As an elderly person continues to age, the amount of help they need increases. For people who live in some sort of senior living, a common concern is that they will have to move to a new place as they get older and need more care. For example, if they are living in a senior apartment or independent living community, they worry that they will have to move to assisted living in another town or a nursing home farther from family when they need more assistance.
In addition to physically moving belongings, there are emotional factors associated with moving an elder to a new home and a feeling of being uprooted.
To address this, Continuing Care Retirement Communities (CCRCs) are becoming more popular.
What is a CCRC?
When living at a CCRC, residents who move in at the independent or assisted living levels would have access to higher levels care as their needs progress, without having to move to a new community. CCRCs are a combination of residential care options: independent living communities, assisted living facilities and skilled nursing. CCRCs provide a ''continuum of care'' for residents, so that residents can move from one level of care to another if the time comes.
How to Find the Right CCRC
If the decision is made that a CCRC is right for your family, how do you go about finding the right one, where your parent will be happy, safe and comfortable? The best way to evaluate a CCRC is to visit in person. Arrange an appointment to tour the facilities, meet the staff, see the living spaces and eat in the dining room. Here are some things to look for when researching and visiting a CCRC.
Level of Care
What types of care are available? What medical services are provided? Ask about routine medical care, treatment of illnesses and diseases. Are there physical therapists or rehabilitation specialists on staff? Is emergency care easily accessible? In addition to medical care, are housekeeping and maintenance services available?
If your parent has any special needs, such as care for progressive Alzheimer's disease, or is wheelchair bound, inquire as to whether or not the community can manage those special needs. Is there a "memory care unit" for Alzheimer's and dementia? Are special meal plans available for people with diabetes? Are all of the areas, including bathrooms and common spaces, handicap accessible?
What security and safety features are in place across the campus? Are grab bars installed in the bathrooms? Do the hallways have hand rails? Does each room have an emergency call system? Are rooms well-lit? Is flooring covered with a no-slip surface?
There are many types of residents living in CCRCs, from those who can live independently; those who need help with daily tasks, and those who require the constant monitoring of a medical staff and nursing facility. Depending on which option is right for your parent, their living area might vary. When visiting, look for a place that feels like home, with large rooms, plenty of closets and storage, well-appointed bathrooms and modern kitchens.
Furniture and Household Items
Are the rooms furnished? Is the furniture comfortable? Are linens, eating utensils and other household items included? Is there a television and/or stereo? Can your parent bring their furniture from home if they prefer? What personal items can be brought from home? Are pets allowed?
The CCRC you choose should be a good fit for your parents. For example, If dad is a golfer, see if there a driving range or golf course on site. Look for a full range of social and physical activities that your parent will enjoy, such as tennis courts, swimming pools, libraries and computer rooms. Personal care services are also important: barber and beauty shops, a wellness center or perhaps group exercise classes.
Food is a big part of life and that doesn't change when your parent moves to senior living. Does the CCRC have a chef on staff? What types of food are on the menu? Is the dining room open during convenient hours, when your parent typically eats? How does the CCRC handle special dietary needs? Can your parent cook or eat in his/her room?
There are three common contract types, or fee schedules, for CCRCs.
- Extensive Contract
This contract covers room and board, residential services, amenities, and unlimited long-term nursing care. Residents pay monthly installments. The nursing care portion of the monthly payments may be adjusted over time for inflation and increased operating costs, but the rent remains the same.
- Modified Contract
The difference with a modified contract is that it only includes a limited amount of nursing care. Room and board, residential services and amenities are included, but any care that goes beyond the "limited care" included in the contract must be paid for. Residents can purchase unlimited additional nursing care after they receive the maximum. The additional services are paid for on a daily or monthly basis.
- Fee-for-Service Contract
This contract covers room and board, residential services, and amenities. Emergency and short-term nursing care is usually included, but long-term nursing care is guaranteed only at daily rates.
Whichever contract you choose, check the clauses governing transfer from one level of care to another.
Oftentimes, a CCRC wants the resident to move in while they are independent and able to enjoy the social, recreational and cultural opportunities. The CCRC may also ask for information about their age, pre-existing health conditions and financial status. Your parents might have to have a medical exam as part of the application process.
CCRC residences are mainly paid for out-of-pocket. Most require entry fees or down payments, and a monthly fee that covers rent, communal areas, home maintenance, meals and, if nursing care is included, a payment toward future nursing care expenses.