The One and Done Appeal of a Life Plan Community
Category: Life Care or CCRC
February 27, 2016 — One of the best pieces of advice we have heard about retirement is to take the long view, rather than just focusing on the early years. The long view idea is to find a place to retire where you can live the rest of your life – regardless of your health or ability to do various activities – without having to move again. And one of the best ways to do this is to choose a Life Plan Community (sometimes Life Care), which are also referred to as Continuing Care Retirement Communities (CCRCs).
Life Communities, of which there are about 2,000 in the U.S., combine the best of several worlds in one package. New residents typically live in a nice apartment or small home that isn’t much different from what you would see in an active adult or 55+ community. There are extensive community facilities, amenities, transportation, and social and cultural programs. The campuses are usually quite compact – often you can walk to everything without having to go outside (making them appealing even in a cold-weather climate). Many are non-profits, have a religious connection, or related to a university. Occasionally an active community or other type of development has a CCRC on campus or located nearby (Fearrington Village, for example, has Galloway Ridge on campus).
The beauty of the Life Plan concept is that as you age and/or your health changes, these communities have options to take care of you. They usually have 3 levels of care: independent living in your own unit, a rehab facility in a smaller unit, and nursing level care. Some have memory units, while in others those with dementia live in the nursing unit. If you fall or have an operation and need recuperation, you can continue to live in the community, although in a different unit. Then as you return to better health you can go back to your regular apartment (where your spouse, if you have one, can continue to live while you recuperate). At the end of life when you might need serious nursing care you can move to a unit where you can live and receive continuous assistance, but still be near your spouse and friends.
Typically most CCRCs have procedures to protect your health and security, such as on-staff nurses, physical therapists, and dietitians. Even in the independent living units there is normally a system to check to see that you are OK every day, and a panic button should you need help.
In most of these facilities there is a nice dining room(s) that feel more like a fancy restaurant or country club than dining hall. Normally you receive a continental breakfast and one meal a day as part of your plan, although you increase that by paying more. The independent units usually have a kitchenette so you can cook as many of your own meals as you prefer.
Most CCRCs require a hefty entrance fee (usually called a Life Care contract) and a physical, plus monthly charges that might range for $3000 to $7000, or more. Others have a fee for service contract. If you or your spouse have a serious health issue or signs of dementia you might be denied entrance, or have to pay more. Sometimes the entrance fee is refundable in whole or in part, sometimes not.
In an unusual twist, some baby boomers have actually moved into the same CCRC that their parents live in. That way they are together, it reduces the stress associated with caring for an aging parent, and the adult child can establishes their own life. See New York Times, “A Twist on Caring for a Parent“.
Due Diligence Required
Choosing a CCRC requires considerable due diligence. We have written about this extensively on our sister site, BestAssistedLiving.com. There are a number of essential issues to investigate before you buy. You should have a lawyer or financial advisor review any documents before you sign. Concerns to look at include potential refunds, what happens if you change your mind and move, the level of care you might expect, and what happens if… you become seriously ill or have advanced dementia… run out of money… the facility is sold to another company… fees, etc. Beyond financial aspects however, you should investigate the amenities, food service, professional services like nursing care, etc. to make sure you know what you are getting. Do the employees appear well-trained and motivated, or is there a lot of turnover because they are only paid minimum wage or other issue. It is best to visit multiple communities and talk with residents about their satisfaction. This is a significant decision and it requires careful investigation.
Thirty states have regulations on CCRCs with varying degrees of strictness (Florida’s are well advanced). In those that don’t, you might be in more of a wild west environment.
Pluses and Minuses
– The biggest plus is the confidence you will be taken care of without having to move again
– Multiple amenities including dining and transportation
– Good medical care
– A social network that is yours for the rest of your life
On the negative side:
– Can be very expensive
– For younger retirees you might feel out of place
– Might not be able to get in if you have serious health issues
Many to choose from
Topretirements is proud to have several fine Life Communities that support this site with advertising. Those include:
La Loma Village in Goodyear, AZ
Grandview Terrace in Sun City, AZ
North Hill in Needham, MA
Messiah Village near Harrisburg, PA
The Hill at Whitemarsh in Philadelphia
Rydal Park in Philadelphia
You can use Advanced Search to find more by state.
Bottom line
Continuing Care Retirement Communities are an ideal solution for retirees who want the security of finding a place to retire for the rest of their life. They require a substantial commitment, however, so you should carefully investigate before you choose.
Comments? Have you been thinking of a CCRC or Lifecare community for your retirement? Please share your thoughts, concerns, and experiences in the Comments section below.
More Resources
Topretirements has 226 communities listed as CCRC or Lifecare on our site (although most undoubtedly do, we cannot certify all actually meet that criteria). You can use Advanced Search to find them by state or other criteria.
Understanding Residency Agreements (2 Part series)
New York Times – Everything-in-One Promise of a CCRC
Leadingage.org
Comments on "The One and Done Appeal of a Life Plan Community"
Jan Cullinane says:
Here's a checklist of questions if you're considering a CCRC: http://www.carepathways.com/checklist-ccrc.cfm
Source: Care Pathways
The Commission on Accreditation of Rehabilitation Facilities (CARF) accredits CCRCs (www.carf.org).
Because CCRC contracts can be fairly complex, it's a good idea to review them with a financial planner, an accountant, or an attorney. And, you or your "money person" should look at the financial statements of the CCRC, too.
If you're in poor health when you enter a CCRC, you could be paying a lot of money for a little time. But for those with the financial means, a CCRC can provide great peace of mind.
Jan Cullinane, author, The Single Woman's Guide to Retirement (AARP/Wiley)
Vincent says:
We are looking at CCRCs in Charlotte. Considering Plantation Estates and Aldersgate. Both are attractive. Comments appreciated.
says:
As we are just in our early 60s we don't feel we are quite ready to pay all the monthly fees, nor utilize all the services that are common in a CCRC . It is, however, our goal to eventually end up in such a place since our children are spread out across the country and we will be on our own. There is only one place, that I can think of, in our area now and it is not for us - so we plan to relocate. My parents live in an Erickson community and it is like living on a cruise ship! We would LOVE a place like that and plan to position ourselves in the area of several so when we DO decided it is time, we will have a choice. Plus, we won't have to change all our Doctors and friends - again.
Lynda says:
Jan, thank you for the checklist. I visited several such communities in St. Petersburg, FL and was favorably impressed by The Fountains at Boca Ciega Bay. I will continue my due diligence, and would be grateful for any information others can share regarding this community.
Lulu says:
My mother chose to live in one of these communities after selling her home because it was too big. For the first few years it was great. She had a cottage, then moved into the main building and had assisted living. She started showing signs of dementia even before she moved into the community so I have always admired her foresight. All went well until the ownership and management changed hands. Then there were thefts and the resident's care deteriorated. Both my brother and I lived at some distance so it was hard to monitor. We eventually moved her to a nice nursing facility closer to my brother.
So, my important advice is to involve your extended family in the choice of facilities. And have them monitor the business end of the place. Also, chose one close to family, if possible. You are anticipating health and ability deterioration over time so someone will need to pick up the slack for you. Make it easy on them!
Rich says:
flatearth6 -- not to try to push you (it's a tough decision in your early 60s to commit a large investment and the rest of your life to one place), but some of these facilities may well have all that you might want. I am only very familiar with one CCRC, Galloway Ridge, which is listed in this article's second paragraph. They are affiliated with the Duke Center for Living which includes a full health/exercise center with coaches, counselors, physical therapists and excellent facilities. They are located adjacent to (walking or golf cart range) of Fearrington Village with shops, restaurants and a beautiful campus, have additional amenities such as a full woodworking shop, etc. and special events such as a Christmas craft fair. We live only a few miles away and seriously considered Galloway Ridge for its great promise and because we love this area of NC just south of Chapel Hill. The cost is high (though probably at a norm for CCRCs) and in the end, we decided that our home plus our excellent long term care plan remains a better alternative for us. And it happens that just a short drive can make some of the facilities available to us.
I provide this info in partial answer to your concern and because there are numerous other on Top Retirements that have been interested in this area. I would also like to reiterate the opening sentence of this article: "One of the best pieces of advice we have heard about retirement is to take the long view, rather than just focusing on the early years." When we were considering Galloway Ridge , we were like you -- in our early 60s. Just 5 or 6 years later we still are happy with our decision, but changes in our health and physical condition have caused us to make changes to our budget in order to allow someone else to help maintain our home. Age related issues don't just creep up on you -- they can happen in leaps and bounds.
Kathy says:
This is really only an option for wealthy people.
Rich says:
Kathy, Being rich or wealthy very much depends on your point of view. For example, we are doing fairly well, but we have to carefully follow a budget to have a hope that our savings will last. Like many retirees, we have a house that is paid for that would have to be sold before we could consider any CCRC possibility. And budgeting would still be part of our lives.
On the other hand, those who are retired and living only on their Social Security would likely indeed feel that we are wealthy. And there is a wide range between Soc Sec and far extending above our income level (and,, unfortunately, below the Soc Sec level).
If people have a house to sell and adequate savings to live out their retirement, then they could consider a CCRC -- many of those would definitely not feel they are wealthy. Those with such wealth that they do not ever fear being without can certainly consider a CCRC. Such wealth is definitely beyond me.
Those who make up Top Retirements span a wide range of "wealth". I would hate for anyone to simply cast off potentially reasonable CCRC options, simply because they thought it was only for the "wealthy". But without question, buying into a CCRC requires resources -- and that was stated in the original article.
Everette Orr says:
CCRC's offer great potential, but there are several big risks.
First, the CCRC services and facilities can change over time with new management or weakened finances. We have friends who loved their CCRC when they first moved into it, but with a change of management, they think the services and facilities have significantly deteriorated over time. With the one-time, non-refundable entrance fee for life care, they feel stuck in a place they no longer enjoy.
Second, although most CCRC's allow residents as young as age 62, I think the average entrance age is typically somewhere between age 75 and 80 so the average age of residents is often well into the 80's. I think it is important to fit reasonably into the age of the residents of a CCRC.
Third, a CCRC is sometimes likened to a monastic way of life, not because of austerity since most are quite nice, but because one is committing to live with a group of people for the rest of our lives. So, it is important to make sure that we can fit into the "culture" of the residents for what matters to us (religion, education, political views, activities, military, etc). It can be hard to live as an outsider.
Again, CCRC's appear to be a beautiful possibility for aging, but we need to perform our own due diligence to minimize the risks associated with CCRC's.
Rich says:
Thank you, Everette. Critically important.
davefh says:
update: we have been on the CCRC search for a few months. we are currently renting a townhouse in WAKE COUNTY NC. we visited TENN, MISS & GREENVILLE S C. going to Charleston SC in APRIL, with a return swing to GEORGIA. pretty obvious COST is a MAJOR factor for most people. many are VERY NICE & others not so much. food quality varies up & down the scale. at this point in time, if money was not an issue, we have 2 we thought covered all of our personal checklist items: 1. THE FORREST AT DUKE ( 5 stars) in DURHAM NC 2. THE WOODLANDS AT FURMAN (5 stars) in GREENVILLE SC. the search continues. good luck to all.
Vincent says:
Davef
In Greenville make sure that you visit Cascades at Verde. One of our top choices. In Charlotte check out Aldersgate and Plantation Estates. All,good choices.
caps says:
Rich....I find it ironic that you should address being "rich!"
FIL and MIL moved to one of these "promising" communities about 10 years ago, that was supposed to grow with more amenities offered. When the economy failed, the management and tenants couldn't fulfill the said intentions. They had to let college students rent to make ends meet. FIL's failing heath required more services, so they moved to a more expensive and absolute dream facility with the amenities already in place. Save the fact, that there is no indoor swimming pool and it's located in freezing Fargo ND.....it is where I would love to be during my later years. FIL now deceased, after needing their acute care wing for a few months. MIL doing okay , still in her apartment, yet says that the most difficult thing about being there is that all her friends pass away the longer she lives. I suppose.......
caps says:
My kids tease me, that they get to pick my nursing home. I tell them......I have already picked it! It is the nicest facility in our home town, and it is beautiful. It already has all the amenities, including an indoor pool, in place. Yeah....it is too expensive, but aren't they all?
Mom is in assisted living and doing well. When we asked dad if he wanted to go there and be with her........he said "Why should I pay to sit up there, when I've already paid to sit here at home!" Well, we found him an in-home nurse to care for him during his last 3 months of life, for much less money.
Betty Ames says:
MY daughter is only 55 but had stroke in 2009 that left her paralyzed on left side, right side works fine-she can stand up but can't manage life alone her mind is good. I am 74 and need a rest from her. I have been taking care of her and do not wish to put her in nursing home where everyone is 80+ - are there no alternatives for younger folks in SE Texas.