When Is the Right Time to Move to a Life Care Community?
Category: Life Care or CCRC
October 26, 2021 — For most people, the answer to the question of the right time for moving to a Life Care community is – “when I get older”. It pretty much doesn’t matter how old the person is at the time; some undefined date in the future is always the answer. True, a minority make the decision when they are in their 60s or early 70s, but they are the outliers, often with a good reason for doing so.
Topretirements has some good friends who have wrestled with this decision for years. Their current situation, unfortunately, illustrates the problem so many people will face. He is in his mid 90s and she in her early 80s. She has wanted for some time to move from their town home into a Continuing Care Retirement Community (CCRC, often known as a Life Care Community). He, however, is never quite ready. Fortunately, they did put a deposit down at a Connecticut CCRC, but used a decision to wait for one of the larger units as a way to delay the move. He just had a serious medical incident requiring an extended hospital stay with an uncertain future, so now he is ready to take any unit that comes up. Although it looks like their deposit has secured them a place, they are about to have a very rough patch ahead. Two elderly people with mobility problems are not going to have an easy time moving, let alone dealing with culling down a jam-packed town home’s contents to fit into a much smaller apartment.
The average age of people who move to a Life Care community is between 75 and 85 years of age. These communities would love to move that age downward because younger residents offer stability and less turnover. More younger people means greater profitability too, since assisted living and nursing services provided to older residents cost much more.
What is a Life Care or Continuing Care Community?
The three main types of housing available to seniors are independent living, assisted living, and nursing homes. Life Care and CCRCs are unique in that they provide all three services in one package. You can move in and live in an independent living apartment or home, take advantage of assisted living if you have a medical setback (temporary or permanent), and move to nursing care if you are unable to take care of yourself at all. If a couple moves into a CCRC facility and only one of them requires the advance services, the other can continue to live in their independent living home. The model offers (at a considerable price) the security and peace of mind that you won’t have to ever move again, and, more importantly, that you will be taken care of and a burden to no one. The fees for these communities usually include one or two meals a day in their restaurant, extensive amenities like indoor pools and activity directors, and luxurious facilities. Entry fees can cost from several hundred thousand to a million dollars, in addition to monthly fees in the thousands. Some portion of the entry fee is usually refundable, depending.
Advantages of moving as a younger person
In a US News & Reports article on “When to Move into a CCRC“, an expert cited several advantages to moving sooner rather than later. The first is reduced financial risk, as you can lock in a fixed monthly rate that will be far lower than what it would cost should you ever have to move into an assisted living facility. The second is social. By moving in early you have time to make friends and avoid an abrupt transition late in life. For people who have lost a partner, or fear they will soon, being in a social environment earlier can help overcome some of the loneliness and loss in their lives. A third advantage is peace of mind – by moving before you have medical troubles (e.g., our friends mentioned above), you have the security that comes with knowing who will be taking care of you, that you are guaranteed that care, and that your partner/spouse will be living in the same facility as you. These facilities usually require a medical examination, and can either deny you entrance or charge a much higher fee if it looks like you are going to need extra care early.
On the downside of moving earlier, people give up some things. Usually the move is to a smaller home, so prized possessions and a sense of space may have to be sacrificed. Living in a communal setting means losing some privacy. Many people will be bothered because moving to a senior facility is unmistakable evidence that you have grown old.
Personal opinions
The decision of when to move into a Life Care facility is personal. As we said earlier, most people delay too long, then something bad happens and they are forced to pull the trigger in a rush. My own attitude is similar. I am pretty sure that Mrs. Topretirements and I will move into one sooner or later, if we are lucky enough to live long enough. The question is when, and under what circumstances. Should one of us develop a serious condition that is going to require daily care, like Parkinsons or dementia, we would do it sooner (but knowing we might have to pay extra because of our medical condition). If both of us can’t drive, that would be a trigger. But we have so many questions that fuel uncertainty. Should we move into a facility in the state where we have our summer home, or where we snowbird in Florida? Eighty years of age seems too young – is ninety better? Could we keep one of our homes and live part of the year in the CCRC, at least for the first few years? Some people can afford to do that, as it is a good compromise that offers security and some independence.
More opinions
We looked at Comments in some of our past Blogs that touched on CCRCs to see what our Members have said. There were many valuable comments, some of which we are including here:
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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. —- Everette
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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)
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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. Flatearth6
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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! — Lulu
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“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. — Rich
Bottom line:
CCRCs and Life Care Communities are a great option that can provide security and permanence for one’s older years. There is a substantial cost to them with the entrance fee and monthly costs. Not everyone can afford them, although if one sells their home they probably have enough equity to cover the entrance fee. Compared to the cost for assisted living or nursing homes over many years, they can be a good deal.
Comments? Are you considering a move to a CCRC, and if so, what is the right age for you? Please share your thoughts in the Comments section below.
For further reading:
Comments on "When Is the Right Time to Move to a Life Care Community?"
Greg W says:
A lot of facets to this article, but as to the question of “when to move”, for me the answer is when it gives me more independence than living in my own house/condo/apartment. My wife and I have just been through the 15 year journey with my in-laws and my father. All progressed through their form of dementia and other infirmities, and CCRCs have helped enable one or both more independence. They’re not perfect solutions (but aging isn’t a perfect condition), and are quite expensive, but they certainly helped with quality of life in the final years for all 3.
ljtucson says:
Greg W. That is probably the smartest answer I've heard. So many think about it in terms of what am I giving up. I think at some point we might recognize better what we might gain because the burdens of a home might be isolating, unsafe, and unhealthy. I have also been thru this with many people and parents. The worst outcomes are those who wait too long or those who jump in way too soon...it seems to have a nuance that might be hard to judge. The important thing for me is always to be aware of my area options and costs.
Kathleen says:
Per my family experience, the average age to enter "assisted living" is 84-85, which was true for my father entering a large CCRC. If he'd been a few years younger, he would have enjoyed Independent Living wing at the complex. Residents came from all over the country, snowbirds came back to where their adult children lived, others were local. The best reason to be in these communities is maintaining social contacts and continuity of medical care in the same community. This community did not require buy ins and was just rental so except for growing monthly costs as my father aged through the complex from assisted, to nursing to hospice, he did not have to move once settled in. Despite the complexes many advantages, as a family, we felt it was important to monitor care and oversee decisions for his care. We told him and we hope to remember our advice - you get to make the decisions now, or later, the decisions for your care will be made for you. Young retirees look for sunny and warm places to live, but in your mid 80s, social contacts and activities and quality of community health care are more important determinants in where to live.
Everette says:
I really liked Kathleen’s comments about using a strictly “rental” ccrc without a huge buy-in because a rental must maintain the same high quality of services.
I have seen the huge buy-in, called right to occupy, “trap”clients and friends into staying when services deteriorate with new management or financial troubles.
You can always move without financial penalties if the rental ccrc no longer meets your needs or expectations.
Just one caveat—you have to have LTC insurance or sufficient investments to cover the expenses through your life.
After a lot of research, my wife and I have decided that a rental ccrc would best meet our needs.
Sharon says:
Everette, I would like more information on rental CCRCs. Any articles or websites you can recommend?
Thanks.
Everette says:
Sharon,
To the best of my knowledge, there is no separate source that specializes in rental ccrc’s.
My research is based on visiting many ccrc’s and talking with friends and clients who live in ccrc’s.
Ccrc’s have two basic contracts: Life care and fee for service (rental contracts).
In a life care community, the ccrc contracts to care for you for life—even if you run out of money.
In a fee-for-service contract, the ccrc contracts to care for you as long as you have money—this the need for LTC insurance and/or wealth.
Take a look at Waltonwoods of Ashburn as an example of a ccrc with a fee-for-service contact.
Be careful with Erickson ccrc’s as they have a huge up front fee and large monthly fees but they are not life care communities. Instead, Erickson first consumes the up front fee and then relies on gifts funded by the residents.
Ccrc’s are complicated. You should read the GAO report on the financial risks of ccrc’s.
Sharon says:
Thank you for the information Everette.
HEF says:
I'm not sure that waiting until we're 85 is the best answer. OF COURSE, it is a personal decision but of the people we've talked to along the way - they all say they wished they had done it SOONER! My husband has Parkinsons so we plan to try to stay put for a few more years and move to the CCRC in our early 70s. We want to be able to enjoy all that it offers, while we still can! We will still be able to come and go, just like a condo or apartment, and continue to participate in our local groups. But, it will free up our responsibilities for the house and yard upkeep, that we have now. Our children and siblings are scattered and far from us so we want that security and camaraderie that such a community offers as well.
We have looked at several "rental" communities. The closest ones seem to be built and finished very cheaply and they don't have the amenities that a "buy in" community has. Financially, it does make sense but your "buy in" ultimately goes back to your estate and heirs while the interest keeps the community running. I get that.
Good discussion and good comments!
Admin says:
One of the problems about waiting to the "right" age is that medical conditions can happen overnight. A stroke or serious diagnosis can arrive suddenly, and then your world has really changed. No one can predict when and if it will happen to you or your partner.
Bill Bamber says:
Thank You as gives me some Direction.
HEF says:
Admin makes a good point about unforeseen medical issues. Be aware that these CCR Communities have WAIT LISTS. Some are up to 8 YEARS! Do yourselves a favor and tour a few and put your name on a couple NOW. They usually require a small deposit of $1000 - $3000. Most of them allow you to stay on the list and refuse an available opening unlimited times. When YOU are ready, you can remove your name and get your money back or move in!
Be also aware that some communities limit the number of times you can refuse. Good to ask questions now and take notes for later.
Roberta says:
That is very true about the wait lists at the continuing care retirement communities. There are a lot of us who are aging and want to go to one of these places before we get too sick etc to go. Go for the visits and tours and ask lots of people about the place. If you like it get on the waiting list for the type of unit you want. Most, if not all, deposits are fully refundable or at least 80% refundable.
K L Soper says:
Just a FYI: I visited a CCRC and put down an application fee (around $1000) to get on wait list. Was told it would be at least two years and I just couldn't wait that long so I sold my house and moved to the state of the CCRC's location. Two years have passed and I have been contacted three times and have postponed it. You need to wait for the unit/style that you're interested in to become available. I'm now just not ready - I guess it's having to face end of life and I'm not ready for that. Additionally, the application fee is not refundable and would not be applied to your costs once you commit.
Joann C says:
I'm interested in moving to a CCRC at some point but I'm having a problem making sense of it from a financial perspective, although I realize that this shouldn't be the deciding factor. I look at the entrance fee (minus any portion that's refundable) as an advance payment of rent, which is amortized over the period of time you are there. The older you are when you move in, the shorter period of time you have to amortize the entrance fee. The younger you are when you move in, the longer you are paying for services you may not need for several years, depending on what's included in the monthly fee. Even though I'm in my mid-70's, I'm just not ready to give up my house and my yard for my dogs, and move into an apartment situation. Moreover, I want to travel for several months of the year and assume that I would be responsible for the monthly fee even if I'm not there. Fingers crossed I stay healthy enough to stay in my home and that when the time comes that I need assisted living, I'll be able to find the appropriate situation.
Admin says:
I just had a conversation with a friend who is in his mid 80s. He is getting concerned about what he and his wife should do in the next phase of retirement. Wife doesn't like the idea of a CCRC, but they both they have to plan for the next phase of life. Maybe hiring an aide to come to the house? Or move from a 2 story single family to a single level apartment? Move to a a CCRC up north near relatives for the summer, and come to FL for the winter? We both agreed, this is a terribly complex decision! He wishes there was a TripAdvisor for CCRCs and Life Care Communities - it's too hard to evaluate them by yourself.
carla says:
Joan, We are in the same situation. As we have no children I think a CCRC would be a good place to be when one of us is alone. Most CCRCs require you pay toward meals so you would have people to at least eat dinner. My husband sees it as buying into "nothing" because to get your $ back after 5 yrs of a descending scale, you have to pay almost double $ to enter. He says you are basically paying for healthcare you might never need. My worry is what if the CCRC goes bankrupt especially if the CCRC is a stand-alone with no affiliated campuses to transfer residents to. If you wait too long you might not be accepted if you have a major health problem. Yes Admin a very difficult decision if you are one person but compounded if you are a couple!!