Dr. Greganti's touching story [1] of a wife who lost her husband and two close friends to the devastating diseases that haunt our increasingly geriatric society is unfortunately typical of hundreds of thousands, probably millions, of people every day. Like the woman at Golden Acres, I live in a life care or continuing care retirement community. I too have experienced the long-term disability and death of my husband and several close friends. Such tragedies are not limited to those who live in continuing care retirement communities but are an inevitable part of the human experience. The only alternatives to the loss of loved ones—neither very attractive—are to avoid love and friendships or to die first.

The distinguishing feature of the continuing care retirement community is not the presence of disability and death. Rather, they allow one to cope with such tragedies through the opportunity to form close new friendships, even at 75 or 80 years of age. They also provide preventive and primary care as well as community supports, enabling even the disabled elderly to live independently longer; the availability of quality long-term care, enabling one spouse to remain in relatively close proximity even when the other is dying; and the possibility of avoiding the physical strain that could otherwise result in the death of both parties rather than just one.

The continuing care retirement community is not a perfect institution. There probably never will be a "perfect" answer to chronic disability, long-term care, and death. The Institute of Medicine and other groups are trying to arrive at better solutions to these difficult challenges. Meanwhile, it is important to distinguish the organizational and financial issues of long-term care—which are at least partially amenable to correction or modification—from the tragedies inherent in aging, loving, and indeed life itself.