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Senior Living in San Francisco

About 20 years ago, Ed, my therapist, who was also a Tibetan Buddhist lama, assured me that the next big thing in my life would be my death. I have outlived him by more than two decades. Now, at the age of 81, I feel closer to dying and death than ever before and more anxious, too, about what the Welsh poet, Dylan Thomas, called “the dying of the light.” Though my death is as certain as my birth, I don’t know when, where, why, or how I will die. I do know the "who" part. 

The memorial for the lama/ therapist, who combined spirituality and psychology, took place in an amphitheater on the campus of the Santa Rosa Junior College. Members of the ashram spoke as did the therapist’s patients. Some of us, including me, were both. 

One man explained that he had been terrified by the thought that the world was ending. The therapist/Buddhist told him, “It is ending,” and laughed. Ed often wore a smile or a smirk on his face. He never gave me advice or suggested what I might do when it came to my third marriage, which took place in Texas in 2000 to a 50 year-old woman who had never left Texas. I took the silence in his office as a sign of disapproval. I should have listened to his unspoken words.

Twenty-two months after I married the Texan, I filed for divorce; the legal process took longer than the time we actually lived together. I remember that my friend, Timothy, told me at a party for a newly married couple, “Divorce is worse than death.” Well, not really, but it can feel like a close encounter with death.

Now, I’m slowly divorcing myself from my life, or maybe it’s divorcing me, all the while that I am engaging with life in San Francisco, which became my new home about 30 months ago. It seems as good a place to die as any other. I’m still adjusting to the rhythms of city life, making new friends, exploring neighborhoods on foot, exercising on the campus of the University of San Francisco (USF), and checking out places for elders to live and die with some grace and dignity, and money, too.

Some are called assisted living communities; they include Coterie, the Carlisle, the Ivy at Golden Gate and Buena Vista Manor House. Some seem like nursing homes for the aged who have lost most of their memories and are waiting to die. Others, which are way more expensive, seem like elite country clubs. The food can be as tasty as any at an upscale restaurant. 

I don’t want to move into one of them now, but sooner or later I will have to accept the inevitable; give up my one-bedroom apartment at Ocean Beach and enter the last phase of my life in a world where I won’t have to shop, cook, wash dishes and clean floors and tables. I will also be able to take part in group activities—watch movies, play cards, discuss current events and more. I probably won’t be lonely, though I have been lonely in some crowds.

George Orwell, the author of Animal Farm and 1984, once said “hospitals are ante-chambers to the grave.” Go into a hospital for a serious condition and the chances are you won’t walk out on your own two feet. The assisted living spaces, also known as “senior living experiences,” strike me as comfortable ante-chambers to the grave. 

If I were to move to Coterie, I would probably have the illusion that mine was a wonderful life and that I would go on living happily ever after. Thinking about Coterie and its sister spaces means thinking about money; how much I have and how much I can spend. One fear is that I’ll run out of money, have to leave Coterie, and die in the streets of the Tenderloin where drug addicts die regularly. 

Directors of sales and marketing pressure me to make up my mind. “Don’t tough it out,” one said. I told him “I’m not ready.” I’ll go on living in my one-bedroom apartment, attend Spanish class at San Francisco Village, plunge into the pool at USF for the water aerobics and watch the Niners on a big screen in a local bar. 

My advice to those who are on the way down and out: Don't go into a senior living space until you’re ready. Your body will tell you when. Trust yourself. And as the Welsh poet, Dylan Thomas, exclaimed, “Do not go gentle into that good night.” He added “Rage, rage against the dying of the light.”


  1. Mitch Clogg September 25, 2023

    Your lament about 81 is more a brag than a Dylan Thomas poem. Pretty nice setup you got. Sounds like you’re good for at least another ten, at minimum. Still, dying sucks. Couldn’t agree more.

    My sister Judy died just three years ago in a hospice outside of Baltimore. It was managed well by all parties. She was in her late eighties. Before that, she lived her last good years at a development for retired people called Willow Valley, in Pennsylvania. She was an athlete all her life, and that continued until cancer re-entered. She was playing pickleball a few weeks before she died.

    I mention this because of this extraordinary moment: In a telephone call she said to me, “This is the happiest I’ve been in my entire life.” She had a very full, very eventful, very admirable life, so that comment carried a lot of weight.

    Mitch Clogg

  2. Marilyn Davin September 26, 2023

    When I hear laments like Raskin’s describing a cornucopia of old-age housing options I wonder how the lamenter plans to pay for one of them. I did some research for a friend in need of “managed care;” I checked out several local facilities and came away both appalled and determined to check out before such a place could appear in my future. One such “facility” really stuck in my mind. A typical 1970s-era suburban East Bay rancher, as I recall the place had 8 “clients” in residence. There were no medical personnel of any kind, no counselors, no other support staff save for those who either cleaned the place or cooked. I located the woman who appeared to be in charge and asked her how many lived in the house. I recall it was eight. Then I asked how much it costs to “live” there: a mere $8,000 per month. Careful to assure her she did not make the rules, I did a quick calculation (8,000 x 8 = $64,000 per month) before showing my astonishment. How can it cost that much to operate the place (undoubtedly mortgage-free for decades) with no services of any kind beyond essential maintenance? She had no idea. As an aside I have visited other such “residential” facilities owned by physicians as LLCs (I don’t know who owned the facility just described). I suppose they need the extra cash since HMOs and the like have cut into their profits. Welcome to post-modern America. If religious pray for a quick, fatal heart attack…

    • Eric Sunswheat September 26, 2023

      Count me in as a retirement investor resident?
      RE: If religious pray…
      —> September 25, 2023
      The Dominican Sisters of San Rafael have decided to sell their retreat center, Santa Sabina, located adjacent to Dominican University…
      The center was built in 1939 to house young women preparing to enter the order, but since 1970 the nuns have used the building to operate a retreat open to spiritual seekers of various traditions…
      The center includes a chapel that accommodates 40 to 60 people, a prayer room suitable for a gathering of a similar size, a conference room that seats 100 people, a dining room that seats 60 people, 38 bedrooms, a library, a pillow room adjacent to the library with a wood-burning fireplace, a smaller meeting room that fits about a dozen people, three staff offices, an inner courtyard garden, a straw bale hermitage and a yurt.

    • Chuck Dunbar September 26, 2023

      Some of these more expensive, fancier assisted living facilities are being bought by private equity firms. There’s money to be made in this field, especially in wealthy areas of the country. One can imagine that in reality the focus of these investors may well be on more profit, at the expense of quality care for residents. High level care for the elderly is very labor intensive, the kind of human service not amenable to cost-efficient plans made by money-men.

  3. Marmon September 26, 2023

    Kaepernick begged the Jets to put him on its practice squad. No dice. He’s old, he’s a political liability and that makes him a locker room liability.


    • Bruce Anderson September 26, 2023

      Kaepernick has a suit pending against the owner’s association for their obvious blackballing of him, which he will win lots and lots of money. I’m sure he can still play. The Jets could use him, for sure. Many NFL players have said Kap is better than a lot of qb’s playing now.

      • Lazarus September 26, 2023

        Kaepernick’s problem is his political choices. Generally, football crowds lean center right from what I saw at old Candlestick during the 80s, 90s, and early 20s.
        That kneeling stuff, among other faux pas, will never be forgotten or forgiven by many, and the NFL knows it. I can imagine the booing every time he shows his face, let alone makes a bad pass or fumbles.
        Kap is aging, the clock is ticking, and time will soon run out.
        Game, set, match…
        Be well, and good luck.

        • Chuck Dunbar September 26, 2023

          Not sure how these football-related comments got into this comment section on housing for the elderly….

          • Lazarus September 26, 2023

            No big deal, James, etc., are merely controlling the narrative…

            • Marmon September 27, 2023

              Actually I posted my comment on this story by mistake. I thought I was posting it on MCT. MY BAD!


  4. Eric Sunswheat September 26, 2023

    RE: When I hear laments like Raskin’s describing a cornucopia of old-age housing options I wonder how the lamenter plans to pay for one of them. (Marilyn Davin)
    —> June 08, 2023
    Paying for a nursing home can seriously deplete your retirement savings. The government-funded Medicaid program can pay some or all nursing home costs, but it’s restricted to people of very limited financial means. You may be able to qualify for government assistance with nursing home costs, even if you control substantial wealth if you transfer nearly all your assets into an irrevocable trust. An irrevocable trust can protect your money from nursing home costs, but they have costs and drawbacks of their own, including permanently losing direct control of your assets…
    The program is administered by states, which determine their own Medicaid eligibility requirements in a variety of ways. In most, the annual income limit is $29,160 or less. This cap includes Social Security and pension benefits as well as wages and investment income. Financial resources such as bank accounts, investments, revocable trusts and real estate typically can’t total more than $2,000. People who have more income and more assets may have to spend their own assets to pay for nursing home care until their assets have declined to the point they meet the Medicaid caps.
    An irrevocable Medicaid trust is designed to help someone qualify for Medicaid without having to deplete their own assets. After creating the trust, they can transfer in enough assets to bring them below Medicaid’s caps…
    Irrevocable trusts have a number of limitations that anyone planning to use one will want to keep in mind. These include:
    One-way transfer. Assets placed in the trust can’t be taken out of the trust for as long as the grantor of the trust is alive.
    Five-year limit. Assets must be transferred into the trust at least five years before the grantor seeks to acquire Medicaid eligibility. Irrevocable trusts can’t help at the last minute.
    Medicaid doesn’t always pay all costs…
    Not all nursing homes qualify. Medicaid only pays for care in certain approved nursing homes…

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