As I mentioned on a couple of other threads, this week dh and I went on what I’m calling an old people’s field trip: We toured a “Life Plan Community” in our own town. I’d like to hear about everyone else’s experience.
Agewise, we don’t even qualify yet (I thought it was 55 and up, but minimum age is 62), but we toured a place on a lark near ds1 and his wife in another state and for some reason I thought it would be fun to look at this place, where a lot of my friends had their moms and loved it.
Pros: DH LOVED it. The word he used was simplicity. The idea that you don’t have to pay a bunch of bills every month, cook for yourself, can be driven places as you age for fun and necessity was so appealing to him. Also, the idea that as you need more help it’s an easy transition, and we were pleasantly surprised by the relatively low upcharge when you need assisted living. The age range right now in their independent living is 63 to 103. Some people are still working. You can keep a car. Three different dining facilities, and the options look great. Kids/grandkids can spend the night with you. Dogs allowed!
CONS: It’s not cheap. I would have to really wrap my head around the expensive initial buy-in fee. I think the monthly fee is fine and affordable, especially when you think of all the things you’ll save on when not having your own home, but the outlay of this big hunk of cash on the front-end that won’t be making money for us is just not what I expected to do. If we do the 90% buy-in, we know that we’d still be leaving something to the kids, but it wouldn’t be as much as we planned. The other con is that we are kind of committing to staying here and not moving near one of the kids. Oh, and for larger units there is a years-long waitlist, but we could get on that now if we wanted.
Anyway, I thought there might be enough interest here to start a separate thread on this topic. I’d love to hear from others who have used them for loved ones. Does anyone on here live in one now? Thoughts? Plusses? Pitfalls? What would be must-haves for you?
There is a very nice one near me. The people I know that live there love it- but they are 80+. At that age I would probably love it.
My neighbors sold their house and moved there 8 mo. ago. Their social circle has expanded considerably and no more home maintenance. They are 84 and 87, their 4 kids all moved away. The buy in was $900k, just as a reference. Not sure the monthly fee but they are happy to have all levels of care at this stage that they will need in the future without having to rely too much on their children.
My in laws’ friends were all in a community that required a buy-in. They chose another community, instead, that didn’t have a buy-in. It was a smallish place with independent and assisted living (MIL was independent & FIL was assisted, but they lived in the same apartment). It also had really good dementia care. They really liked it. However, they were in their 90’s when they moved in. Most of the residents were in their 80’s. I definitely wouldn’t have wanted to be there in my 60’s.
If you are considering moving into a community when you are youngish, I am not sure that there are many options available that have a continuum of care that don’t charge a buy-in fee. My grandma was in a senior citizen apartment, where she had social activities and could opt to eat in a community dining room - but there was no assisted living or dementia care associated with her place (she enjoyed being there, though).
We wouldn’t even consider this for 10 years. I just like to collect data so that when a decision needs to be made I’ve already mulled it all over. I like hearing from others so I have a better idea of questions that I should be asking.
You need to check the fine print on the out of pocket costs (additional) when you need “step up” care. Some places impose a minimum number of hours per shift for the LPN’s and CNA’s (they obviously need to make sure their aides are making a living so I understand completely) but if you need half an hour of help in the morning to make sure you don’t fall in the shower, and half an hour of help in the evening getting ready for bed- and the facility has a four hour minimum PER SHIFT, you’ll be paying for an 8 hour day before you know it.
This is likely the biggest surprise/bone of my contention the people I know have with the Life Plan concept. No, you don’t need to put together piece meal your own care plan once you need help. But even if the hourly fees seem reasonable (and that depends on where you live- high cost vs. low cost location, access to public transportation for aides vs. needing cars, taxis or ubers…) some places are not flexible on this.
Again- I understand. They are trying to minimize the number of strangers wandering around their “neighborhood” at all hours. But locked in shift minimums means the costs could skyrocket even for a relatively healthy person.
A friend of mine had a parent in a terrific place, but arguing with the billing people every month was not fun. Her parent had some vision issues (otherwise very healthy and mobile) but the physician recommended that someone else administer the meds (just statin and something else for BP) “just in case”. Which seems reasonable-- the print on the bottles, or even in a sealed script packet is pretty tiny. The facility insisted on “full meds management” service which was a daily fee… my friend argued that the aide that came around in the morning to remind the dad to go to breakfast could just hand him his two pills. But no, that aide was a recreation aide, not a meds management aide. Sigh.
Their profit is in the ancillary services, so that’s where you need to be careful. The other stuff is baked into the cake already…
Now, see … THAT’S the kind of excellent info I was seeking! @blossom FTW, as usual.
We were told that moving to assisted living is an additional $450/month, and that incudes more meals and dispensing of meds, etc. I’m hoping that what you are talking about is part of that $450, but now I know to ask to be sure whether there are other fees.
The initial AL my FIL was in did not charge extra for medication management. When my MIL moved to a different facility, they did not charge for med management, but they charged an extra fee for every meal they delivered to her room … which added up, since she never left her room for meals. The first facility did not charge for transportation to/from appointments. The second facility charged for transportation. The new one she is in does not provide transportation. There really is a lot to consider, and it is wise to look into it in advance.
That “buy in” number is huge. Can I ask what these “buy ins” cover and do you get something back if you leave?
A friend’s mother paid the “buy in” when she moved into senior living. After 4 years, she needed memory care, but there were no openings at her facility. For several months, they tried sending in extra help, but she really needed full time care. She had to be moved to another facility, which has been so confusing for her.
Agree with @Blossom. However, for someone living alone that needs medication management it is unlikley that they could hire an aide willing to come for a half an hour in the morning and at night and only charge for that.
My FIL was in a continuing care facility and he had only very limited help, primarily with getting his compression socks on and off. We tried to get him to add medication management, but he would not (even though he was not great at remembering to take his meds at the right time).
The contracts vary at the CCRC. As others noted, the type of services vary. You get some of your deposit back, if someone takes your place, minus the fee and how much you have spent. Having an eldercare lawyer review and doing lots of investigation is key.
My 78yr old parents are in the process of moving to one. My mom is mostly blind and would be unable to look after herself should something happen to my dad.
The place they are going to is outrageously expensive. You can choose to pay the buy in as partly refundable or a lower price that is not refundable. It is lovely though and their soon to be condo is very nice, 2000sqft and fancy. There are even cottages on the property that are stand alone units. The food, activities, and grounds are all great.
My parents were surprised to learn that while they are guaranteed assisted living, they may need to also bring in additional help if necessary. So potentially extra cost. The other thing that I’ve noticed is that the place is a gossip mill, they have a great time but it’s a little like a very nice college campus and the gossip that goes with it.
I’ve seen numerous residents using additional paid help at all three facilities my MIL has been in. At the first, only aides from approved agencies could be brought in. We had to hire an overnight aide for FIL for his final weeks, and it was really expensive. At the second facility, there were no restrictions on who could come in as a resident aide. We had hoped to hire one of the staffers to help MIL in early evenings, but the facility would not allow us to hire anyone on their staff (whereas at the first facility, their staff members could be aides when they were off duty as long as the director knew about it). At the current facility, outside aides have to go through an approval process. We ended up hiring someone through the hospice.
MIL needs someone other than family to try to motivate her to engage in activities, and she needs companionship & help with getting ready for bed. Having an aide 3 hours a day, 5 times a week - 3 evenings & 2 afternoons - allows MIL to get a little more one-on-one attention than the staff is able to provide. They appreciate the fact that their load is a bit lighter when she has the aide with her.
My mom was in a great CCRC near us. We looked at several. They all have different payment models. The one my mom was in is a non-profit “fee for service” with equity model. She bought her apartment (currently $224K) and then when she moved out of independent living into assisted and they sold the apartment to the next resident she received most of the sale $$. The CCRC kept a percentage but I think she got well over 75% back. I have 90% in my head but not sure on that. Her fee for service went up in Assisted and then up more when she went to the nursing home. There was no need for additional aides or anything like that. (Familiar with that from the crappy nursing home my dad was in in my hometown.) Those transitions were pretty seamless. She still got to see the same on campus doctor. I would definitely consider one for myself and my husband maybe when we hit 80. They took such good care of my mom and she had so many opportunities to get involved in stuff. There was one guy there in his 60s who shared an apartment in my mom’s building with his 95 year old dad.
Wanted to add that everybody who worked there seemed to be really happy to be there which was a big contrast to the disgruntled folks who worked at my dad’s nursing home.
Many entry fee CCRCs are developed by non-profits who take on quite a bit of debt to build the facility. There have been a number of high profile bankruptcies in this asset class. If you pick the wrong sponsor/operator you may not be able to recover some/all of the entry fee or get the “life care” you thought you bought.
Agree with the comments above regarding the “ala carte/extra” services. That’s where the money is in these businesses
My parents CCRC did allow you to hire for short increments of time—as little as 15 - 60 minutes (remind them to walk down to eat breakfast, remind them to take pills, shower assist as needed, wash laundry. The aides were an extra cost. My folks had a buy in but after they died, estate got 90% back. (It was $1,000,000 buy in for 2 bedroom place with appliances.).
You can hire aides for skilled nursing and AL. If you transition from independent living to AL, the facility alone gets to decide when they need higher levels of care, even against protests by family & patient. If you opt to stay in independent living, the patient and family maintain control.
I looked at lots of places for my mother (who landed in a small mostly assisted living) and have been looking for myself (I am early 70’s and many have waiting lists). Brochures seem to feature a lot of golf and kayaking!
Locally there is one in the $500k range for a small one bedroom apartment. There is also one that has a different model: no assisted living, people go in as independent and then the facility has a contract with a local care agency. This may save money because it is a la carte.
Unfortunately I have many allergies and so far every place has been toxic for me with carpet cleaning, new carpet or laminate flooring in the units, people’s scents etc. Group living won’t be for me! Sorry to miss the high school romance and gossip!
Residents are “tenants” in assist living, not “patients,” and have the right to refuse help. This becomes problematic when the resident has dementia. I ended up doing everything because staff was legally required to leave the room when my mother said “no” to help! Her facility had only 10 spots for dementia and criteria were about liability or bothering staff more than the welfare of the resident. About 85 total residents. I was moving her to a memory care only facility but she died before I could do it.
These big buy ins smell a bit like pyramid scheme to me. Aegis has been building facilities in my area like crazy. At some point, there will be no room to expand further… then look out below!
I feel good about this particular place as it’s a nonprofit and has been around for 60 years. I would be a bit more suspicious of a large, for-profit company. These things ARE popping up all over as the Boomers age, but, yeah, I do wonder about what happens when the Boomers die out and there are fewer people to fill these things.
That said, the woman leading the tour said something really interesting that might help with the concern I just mentioned. She said that as one bedrooms come open, they sometimes are holding them until an adjoining one comes open and then they convert those two one-bedrooms into a two- or three- bedroom. She said retirees seem to want more room. I guess it’s all those years in McMansions! Anyway, there would be fewer, larger units.
My ILs moved into AL after MIL had a stroke and spent time in rehab. It was fine. I think it was around $6,500/month for a 2BR, then fees on top of that. “Points” for additional care (med dispensing, etc.) added more.
MIL didn’t participate in anything. FIL started out doing things, then stopped within the first year or so. Meals downstairs were about it.
Hospice was allowed in, so they were there til they died. FIL had dementia, but was able to stay in their apartment & didn’t have to move to the memory care facility.
One consideration is how contagious illnesses are handled. There were a number of norovirus breakouts requiring isolation for all resident. They could leave, but no one was allowed in. Meals in rooms, no activities. During Covid, MIL couldn’t have any visitors, nor could she go anywhere but to medical appointments. She died in June 2020, so that was at least only 3 months.
I don’t know how Aegis can keep building new places. You’d think we’d hit saturation sooner rather than later.
Anyway, there would be fewer, larger units.