<p>Does anyone here have any experience with Continuing Care Retirement Communities?</p>
<p>There are several large communities near us, and as my husband and I get older, I wonder whether this might be an appropriate choice for us at some point. But I don’t know much about people’s experiences with this type of community.</p>
<p>Anything to share?</p>
<p>A couple thoughts ~ the sooner you move in, the sooner you make friends. A continuing care community will have a more stable population in that people don’t have to move-on to other facilities (generally) There would be style differences. I know a facility in South Carolina where jacket & ties are worn in the dining hall. My parents in the midwest would laugh at and would not like that. Some facilities track their residents movements - did you miss lunch and dinner? - they may check on you -do you want that? Would you find that intrusive? My 90 yr old parents are in a facility which offers meals, pull chords for emergencies to alert management (which is a live-in couple which is nice) activities but no care ~ any nursing/assisted living care would be hired/brought in from the outside (much like if a private home) -not arranged by the facility but the facility certainly has ideas and a network of resources they can suggest. I like the arrangement- no buy in, it’s month-to-month - but when a resident needs more continuing care, they have to move, and my parents lose friends with the turnover.</p>
<p>This comes as a surprise to many people: say you have an apartment in the assisted living section and then an event occurs and you need nursing care. This is often for a short time - say after returning from a hospital visit. You will be moved to a nursing room at the CC facility, but you will need to continue paying for your apartment in the assisted living section. Most people move in-and-out of nursing care- they don’t move into the nursing section permanently. Of course if a spouse is still residing in the apartment, it’s not much of an issue.</p>
<p>That’s an important point, Snugapug. Thanks for pointing it out.</p>
<p>How much assistance do people living in these communities need from family member? I ask because some people move into a CCRC relatively early, and nearby family members might move away after that, leaving them with no nearby relatives. Also, because some people move into these communities early, they might want to choose a community that’s near where their friends live, rather than moving to another part of the country to be near a grown child. Is this a problem?</p>
<p>For example, what if one of your 90-year-old parents needs some new clothing but is not independent enough to go shopping? Is this something a family member needs to handle? And therefore would there be a problem if no family member lived nearby?</p>
<p>My parents moved into a CCRC when they were 77 years old. For many years they lived pretty independently (just having meals in the dining room, participating in exercise classes, etc.). In the last years of his life my dad used the services of the skilled nursing floor (it’s a high rise facility) extensively, as he was in and out of the hospital several times (he died at age 92). My mom still lives there in the apartment and at age 95 she has used the skilled nursing several times as well, and also used the physical and occupational therapy services which are available.</p>
<p>Each place runs differently, I think. But my folks’ place has shuttle services available to take residents to the doctor, go shopping, etc. Once they gave up their car, my parents used these services frequently. There are also younger residents who may be able to give older residents a ride somewhere from time to time.</p>
<p>This is all good, because my siblings and I live from 2,500 to 5,000 miles away. We are able to get back to visit, but certainly can’t be there to take them shopping at the drop of a hat. When contemplating this move, my parents felt they had the choice of 1) moving into a CCRC in the community where they had lived for almost 50 years and had many friends or 2) moving to a community 2,500 to 5,000 miles away where they knew no one except their child and his family, with no guarantee that their child might not have to move away at some point in the future. I think they made the right choice, both for them and for my siblings and me.</p>
<p>One issue they complained about is that the services, rules and regulations change over time. The rates always go up. And its not as if you are likely to move out at age 90 after having lived their for 10 years because you don’t like some new policy or fee. So choose carefully, because you are likely to be where you choose for the rest of your life.</p>
<p>My 90-year old MIL lives in a CCRC (currently in the independent living section) which is 1800 miles away from us. It’s tough that she’s so far away, and we wish we lived closer to her so that we could see her weekly. But we all agreed that moving her to where we live would not be good for her–she has friends where she is and we live in the middle of nowhere. Luckily my H has a cousin who lives nearby and he is willing to help out as needed. Without him there, I don’t know what we would do–he brings her to all of her medical appointments and helps with other essentials. It’s not a great situation because my H is an only child–but he goes out there 3-4 times a year and that’s when they go clothes shopping and he runs other errands which are not essential but need to be done now and then.</p>
<p>My mother is in an assisted living community that offers care just short of a nursing home, primarily because she is now wheelchair bound and needs two people to help with transfers. She also has some dementia and other neurological problems. She was always very independent and never would have chosen to move there. As a result, the residents and staff all know her as a very disabled and relatively unhappy person. They never got to know the vibrant, compassionate, artistic person that she was. She will never be able to build new relationships like her old ones because she is no longer able to share the kind of experiences or conversations that she once had. If we’d had a crystal ball, we would have encouraged her to move to a CCRC years ago, so she would have friends nearby.</p>
<p>Regarding the costs when a parent is hospitalized or in rehab, that is often covered by medicare so the living expenses aren’t doubled. In my mother’s case, the first community she was in charged a flat rate for rent, meals and the care provided. If she was not there she still paid for everything. She had to move after breaking her neck last summer; the current facility bills separately for care so if she is hospitalized again the only charges will be for the room.</p>
<p>I make the 1300 mile RT about every other month. My father is still at home; he is in poor health and has someone who comes in every day to cook, clean, sort pills and drive him around. I would be very happy if I could get them to move near me and have found a very nice CCRC that is affordable in the short term and is a non-profit that would not put them on the street if they ran out of money. (They need to have a fairly sizable nest egg to move in; I’m sure the facility has actuaries who have figured out what is needed to make the model work.) I worry constantly that they will outlive there savings and have to move to a place that accepts medicaid.</p>
<p>My mother lives in a continuing care community. It’s great; the staff is friendly, there are many scheduled talks, trips, movies and so forth, my mother has friends and participates in various activities.</p>
<p>One thing, though: if I were choosing a continuing care facility, or designing one, I’d put in right in a town. My mom’s facility is located about a mile from a suburban downtown, in a beautiful wooded section. The facility location is lovely, but many of the residents, including Mom, are no longer able to drive, and no longer can walk a mile. If the facility were right in town, she could pop out to a cafe for tea, or to a store to shop for her grandchildren, or to the (wonderful) ice cream shop in town to get a dish of ice cream. Mom’s facility provides scheduled shuttle busses, but it’s not the same.</p>
<p>I wouldn’t suggest a continuing care facility for people of the usual age of CC parents (40s, 50s and 60s). Unless there is some serious health issue, I think such a place might be slow. Most people move into Mom’s place in their mid-70s or later.</p>
<p>I think the flip side of my mom’s rather dismal situation is what you’re considering, Marian. I live in a college town and people sometimes retire to one of the CCRCs here when they have no family or history here. One of my friends moved to the local Quaker community last year. (She has Parkinson’s.) There are art studios, book groups, a library, computer lab, you name it. There is a shuttle that, among other things, provides transportation to concerts and other programs on campus. She has a small apartment and still does all her own cooking but if she is no longer able to it will be relatively easy to start using more of the available services. There are also community gardens and I noticed a full bike rack when I was there. Another benefit is that the Quaker elementary school is next door. Many retirees volunteer at the school and, instead of building an auditorium in the school, they arranged to put their plays and concerts on at the CCRC. The place is full of interesting people. I was on the board of trustees when the school was built and was surprised to learn that one of my husband’s MIT professors was living there.</p>
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<p>I wouldn’t, either. But some people in this age group might be considering suggesting it to older relatives, and others might be thinking in terms of their housing options a ways down the road. I’ve been thinking about it because there are CCRCs in my community, and I’ve wondered about how they work and whether people like them. My parents resisted the idea of any sort of senior living, but my husband and I might have a different opinion when we reach our 70s.</p>
<p>Thank you all for sharing your stories.</p>
<p>I just moved my mom into the memory care assisted unit of a continuing care facility after 7 months on their waiting list. On her first day we were greeted by a wonderful couple who have lived at the facility for 17 years. They had just moved to the memory care section because the husband was beginning to have symptoms of dementia. The woman had a neurological affliction, but was 100% cognitively. She said they frequently dine with their old friends in the main dining room (for independent living residents) and make the most of the activities available. She liked it because she was able to continue living with her husband, but still able to get out and “have fun” with others. We saw her line-dancing in her wheelchair at a weekend concert at the facility. Residents of the independent living apartments have priority for assisted care apartments, so it is very difficult to enter once you already need help. Many are able to continue living in the independent apartments even when they begin to need help by paying a fee for various extra services, such as help shopping/bathing/transportation etc. </p>
<p>The contract spells out the procedure should you need to leave the apartment for hospitalization or other reason. This place offers a reduced monthly fee to hold the apartment for a temporary move. The biggest advantage for my mother, a widow, is the social interactions that were missing when she lived alone. However she waited too long before moving, and now is quite stressed and confused about the new accommodations. The take home message for me was to move before you HAVE to move.</p>
<p>It really depends on the community. My half brother’s mother has been living in one for over 30 years. She and her husband (who has since passed away) moved into a cottage and started as one of the early members of the community and were very active in the non nursing care part of the facility. Now in her 90s, she is in the nursing home. She was given more care, and moved according to needs after consultation with family as needed. She considers the place home, and loves it there. My brother is very happy. This has truly taken care of all of the need issues that his parents would have had and had.</p>
<p>My MIL refused to consider any such thing and insisted on staying in her home until she just could not. We hired help–she fired them, they quit, could not get round the clock care, she did not want it though she should have ahd it. Finally she broke her hip, and we brought her to our place and she had a number of surgeries. It was pretty clear by then that she did not just have physical issues. So she’s been here since. We’ve had her in some of the best nursing homes, some attached to continuing care and retirement communities, but she is just too far gone to be able to bond to any of them. Had she done this even 10 years ago, I think she would have had a chance of integrating herself in there, but now, it just doesn’t work, as she needs close to the highest level of care.</p>
<p>Her cousin , in his nineties, and his wife, live in such a community that doesn’t look any different from any gated communtiy. There are people in their 60s there, and it’s like living in a condo community with a nursing home one site, with privileges to the dining and rec centers there. They had nothing to do with the residents who need a lot of care, but just partook in what they pleased. Buses and helpers to take them shopping if they didn’t want to drives. Some rudimentary care faciliiites, Lots of activities and day trips. All sorts of amentiies right there. Now his wife is having issues, and he can leave her at the day program when he wants to go somewhere and also have her have OT and PT at the center there. It makes life a lot easier for him, though he is grieved that she is going that way. </p>
<p>My SIL’s parents along with a lot of others in their ethnic community have pretty much taken over one facility. They are in condos and according to my brother, you would never guess that this is a care community. They have only needed to use the PT facility when SIL’s mom took a spill and needed to do PT. They had lived in a beach town in a big lovely house for years after retirement, but the medical faciilties were just not there. They made the move to continuing care when a number of their friends bought units in that community. They visited, checked it out, sold their beach home and moved there into a rather large unit. In time, they may move into something smaller and closer to the core of services there.</p>
<p>Just moved my 78/79 year old parents to a CCRC. It is great. They love the food. They should have moved in earlier before a bit of dementia so that they can make friends more easily. They figured a CCRC was the best way not to be a burden on family though it’s very nice they are nearby. Momsquad is right. Move before you have to. The best ones in my community have as long as a 10 year waiting list.</p>
<p>As mentioned, different facilities have different vibes, so picking a facility that suits your needs could be viewed as similar to finding the right fit at a college. Do want to live in a city or suburb, apartment or house, prefer fee-for-service or life care, a refundable or non-refundable entrance fee or even a rental? There is no one model or one decision that is right for everybody. As consumer tastes change, the options that are offered change as well. Communities that used to offer only formal dining may have added casual dining, as well. Fitness centers are increasingly popular, perhaps with a separate pool for laps that is kept at a cooler temperature than the pool for aerobics classes. </p>
<p>I am most familiar with not-for-profit entrance fee communities, with all three levels of care on a single campus. A vanishingly small number of voluntary move-outs occur at these facilities and resident satisfaction levels are high in survey results. Residents should assume a 3% to 4% annual increase in the monthly fee and do their homework on the community’s financial viability. The decline in the real estate market has been challenging for entrance fee communities. Most residents use the proceeds from the sale of their home to pay the entrance fee, so a weak real estate market has kept entrance fees from rising, placing more pressure on the monthly fee and expenses.</p>
<p>My mother lives in a CCRC about 30 minutes from me, so I have some experience on the personal side as well. She is in independent living, does not drive, and does not require any help from family so our visits are purely social. The community provides transportation services to stores, malls, doctors, and entertainment. Other residents who still drive give her rides to church and elsewhere. When policies have changed at her community, residents have been given the choice to be grandfathered under the old rules. Management tries very hard to keep residents happy because new move-ins are heavily driven by resident referrals. She loves it there. At 91 years of age, one of her favorite activities is the Tuesday night square dancing.</p>
<p>I would agree that you need to be healthy when you first move to a CCRC. If I remember correctly that was required for the place my MIL is in. She starts out in independent living and she is set now for whatever level of care she needs in the future. I don’t think she could have moved in if she needed assisted living at the start.</p>
<p>I too agree that it’s better to be mentally healthy, and active enough to socialize, when moving in to a CCRC.</p>
<p>Some CCRCs will take direct admits into assisted living, so it pays to check and ask around if interested. The decision on direct admits may even change month to month at a single facility, depending on turnover and current occupancy in their assisted living units. There may or may not be an entrance fee for an assisted living direct admit. If an entrance fee is charged, there will be a smaller monthly fee.</p>
<p>With that said, I’m not sure there is a reason to prefer a CCRC over a stand-alone facility at the assisted living stage. The advantage of independent living for the resident, in addition to the social side, is the ability to stay out of assisted living. Most CCRCs offer some support while still in independent living even if they wouldn’t admit a person that frail because the lower the acuity setting, the less costly for the community and the happier the resident. Nevertheless, some communities will worry about the optics of too much aging in place. If the average resident in independent living becomes too frail, then healthy seniors will not want to move into the community until they too need assistance.</p>
<p>Ideally, a resident will have about ten years in independent living before needing a higher level of care so should not wait until their health is cuspy.</p>
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<p>When we visited the first assisted living place my mom was in they assured us that residents in wheelchairs managed fine. Having just come from a nursing home where she was always pushed around, neither my mom (nor I) had any sense of how difficult it would be. And it was difficult, especially with her room being the farthest one from the dining room, etc.</p>
<p>Having my parents in different living situations has been a blessing as they bickered constantly and should have divorced decades ago. My mother is not taking blood pressure meds for the first time since she was in her thirties.</p>
<p>This is a helpful thread. My parents are 75 and 76 and still in good health (my dad just started on a half-time basis as a prof after being full-time since 1965). They have gotten on a waiting list for a nice facility in Austin. I will have to do some research and see how the place is set up. It will be hard on my sister and me when they move, since they built “our” house in 1973 and have lived there ever since.</p>