For many elderly individuals who can no longer remain independent, the choices of residence are very limited. Assisted living facilities, employing a 24-hour caregiver, or moving in to a nursing home are not very enticing options. However, prolonged cruise vacations might be an economical and luxurious assisted living alternative. Millions of seniors already choose to vacation by cruise for the service, food, ease of movement, amazing itineraries, and the all-inclusive nature. Many of these individuals would stay on board for months at a time by booking the trips back to back and reserving their cabins.

Dr. Lee Lindquist, an assistant professor of medicine at Northwestern University Feinberg School of Medicine, proposed “cruise ship care” as an alternative to typical nursing homes. "A lot of people in assisted living facilities are dissatisfied with what they're paying and the services that they get," said Dr. Lindquist. "A nice facility can be extremely expensive, and a lot of seniors have to go into their own savings because Medicare doesn't cover it. When you think about all the amenities you get, living on a cruise ship is more desirable for certain people."

Dr. Lindquist believes “seniors who enjoy travel, have good or excellent cognitive function, and require some assistance with activities of daily livings are the ideal candidates for cruise ship care.” One of the benefits of cruise ship in particular is that many amenities overlap with what are offered at assisted living facilities. The Table below examines the similarities.

First a first hand perspective, an article published in the St. Petersburg Times tells the story of Beatrice Muller, an 87 year young lady that has been living on the Queen Elizabeth 2 cruise ship. “It's been a fantastic life for me here," is how she describes her six and a half years onboard the ship. Before being a resident on the ship, Muller and her husband were frequent passengers already for four years. They always went ashore at each of the 40 ports of call - "one must keep one's land legs." Muller especially enjoyed shopping in Hong Kong's Stanley Market. Other favorite destinations include Cape Town, Durban and the Isle of St Helena. After her husband passed away, her family suggested that since all her friends were on the ship, why didn't she live on the ship? "The greatest difficulty is giving up one life and starting another, but as I don't have grandchildren, and my sight is not good enough for me to drive, I feel I'm at the age where I need to live here. But I'm learning to drive the ship: they've taught me how to blow the whistle."

"My priorities on this ship are ballroom dancing, playing duplicate bridge, and trying not to eat [too much] - not necessarily in that order. I like all kinds of dancing, but right now I'm not dancing sambas or the cha cha - I don't want to jump on my new hip just yet." After dancing until 11:30 pm each night, Muller reads in her cabin, and sometimes doesn't get up for breakfast.

Muller says it costs her "less than $100,000" a year to live as a permanent resident on board, including trips on shore and for the traveling she does at other times.
In Dr. Lindquist's study, there were some further comparisons. The room sizes on the cruise ship are likely to be smaller than in an assisted living facilities. But the common areas on the ship such as the dens, libraries, dance halls, atria, are much larger and more expansive than the average assisted living facilities. Furthermore, the number of employees serving the tenants far outnumber those seen in a typical nursing home. The largest cruise lines on average have a ratio of two or three passengers to one employee.

More importantly, the ships have several nurses and a doctor are two are available around the clock. Most ships have medical equipment such as defibrillators and even dialysis machines. These health resources are actually something many assisted living facilities can't compete. For people in good health, the medical services on the ships are adequate. On the other hand, expect long delays in emergency medical care if you are out in the sea and need to get to a hospital.

As for family or friend visits, the senior have the option of disembarking in between trips or have people come to visit 'on vacation'. In any case, living on a cruise ship would be better for someone who doesn't mind being distant from their family for long periods of time.

According to Dr. Lindquist, the average cost of living in a nursing home in the United States is $28,689 compared to $33,260 to live on the cruise ship, Royal Caribbean. Although the numbers can vary significantly depending on where you live and which cruise ship and options you choose (note that Beatrice Muller gave a figure of $100,000 on the QE2 including all her land excursions and extras), the costs are actually not significantly more than traditional nursing homes. Considering all these extras you get for living on a cruise ship, I think it is definitely worth it if you feel the lifestyle is suitable for you.

Certainly, you don't have to jump in and make the change right away. The easiest way to test the water, so to speak, is to get onboard a ship and stay for a month or two. Who knows, perhaps you might decide to stay?

Sources:

Lee A. Lindquist, Cruise Ship Care: A Proposed Alternative to Assisted Living Facilities, Journal of the American Geriatrics Society, 2004.
Mim Swartz, Cabin fever, St. Petersburg Times, 2006.
Beatrice Muller living on the QE2, Grande Dame of the Seas, 2006.
Anahad O'Connor, At Sea, Care for Aged (and All You Can Eat), The New York Times, 2004.
Photo by Dawn Endico.