In 1999, Mildred and her husband, George, moved into a CCRC (Continuing Care Retirement Community) that I'll call Pine Lakes. CCRCs offer a range of living options. People typically can live in apartments, in Assisted Living, or in Skilled Nursing.

Mildred and George, both in their late 70s, were still able to handle every detail of their lives. Like most people entering Pine Lakes, they moved into an independent living apartment. Mildred loved it, particularly the sun porch opening onto a greenbelt. She spent hours there, soothed by the sights and sounds of nature. "I'm never giving up this apartment!" she repeatedly warned anyone who would listen.

As the years went by, both she and George started to have trouble managing their finances, their meals and other activities. Mildred started to have frequent falls. Often, though, she refused to see the on-site doctor. She was afraid that if the medical staff thought she needed more attention, they would suggest a move to Assisted Living. "Over my dead body!" she declared.

One night in 2008, their daughter Carol's phone rang around 9:30 p.m. Caller ID showed that the call was coming from Pine Lakes, but not from her parents' apartment. Before she even picked up the phone, she felt a sense of dread.

Mildred had fallen and broken her hip. When she got out of the hospital after surgery, she and George were moved into a room together in the Skilled Nursing unit. George could not be left on his own.

They never went back to the apartment again. Devastated that Mildred had been injured, George was often distraught. For months, he imagined that Mildred was going to die suddenly. In reality, she was out of danger after a few weeks. Even as Mildred got better, George declined rapidly and died the following year.

It has been four years since Mildred, now 90, broke her hip. She recovered remarkably well. She loves going for walks on the grounds of Pine Lakes, something she is able to do by herself. She doesn't use a cane or a walker. She doesn't need an aide to go with her.

However, Mildred is still living in the Skilled Nursing unit. She is no more impaired than some of the people in Assisted Living. If she were in Assisted Living, she would have more space, more privacy and a more home-like setting. It would also cost about half as much.

But everyone agreed after George died that it would be too hard for Mildred to make another move. She would have to relearn everything - how to find her room, how to get outside, where meals are, who the staff are, and so forth. The professionals warned that such a move would disorient Mildred and push her into rapid decline. Instead, she will spend the rest of her life housed with people who are so impaired that she doesn't even have anyone to talk with.

Carol is haunted by thoughts of what might have been. Mildred had lost 20 percent of her body weight by the time she fell and broke her hip. Did she fall because she was faint from poor nutrition and from not eating?

If she and George had moved to Assisted Living, they would have had three supervised meals a day. In the Skilled Nursing unit, with three meals a day, Mildred rapidly regained the weight she had lost. In Assisted Living, could she have avoided the fall that broke her hip? In three years in the Skilled Nursing unit, she hasn't had any falls at all.

Could she and George have lived out their lives in a more comfortable setting with four times the space of their room in the Skilled Nursing unit, at half the cost? Could they have had 80 percent of the benefits of independent living, with less risk? Did Mildred, by trying so hard to preserve the life she loved, put in motion a chain of events that cost her that life?

Mildred's situation highlights an important point people face in managing their healthcare. Often, people compare the plusses of one choice to the minuses of another. In Mildred's case, the benefit of staying in their apartment was that she got to live in a setting she loved. The downside to moving was that she would have to give up the apartment.

She did not consider the potential risk of that first choice: that she and George might abruptly lose the apartment - and be injured, devastated, and distraught - and spend the rest of their lives in the Skilled Nursing unit because of a medical crisis resulting from their inability to take proper care of themselves.

"It is a lesson for us all," Carol said.

People may increase their chances of living the lives they want if they understand clearly both sides of the equation - benefits and risks - when they decide to accept or to reject healthcare tests, treatments, or housing options.