Aging in place may be the preference of most seniors, but let’s face it: it’s not always the best choice. Some seniors may find that they prefer – or need – the security of a structured institutional setting. Some of us might discover that we need a little extra assistance as we age, while others simply prefer to give up the hassles of home ownership and move into a facility that caters to our wants and needs.
Most of us know that there’s a spectrum of senior living options available today. Independent living facilities offer retirement living for those in good health who want to live in community but come and go as they please. Assisted living communities exist as a bridge between independence and nursing care. Nursing homes cater to those least able to care for themselves. But as this US News article by reporter Elaine Howley explains, there’s a fourth option available. She calls it “a sort of one-stop-shop type of living arrangement called a continuing care retirement community, or CCRC.”
Is a CCRC right for you? And, if so, when? Let’s take a look.
Continuing Care Retirement Communities Explained
At the start of the article, Dr. Susan D. Leonard of UCLA Medical Center gives us a pretty easy explanation of a CCRC. She says, “CCRCs are structured as the last place a senior will live, covering all their current and future senior living needs. Typically, they include a combination of independent living, assisted living and nursing home care levels. This allows seniors to age in one location and transition to a higher care level as their care needs change – such as due to functional or cognitive decline – without having to move away.”
The only real difference between a CCRC and similar senior living accommodations is the sheer convenience and peace of mind of having every life stage under one roof, giving seniors a better chance of developing friendships and a sense of community that remain in place throughout their aging process.
Making the Decision to Move to a CCRC
Howley explains that CCRCs are based around the concept of “lifecare.” This means, on a practical level, that certain considerations need to be made when deciding to move into a CCRC. After all, the idea is that you’ll be there for the rest of your life.
“Chief among these considerations is money,” Howley writes. “CCRCs involve a significant financial commitment and may be quite expensive.”
Senior living expert Sue Johansen explains, “CCRCs usually require an up-front investment, known as a ‘buy-in.’ Up-front fees can range from the low six-figures to more than $1 million. These buy-ins do not include the monthly fees that CCRCs charge. However, once a resident has paid their up-front fee, the monthly rates are locked in at a predetermined level, no matter the type of care required.”
While this is a significant investment, the idea of locking in a monthly fee is not unwise compared to other options out there. Howley notes that the costs of skilled nursing facilities are only expected to rise, stating, “Genworth Financial’s 2021 Cost of Care Survey notes that skilled nursing in a private room costs $108,405 annually on average.”
The Big Decision: When to Move?
While it may be tempting to postpone moving into a CCRC until absolutely necessary, many experts encourage seniors to consider moving sooner rather than later in order to get all of the social and financial benefits. “Actuarial consulting firm Milliman reports that new residents entering a CCRC typically range in age from 65 to 95, but they must be able to live independently when they arrive,” Howley explains. “Over the past decade, the average age at move-in has increased, with many facilities reporting that their residents are 80 to 85 years old.”
But Johansen is among the experts who encourages moving in early. “There are clear advantages to moving into a CCRC as a ‘young’ senior. One major one is financial – you are locked into a fixed monthly fee after your buy-in costs, no matter the level of care you might need in the future.” Moreover, she continues, “It can also make more sense socially. Another advantage to joining a CCRC sooner rather than later is the opportunity to form relationships with other community members.”
This can be especially helpful for those who have lost a spouse, which is typically a terribly lonely time. In general, CCRCs are known for being very social, active, lively settings, which can have huge benefits for any senior at risk of feeling isolated at home.
Ultimately, the choice of when to move is individual, and based on when you feel the most emotionally and physically ready.
How to Choose the CCRC that’s Right for You
As with any big decision, choosing to move into a CCRC requires research and asking plenty of smart questions beforehand. Be ready to talk to the residents and staff, too. Dr. Leonard says, “Visit and look around to find a place that would be comfortable for you or your loved one. Some may allow a trial weekend or week stay,” giving you the opportunity to test out the facility.
Leonard highly recommends the trial visit idea, if it’s available. “You’re looking for a new place to live and need to feel comfortable,” she says. “You wouldn’t buy a house or rent an apartment without visiting, right?”
Howley includes a list of questions in her article that you should consider when looking at CCRCs. It’s such a good list, we’ve included it verbatim, and in full:
- Can you see yourself living here for the rest of your life?
- Do the residents you meet seem like the type of people you’d enjoy living with or around?
- Can you envision being friends with them?
- What sorts of activities are available on the campus and do they sound appealing?
- Can the staff accommodate particular requests or personal preferences?
- What are their licensing and standards requirements?
- Do they have inspection reports available?
- Are there any other outstanding issues or concerns regarding the property or how the business is being run?
Finances and Fine Print
The financial upside and downside of a CCRC cannot be overlooked in making your decision. Howley explains, “A sense of sticker shock from the buy-in fee can make a CCRC seem like an expensive option for many people. But it’s important to weigh it in the context of the fixed monthly fee – your rate won’t change once you’re in the community no matter what happens with your health. That’s not necessarily the case with other types of senior living options.”
When it comes to insurance to cover costs, the options are a bit thin on the ground. Medicare typically doesn’t cover assisted living facilities, but may cover specific health care services while you’re residing in a CCRC. Doctor visits and screenings would be covered, as usual. But Howley warns, “For all other aspects of living there, you’ll be out of pocket, so locking in a rate you know you’ll be able to afford over the long right might be a good idea.”
So how do people pay for their CCRC? Johansen says, “Many seniors opt to pay for their care in a CCRC by selling their home. There might be tax advantages to selling your home the year before you pay the up-front fee. Additionally, you may be able to deduct part of that fee as a pre-paid medical expense.”
As With Any Major Purchase, Remember: Buyer Beware
Most importantly, know what you’re getting before you sign on the dotted line. Just like any senior living facility, CCRCs can vary widely. Amenities and contracts should be scrutinized to make sure you know exactly what you’re paying for.
In fact, CCRCs do have a bit of a less-understood side: most of them are businesses. Johansen explains, “Traditionally, CCRCs were run as nonprofit organizations, though today some CCRCs are run by for-profit institutions.” She adds, “If a CCRC is for-profit, you’ll want to understand how a potential sale of the business would affect the resident and their contract.”
Howley advises, “As with any contract, read the fine print and make sure you understand what you’re agreeing to. You may want to involve an attorney and/or a financial planner in determining whether you’re getting a good deal and to make sure any contract you or a loved one signs is solid.”
While refunds are sometimes available if you’re not satisfied, this isn’t always the case with any given CCRC. So, it should be common sense, but it bears saying: do your homework! Go in with eyes open, and ask plenty of questions. This way you can make sure that the place you choose to live out your days is the best fit for you, your lifestyle, and your goals.
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(originally reported at https://health.usnews.com)