When You Can No Longer Care for Yourself

 


When You Can No Longer Care for Yourself — Don't Go to a Nursing Home, Do 'This' Instead - YouTube

Three Alternatives for Independent Senior Living in San Diego

BLUF (Bottom Line Up Front): For San Diego seniors facing declining independence, nursing homes are not the only option—and often not the best one. Three proven alternatives offer dignity, community, and significant cost savings: Adult Family Homes (residential care in regular neighborhood homes for 2-6 residents, averaging $3,000-$5,000/month), Senior Cohousing (self-governing communities where residents own private units but share common spaces and responsibilities), and the Village Model (membership-based nonprofits like ElderHelp of San Diego that help seniors stay in their own homes with volunteer support and services for as little as $200-$500/year). Each model provides quality care while preserving autonomy and connection to community—at a fraction of nursing home costs that now exceed $10,700/month in San Diego.

For decades, the conventional wisdom has been simple: when seniors can no longer manage alone, they move to a nursing home. But that narrative is changing, driven by both economics and a growing recognition that institutional care often isn't what seniors actually want or need.

The numbers tell a stark story. In San Diego, nursing home costs average $10,722 per month for a semi-private room, while private rooms in California now cost an average of $12,167 monthly. These figures represent consistent 5% annual increases since 2015, straining family budgets across the state. Meanwhile, over 11 million Americans over age 65 now live alone, many facing a future that seems to offer only two choices: struggle in isolation or surrender independence.

But a quiet revolution has been underway. Across San Diego County and California, three alternative models have emerged that allow seniors to maintain dignity, community connections, and autonomy—often at dramatically lower costs than traditional institutional care.

Adult Family Homes: Care in a Neighborhood Setting

Adult family homes represent a fundamentally different approach to senior care. Rather than large institutional facilities, these are regular houses in regular neighborhoods, licensed to care for a small number of residents with a trained caregiver who actually lives there.

In San Diego County, there are over 100 adult family homes, officially called Residential Care Facilities for the Elderly (RCFEs). These homes provide 24-hour support, home-cooked meals, shared living spaces, and private bedrooms—all in a setting that feels more like a family home than a medical facility.

The cost difference is substantial. While the average San Diego nursing home charges over $10,000 monthly, residential care facilities in California average $6,000 per month, with costs ranging from around $1,420 for residents on Supplemental Security Income to over $10,000 for specialized services. Many adult family homes in San Diego fall in the $3,000-$5,000 monthly range—roughly half the cost of traditional nursing homes.

Adult family homes serve six residents or less, so the ratio of residents to staff is optimal for care. This stands in sharp contrast to the staffing challenges plaguing traditional nursing homes, where during the day, one aide might be responsible for seven or eight residents, with that number rising to 14 or more at night.

The homes themselves vary in character and specialization. According to local listings, facilities like HarborView Senior Assisted Living, House of Grace Senior Care, and Canyon Guest Home serve different neighborhoods across San Diego County, from Chula Vista to Spring Valley, offering families geographic options that keep seniors connected to familiar communities.

Residential care facilities must be licensed by California's Department of Social Services Community Care Licensing Division, ensuring regulatory oversight while maintaining the home-like environment that many seniors prefer. In Medi-Cal (California's Medicaid program), asset limits were eliminated in January 2024, potentially expanding access for many seniors who previously wouldn't have qualified for assistance.

Senior Cohousing: Community by Design

Senior cohousing takes a radically different approach: residents design and run their own intentional communities. Each person or couple has a private unit with their own kitchen, bathroom, and front door. But they also share common spaces—large kitchens for group dinners, gardens, workshops, libraries—and collectively manage the community through consensus decision-making.

While rare, cohousing communities do exist in California. La Querencia Co-Housing Community was formed in 2013 near downtown San Diego, creating what founders describe as "a place where one feels safe, a place from which one's strength of character is drawn." The community sits on a third acre with 6 units, featuring garden space, bicycle storage, tools and multi-purpose workshop, study and art space, and outdoor kitchen.

San Diego Urban CoHousing is also in development, envisioning 25 private residences plus a Common House with professional kitchen, targeting adults ranging from their 30s through seniors, demonstrating the intergenerational appeal of this model.

The financial advantages come from shared resources. Senior co-housing can reduce monthly living costs by 40 to 50% compared to living alone through shared utilities, shared maintenance, bulk purchasing, and group insurance plans. Beyond economics, residents consistently report something more valuable: genuine community without institutional control.

However, cohousing requires active participation. Residents attend meetings, share responsibilities, and function as neighbors in the fullest sense. The limitation is availability—senior co-housing communities are still relatively rare, mostly concentrated in western states, and they require a certain personality willing to participate and be a neighbor.

The Village Model: Staying Home with Support

The third alternative may be the most accessible: the Village Model allows seniors to stay in their own homes while joining a membership-based community that provides support, services, and social connection.

ElderHelp of San Diego, founded in 1973, operates a variation of the village model, providing personalized services that help seniors remain independent and live with dignity in their own homes. Unlike traditional villages that rely primarily on membership dues, ElderHelp evolved from a social agency model and serves a largely lower-income group of seniors, raising private funds to support an extensive professional and volunteer service network.

ElderHelp's services include volunteers who reduce isolation and keep seniors healthy and happy with grocery shopping, friendly visiting, home safety modifications, and financial advocacy. The organization also offers a unique HomeShare program, matching people seeking affordable housing with homeowners—primarily older adults—who want to remain in their homes.

Research supports the village model's effectiveness. A study found that villages have the strongest impact in promoting social engagement and facilitating access to services, with three-quarters of participants reporting that the village increases their ability to age in place. A longitudinal study found the strongest positive results in the domain of confidence, including significantly greater confidence aging in place, perceived social support, and less intention to relocate after one year in the village.

Nationally, most villages charge yearly membership fees ranging from $10 to $900 for individuals and $15 to $1,309 for couples. The typical annual fee is between $200 and $500 a year, providing access to rides to doctor appointments, help with groceries, home repairs, technology support, and regular social events.

The model isn't perfect. Villages remain a model that attracts mostly white, well-educated, and well-resourced older adults, with only about 11 percent of members identifying as non-white, a quarter having annual income under $50,000. However, a 2025 study examining socioeconomic and institutional factors found that the Village Movement, which began in 2002, represents a grassroots response to sustainable, community-based aging solutions, with villages established and operated by older adults already living in neighborhoods.

As of recent counts, there are over 264 open villages and more than 55 in development across 43 states, the District of Columbia, and four countries.

The Road Ahead

These alternatives share common threads: smaller scale, community integration, and resident empowerment. They reject the one-size-fits-all institutional approach in favor of models that adapt to individual needs and preferences.

The barriers are real. Adult family homes require careful vetting—not all are well-run. Cohousing demands active participation and remains geographically limited. Village models work best for those who are mostly independent, not those needing round-the-clock medical care.

Yet for many San Diego seniors and their families, these alternatives offer something invaluable: the ability to age on your own terms. As ElderHelp's mission states, the goal is to help seniors "live independently and with dignity in their own homes," targeting "the oldest, poorest and most frail seniors—those with the fewest resources and the least support".

The choice between independence and safety is a false dichotomy. With the right support structures, seniors can have both—in their neighborhoods, their communities, and their homes.

Resources for San Diego Seniors

Adult Family Homes/Residential Care:

  • California Department of Social Services, Community Care Licensing Division: https://www.cdss.ca.gov/inforesources/senior-care-licensing
  • A Place for Mom (San Diego residential care homes): https://www.aplaceformom.com/care-homes/california/san-diego
  • Better Business Bureau Adult Family Homes directory: https://www.bbb.org/us/ca/san-diego/category/adult-family-homes

Cohousing:

  • Cohousing California: https://www.calcoho.org/communities
  • La Querencia Co-Housing Community: https://www.calcoho.org/la_querencia_san_diego
  • Cohousing Association of the United States: https://www.cohousing.org

Village Model/Aging in Place:

  • ElderHelp of San Diego: https://elderhelpofsandiego.org (619) 284-9281
  • Village to Village Network: https://www.vtvnetwork.org
  • California Village Movement: https://www.villagemovementcalifornia.org

General Senior Resources:

  • San Diego County Area Agency on Aging: (800) 339-4661
  • 2-1-1 San Diego (Information and referral): Dial 211
  • California Department of Aging: https://www.aging.ca.gov

Verified Sources

  1. U.S. News & World Report. "Senior Villages Take Root as Movement Matures." January 28, 2011. https://money.usnews.com/money/blogs/the-best-life/2011/01/28/senior-villages-take-root-as-movement-matures

  2. CareAvailability. "Adult Care Homes in San Diego, CA." July 2, 2024. https://careavailability.com/senior-living/adult-care-homes/adult-care-homes-in-california/adult-care-homes-in-san-diego-ca/

  3. ElderHelp of San Diego. "Home." July 14, 2025. https://elderhelpofsandiego.org/

  4. GuideStar. "ElderHelp of San Diego Profile." https://www.guidestar.org/profile/95-2880426

  5. Charity Navigator. "Rating for ElderHelp of San Diego." June 18, 2025. https://www.charitynavigator.org/ein/952880426

  6. Cohousing California. "La Querencia Community." https://www.calcoho.org/la_querencia_san_diego

  7. Cohousing Association of the United States. "San Diego Urban CoHousing." December 17, 2024. https://www.cohousing.org/directory/san-diego-urban-cohousing-2/

  8. Harvard Health Publishing. "A new angle on aging in place: The virtual village." July 1, 2022. https://www.health.harvard.edu/staying-healthy/a-new-angle-on-aging-in-place-the-virtual-village

  9. AARP Public Policy Institute. Graham, C., and Guzman, S. "The Village Model: Current Trends, Challenges, and Opportunities." October 2022. https://doi.org/10.26419/ppi.00169.001

  10. Chiu, Y. "Socioeconomic Factors Influencing the Growth and Sustainability of the Village Movement." Journal of Aging Research, June 12, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12178741/

  11. Graham, C., Scharlach, A.E., Kurtovich, E. "Do Villages Promote Aging in Place? Results of a Longitudinal Study." Journal of Applied Gerontology, 37(3):310-331, March 2018. https://pubmed.ncbi.nlm.nih.gov/27708072/

  12. Scharlach, A., Graham, C., Lehning, A. "The 'Village' Model: A Consumer-Driven Approach for Aging in Place." The Gerontologist, 52(3):418-427, June 2012. https://doi.org/10.1093/geront/gnr083

  13. SeniorSite. "Nursing Home Cost in California: The Real Price Guide for 2025." March 12, 2025. https://seniorsite.org/resource/nursing-home-cost-in-california-the-real-price-guide-for-2025/

  14. Caring.com. "Nursing Homes in California." https://www.caring.com/senior-living/nursing-homes/california

  15. A Place for Mom. "10 Best Nursing Homes in San Diego County, CA." https://www.aplaceformom.com/nursing-homes/california/san-diego-county

  16. California Advocates for Nursing Home Reform (CANHR). "Overview of Assisted Living/Residential Care Facilities for the Elderly (RCFEs)." June 27, 2025. https://canhr.org/overview-of-assisted-living-residential-care-facilities-for-the-elderly-rcfes/

  17. Village to Village Network. "Village Movement Forward: Evolving the Village Model." https://virginianavigator.org/article/72581/village-movement-forward-evolving-village-model

  18. Senior Planet from AARP. "The Village Model: A Neighborly Way to Age in Place." November 22, 2021. https://seniorplanet.org/the-village-model-a-neighborly-way-to-age-in-place/

  19. Next Avenue. "The Village Movement: Redefining Aging in Place." June 4, 2012. https://www.nextavenue.org/village-movement-redefining-aging-place/

  20. Eastside Friends of Seniors. "The Village Movement: Aging in Place with Community Support." February 18, 2025. https://www.eastsidefriendsofseniors.org/post/the-village-movement-aging-in-place-with-community-support

Stephen L. Pendergast is a member of the Informed Prostate Cancer Support Group (IPCSG) and contributes regularly to the newsletter on health policy and aging issues.

Special Focus: Options for Seniors with Significant Medical Conditions Including Prostate Cancer

BLUF (Bottom Line Up Front): For San Diego seniors managing significant medical conditions like prostate cancer, nursing homes are not the only option—and often not the best one. Three proven alternatives offer dignity, community, and significant cost savings while accommodating medical needs: Adult Family Homes/Residential Care Facilities (residential care in regular neighborhood homes for 2-6 residents, averaging $3,000-$6,000/month, with hospice care available), Senior Cohousing (self-governing communities where residents own private units but share common spaces and can arrange for home health services), and the Village Model (membership-based nonprofits like ElderHelp of San Diego that help seniors stay in their own homes with volunteer support and coordinated medical services for as little as $200-$500/year). California regulations specifically allow residential care facilities to provide hospice care and work with home health agencies, meaning cancer patients can receive medical oversight and palliative care while maintaining independence and community connections—at a fraction of nursing home costs that now exceed $10,700/month in San Diego.

For prostate cancer patients and survivors in the IPCSG community, the question of where to live as we age takes on added complexity. Managing ongoing medical surveillance, potential treatment side effects, and the physical demands of advanced disease requires more than just a roof overhead. Yet the assumption that serious medical conditions automatically require institutional nursing home care overlooks a range of alternatives that can provide both medical support and quality of life.

The numbers tell a stark story. In San Diego, nursing home costs average $10,722 per month for a semi-private room, while private rooms in California now cost an average of $12,167 monthly. These figures represent consistent 5% annual increases since 2015, straining family budgets across the state. Meanwhile, over 11 million Americans over age 65 now live alone, many facing a future that seems to offer only two choices: struggle in isolation or surrender independence.

But a quiet revolution has been underway. Across San Diego County and California, three alternative models have emerged that allow seniors—even those with significant medical conditions—to maintain dignity, community connections, and autonomy, often while receiving coordinated medical care at dramatically lower costs than traditional institutional settings.

Adult Family Homes: Medical Care in a Neighborhood Setting

Adult family homes (officially called Residential Care Facilities for the Elderly or RCFEs in California) represent a fundamentally different approach to senior care that can accommodate residents with serious medical conditions, including cancer.

In San Diego County, there are over 100 adult family homes, providing 24-hour support in regular houses in regular neighborhoods. What many don't realize is that California regulations specifically allow these facilities to work with hospice agencies and provide coordinated medical care.

Medical Services in Residential Care Facilities:

California Code of Regulations Section 87633 explicitly permits residential care facilities to retain terminally ill residents or accept residents already receiving hospice care, provided they work with a Medicare-certified hospice agency to develop and implement a hospice care plan. This means prostate cancer patients, even those with advanced or metastatic disease, can receive palliative care, pain management, and end-of-life support in these smaller, home-like settings.

Residential care facilities can hire appropriately skilled professionals (e.g., licensed nurses) to provide medication administration and incidental medical services. For prostate cancer patients managing hormone therapy, bone-directed therapy, or pain medications, this means trained staff can assist with complex medication regimens while maintaining the home-like environment.

The regulatory framework is clear: The hospice care plan specifies the care, services, and necessary medical intervention related to the terminal illness as necessary to supplement the care and supervision provided by the facility. The hospice agency provides nursing care, symptom management, and medical oversight, while the residential care facility provides the daily living support and home environment.

Cost and Access:

While the average San Diego nursing home charges over $10,000 monthly, residential care facilities in California average $6,000 per month, with costs ranging from around $1,420 for residents on Supplemental Security Income to over $10,000 for specialized services. Many adult family homes in San Diego fall in the $3,000-$5,000 monthly range for standard care, with additional costs for specialized medical needs.

Importantly, California eliminated asset limits for Medi-Cal (Medicaid) eligibility on January 1, 2024, potentially expanding access for many cancer patients who previously wouldn't have qualified for assistance. This is particularly significant for prostate cancer patients who may have depleted savings paying for treatments not covered by insurance.

Adult family homes serve six residents or less, so the ratio of residents to staff is optimal for care. This stands in sharp contrast to the staffing challenges plaguing traditional nursing homes, where during the day, one aide might be responsible for seven or eight residents, with that number rising to 14 or more at night.

Senior Cohousing: Independent Living with Health Support

Senior cohousing takes a radically different approach but can still accommodate medical needs through coordinated home health services. Each person or couple has a private unit with their own kitchen, bathroom, and front door, where they can receive home health nursing, physical therapy, or hospice care just as they would in a standalone home.

La Querencia Co-Housing Community was formed in 2013 near downtown San Diego, creating what founders describe as "a place where one feels safe, a place from which one's strength of character is drawn." The community sits on a third acre with 6 units, and because residents maintain independent living units, they can contract directly with home health agencies, visiting nurses, and hospice providers.

For prostate cancer patients, this model offers several advantages:

  • Privacy for medical procedures: Home health nurses can provide injections, wound care, or catheter management in your private unit
  • Community support during treatment: Neighbors can help with meals, transportation to appointments, or companionship during recovery from procedures
  • Shared cost benefits: Bulk purchasing and shared utilities reduce living costs by 40-50%, freeing up resources for medical expenses

The limitation is availability—senior co-housing communities remain rare in San Diego. However, for those who can access them, the combination of independence, community, and ability to bring in medical services offers a unique middle ground.

The Village Model: Aging in Place with Coordinated Medical Support

The third alternative may be the most accessible for cancer patients who want to remain in their own homes while receiving medical care. The Village Model provides membership-based support that can coordinate with existing medical teams.

ElderHelp of San Diego, founded in 1973, provides personalized services that help seniors remain independent and live with dignity in their own homes. Unlike traditional villages that rely primarily on membership dues, ElderHelp serves a largely lower-income group of seniors, raising private funds to support an extensive professional and volunteer service network.

Medical Care Coordination:

While villages don't provide medical care directly, they excel at facilitating access to medical services. ElderHelp's services include volunteers who reduce isolation and keep seniors healthy with grocery shopping, friendly visiting, home safety modifications, and financial advocacy. For cancer patients, this translates to:

  • Transportation to medical appointments: Chemotherapy infusions, radiation treatments, and specialist consultations
  • Medication management support: Helping organize complex medication schedules common with hormone therapy and supportive care
  • Home safety modifications: Installing grab bars, removing fall hazards—critical for patients with bone metastases or those on medications affecting balance
  • Care coordination: Connecting members with home health agencies, hospice providers, and community resources

Research supports the village model's effectiveness for supporting health. A study found that villages have the strongest impact in promoting social engagement and facilitating access to services, with three-quarters of participants reporting that the village increases their ability to age in place. For cancer patients, this access to services can mean the difference between managing at home and needing institutional care.

Nationally, most villages charge yearly membership fees ranging from $10 to $900 for individuals and $15 to $1,309 for couples. The typical annual fee is between $200 and $500 a year—far less than a single month in a nursing home.

The Medical Home Care Component

All three models can work in conjunction with home health services that bring medical care directly to where you live. Home care encompasses a wide range of health, social, and rehabilitative services for recovering, disabled, chronically ill, or terminally ill patients, chosen during different stages of their cancer journey.

For prostate cancer patients, home health services might include:

  • Skilled nursing: Managing side effects from hormone therapy, monitoring for complications, wound care after procedures
  • Physical therapy: Regaining strength after surgery, managing treatment-related fatigue, fall prevention for those with bone metastases
  • Occupational therapy: Adapting to functional limitations, energy conservation techniques
  • Palliative care: Symptom management, pain control, coordinating complex care needs
  • Hospice care: When curative treatment is no longer the goal, providing comfort-focused care

Medicare covers home health services when the patient is homebound or normally unable to leave home unassisted, and services are provided by a Medicare-certified agency. Importantly, this coverage is available regardless of whether you live in your own home, an adult family home, or a cohousing unit.

Special Considerations for Prostate Cancer Patients

Prostate cancer presents unique challenges that these alternative living arrangements can accommodate:

For men on active surveillance: The village model or cohousing allows complete independence while providing support for medical appointments and peace of mind through community connections.

For men undergoing active treatment: Adult family homes with trained staff can assist with medication management, monitor for side effects, and coordinate with medical teams. The small resident-to-staff ratio ensures personalized attention.

For men with advanced disease: Prostate cancer can metastasize to bones, causing severe pain. All three models can work with hospice agencies that specialize in pain, nausea, and difficulty breathing management, ensuring comfort, dignity, and quality of life.

For men experiencing treatment side effects: Urinary incontinence, bowel urgency, erectile dysfunction, and hot flashes from hormone therapy are better managed in smaller, more private settings where dignity is preserved and staff-to-resident ratios allow for respectful, individualized care.

The Regulatory Framework Supporting Medical Care

California's regulatory structure actively supports seniors with medical conditions living outside nursing homes:

In order to allow residents to stay in Assisted Living communities after they opt for hospice care, providers must have a hospice waiver from California's Community Care Licensing Division (Sections 87632 and 87633). This waiver system has been streamlined: Residents already receiving hospice care may be admitted to RCFEs, and the need for individual exceptions when a resident is receiving hospice care was eliminated.

This regulatory support means that prostate cancer patients don't need to move to institutional care as their disease progresses. They can establish roots in an adult family home or cohousing community, knowing they can receive increasing levels of medical support without relocation.

Financial Realities and Planning

For IPCSG members, many of whom have experienced the financial impact of cancer treatment, the cost differential between these alternatives and nursing homes is substantial:

  • Nursing home: $10,722/month in San Diego ($128,664/year)
  • Adult family home: $3,000-$6,000/month ($36,000-$72,000/year)
  • Cohousing with home health: Variable, but typically 40-50% less than living alone
  • Village membership plus remaining in own home: $200-$500/year membership, plus existing housing costs

These savings can fund:

  • Advanced imaging not covered by insurance
  • Genetic testing for treatment selection
  • Experimental therapies
  • Quality-of-life enhancements
  • Legacy planning for family

The Road Ahead

These alternatives share common threads: smaller scale, community integration, resident empowerment, and the ability to coordinate medical care without institutional control. They reject the one-size-fits-all approach in favor of models that adapt to individual needs—including serious medical conditions.

The barriers are real. Adult family homes require careful vetting and verification that they have hospice waivers if needed. Cohousing demands active participation (though less so as medical needs increase). Village models work best for those who are mostly independent, though they can coordinate escalating care needs.

Yet for many San Diego cancer patients and their families, these alternatives offer something invaluable: the ability to manage serious illness on your own terms, in community with others, while receiving appropriate medical care.

As ElderHelp's mission states, the goal is to help seniors "live independently and with dignity in their own homes," targeting "the oldest, poorest and most frail seniors—those with the fewest resources and the least support". For prostate cancer patients, who may live many years with advanced disease, this model of supported independence offers a viable alternative to the nursing home assumption.

The choice between independence and medical care is a false dichotomy. With the right support structures—whether through residential care facilities working with hospice, cohousing with home health services, or village models coordinating care—cancer patients can have both.

Resources for San Diego Seniors with Medical Conditions

Adult Family Homes/Residential Care:

  • California Department of Social Services, Community Care Licensing Division: https://www.cdss.ca.gov/inforesources/senior-care-licensing
  • To verify a facility has hospice waiver capability: Contact CDSS at (916) 651-8848
  • A Place for Mom (San Diego residential care homes): https://www.aplaceformom.com/care-homes/california/san-diego
  • Better Business Bureau Adult Family Homes directory: https://www.bbb.org/us/ca/san-diego/category/adult-family-homes

Home Health & Hospice:

  • St. Paul's Program of All-Inclusive Care for the Elderly (PACE): Provides wrap-around care services for San Diego's frailest seniors, (619) 767-3850
  • California Hospice and Palliative Care Association: https://www.calhospice.org
  • Medicare.gov Home Health Compare: https://www.medicare.gov/care-compare/
  • Hospice care information and provider search: Call 1-800-227-2345 (American Cancer Society)

Cohousing:

  • Cohousing California: https://www.calcoho.org/communities
  • La Querencia Co-Housing Community: https://www.calcoho.org/la_querencia_san_diego
  • Cohousing Association of the United States: https://www.cohousing.org

Village Model/Aging in Place:

  • ElderHelp of San Diego: https://elderhelpofsandiego.org (619) 284-9281
  • Village to Village Network: https://www.vtvnetwork.org
  • California Village Movement: https://www.villagemovementcalifornia.org

Cancer-Specific Support:

  • American Cancer Society Patient Lodging Programs: 1-800-227-2345
  • CancerCare (free counseling, support groups, financial assistance): 1-800-813-HOPE (4673)
  • National Cancer Institute Cancer Information Service: 1-800-4-CANCER (1-800-422-6237)

General Senior Resources:

  • San Diego County Area Agency on Aging: (800) 339-4661
  • 2-1-1 San Diego (Information and referral): Dial 211
  • California Department of Aging: https://www.aging.ca.gov
  • Medicare Rights Center (help with Medicare questions): 1-800-333-4114

Verified Sources

  1. U.S. News & World Report. "Senior Villages Take Root as Movement Matures." January 28, 2011. https://money.usnews.com/money/blogs/the-best-life/2011/01/28/senior-villages-take-root-as-movement-matures

  2. CareAvailability. "Adult Care Homes in San Diego, CA." July 2, 2024. https://careavailability.com/senior-living/adult-care-homes/adult-care-homes-in-california/adult-care-homes-in-san-diego-ca/

  3. ElderHelp of San Diego. "Home." July 14, 2025. https://elderhelpofsandiego.org/

  4. GuideStar. "ElderHelp of San Diego Profile." https://www.guidestar.org/profile/95-2880426

  5. Charity Navigator. "Rating for ElderHelp of San Diego." June 18, 2025. https://www.charitynavigator.org/ein/952880426

  6. Cohousing California. "La Querencia Community." https://www.calcoho.org/la_querencia_san_diego

  7. Harvard Health Publishing. "A new angle on aging in place: The virtual village." July 1, 2022. https://www.health.harvard.edu/staying-healthy/a-new-angle-on-aging-in-place-the-virtual-village

  8. AARP Public Policy Institute. Graham, C., and Guzman, S. "The Village Model: Current Trends, Challenges, and Opportunities." October 2022. https://doi.org/10.26419/ppi.00169.001

  9. Chiu, Y. "Socioeconomic Factors Influencing the Growth and Sustainability of the Village Movement." Journal of Aging Research, June 12, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12178741/

  10. Graham, C., Scharlach, A.E., Kurtovich, E. "Do Villages Promote Aging in Place? Results of a Longitudinal Study." Journal of Applied Gerontology, 37(3):310-331, March 2018. https://pubmed.ncbi.nlm.nih.gov/27708072/

  11. Scharlach, A., Graham, C., Lehning, A. "The 'Village' Model: A Consumer-Driven Approach for Aging in Place." The Gerontologist, 52(3):418-427, June 2012. https://doi.org/10.1093/geront/gnr083

  12. SeniorSite. "Nursing Home Cost in California: The Real Price Guide for 2025." March 12, 2025. https://seniorsite.org/resource/nursing-home-cost-in-california-the-real-price-guide-for-2025/

  13. Caring.com. "Nursing Homes in California." https://www.caring.com/senior-living/nursing-homes/california

  14. California Advocates for Nursing Home Reform (CANHR). "Overview of Assisted Living/Residential Care Facilities for the Elderly (RCFEs)." June 27, 2025. https://canhr.org/overview-of-assisted-living-residential-care-facilities-for-the-elderly-rcfes/

  15. Blood Cancer United. "Home Care." https://www.lls.org/managing-your-cancer/home-care

  16. SoCal Premium Healthcare. "Cancer Care." https://socalpremiumhealthcare.com/cancer-care/

  17. California Code of Regulations, Title 22, Section 87633. "Hospice Care for Terminally Ill Residents." https://www.law.cornell.edu/regulations/california/22-CCR-87633

  18. California Assisted Living Association. "End of Life Resources." https://www.caassistedliving.org/CALA/Member_Resources/Resident_Care/End_of_Life_Resources.aspx

  19. California Code of Regulations, Title 22, Section 87632. "Hospice Care Waiver." https://regulations.justia.com/states/california/title-22/division-6/chapter-8/article-11/section-87632/

  20. U.S. Department of Health and Human Services, ASPE. "Residential Care/Assisted Living Compendium: California." https://aspe.hhs.gov/sites/default/files/private/pdf/110416/15alcom-CA.pdf

Stephen L. Pendergast is a member of the Informed Prostate Cancer Support Group (IPCSG) and contributes regularly to the newsletter on health policy and aging issues.

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Dr. Christopher Kane of UCSD Health Appointed Chairman of the American Board of Urology

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  Dr. Christopher Kane of UCSD Health Appointed Chairman of the American Board of Urology SAN DIEGO, May 21, 2025 - Dr. Christopher Kane, a distinguished urologist and Professor of Urology at UC San Diego Health, has been appointed Chairman of the American Board of Urology (ABU), the organization announced today. Dr. Kane, who has served as CEO of UC San Diego Health Physician Group and Dean of Clinical Affairs at the UC San Diego School of Medicine, brings decades of experience in urologic oncology and leadership to this prestigious national position. Extensive Academic and Research Background Dr. Kane earned his medical degree from Uniformed Services University in Bethesda, Maryland, followed by a residency in urology at the Naval Medical Center San Diego and a fellowship in urologic oncology at the National Cancer Institute. He joined the UCSD faculty in 2007 after serving as a Navy physician for 12 years. As the C. Lowell and JoEllen Parsons Endowed Chair in Urology, Dr. ...
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PSMA-Targeted Therapies for Prostate Cancer: Move Treatment Earlier in Disease Course

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  Interactive Graphic PSMA-Targeted Therapies for Prostate Cancer: Move Treatment Earlier in Disease Course Landmark FDA approval expands access to radioligand therapy while new research explores next-generation treatments By [Your Name] for the IPCSG Newsletter The landscape of prostate cancer treatment has undergone a seismic shift in recent months, with groundbreaking advances in prostate-specific membrane antigen (PSMA)-targeted therapies offering new hope to patients across different stages of the disease. Most significantly, the FDA's March 2025 expansion of Pluvicto (lutetium-177-PSMA-617) approval now allows treatment before chemotherapy, potentially tripling the number of eligible patients. Major FDA Approval Expands Treatment Access On March 28, 2025, the FDA approved a crucial expansion of Pluvicto's indication, allowing its use in patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen recepto...
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ASCO 2025: Non-Androgen-Receptor–Driven Prostate Cancer: Updates in Biology, Classification, and Management

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New Hope for Aggressive Prostate Cancer: Advances in Understanding and Treating Neuroendocrine Prostate Cancer Revolutionary diagnostic tools and promising new therapies offer renewed hope for patients with treatment-resistant disease What Patients Need to Know For most men with prostate cancer, treatments targeting the androgen receptor (AR) pathway—including hormone therapy and newer drugs like enzalutamide and abiraterone—are highly effective. However, as these treatments have become more successful, doctors have observed an important but concerning phenomenon: some cancers develop resistance by essentially changing their identity. This transformation, called neuroendocrine prostate cancer (NEPC), represents one of the most aggressive forms of the disease. At the recent 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, Dr. Himisha Beltran from Dana-Farber Cancer Institute presented groundbreaking research that offers new hope for patients facing this challenging ...
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