It’s no secret that America is aging. More and more of the largest generation, the baby boomers, are reaching retirement age and retiring every day. When people first leave the workforce, they can generally take care of themselves, but as they age, oftentimes they need more help. Many times, it’s not possible for their children to be there all the time, yet many seniors crave some amount of independence. This can make living at home more difficult, even though they may still be able to do most daily tasks. When full-time assistance becomes necessary, many cringe at the thought of having to move into a nursing home. If only there were someplace where an older person could live on their own but still have access to amenities and assistance when they need them most. If you haven’t heard of CCRCs (continuing care retirement communities), you’re not alone. Although these retirement communities are gaining popularity, they are still relatively new. But they can be a great option for a parent or a loved one who is aging and needs more help.

What is CCRC?

A CCRC is a retirement community where people receive the care they need as they move through life. When someone first enters a CCRC, they purchase a unit on the premises. They live on their own or with a spouse, but they have access to assistance or medical care when they need it. They are also in a community with people like them with whom they can socialize and interact. As they age and need more constant care, they move to a facility on campus where they can get the care and attention they need. It’s a way for someone to be independent while they can be but have access to the resources they need in a familiar environment when they do need some more help.

CCRCs typically have all services — a restaurant, cleaning services, a salon, a tavern, sometimes a bank and a food store and the like — inside one building. This offers one-stop shopping for residents.

Typically, CCRCs offer three levels of care — independent living, assisted living and skilled nursing, along with memory units.

Eligibility

Not everyone can enter a CCRC. Most require that you be able to live independently for at least a year. You have to pass a medical screening and qualify financially as well. Many CCRCs will count your long-term care insurance policy as additional assets upon entry, helping you qualify.

Many CCRCs have waiting lists.

How much do they cost?

The contracts will vary from CCRC to CCRC. Generally, you would be expected to put down a partially refundable entrance fee to purchase the unit at the community, similar to buying a condo. On top of that, you would be expected to pay a monthly fee for the social, entertainment and medical services provided. The monthly amount will increase over time as the costs to the facility increase. The monthly fee will be somewhere in the range of a few thousand dollars; the larger your unit, the larger the fee. The fee for couples is higher, usually by about 50%.

Genworth issues a cost of care study each year to show the total cost (including home care, assisted living and nursing home) once you need assistance.

Is there any income assistance?

Yes and no. Most CCRCs do not accept Medicaid, since they require the entrance fee up front. They will also review your assets prior to acceptance to ensure that you will be able to afford the cost years down the road. The good news is that if you do happen to run out of assets while you’re living in a CCRC, it is unlikely that they will kick you out. Many of these communities have “benevolent” funds set aside in the event you run short of funds. Therefore, if you qualify to get in, you should have care for the rest of your life.

Why might I want to go into a CCRC?

A CCRC is a potentially great option for those who are transitioning from living on their own to needing a little more assistance. They also generally have far nicer accommodations than a nursing home. If you’re accepted into a CCRC, you are more or less set for medical care for the rest of your life. If you need full-time care, instead of being moved to a nursing home, you would be moved to a different facility on campus. The combination of maintaining independence, being able to socialize with other seniors, and the access to medical care on campus is what makes many CCRCs an attractive option for the aging population.

What should I look out for in evaluating a CCRC?

Often-overlooked areas when evaluating CCRCs are the skilled nursing and memory care units. We often don’t want to face our own mortality, and so we focus on just the beautiful, newly built independent living units on a CCRC campus. However, many CCRC contracts indicate that if your primary care physician and the CCRC director agree, you can be moved to the skilled nursing or memory unit without your permission. It is very important to have a plan and understand where you will be moved to if that becomes necessary.

The upside of moving to skilled nursing is that your long-term care insurance contract will usually start paying for your rent after a period of time, known as an “elimination period.” Your insurance contract will have this information.

In any event, it is important that you have an advocate (usually a close friend or a family member) who will help you manage this process and work with the facility to do what is in your best interest.

What if I want to continue to live at home?

It is common for people to tell us that they want to remain at home as long as possible. Unfortunately, it can be difficult to find caregivers to come into the home, and if they do, the risk of fraud goes up exponentially. Additionally, living at home can be very isolating once you can no longer drive, especially if you don’t want to be a burden on your children or other loved ones.

Staying in your home can also be expensive, as you may need to make expensive changes if you develop dementia or mobility issues.
There have been some studies that show that healthy aging is based on relationships, and these may be harder to maintain while living at home.

Lastly, if you stay in your home and eventually can no longer care for yourself, you then would be too ill to qualify for a CCRC, and your only option may be a nursing home.

What else should I consider?

It is important to evaluate your options while you are still able to make decisions. As important as long-term care planning decisions is having the legal documents in place for when you can no longer make decisions for yourself.

There are many facets of planning for long-term care. Do your research, and make sure you understand not only where you might live but also how you will pay for it.