It seems that one of your primary concerns is the possible scenario of one of you being the lone survivor and declining.
I would assume that if you have a family network of sorts, even out of state, and they are willing to assist in that, you can talk now and come to an understanding about the scope of assistance they can reasonably offer in that scenario. Then everyone will be on the same page.
If you have specific wishes or criteria you want met, you must be clear with them about your desires and allow them that knowledge ahead of time, so they know what will be expected of them, should they agree. This also speaks to living wills and the like.
Even if everything is agreed ahead of time, remember that life circumstances can change. One may be willing and able in the present, but unable for whatever reason later in time. Unforeseen circumstances may happen down the road, preventing the original plan.
Being sensible and prepared is good, if it allows for alternatives, should one path become unavailable. It can serve to lessen anxiety somewhat. Only you can let that go.
We do know that our medical coverage will continue to be re-defined, so there is no absolute we can be assured of for our duration. We can't steer THAT boat, no matter how we try to plan.
If holding two residences to have a place to go back to (to facilitate assistance) is a consideration, understand that it can become an additional burden to govern, for yourself and/or others who assist, if your health commands your primary attention.
Whatever you choose, may you find a path that serves you well and gives you and your spouse a good gut feeling.
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