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Continuing Care Retirement Communities

Continuing care retirement communities, or CCRCs, offer a full range of housing choices and services on one campus -- from independent living to assisted living to skilled nursing. CCRCs are best for those who want to be able to stay in one place as they age.

Continuing Care Retirement Explained

By Caring.com Staff

A continuing care community is the "one-stop shopping" of the retirement world -- a campus-like setting (or an urban high-rise) that offers a variety of rooms and apartments designed for independent living, assisted living, or skilled nursing care. The biggest benefit of continuing care retirement is that once your loved one moves in, she can remain, even if her health status changes. A continuing care community (also called life-care-community or CCRC) is also a good choice for couples where one spouse needs more care than the other.

Generally, a continuing care retirement community will expect an older adult to move in when he's still healthy enough to live independently. As residents age and their needs change, they can get a greater level of care without having to uproot themselves. They can also stay within the community and receive short-term nursing care if they need it after an illness or injury, then move back to their apartment once they recover. If a couple moves in, they'll be able to remain near each other, if not in the same apartment, even if one becomes ill and requires much more care than the other.

Meals, housekeeping, activities, and some medical care are usually included in the contract -- although this varies from one community to another, so be sure to check.

Jump to: Cost of Continuing Care Retirement | Independent living in a CCRC | Assisted living in a CCRC | Skilled nursing care in a CCRC | Who should move to a CCRC | How to find a CCRC

COST OF CONTINUING CARE RETIREMENT

Continuing care is an expensive option. But if your loved one can afford it, she can generally be confident that once she moves in, her needs will be met for the rest of her life.

Continuing care payment arrangements vary widely from one community to another, and these systems can be complex. In most cases, residents pay a large entrance fee up front, then pay monthly fees for the duration of their residence. In some CCRCs, residents purchase the unit they move into. The up-front deposit might be anywhere from $20,000 to $550,000, and monthly fees might be anywhere from $500 to $4,000 per month. In some communities, there are charges for additional services.

If your loved one purchases a life-care contract, everything including housing, meals, medical care, and skilled nursing care will be covered, and the monthly fee shouldn't go up as she moves from one level of care to the next. She can also choose a modified or fee-for-service contract; this is generally less expensive at first, but additional fees will be charged as more care or services are needed.

Costs will also vary based on the size of the unit your loved one chooses.

Reading and understanding the contract is important in helping an older adult choose any kind of housing option, but when it comes to continuing care, it's a must. In fact, because a CCRC represents both a long-term commitment and a significant financial investment -- and because contracts can be long, detailed, and complex -- it may be worth it to her to have an elder law attorney go over the contract once she has selected a community or communities to consider. To find an elder law attorney in your area, search in the Caring.com Elder Law Directory.

Most CCRC payment is private pay. Your loved one can also use long-term care insurance (LTCI) benefits to help cover CCRC expenses. In the case of an acute illness or injury, there are some cases where Medicare, Medigap, or veterans benefits will help cover some health-related costs. When touring CCRCs, be sure to ask for details about how residents pay for care and what your options might be. This is also a good topic to explore with your attorney or a trusted financial advisor.

INDEPENDENT LIVING IN A CCRC

Residents usually move into CCRCs when they're active and independent. In the independent living area, you can expect to find apartments with full kitchens and standard amenities. Many CCRCs offer highly engaging social outings, classes and cultural events, and a full program of activities. You can also expect healthful, flavorful meals in a nice dining room.

ASSISTED LIVING IN A CCRC

As your loved one begins to need help with activities of daily living, the CCRC will provide care similar to that in an assisted living community. CCRC caregivers can help your loved one with dressing, walking, grooming, toileting, bathing, and other activities of daily living. CCRC caregivers can also remind your loved one to take medications. (Note that your loved one may be asked move to a new apartment within the CCRC to receive this additional level of support.)

SKILLED NURSING IN A CCRC

It's not uncommon for aging seniors to experience a health emergency: a fall, broken bone, stroke, heart attack, or serious illness. If your loved one experiences this type of acute health need, he may move into the CCRC's skilled nursing wing. Unlike assisted living communities, CCRCs can provide skilled nursing on-site. Once your loved one has recovered, he can move back to his assisted living or independent living apartment.

WHO SHOULD MOVE TO A CCRC?

A CCRC is a good option for people who value security. Knowing that no matter how their health changes down the line, their needs will be met and they won't have to move can bring great peace of mind. A CCRC can also be a great choice if your loved one is becoming socially isolated as he ages and would welcome an opportunity to make new friends and share in group activities.

If, on the other hand, your loved one values independence over security, continuing care may not be his best option. To join such a community, he'll likely be handing over a large chunk of his assets to secure a spot, and CCRC administrators will play a big role in deciding when he needs to move from one level of care to the next.

HOW TO FIND A CCRC

To find a CCRC near you, search by zip code here in the Caring.com Continuing Care Retirement Directory. Be sure to look for reviews of CCRCs written by other family caregivers.

Once you've narrowed down a list of CCRCs that you want to talk to, call to schedule tours. While there, be sure to ask for licensing reports, which give you an idea of how the CCRC has fared on past inspections and whether there have been any substantiated complaints. Look at the activity calendar and see whether it matches your loved one's interests. Also make sure you visit all three wings or areas -- independent living, assisted living, and skilled nursing -- to get an impression of whether they're clean and pleasant, whether residents seem content, whether enough staffers seem to be present for the number of residents, and so on.

As with any senior care option, there's no substitute for spending time there, joining residents for meals, and talking with them about their experience. (If administrators discourage you from talking to current residents, this may a red flag.) The whole idea behind continuing care is that this is a place your loved one will spend the rest of his life, so invest some time in getting to know the community and making sure he feels comfortable there before making a commitment.

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