Elder care at Continuous Care Retirement Communities

Among the choices of housing where aging parents and spouses can get the care they need, Continuous Care Retirement Communities (CCRCs) are considered the top-of-the-line option. That’s because, as the name implies, these facilities provide the care required as the resident’s needs change. So one can take up residency and live independently (meaning he or she can manage daily personal care, daily activities and medications) in a house or apartment, even if confined to a wheelchair. As individuals begin to need some help with routine daily activities — bathing, eating, dressing, light housework, shopping and food preparation, managing medications — they can receive those as an assisted living resident within the same facility. Then, when full-time help becomes necessary, along with a wider range of services and some professional medical care, the resident can receive those within the same facility. Finally, as the loved one’s health deteriorates, necessitating a higher level of personal care and full-time medical care or hospice care, the same facility will provide these. Because these communities offer older adults the option to live in one location with a comprehensive, lifetime range of services, CCRCs are probably the most expensive option of all long-term-care options. There is an “entrance fee” plus monthly charges. Entrance fees, according to AARP, can range from $100,000 to $1 million, and normal monthly charges, from $3,000 to $5,000 or more. Monthly fees may increase as the resident’s needs change. Luckily for those of us living in San Antonio, where a great life is a real value, the fees here for CCRCs are lower. Of course, if you consider that the senior may be selling one home and buying another, it places a different perspective on the fees.

What about couples?
Yes, they can come in and live together. They may each be charged an entrance fee, monthly charges and maintenance fees. If one spouse requires a higher level of care or dies, there are usually options available for the other spouse. For example, monthly maintenance for the person remaining in independent or assisted living quarters may be adjusted to fees for one. The spouse requiring hospitalization might then go from paying his or her maintenance fee onto a different fee base of “x” dollars per day. At this point, the patient can apply for benefits from Medicare, long-term-care Insurance, other health insurance benefits and resources available. Are military-related CCRCs only for military officers? Well, some are, but others may have expanded their eligibility. More than likely, the military-related CCRCs will also accept spouses and widows or widowers of military officers.

Get your loved one’s financial matters straightened out and discuss the various options for the needed care he or she is eligible for and what is affordable. If you and the older person or persons decide a Continuing Care Residential Community is the right option, start researching the facilities in the local area. You will want to visit and tour the entire facility together, including the grounds and the various housing choices available. Try to have a meal in the dining room. Talk to the staff and residents, observing whether or not they look happy and well cared for. Ask many questions to help determine costs and contracts. You might want to make arrangements for your seniors to stay a weekend or so to assure this is the place they want for a new home.

Resources Continuing Care Retirement Communities:
• American Association of Retired People (AARP) www.AARP.org.

• American Association of Homes and Services for the Aging (AAHSA)

• National Association of Area Agencies on Aging (n4a) www.n4a.org.

• U.S. Department of Housing and Urban Development (HUD) www.hud.gov.

• American Bar Association (ABA) – Commission on Law and Aging

• Administration on Aging (AoA-U.S. Department of Health and Human Services DHHS) www.aoa.gov.

• Eldercare Locator- U.S. Administration on Aging. www.eldercare.gov.

• Search by ZIP code, city or topic.

To find a comprehensive list of questions to ask and more observations when choosing the retirement community, go to www.AARP.com.

As with any important document, it would be wise to have your attorney review the proposed contracts to assure everything is covered, including licensing, the routine fees and services and the optional fees, the type of care you’ll receive and what the CCRC expects of a resident. Additionally, check out the quality of care promised and enforcement, the rights of those who are abused or neglected, the transfer, discharge or eviction policies, process and rights of the resident. Check out the Better Business Bureau and the credentials of the staff and the medical providers.
Government and other resources can be a great help for providing information about CCRCs and where to find them. Remember to write down your list of questions and take extra paper and pen to write down the answers. You and your loved one will be relieved once you’ve found a new home with needed care for the rest of life.

by Anne Moore