and how different it can look for everyone. There is no single right way to do it.
Staying in your own home can absolutely be part of aging well. But the address itself shouldn't be our only measure of success.
Are you safe? Are you eating well? Are you sleeping? Are you seeing people you enjoy? Can you participate in the things that give your life meaning? And after you've taken care of everything you have to do each day, do you still have enough energy left for the things you want to do?
Sometimes accepting a little more help can actually give us back some of the independence we're trying so hard to protect.
So maybe it's worth sitting with the uncomfortable question:
Are you thriving at home—or are you working so hard to stay there that you're just surviving?
Written by Kayla Fluder, PT, DPT, CAPS
“The longer I live, the more beautiful life becomes”
