Judy Karofsky presents a personal account of unmet needs in assisted living and hospice. She aims to spark discussions about new approaches for America’s aging population and family decision makers. There are over 30 thousand assisted living facilities in the US, but most are unaffordable for middle class Americans and fraught with staffing deficiencies and mismanagement. Chapters on the author’s experience helping her mother move from an age-restricted community in Florida to independent living in Wisconsin to assisted living will interest seniors and their family members who know the struggle of finding long-term affordable care. The chapter on hospice care distinguishes it from assisted living through the author’s experiences and misconceptions, then moves to a broader discussion of Medicare spending, and finally a meditation on dying of old age. The author strikes an effective balance between the personal, political, and cultural aspects of aging. Karofsky dedicates the last chapter of the book to a discussion of recent failures to protect long-term care patients during the COVID19 pandemic.