None of us can avoid the mirror of life reflecting physical aging. Innately, we fear languishing in a nursing home, so we grasp every opportunity to stay in our comfort zone.

Aging sometimes forces us away from independent home living as debilities jeopardize our well-being. This involves many factors that are wrapped in a system which not only remains complex and difficult to navigate but is also shepherded by laws that are counter-intuitive for elder seniors.

Even many healthcare professionals do not know the difference between assisted living and a board-and-care. When the time comes in our aging process to move from our comfort zone, distinguishing the alternatives can be helpful when making a decision for you or your loved one.

On the periphery of independent living are senior communities (e.g., Friendly Valley, Belcaro). Some are gated and have houses, condos and apartments with convenient features of bus transportation for personal errands, common lawn areas and recreational activities.

Another option is secure senior apartments (e.g., Valley Oaks Village, Willows, Bouquet Canyon and Canyon Country Senior Apartments) where you maintain your own living quarters with a community center and sometimes transportation availability.

There are three more alternatives that are becoming popular and might be explored to keep seniors in their comfort zone.

One is shared living, usually with another elder senior, in a house or apartment with a common area but separate bedrooms and bath. Expenses for both parties are lessened.

A second is having daily home caregivers for part or all of 24 hours. Having a reliable agency is important in assuring they are well-trained, bonded, and personality compatible. Costs can be high.

Lastly, one can move in with family. Some new single-structure homes are divisionally built with this in mind. Separation and independence can be maintained, while proximity allows improved convenience and monitoring of loved ones.

Once, though, you are incapable of living independently in your own home or with family, options decrease and costs may increase.

Assisted living is similar to apartment living, except there is a congregate dining room where food is prepared for the resident. We have three in our valley: Sunrise, Summerhill and Pacifica. Caregivers monitor health, distribute medication, keep the apartment tidy, provide group activities, transport residents to doctor appointments, and have a dementia unit for those with memory problems.

Board-and-cares are private homes with bedrooms occupied by one or two residents, with a capacity of 5 or 6. The ratio of caregiver to patient is better, but the training of these individuals is not strictly regulated. Dispensing of medication is provided, and meals are prepared by caregivers.

Costs for assisted living and board-and-cares are not paid by Medicare. Sometimes, certain insurance plans cover the cost, but this is rare. For veterans and their spouse, there might be supplementation by the VA, if you qualify.

Finally, nursing homes have been re-labelled “skilled nursing facilities” (SNF, pronounced “sniff”) to enhance appeal. Should you be admitted after hospitalization, the first three months may be covered by Medicare. After that, you are financially on your own unless you have coverage by Medi-Cal (federally known as Medicaid).

We have one SNF in Santa Clarita and several in the San Fernando Valley that vary in care. Costs are high as in assisted living and board-and-care facilities, so your “nest egg” can be rapidly and easily depleted.

This brings us back to the elder senior question: “Why can’t I live at home?” With the baby boom generation, more seniors will be looking for alternative living as age creeps toward them, yet the best place to live is still at home.

Here is a potpourri of suggestions that might enhance in-home elder senior living:

– Any new house built must be “senior friendly.” Preferably, they are single story and minimally have bathroom safety bars, nightlight flooring, wheelchair access ramp convertibility, and softened floors (like at the gym) for falls. As mentioned, they should be divisional into separate living quarters.

– Home healthcare must be improved. Medicare services including physical and occupational therapy, IV therapy and post-hospitalization follow-up must be streamlined, especially as some laws are counter-intuitive to home care (archaic restrictions on IV lines, insulin injections, urinary catheters, and feeding tubes).

– All seniors should have a one-touch bracelet or necklace with an emergency button calling for help. Some of these now detect if a senior has fallen and calls automatically.

– Include motion detectors and TV camera observing (within the realm of privacy) to monitor activity.

– Now on the market are automatic drug dispensers assuring compliance with physician medication therapy.

– Have available home delivered grocery and restaurant shopping done by phone (which we already have in Santa Clarita).

– Simplify cell phones for those who are still challenged by the technology so they can always have it at hand.

– For those with hearing problems, emphasize closed-captioned televisions and telephones.

– Bring the autonomous car (computerized self-driving) to Santa Clarita allowing our seniors to remain transportation independent.

– Finally, instead of “fighting robots,” let’s develop technology using robots to serve our elder seniors in their home. Used in the right way, this might allow those marginal seniors to remain at home instead of a SNF.

This is just a short list of suggestions that can be lengthened with creativity and technological entrepreneurialism.

Now, go look in the mirror and you’ll see yourself getting older. The time will come when you will be asking, “Why can’t I live at home?” Hopefully then, the answer will be, “You can.”

Gene Uzawa Dorio, M.D., is a housecall geriatric physician on staff at Henry Mayo Newhall Memorial Hospital and has been engaged as an advocate in many community activities. The views expressed in this column as his alone.