Introduction to 7 Actions to Take to Stay OUT of a Nursing Home

Introduction: Reasons to read this book

Do not spend the last year of your life in a nursing home. Too often people assume that nursing homes are inevitable. No! Too often people assume that paid and family caregivers will help you stay at home. Really?

I don’t want to spend the last year of my life in a nursing home. You don’t want to spend the last year of your life in a nursing home, and I don’t want you to either. Reading this book will decrease your risk significantly.

Getting old sneaks up on you. Even as a Ph.D. gerontologist writing and teaching about aging and having done research on long-term care, I am surprised at what is happening to me in my 70s. The people I love the most die. Even with two new hips I am not nearly as fast, as flexible, and as active as I was even just ten years ago. “Just”—did I ever think I would call ten years ago, “just” ten years ago?

This is not a book that is anti-aging or ageist. You cannot, nor should you want to prevent aging. You want to be healthy, attractive, and smart at whatever age you are.

You don’t want people to be ageist. If that word does not provoke dismay in you, think of how odious are the clichés, negative stereotypes and bigotry of people who are sexist or racist. Those are despicable.  Just like sexism and racism, ageism is awful. It’s inspires self-loathing, limits potential and opportunities, and is just plain wrong. Ageism may itself play into the existence of nursing homes and the unlovely lives that people live in them.

There often is a societal culture of discounting old people. Believe me, it’s much more difficult for a single gray-haired woman to promptly get a nice table at a restaurant than it is for an attractive 25-year-old. If a 20-somehing person has a severe disability and cannot care for him or herself, it is much less likely he or she will be placed in a nursing home than an eighty-year-old. The first is a minor lament; the second is grossly discriminatory. The 87-year-old wants to stay out of a nuring home just as much as the 27-year-old.


So this book is about factors that promote staying out of nursing homes.


How to read this book

You need not read these chapters in the order they are written. You may already be an expert on end-of-life planning, estates, and finances. (However, even as an expert, you still may learn something new—or tell me about important facts omitted or update information in this fast-changing world.)

Some factors that contribute to staying out of a nursing home, such as exercise and a healthy lifestyle, are well established. However, are you really practicing a healthy lifestyle?  There are tricks you may not know for acquiring healthier habits. This is more important than ever because we continue to learn more about dementia and how a healthy lifestyle, particularly exercise, can lower your risk of Alzheimer’s disease. Other topics, such as in Chapter One, rarely occur to people until it is too late.


I’m not asserting that all nursing homes are bad. After spending hundreds of hours interviewing hundreds of people in dozens of nursing homes, I know there are fine skilled-care facilities with kind and well-trained staff. But even in these well-run and well-designed places, most people don’t want to live there, especially for over a year.

So read this book in any order you please but please learn what you can in order to lessen the risk of spending the last year of your life in a nursing home.


Chapter One: How can UD keep you out of a nursing home?

Published by jeannettefranks

Jeannette Franks, PhD, is a passionate gerontologist and for over 20 years has taught ethics, grief and loss, and courses on geriatrics and gerontology for the University of Washington. Franks' most recent book is, To Move or To Stay Put: A Guide for Your Last Decades. Look for it now on the University Bookstore website It is also available at Eagle Harbor Books on Bainbridge. Franks previously published a definitive guide to independent and assisted living titled Washington Retirement Options, and often speaks on retirement options, disability issues, end-of-life issues and is an advocate for accessibility. She has a goal of making Bainbridge an elder-friendly community and is available to groups and families to discuss these issues. She served for nine years on the Kitsap County Advisory Council on Aging and Long-term Care. She also has the privilege of working in a small way for the past 15 years with the Suquamish tribal elders.

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