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A senior moment: Would a Continuing Care Retirement Community be a good choice for you?
If you are approaching retirement age, you are probably giving some serious thought to your housing options. Should you stay in your family home? Decrease the time and money needed for household maintenance by moving to a smaller house with a “patio” yard? Move to a retirement community or an independent living facility? Or would your best choice be a CCRC?
A Continuing Care Retirement Community, as the name implies, offers the different levels of care and services that one may require in the process of aging — independent living, assisted living, skilled nursing care, and possibly memory care or palliative care or hospice — all on the same campus. These facilities provide not only housing, but many of the services such as meals, transportation, activities, and health care.
California licenses the CCRC provider to enter into a contract to provide services and care, usually for life. The residents pay a large registration fee — usually several hundred thousand dollars — and a monthly fee thereafter, usually based on the type of housing they have chosen or the level of care they are receiving.
Entering a CCRC is a big commitment, both in terms of financial investment and permanency, so deciding to do so may be one of the biggest decisions older adults could make in planning their futures. The California Advocates for Nursing Home Reform website (www.canhr.org/CCRC/) has links both to an online guide “Continuing Care Retirement Communities in California” and a checklist, “Points to Consider for CCRC Consumers,” to guide the decision-making of anyone thinking of moving to a CCRC.
The CANHR materials list both advantages and challenges to choosing a CCRC. The primary advantage is that you have taken care of your future care needs, and you will not need to move if you experience decline. You need not be concerned that you will burden your family with worries about your care or safety. Couples can remain on one campus even if one needs a higher level of care than the other. You should be “set for life.”
On the other hand, it is important that you find a CCRC that is a good fit for you. Will the location seem isolating or remote or will it allow easy visiting by family and friends? Do you value a peaceful rural setting or do you need access to big city cultural offerings? Will the CCRC have scheduled meals and activities that seem restrictive or will you have a lot of choice in what you do? Will you find living exclusively with people of your own age group to be stimulating or limiting? Each CCRC has its own culture. Some prospective residents might be looking for access to a golf course, tennis courts and happy hour socializing. Others might prefer community activism, “green living” and a meditative environment.
Frequently retirement communities extol the freedom that residents will have when they no longer need to maintain a large house or yard, but this freedom from can have drawbacks. At some other facilities I have viewed, residents feel diminished by having their usual meaningful activities replaced by bingo and TV. The CANHR article warns that residents can be made to feel patronized when activities they formerly did for themselves are suddenly done for them.
CANHR recommends that prospective residents visit the communities they are considering several times, perhaps on weekdays and weekends and during different times of day and if possible different seasons. This ways you can really experience the “rhythm” of the community and get a feel for its culture. You should make sure that you talk to several residents and staff members as well as administration, not only the marketing staff. Each person you speak with will have different information and a unique perspective, and it is important to get a well-rounded and accurate picture before making such an important decision.
CANHR also recommends that you enter while you are young and healthy enough to participate in the activities the community offers and to make friends who can be your support group should you face some of the difficulties of aging. Make sure that you are able to thoroughly check out all levels of care offered. Sometimes those who enter while they are fit and active concentrate on the housing and amenities that are offered for independent living without really checking out the facilities and services that will be available to them should they need to move to a higher level of care.
You will want to find out what cost increases will be associated with moving to a higher level of care. This may depend on the type of contract that the CCRC is asking you to sign. CCRCs generally have one of three types of contracts: a life care contract, a modified contract, or a fee for service contract. If a facility uses the fee for service model, a resident moving from independent living to skilled nursing will sign a new contract.
The CCRC will be thoroughly checking your finances to make sure that you will have the funds to pay for your full stay, as long as that may be, predicted by actuarial tables. You need to consider this, too. Ask how often and how much monthly fees have been raised in the last five years. What increased costs are associated with increased levels of care? Will the skilled nursing facility of the community accept Medi-Cal as payment? Can you receive a refund of any portion of your entrance fee if your choice or your circumstances change?
While some facilities in Butte County offer several levels of care in one location, there are no licensed CCRCs in Butte Country. However, over 20,000 older adults currently live in CCRCs in California. If you think that perhaps a CCRC would be a good solution to planning for a secure future, the CANHR website offers a search engine for finding these facilities both in California and in other states. Check out several to find the one that suits you best, and prepare yourself for making a good choice by carefully reading the information on the CANHR website and other online resources.