Dealing with decisions of old age.

Bad health or a financial crisis may require that some decisions be made abruptly, but by familiarizing themselves with their own and/or a spouse's routines and limitations, mature people can become better prepared for making plans related to aging, according to Cynthia Robinson, geriatric specialist and assistant professor of occupational therapy, University of Oklahoma Health Sciences Center.

One of the biggest lifestyle changes, obviously, is retirement. If possible, she suggests, it should not occur until the person feels emotionally and financially ready. It is important that the normal routine of the workday be replaced with new activities. "Routine is healthy and important. Develop new activities or indulge those you haven't had time to before. Routine provides structure, and structure is very important for elders who may have short-term memory problems. For example, always keep your car keys, glasses, medications, etc. in the same place."

A popular trend has been for a couple to retire and promptly move away to sunnier, vacation-type locations such as Florida or Arizona. This, however, is not necessarily healthy for everyone. "Once you have spent years in a community, you usually have a very important support system that includes a close circle of friends and people in the community, such as your physician, banker, grocer, mailman, etc. Moving away requires that you re-establish all those community ties."

Both psychologically and financially, the best option often is to take advantage of that support system in order to remain in one's home for as long as possible. When an individual notices that he or she is having difficulty performing certain self-care tasks, there are many devices and adaptations available that can be used to make the home safer and everyday activities easier. These may include improving lighting, installing handrails and benches in the bathtub, removing slippery scatter rugs, and re-arranging kitchen cabinets.

Driving is a complex task, requiring numerous cognitive, sensory/perceptual, and physical skills. When an older person begins having difficulty behind the wheel, this calls for a comprehensive, multi-disciplinary evaluation which may result in recommendations as simple as new glasses. Giving up driving involves sacrificing a substantial amount of independence, and sometimes an elderly person may be unwilling to admit or may not realize that...