|Friendship Village, Tempe, AZ|
OK, let's start with an important definition: what is a CCRC? This is the abbreviation for a Continuing Care Retirement Community, a type of retirement environment that provides living and health care through three stages of aging needs: independent living, assisted living, and nursing home care. If you'd like an excellent overview of how this type of community operates, costs, and what types of questions to ask of those you may be considering, click this link.
While all three styles of living arrangements can be found separately, a CCRC makes the transition from one stage to the next easier and prearranged. All sorts of places offer independent and assisted living. But, finding space in a well-run nursing home is not an easy task. There could be a lengthy waiting list or other limitations. The costs are quite substantial and few insurance options exist.
A reader has decided this three-stage community is best for him and his wife. One of the toughest decisions to make is when to move into a CCRC. Knowing that Betty and I plan on such a move at some point, he asked me to provide a few guidelines and the factors I will be considering when we decide it is the time to proceed.
Like many of the important decisions in life, deciding when to move into a CCRC is not a simple one to make. There are several factors to consider. Let's see if I can identify the ones that might be giving you pause.
* I want to stay in my own home. Moving to any type of retirement community is not in the cards. This is common for many of us. Home is often where we raised a family, made memories, or have a space that welcomes and comforts us. Unfortunately, it can also be dangerous if the house isn't altered to be made safer as we age. And, at some point, our needs for nursing or daily health needs cannot be safely met in our own home.
* Those places are expensive. I can't afford such a choice. There is no argument: CCRCs are expensive. Most require a "buying" fee, an amount of money that allows you to move into the community. That charge guarantees your space in all levels of care when appropriate for you and helps pay to maintain the facilities. Usually in the range of $200-400,000, this initial charge is either refundable to your estate upon death, or a one time fee that you cannot recover. If you choose the returnable option, this one time charge will be higher.
Also, expect to pay a monthly rental fee of $2,500-$4,500. This fee normally does not change as you move from independent to assisted to nursing center living. It covers maintenance and repair of where you live, meals, and facility use. Think of it as what you would pay for an upscale apartment.
* I'm too young. Most CCRC's require at least one member of a couple to be over 55. Adult or grandchildren are not allowed to live with you permanently. If you are younger than 55 and aren't ready to live with only older folks, you are probably too young (either physically or mentally) for such a choice. Of course, if you have just turned 55.
* I'm too old. This is the risk you might face if you wait too long to move to a CCRC. Most have requirements that you must be able to perform at least a few of the basic functions of daily care on your own. You can move directly into an assisted living environment, but not directly to a nursing care facility. Wait too long and you may be denied entry. For Betty and me, when I turn 80 is probably the time when such a move is best.
* What happens if it goes bankrupt or out of business after I move in? This risk is one that is faced by all of us who must depend on someone or some service. An insurance company can decide it can't continue to pay your monthly annuity. A nursing home may default on a loan or the owners decide to close the business. A CCRC can fail. It is up to you to perform basic due diligence before agreeing to sign on the dotted line. How many years have they been in business? Has ownership changed often, or recently? Why? Tour the facility, all of it, and ask questions of residents.
* What are CCRC's like? I don't want a warehouse for old people or something with constant activities and meetings. I can only speak with some authority about the one I know best: my parents lived in one for ten years, until their deaths. I visited them often, ate in the restaurants, buffets, and cafes, saw the facilities, and was able to experience, firsthand, the hands-on, caring quality of care from the nurses.
There was a mix of those who were active and those who preferred a quiet lifestyle. There were plenty of clubs and groups if one was so inclined. A nearby University held classes at the community center for lifetime learners. A well-stocked library, bank branch, space for a weekly church service, pool, fitness center, an on-site small grocery store, beauty salon, and barbershop were available.
Frequent shuttles to doctors' offices, pharmacies, or off-site restaurants and shopping made life easy for those without a car or family nearby. A full-service hospital was next door. Located in the suburb of a major city, the ability to go to concerts, museums, plays, and sporting events was there for those who wanted to partake.
OK, now to answer the reader's specific question about knowing when it is time to move into a CCRC, the answer depends:
- On finding a place you can spend the rest of your life,
- that you can afford,
- that includes the services and amenities that are important to you and,
- that is financially stable and has a solid history
Do your homework, decide what will make you feel happy, safe, and taken care of, and then go for it.