August 1, 2011

What's Best: A Retirement Community or Aging in Place?

One of the most important decisions that must be made at some point is where to live for a satisfying retirement. Previous posts have addressed some of the factors you should consider when making that initial decision. Links to these are available under Related Posts and Links at the end of this post.

This time I would like to look at some of the types of housing choices that you could face. Each has its advantages and disadvantages. One may be better than another depending on your health, your financial resources, your closeness to family and their willingness to be involved in your care.

For many retirees, aging in place is the preferred choice. Simply, this means the best place to retire is where you live now for the foreseeable future. The reason are numerous. Maybe you have no mortgage and the home is yours free and clear. That is a major recurring expense that you do not have to worry about. It can also be the source of substantial equity you could tap in a reverse mortgage. You raised your family in that house. Your memories, and theirs, are tied to that home. It is is more than four walls, it is where people come to feel safe and loved.

Your friends and your church are close. The neighborhood is like an old shoe: you know where to shop, where the doctor's office is, which coffee shop is least crowded on a Monday morning, and where to get your car repaired. You can't even imagine the hassle of packing up everything you'll accumulated over the last umpteen years and starting all over again.

The disadvantages, unfortunately, are not trivial. It is a fact that at some point you are likely to need help with your care. The day you can no longer drive, that home becomes a prison unless you are lucky enough to be near mass transportation or have friends and family willing to become your wheels. The mortgage may be paid, but a house needs maintenance as long as it is standing. A new roof, paint job, furnace or windows won't wait. The crack in the sidewalk needs patching. The sprinkler system has a leak somewhere. As you become older, help in basic physical needs may be an unpleasant reality. Counting out pills, help with personal hygiene and meal preparation are needs that must be met. If your home is two-story it is likely there will come a day when getting up those stairs becomes impossible.

Another choice is a Continuing Care Community (CCC). In this environment you pay to move into a community that includes independent living, assisted living, and nursing home facilities.  The advantages are many. Once accepted you are guaranteed  a place to live and be cared for the rest of your life. The communities are usually safe and well-maintained. All maintenance, both inside and outside your living area are taken care of. Medical staff and emergency personnel are available 24 hours day. Transportation within the community and to local shopping or doctor offices is often provided.  

Disadvantages primarily involve the cost. For a well-run community expect to pay at least $200,000 entry fee and a monthly rent of at least $2,000. High end communities that feel more like resort living may be substantially pricier. Some extra services or specialized needs you have will cost extra. If you change your mind or want to move somewhere else, your initial investment is probably lost.

Somewhere between aging in place and a continuing care community is an age-restricted community. Because of various exceptions in the law, it is legal to require someone to be older than a certain age to purchase property in places like Sun City. Usually this type of "active adult community" includes lots of recreational and educational opportunities but is not equipped to provide assisted living or nursing care on site. Usually you will require a car for the majority of your transportation needs. Depending on your preferences, not having younger families or folks in their 30's and 40's living their may be great for you, or may leave you feeling cut off from normal society.

By no means am I an expert on all the factors that you should consider in making such an important decision on the best place to retire. My parents lived in both an age-restricted community and then, as they looked ahead to health challenges, moved into a continuing care community where my dad continues to live after my mom died last December. Both choices worked out well for them and my family. I will be eternally thankful that they planned ahead and moved into the CCC while still able. It is quite likely that my wife and I will move to the same location at some point in the future so we don't burden our kids with declining health issues.

It isn't an easy subject to think about, but it is part of life. Wait too long, and the decision may be made for you. Where do you stand? Have you made your decision yet? Are you still thinking through all your options?


Related Posts and Links:

30 comments:

  1. Sigh. This is exactly the topic of conversation among the four of us playing golf over the weekend. What happened to all the joking around we used to do about sex and girls and booze and gambling and rock bands and the places we traveled? Not that any of us actually DID much of what we joked about (altho' we still do have a friendly poker game, and some of us still travel) but as the subject of an afternoon's conversation ... boy, it was a lot more fun than discussing the difference between independent living and assisted living, and whether our aging knees can still negotiate a flight of stairs!

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  2. Hi Sightings,

    Isn't it interesting how our focus on what's important changes over the years. Being a rock radio DJ in my younger days, the women and booze conversations pretty much kept my immature mind full for several years.

    Now, it is seemingly impossible to have dinner with friends and not have the conversation turn at some point to health. The good news is you were playing golf while having your discussion. That implies you are still healthy enough to be active and involved!

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  3. The CCC that we have found have the initial buy in- but the person/estate gets back 90% when the person moves out. It may take up to 24 months-but it is available.
    I am liking that more CCC let the person who moves into independent living then age in place. They have to have the funds for the care- but they are allowed to stay. My mother is moving in to one such place in Phoenix. She signed last week and will move shortly after my son gets married in September.
    It is a tough conversation. I wish she had consented six months ago when she was in better spirits and health.
    For me---I plan on an iceburg float into the Pacific. :>) Actually, I am hoping we have plenty to move into a CCC when my dh is 77. I will be 70. I have reasoned it out and am pretty sure we can make it for the rest of our lives there....
    Unless there is no Social Security- then I will be aging in place---no matter where that is :<(

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  4. Good Morning JBO,

    The place my dad lives offered the return of the buy-in option but the price was almost $100,000 more. So, mom and dad decided this was going to be the final choice and opted for the lower fee and no return of fee. They managed to sell their home in an age-restricted community at the height of the real estate boom. That more than covered the buy in and a few years of monthly fees.

    My wife and I will probably live in the same place at some point down the road. My parents moved just in time when mom was 78 and dad 80. Within a year mom started going downhill. If they had waited much longer they probably would not have been allowed to buy in.

    The way the ice caps are melting the ice flow scenario is not likely to be an option!

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  5. Right now I am aging in place. My father moved to a senior residence at 85. The monthly cost included his apartment,meals and entertainment. He was happy there. If he would have lived and needed extra care he would have to provide it,but he could stay. My mother is in a nursing home-she needs more care than can be provided at home. This is my the thing I am most afraid of-although it's a good place someone has to check on her everyday. Both my parents were always very active-walking everywhere and staying in good shape. I hope I can stay independent and would eventually move to a senior residence.

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  6. Did you hear that in "the package" is an 11% cut in nursing care by medicare? OW!

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  7. Donna,

    To my mind aging in place is the first choice. We all want to stay independent as long as possible. But, if the finances permit it, making arrangements for the next phase is so important for everyone concerned.

    Here's hoping you (and I) can stay on our own for many more years.

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  8. JBO,

    I assume you mean the debit limit deal? I've been at the prison ministry office for the last several hours and am out of the loop.

    From what I understand the "deal" averted the immediate disaster but really just kicked the can down the road again without tackling anything of real substance. The fact that any short term fixes comes on the backs of the poorest and neediest among us shouldn't surprise anyone.

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  9. You forgot another option. You could rent out your house, move to a place like Thailand, Belize (put your desired country here) and rent for $600/month and get cheap medicine and much less expensive help to take care of your cooking, doctor appointments etc. Then your kids can come over and visit as part of a vacation. A guy at the gym told me that's what his 75+ buddy decided to do and he's very happy. I wonder why?

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  10. Sonia,

    Good thinking outside the box. I hadn't considered that. Being an expat in a place with much cheaper living and health care costs is a very viable option for some.

    Of course, if the original house was rented out instead of sold it would be possible to return at some point to be near family when that became more important.

    Good idea. How about 5-7 years living in Paris? Think I'd like that even though I don't speak French (3 years in high school is gone)?

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  11. I'm hoping I will be able to stay in my home. I love it so much. I'm hoping I take after the women on my mom's side who lived a long time and then died without a long, lingering illness. But, of course, we don't know what time will bring. When I lived overseas, I knew a lot of permanent expatriates, so I am familiar with that option, which was a very happy choice for the people I knew. I don't think it's for me, though. Anyway, very informative post. Thanks.

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  12. Galen,

    Thanks for adding your thoughts. Like you, I don't think I could move overseas permanently. Family is too important.

    We all hope we will die peacefully and quickly in our sleep. But, will be will be.

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  13. Apologies in advance, this comment is out of phase. Related to your post, "This Can't be the Answer" and the discussion that contained concern for legitimately committed married partners that found themselves surviving a lengthy physical separation. Here is one organization that purposely provides support to those in that situation: "Military Spouse". Here is their website: http://www.milspouse.com/

    To the current post, I'm right there with Gutsy and you -- can see my wife and I living as expats temporarily in residence abroad for a period of time ... maybe in Prague

    ??

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  14. QwkDrw,

    Thanks for the web site reference. Military couples face that problem as a matter of course. I appreciate your passing on the info.

    I have never been to Poland, but I have read that Prague is a beautiful and fascinating city. I'd probably need a city or area where there was at least a passing knowledge of English. My language skills were never very good and have eroded further with age!

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  15. I think that the idea of "aging in place" depends a great deal on the place. We have a great little one-storey retirement house in a planned city with stores and medical care nearby, and some pretty good options for in-home assistance. There's even a "senior center" a few blocks away. If we lived in a typical bedroom-community suburb, or out in the country where everything was a long car ride away, growing older in our own home would be much more difficult. As it is, we're planning to stay put for as long as possible. I can see moving to assisted living if our disabilities become too great, but I can't imagine being an elderly ex-pat. Family is too important to live so far away.

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  16. Jean,

    I am on the same page as you in terms of being an elderly expat, though doing it for a few years might be interesting.

    Our present home is 2 story and in a typical suburb. Even though we are less than a mile from all basic services, this house is not appropriate when we have health issues.

    We'll stay here until the real estate market improves and then, hopefully, a smaller town home or condo closer to downtown. I'd love to be able to walk to restaurants, theaters, and museums, plus take advantage of buses or light rail.

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  17. Hey, the other Jean---I would love to hear in what city you reside!

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  18. Well, I dont expect to stay where I am forever, with the house and the mortage and 2300 square feet...but my next choice will be to downsize closer to family, and THEN age in place.

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  19. Hi Barb,

    So how was Denver? That's where your family is, right? The draw of family, if the relationships are good, is pretty much irresistible as we age.

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  20. JBO, we're in Columbia, Maryland. It isn't quite the fairy-tale Utopia that Jim Rouse hoped it would be, but it's still a pretty nice place, 40-odd years on.

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  21. TO Jean,

    I was wondering, too. I've read about Columbia but never have known anyone who lived there.

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  22. Bob -- In your comment above to Jean, you bring up the idea that some (if not typical) post-WWII American suburbs may have flaws detrimental to 'aging-in-place'. Over at my blog last August I wrote a post around that idea: "Suburbs Diversify and Transform". With your permission, here is the web address for that post:
    http://givemeamomentblog.blogspot.com/2010/08/suburbs-diversify-and-transform.html

    Probably beyond my allotment of comments here today, but I do like encouraging readers. Thank you for your writing on this thought provoking and timely topic

    ..

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  23. QwkDrw,

    I have no limit to comments that extend the discussion and add to our collective knowledge. I will certainly take a look at your post.

    The "active adult" community my parents lived in before moving to the CCC where my dad is now, was built around having an automobile. For a place with aging residents, it was completely counterproductive. Once someone couldn't drive they were trapped.

    Finally, Phoenix is beginning to have in-fill neighborhoods that are more self-contained and don't require a car for daily living.

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  24. On a shoestring...where do you find that CCC! $200,000...maybe $50,000. I know...reaching!

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  25. Anonymous,

    My parents sold their home in the active adult community at the peak of the real estate boom in the area. They used the cash from that sale to pay the entry fee into the Continuing Care Community and one year of monthly fees.

    While $200,000 is a lot of money, there are CCC's in the Phoenix area that cost double that. I would guess other parts of the country have much more reasonable fees. There are also communities where you pay for all services instead of having many of them included.

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  26. My husband and I retired a year ago and moved from Los Angeles to a new Sun City in rural Arizona. We love the change: the quiet, the lack of traffic, clear skies and lots of amenities (we both love working out and taking college classes, all available here). We had lived in our former home in a suburb of Los Angeles for 29 years and felt increasingly marginalized as a childless older couple in a very family-oriented community. So leaving wasn't hard. We're still close enough to L.A. to go visit family and friends or have them come here. Since this is a brand new community, it has been easy to make friends as everyone is from somewhere else, new to the area and eager to make friends. Sun City Grand, which sold out in 2005, now has a continuing care community on the premises, so maybe that's a new model for the active adult communities.

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  27. Dr McCoy,

    Welcome to Arizona. Having two daughters who lived in southern California and moved back in part to escape the traffic and hassles I can relate to your comments. Being in an area that was filling with families couldn't have been all that pleasant, either.

    I agree with your assessment: the future of active adult communities will include assisted living and nursing centers as part of the package. My mom and dad moved to such a community in Tempe 6 years ago. It was a complete blessing for them and us when mom started a serious decline in 2009 and finally died last December.

    I'm sure my wife and I will make the same choice at some point.

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  28. Retirement communities are basically special groups of retired people, who have a common interest or passion and leisure to pursue it together. The biggest benefit of these communities is to get like minded companions and comrades to live with and pursue life's goals and happiness together. Thanks a lot.

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  29. Sandy,

    My parents moved to an excellent CCC several years ago. When mom become sick and had to move into the nursing care facility she was surrounded with love and compassion from the nursing staff. She died just about a year ago.

    My dad continues to live in an independent cottage on the campus and is happy and well cared for.

    I am all for CCC's, particularly so my kids don't have to worry about our care. My wife and I have at least another 15 years before we make such a move, but it is in our future.

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  30. Bob,

    You are right; aging in place does have its drawbacks and might require some assistance, but its benefits go far beyond simply enjoying a certain familiarity with your neighborhood. Investing in minor home modifications and mobility equipment can also help seniors maintain a sense of independence and ward off depression. It can also be a less expensive option when compared to certain facilities, depending on the amount of personal care from nurses and staff members. Installing a stair lift or walk-in tub can be offer a considerable savings over relocating. While this might not be the right choice for everyone, it is a viable option for those with minor mobility challenges. In fact, technology has advanced far enough that pill cases can be programmed with reminders and alerts that go out to family members if mom or dad has gone too long without taking their medication. This type of remote supervision might seem intrusive, but once again, some may consider it a worthwhile trade-off.

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