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Happily Ever Older: Revolutionary Approaches to Long-Term Care
Reporter Moira Welsh has spent years investigating retirement homes and long-term care facilities and wants to tell the dangerous stories. Not the accounts of falls or bedsores or overmedication, but of seniors living with purpose and energy and love. Stories that could change the status quo.
Welsh takes readers across North America and into Europe on a whirlwind tour of facilities with novel approaches to community living, including a day program in a fake town out of the 1950s, a residence where seniors school their student roommates in beer pong, and an aging-in-place community in a forest where everyone seems to have a pet or a garden or both. The COVID-19 pandemic cruelly showed us that social isolation is debilitating, and Welsh tells stories of elders living with friendship, new and old, in their later years.
Welsh takes readers across North America and into Europe on a whirlwind tour of facilities with novel approaches to community living, including a day program in a fake town out of the 1950s, a residence where seniors school their student roommates in beer pong, and an aging-in-place community in a forest where everyone seems to have a pet or a garden or both. The COVID-19 pandemic cruelly showed us that social isolation is debilitating, and Welsh tells stories of elders living with friendship, new and old, in their later years.
- GenresNonfictionAudiobookAging
272 pages, Paperback
Published February 9, 2021
About the author
Moira Welsh
3 books6 followersMoira Welsh is an investigative journalist with the Toronto Star, Moira has co-authored investigations that have won three National Newspaper Awards and a Michener Award for Public Service Journalism. She was a finalist for the Justicia Award for Legal Reporting and the Canadian Hillman Prize. She started as a breaking news reporter and soon joined the investigative team where she has written on social justice, the environment, and the lives of people living in seniors’ homes. Moira lives in Toronto, Ontario, with her family.
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Displaying 1 - 23 of 23 reviews
January 28, 2021
Happily Ever Older is essential reading for anyone who hopes to grow old and to do so with dignity. Instead of seniors’ housing that resembles warehouses for storage, think greenhouses for growth. It’s a fundamental paradigm shift that Moira Welsh depicts through innovative housing models that have launched across North America and in the Netherlands. Each of them defeats the three plagues of old age: loneliness, boredom, and helplessness. But as a society, we will succumb if we don’t act now. Between 2019 and 2050, the cost of long term care housing is estimated to triple. To combat that future, we need healthier models and better government policies with a laser focus: supporting seniors’ independence. Only then might we live happily ever older.
Bonnie Lendrum is the author of Autumn's Grace, the story of how one family manages the experience of palliative care with hope and humour despite sibling conflicts, generational pulls and career demands.
Bonnie Lendrum is the author of Autumn's Grace, the story of how one family manages the experience of palliative care with hope and humour despite sibling conflicts, generational pulls and career demands.
February 10, 2021
Excellent book filled with hopeful ideas of how much better we as a society can do for seniors and long term care. I loved the success stories. Couldn’t put it down.
May 25, 2023
“Happily Ever Older. Revolutionary Approaches to Long-Term Care” is a nonfiction book that provides hope and inspiration to the reader as they become older and begin to consider long-term care plans. The book consists of a prologue, introduction, nine chapters, an epilogue, acknowledgments, notes, and an index.
In the prologue, author Moira Welsh shares that the book was written in the middle of the COVID-19 global pandemic and its toll on nursing homes worldwide. Welsh relays how the pandemic affected those in her home country of Canada and how as of June 2022, there was no idea of how many elders would die as well as how staffing shortages lead to employees working in two or three nursing home locations which lead to an quicker spread of the COVID-19 virus. This book is meant to present ways for the reader to consider a different approach to how they age, with a focus on friendships, purpose, and potential rather than submitting to a life of loss of independence and forced submission in a warehouse style nursing home.
Each chapter highlights innovative ways in which long-term elder care is being changed with a specific focus on dementia and Alzheimer's patients.
In the introduction, Welsh discusses her personal experience with the elderly as as she shares the story of her father’s transformation from a strong man until his health decline at the age of eighty-eight which started with a fall. Despite both her parents eventually required canes or walkers to walk, they are not deterred and remained active in their own home. Welsh provide a history of senior housing in North America which initially was done by family but eventually transitioned to sending elders to nursing homes after World War II.
Chapter one, “The Butterfly Effect,” focuses on Dementia Care Matters which is run by David Sheard and his innovative ideas about creating cozy communities for those with dementia. The “butterfly model” focuses on letting those with cognitive decline have their moments of being rather than telling them where they really are. Also notable about the Butterfly model is that uniforms are banned, hallways are painted in bright colors, and filling homes with personal mementos. Another component of the Butterfly model involves staff taking intense emotional training which helps them connect with their feelings and create a sense of empathy towards care facility residents. By giving residents the freedom of choice and not being flexible with eat, activities, and social activities, this can re-energize the residents and lead to friendly relationships with staff. Chapter one ends with Welsh sharing her own mother’s loss of independence after a late-night fall and Welsh realizing how fragile her parents have become.
Chapter two, “The Eden Alternative, the Green House Project and De-Institutionalizing Eldercare,” focuses on teaching intergenerational living. The Eden Alternative focuses on creating a community that abolishes the three plagues of old age: loneliness, boredom, and helplessness by using green space and gardens. The Green House home model consists of a senior housing connected by a garden with small households of six to ten bedrooms with an open kitchen and living rooms and elders are in charge of their day. Green House staff interact with the elders in the house daily and relationships between workers and residents are not rushed. I was really fascinated by the concept of Minka homes that are created using methods similar to 3D printing with a telepresence robot to monitor those with dementia, especially in established residential neighborhoods. Chapter two ends with Welch feeling lost in what to do with her father due to his increased confusion, more instances of falling and eventually goes to the hospital for assistance which leads to her leaving her father at the hospital to have cognitive tests done.
Chapter three, “Park Springs and Pebblebrook; Making Dementia Care More Humane,” focuses on the struggle of having to move elders with dementia to various care facilities as their dementia worsens. Although those with those with dementia lose their ability to reason, they hold on to their feelings. Park Springs consists of a campus style all-inclusive retirement community that looks like a ski resort, has four restaurants, 50-foot vaulted ceiling, and a variety of activities and lectures from outside speakers as well as residents who’ve had successful careers. Pebblebrook is a skilled nursing floor for the very sick or people in a palliative stage of care. By making a personal connection with elder residents through food or music, this can unlock a lifetime of memories and lead to bonding opportunities for residents and staff.
It was interesting to learn how those with dementia lose short term memory but retain their long-term memory. I liked how at Pebblebrook, the renaming of nursing staff as "care partners" shows a home with caring staff as well as a providing a binder of pictures and personal stories so families can know more about the staff caring for their loved ones. Butterfly training gives workers the freedom to think intuitively about those in their care and offers loved ones comfort in their final years. The chapter ends with Welsh visiting her father at a hospital and seeing him socializing with others while her mother laments of having an a bad home care experience with a swollen leg. Although both parents return home, Walsh’s mother suggests moving into a retirement home.
In chapter four, “The Little Blue House and the Glenner Town Square: New Ideas in Day Programs,” tells the story of Dr. George Glenner. Although Glenner was known as a pioneer in Alzheimer’s research, he is better known for creation of the Little Blue House which is a daytime respite center for people with dementia which offers freedom to family caregivers on a daily basis. After The Little Blue House becomes popular, Glenner and his wife Joy works with others to create an old-fashioned time square which becomes known as Glenner Town Square. This chapter mentions how reminisce therapy has been shown to improve cognition while lying to those with dementia is bad considering that if they figure out the lie, trust with the senior citizen is broken. The chapter end with Welsh visiting her parents in their local retirement home, visit them on open house days, and a fun experience taking them shopping during a snowstorm.
In chapter five, “The Dutch Model,” Welsh visits the Netherlands to see a Dutch nursing home “neighborhood” for people with severe dementia. It's discussed how two women created a model in which created a normal life for people with dementia. The Hogeweyk communities include a beauty parlor, a courtyard with greenery, outdoor markets, a grocery store, and club rooms for baking or art. Surprising to learn that those who share a disease doesn’t mean that they share interests. The Hogeweyk community consists of four different housing styles and it was interesting to read how adult children may choose one style of home for their parent, but the parent may eventually change their mind and choose another home model. The chapter ends with Welsh’s father getting a dire diagnosis and introducing her mother to a book that changes her perspective on life-saving measures for her and her husband.
In chapter six, “Primacare and the Potential of Virtual Reality,” shows how using virtual reality can help bring new to those with Alzheimer’s back to life. Focuses on Matthew Melchior working to create a “campus of care” the provides seniors with an easier transition from independent living to an intimate nursing home setting. With a new generation of people getting older, many are creating more technologies to keep the elderly active and engaged as well as creating happy memories for those with Alzheimer’s and reduce the use of medications. Ironically, those who create change in long-term care homes often end up diagnosed with Alzheimer’s or dementia, moving to and dying in the buildings they’ve created. While many nursing homes are set up to keep people inside and safe, it’s more beneficial to have them spend time outside, even if it is done virtually. It was interesting to learn about virtual reality Google alternative Broomx which provides a 360-degree immersive experience that project video on three wall. The chapter ends with Welsh’s father health returning before eventually having another fall and mother sharing with Welsh that her father loves her because he needs her.
In chapter seven, “Sherbrooke Community Centre and the Eden Alternative,” Welsh visits Sherbrooke Community Centre and discusses how locked dementia units were akin to segregation and expresses the need to open these doors and allow people to live among residents of all abilities. By mixing dementia units with children, this can provide purpose to the elders and access to friendship for the children. Sherbrooke provides residents with a little households as well wine-making club, a full-sized swimming pool, happy hours, day programs, bird, cats, aquariums, and plants. The Eden alternative says that caring for another living being (whether plant, pet, or person) help alleviate loneliness and helplessness. By having staff discuss the Eden principles daily and monitor their facial expressions, this creates a sense of joy, peace, and acceptance for residents. Little things mean a lot including hanging artwork at wheelchair eye level which shows respects for its residents and help residents feel comfortable in their space. The chapter ends with Welsh’s mother asking about her experiences writing the book, visiting different nursing and retirement homes, and giving advice on how to improve the lives of seniors through her time at her retirement home.
Chapter eight, “Carol Woods and the Importance of Freedom,” begins with the story of Pat Sprigg and her mission to stop nursing homes from restraining elderly residents with belts or chains in an effort to keep the restrained. The chapter highlights Carol Woods Retirement Community which allows people to spend their later years living independently but still close to a college town. Sprigg shares with Welsh different committees at Carol Woods including a emergency room committee so no one goes to the hospital alone, the vigil corps so no one dies alone, and the companion corps so no I’ve doesn’t spend their days alone. The chapter ends with Welsh’s mother passing away, her father feeling adrift after the loss and details from Welsh’s mother’s funeral including the funeral reception playlist and the family slowly resuming life after the loss of their matriarch.
Chapter nine, “Other Ways of Living Well,” dementia is being acknowledged as a part of our existence and it need to be spoken of more openly. By talking about memory loss instead of isolating others, society can stop viewing people with dementia as “others.” Evidence suggests that exercise and creative pursuits such as art, learning language or playing a musical instrument can challenge the brain possibility keeping it sharper and stave off dementia. Welsh shares Ontario’s efforts involving city workers and art gallery staff to interact with those with everyone is still worthy of living with dignity and to ask yes or no questions versus open ended questions. Highlights Humanities Deventer which is a Dutch seniors’ residence where university students can live rent-free in return for their community spirit and spend thirty hours a month being a “good neighbor” to the seniors like talking to them, discussing travel, and the senior sharing life details not found in books. The relationships made between the university students and seniors provides social interaction for the senior and a wealth of knowledge for the university student. Welsh presents four general categories for newer ways of living for the elderly which are home sharing, cohousing, virtual villages where seniors live in their homes and connect by telephone or email, and NORCS which stands for Naturally Occurring Retirement Communities. The chapter ends with Welsh and her family having their first Thanksgiving minus their mother and how her father carries on living in the retirement community.
In the epilogue, Welsh encourages the reader, especially boomers to begin to advocate for how they’re cared for in their elderly years now, not when they reach sixty-five. With the elderly living longer it is vital to look they have the financial means to provide for long-term care and work to
push government leaders in making policies to focus on seniors’ rights, building intergenerational communities of smaller homes, and the rights of those with cognitive decline. It is vital to Erase old nursing home standards and create more small living spaces with high walkability which allows the elderly to remain independent as long as they can. The book ends with Welsh encouraging the reader that although we all might not have dementia, we all should improve our odds by embracing old age now, travel well, learn a new language, and to tell the dangerous stories that go against the old rigid ways.
As I I read this book, I found it interesting the variety of research presented such as for every five years after the age if 65, the odds of developing dementia will doubleThe longer the lifespan, the longer the possible amount of time one may spend in a nursing home. It was interesting to learn the term young seniors which are people between the ages of sixty-five to seventy-five as well as the surprising popularity of the sport of Pickleball.
Although the book compares aging and long-term care between America and Canada since the author is Canadian, the conclusion is the same, the state of long-term care and aging will have far reaching effects on not only the elderly but also their children and other family members. After finishing this book, I realize that as one gets older, living in a nursing home isn’t a forgone conclusion but instead, it’s possible to consider other options such as living as co-owner in a detached house (like the Golden Girls,) sharing one's home with college students, or living in an aging in place community.
In the prologue, author Moira Welsh shares that the book was written in the middle of the COVID-19 global pandemic and its toll on nursing homes worldwide. Welsh relays how the pandemic affected those in her home country of Canada and how as of June 2022, there was no idea of how many elders would die as well as how staffing shortages lead to employees working in two or three nursing home locations which lead to an quicker spread of the COVID-19 virus. This book is meant to present ways for the reader to consider a different approach to how they age, with a focus on friendships, purpose, and potential rather than submitting to a life of loss of independence and forced submission in a warehouse style nursing home.
Each chapter highlights innovative ways in which long-term elder care is being changed with a specific focus on dementia and Alzheimer's patients.
In the introduction, Welsh discusses her personal experience with the elderly as as she shares the story of her father’s transformation from a strong man until his health decline at the age of eighty-eight which started with a fall. Despite both her parents eventually required canes or walkers to walk, they are not deterred and remained active in their own home. Welsh provide a history of senior housing in North America which initially was done by family but eventually transitioned to sending elders to nursing homes after World War II.
Chapter one, “The Butterfly Effect,” focuses on Dementia Care Matters which is run by David Sheard and his innovative ideas about creating cozy communities for those with dementia. The “butterfly model” focuses on letting those with cognitive decline have their moments of being rather than telling them where they really are. Also notable about the Butterfly model is that uniforms are banned, hallways are painted in bright colors, and filling homes with personal mementos. Another component of the Butterfly model involves staff taking intense emotional training which helps them connect with their feelings and create a sense of empathy towards care facility residents. By giving residents the freedom of choice and not being flexible with eat, activities, and social activities, this can re-energize the residents and lead to friendly relationships with staff. Chapter one ends with Welsh sharing her own mother’s loss of independence after a late-night fall and Welsh realizing how fragile her parents have become.
Chapter two, “The Eden Alternative, the Green House Project and De-Institutionalizing Eldercare,” focuses on teaching intergenerational living. The Eden Alternative focuses on creating a community that abolishes the three plagues of old age: loneliness, boredom, and helplessness by using green space and gardens. The Green House home model consists of a senior housing connected by a garden with small households of six to ten bedrooms with an open kitchen and living rooms and elders are in charge of their day. Green House staff interact with the elders in the house daily and relationships between workers and residents are not rushed. I was really fascinated by the concept of Minka homes that are created using methods similar to 3D printing with a telepresence robot to monitor those with dementia, especially in established residential neighborhoods. Chapter two ends with Welch feeling lost in what to do with her father due to his increased confusion, more instances of falling and eventually goes to the hospital for assistance which leads to her leaving her father at the hospital to have cognitive tests done.
Chapter three, “Park Springs and Pebblebrook; Making Dementia Care More Humane,” focuses on the struggle of having to move elders with dementia to various care facilities as their dementia worsens. Although those with those with dementia lose their ability to reason, they hold on to their feelings. Park Springs consists of a campus style all-inclusive retirement community that looks like a ski resort, has four restaurants, 50-foot vaulted ceiling, and a variety of activities and lectures from outside speakers as well as residents who’ve had successful careers. Pebblebrook is a skilled nursing floor for the very sick or people in a palliative stage of care. By making a personal connection with elder residents through food or music, this can unlock a lifetime of memories and lead to bonding opportunities for residents and staff.
It was interesting to learn how those with dementia lose short term memory but retain their long-term memory. I liked how at Pebblebrook, the renaming of nursing staff as "care partners" shows a home with caring staff as well as a providing a binder of pictures and personal stories so families can know more about the staff caring for their loved ones. Butterfly training gives workers the freedom to think intuitively about those in their care and offers loved ones comfort in their final years. The chapter ends with Welsh visiting her father at a hospital and seeing him socializing with others while her mother laments of having an a bad home care experience with a swollen leg. Although both parents return home, Walsh’s mother suggests moving into a retirement home.
In chapter four, “The Little Blue House and the Glenner Town Square: New Ideas in Day Programs,” tells the story of Dr. George Glenner. Although Glenner was known as a pioneer in Alzheimer’s research, he is better known for creation of the Little Blue House which is a daytime respite center for people with dementia which offers freedom to family caregivers on a daily basis. After The Little Blue House becomes popular, Glenner and his wife Joy works with others to create an old-fashioned time square which becomes known as Glenner Town Square. This chapter mentions how reminisce therapy has been shown to improve cognition while lying to those with dementia is bad considering that if they figure out the lie, trust with the senior citizen is broken. The chapter end with Welsh visiting her parents in their local retirement home, visit them on open house days, and a fun experience taking them shopping during a snowstorm.
In chapter five, “The Dutch Model,” Welsh visits the Netherlands to see a Dutch nursing home “neighborhood” for people with severe dementia. It's discussed how two women created a model in which created a normal life for people with dementia. The Hogeweyk communities include a beauty parlor, a courtyard with greenery, outdoor markets, a grocery store, and club rooms for baking or art. Surprising to learn that those who share a disease doesn’t mean that they share interests. The Hogeweyk community consists of four different housing styles and it was interesting to read how adult children may choose one style of home for their parent, but the parent may eventually change their mind and choose another home model. The chapter ends with Welsh’s father getting a dire diagnosis and introducing her mother to a book that changes her perspective on life-saving measures for her and her husband.
In chapter six, “Primacare and the Potential of Virtual Reality,” shows how using virtual reality can help bring new to those with Alzheimer’s back to life. Focuses on Matthew Melchior working to create a “campus of care” the provides seniors with an easier transition from independent living to an intimate nursing home setting. With a new generation of people getting older, many are creating more technologies to keep the elderly active and engaged as well as creating happy memories for those with Alzheimer’s and reduce the use of medications. Ironically, those who create change in long-term care homes often end up diagnosed with Alzheimer’s or dementia, moving to and dying in the buildings they’ve created. While many nursing homes are set up to keep people inside and safe, it’s more beneficial to have them spend time outside, even if it is done virtually. It was interesting to learn about virtual reality Google alternative Broomx which provides a 360-degree immersive experience that project video on three wall. The chapter ends with Welsh’s father health returning before eventually having another fall and mother sharing with Welsh that her father loves her because he needs her.
In chapter seven, “Sherbrooke Community Centre and the Eden Alternative,” Welsh visits Sherbrooke Community Centre and discusses how locked dementia units were akin to segregation and expresses the need to open these doors and allow people to live among residents of all abilities. By mixing dementia units with children, this can provide purpose to the elders and access to friendship for the children. Sherbrooke provides residents with a little households as well wine-making club, a full-sized swimming pool, happy hours, day programs, bird, cats, aquariums, and plants. The Eden alternative says that caring for another living being (whether plant, pet, or person) help alleviate loneliness and helplessness. By having staff discuss the Eden principles daily and monitor their facial expressions, this creates a sense of joy, peace, and acceptance for residents. Little things mean a lot including hanging artwork at wheelchair eye level which shows respects for its residents and help residents feel comfortable in their space. The chapter ends with Welsh’s mother asking about her experiences writing the book, visiting different nursing and retirement homes, and giving advice on how to improve the lives of seniors through her time at her retirement home.
Chapter eight, “Carol Woods and the Importance of Freedom,” begins with the story of Pat Sprigg and her mission to stop nursing homes from restraining elderly residents with belts or chains in an effort to keep the restrained. The chapter highlights Carol Woods Retirement Community which allows people to spend their later years living independently but still close to a college town. Sprigg shares with Welsh different committees at Carol Woods including a emergency room committee so no one goes to the hospital alone, the vigil corps so no one dies alone, and the companion corps so no I’ve doesn’t spend their days alone. The chapter ends with Welsh’s mother passing away, her father feeling adrift after the loss and details from Welsh’s mother’s funeral including the funeral reception playlist and the family slowly resuming life after the loss of their matriarch.
Chapter nine, “Other Ways of Living Well,” dementia is being acknowledged as a part of our existence and it need to be spoken of more openly. By talking about memory loss instead of isolating others, society can stop viewing people with dementia as “others.” Evidence suggests that exercise and creative pursuits such as art, learning language or playing a musical instrument can challenge the brain possibility keeping it sharper and stave off dementia. Welsh shares Ontario’s efforts involving city workers and art gallery staff to interact with those with everyone is still worthy of living with dignity and to ask yes or no questions versus open ended questions. Highlights Humanities Deventer which is a Dutch seniors’ residence where university students can live rent-free in return for their community spirit and spend thirty hours a month being a “good neighbor” to the seniors like talking to them, discussing travel, and the senior sharing life details not found in books. The relationships made between the university students and seniors provides social interaction for the senior and a wealth of knowledge for the university student. Welsh presents four general categories for newer ways of living for the elderly which are home sharing, cohousing, virtual villages where seniors live in their homes and connect by telephone or email, and NORCS which stands for Naturally Occurring Retirement Communities. The chapter ends with Welsh and her family having their first Thanksgiving minus their mother and how her father carries on living in the retirement community.
In the epilogue, Welsh encourages the reader, especially boomers to begin to advocate for how they’re cared for in their elderly years now, not when they reach sixty-five. With the elderly living longer it is vital to look they have the financial means to provide for long-term care and work to
push government leaders in making policies to focus on seniors’ rights, building intergenerational communities of smaller homes, and the rights of those with cognitive decline. It is vital to Erase old nursing home standards and create more small living spaces with high walkability which allows the elderly to remain independent as long as they can. The book ends with Welsh encouraging the reader that although we all might not have dementia, we all should improve our odds by embracing old age now, travel well, learn a new language, and to tell the dangerous stories that go against the old rigid ways.
As I I read this book, I found it interesting the variety of research presented such as for every five years after the age if 65, the odds of developing dementia will doubleThe longer the lifespan, the longer the possible amount of time one may spend in a nursing home. It was interesting to learn the term young seniors which are people between the ages of sixty-five to seventy-five as well as the surprising popularity of the sport of Pickleball.
Although the book compares aging and long-term care between America and Canada since the author is Canadian, the conclusion is the same, the state of long-term care and aging will have far reaching effects on not only the elderly but also their children and other family members. After finishing this book, I realize that as one gets older, living in a nursing home isn’t a forgone conclusion but instead, it’s possible to consider other options such as living as co-owner in a detached house (like the Golden Girls,) sharing one's home with college students, or living in an aging in place community.
This entire review has been hidden because of spoilers.
May 5, 2021
A recommended read for politicians, health care workers, anyone who is aging, and anyone who has aging family members. There are some excellent examples in Canada & internationally.
May 16, 2026
This book discusses the high costs, lack of care, community, activities/engagement, and understaffing at assisted living and memory care facilities across Canada and the United States. It also highlights excellent facilities that create and experiment with alternative living arrangements for older adults with memory loss, boosting morale and happiness for residents and caregivers. Additionally, it provides details about how different types of facilities, homes, and communities are working to make memory care feel more like a home rather than a prison for older people.
One of the biggest takeaways I have from this is that the cost of retirement in the U.S. can become unsustainable if you're not prepared for the possibility of living a long life. Your money can run out quickly, since many assisted and memory care homes can cost upwards of $10,000 per month in California. When I researched assisted living for my mother in 2022, the cheapest option I found was around $4,500 per month with a roommate (which she was hesitant about), and she was only receiving about $4,500 per month combined from her Social Security and retirement annuity. At that rate, she couldn’t afford groceries or pre-made food, let alone other essentials she might need!
So, if you haven’t thought about retirement, how long you might live, the possibility of memory loss, and where you’ll live geographically, this book will give you pause to consider these important decisions. It’s a must-read for you and your aging loved ones!
One of the biggest takeaways I have from this is that the cost of retirement in the U.S. can become unsustainable if you're not prepared for the possibility of living a long life. Your money can run out quickly, since many assisted and memory care homes can cost upwards of $10,000 per month in California. When I researched assisted living for my mother in 2022, the cheapest option I found was around $4,500 per month with a roommate (which she was hesitant about), and she was only receiving about $4,500 per month combined from her Social Security and retirement annuity. At that rate, she couldn’t afford groceries or pre-made food, let alone other essentials she might need!
So, if you haven’t thought about retirement, how long you might live, the possibility of memory loss, and where you’ll live geographically, this book will give you pause to consider these important decisions. It’s a must-read for you and your aging loved ones!
May 27, 2021
We have done a disservice to our elderly and those with dementia, and ultimately to ourselves. Nobody is getting any younger here. It's time to stop warehousing and forgetting about those that need our care, love and attention the most. Ms. Welsh offers examples of where the system has failed and alternately fresh ideas and examples to bring back dignity, respect and even fun to the aged and/or those living with dementia.
June 22, 2025
I skipped around a bit, overall I felt it was a good book. The types of models and systems discussed are pretty similar to what I’ve seen working in memory care. I wish the book touched more on the financial impact of these programs and the cost of older adult care in general. It’s nice to think these programs can be implemented everywhere, but it’s foolish to think they’re affordable for everyone.
The book mentions how music can impact someone with dementia, but fails to discuss music therapy, which was a huge missed opportunity. For a book published in 2021, they should have known the phrase “music as therapy” is incorrect. There’s music therapy and music in medicine. If it’s therapy, you need to be a therapist.
It’s a pretty minor correction grammar wise, but to me it really hinders my trust in the author.
Overall the book is mostly anecdotal and only focuses on care in a general/group sense.
Definitely recommend to someone that has little experience in memory care or maybe someone who’s worried about their family being in long term care. This book did a good job highlighting how long term care facilities can support and improve the quality of life for someone with dementia.
The book mentions how music can impact someone with dementia, but fails to discuss music therapy, which was a huge missed opportunity. For a book published in 2021, they should have known the phrase “music as therapy” is incorrect. There’s music therapy and music in medicine. If it’s therapy, you need to be a therapist.
It’s a pretty minor correction grammar wise, but to me it really hinders my trust in the author.
Overall the book is mostly anecdotal and only focuses on care in a general/group sense.
Definitely recommend to someone that has little experience in memory care or maybe someone who’s worried about their family being in long term care. This book did a good job highlighting how long term care facilities can support and improve the quality of life for someone with dementia.
November 14, 2021
I think this book is overrated. Without being more specific, my wife and I could be characters in her book. True, there are some interesting stories and some innovative ideas that break down traditional norms about what is proper and appropriate in eldercare and expose some of the horrors. Yes, we have to add "caring, loving, person-centered and respectful" as descriptors of what we want in senior care facilities and it's much harder to measure these than it is to measure "safe and effective". We need more of the former for sure. But I find her book lacks a smooth flow, but rather wanders, and is disjointed. There is no build and no synthesis. For someone looking for fresh ideas or leads to support evidence based systemic change I found it very frustrating to see sketches of what seem to be great ideas without more flesh on the bones, and without an attempt to make a connection or show common themes between different approaches. What are the lessons learned? Where does she think we might go from here? What is the challenge for our politicians? For our educators? I think this was a missed opportunity to promote big dollar investment in systemic change.
April 22, 2026
Hoopla bonus borrow. Interesting to hear about senior care in North America. Also scary to consider what my future might be and sad to think of deceased relatives who went through some of the difficulties described even if as far as I know there weren’t any real horror stories of pain and suffering. Definitely think being able to stay in the home is the best option whatever cognitive issues people may face, but also understandable how families may not be able to handle the caretaking required. Mixed generation housing and creating communities seems like a nice option. I wish there was a nursing home within walking distance that I could volunteer at, I don’t have the musical skills to entertain people but I could play games or read at least.
March 27, 2022
So many of the principles that I believe are worked into the pages of this inspiring book. I believe that everyone needs and wants a sense of purpose and that wonderful things build from that. I believe that community is a great way to grow. I believe that we can and should always learn, move and do. The focus of the book is care of people with dementia in LTC but it feels like it has a bigger message. I feel inspired.
November 21, 2023
This book had some excellent insight into elder care and the system. I appreciated the realistic yet positive ideas for improvements to care.
I think this is required reading for anyone who works in long term care. I found this helpful as a partial care giver for my grandparents and understanding this stage of life.
I felt there could have been some more succinct language at times, but overall, an interesting, insightful, and actionable read.
I think this is required reading for anyone who works in long term care. I found this helpful as a partial care giver for my grandparents and understanding this stage of life.
I felt there could have been some more succinct language at times, but overall, an interesting, insightful, and actionable read.
December 18, 2024
Rueben Hernandez recommended this book at a talk/event I attended earlier this year.
There is SO much story telling in this book. Every kind of experience unified into a singular narrative, striving for a happily ever after for our loved ones, and eventually ourselves.
I definitely need to revisit this book but for a first read through, it was a great read. Less of a gut punch than Neglected No More but still just as powerful.
There is SO much story telling in this book. Every kind of experience unified into a singular narrative, striving for a happily ever after for our loved ones, and eventually ourselves.
I definitely need to revisit this book but for a first read through, it was a great read. Less of a gut punch than Neglected No More but still just as powerful.
October 15, 2021
This is a necessary book. In a world where there is so little written that is positive about housing and care for seniors, Ms Welsh offers us hopeful examples. However we are still left with the grim reality that these innovations are not more widely available! Nevertheless its a good starting point.
May 21, 2026
So big news, you and or your loved ones will hopefully get older. Eventually you may need an assisted living situation. If that is the case, remembering to treat memory challenged people...as people first if the #1 way to care for them. I live in the USA so it is a joke how bad our system handles the elderly.
October 19, 2021
Read the epilogue first, then the inspiring stories. Change to de-institutionalize and de-medicalize LTC is slow, we need to advocate and push now for that change if those of us currently in our 60s want to have a full productive life into our 80s.
Read
June 2, 2022I loved the perspectives and ideas in this book for how to design and manage facilities with quality of life in mind.
August 6, 2022
I highly recommend that everyone read this! It has many I inspiring ideas for elder and memory care.
April 21, 2026
Made me feel hopeful about growing older. A nice contrast to the terrible situations one normally hears about old age homes.
April 24, 2026
Such an interesting book about how we age in place and what that “place” looks like. Def encouraged me to be more compassionate with my elderly patients and family members.
May 20, 2026
4.25 stars rounded to 4
Really thought provoking book about how to care for older folks, especially those with memory issues. Highly recommend.
Really thought provoking book about how to care for older folks, especially those with memory issues. Highly recommend.
June 28, 2026
Did not finish at 55%. Can’t support a book that suggests sex work is an idea worth considering.
June 25, 2022
Loved reading about the innovative ideas!
May 23, 2026
What does a good nursing home look like? If I get
dementia does that mean I need to be locked up or become a danger? Can we find ways to provide a good end of life to people as we all hopefully live longer or are we staying alive just to molder away? These were some of the central questions asked by this book. It was mostly made up of case studies of different nursing homes and other care facilite on the cutting edge of senior care. Because moving to a good facility can be great. It frees people from burdens of housework and gives them activities and a community. But there are barriers in place. Many people can't afford to leave their house since it is their biggest asset. And good homes can be expensive and hard to find. Even outside the US. Much of the burden of care is expected to be taken on, unpaid, by children. But that doesn't work in the real world where peaple have messy lives. And many seniors who do stay at home and need some help are more likely to accept it from people closer to their own age and experience.
I found this book readable, thought provoking, and often surprising. It challenged my assumptions about what aging looks like. Highly recommend for an intro for people who find themselves concerned about aging loved ones or getting older.
dementia does that mean I need to be locked up or become a danger? Can we find ways to provide a good end of life to people as we all hopefully live longer or are we staying alive just to molder away? These were some of the central questions asked by this book. It was mostly made up of case studies of different nursing homes and other care facilite on the cutting edge of senior care. Because moving to a good facility can be great. It frees people from burdens of housework and gives them activities and a community. But there are barriers in place. Many people can't afford to leave their house since it is their biggest asset. And good homes can be expensive and hard to find. Even outside the US. Much of the burden of care is expected to be taken on, unpaid, by children. But that doesn't work in the real world where peaple have messy lives. And many seniors who do stay at home and need some help are more likely to accept it from people closer to their own age and experience.
I found this book readable, thought provoking, and often surprising. It challenged my assumptions about what aging looks like. Highly recommend for an intro for people who find themselves concerned about aging loved ones or getting older.
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