Page Two of Making Thoughtful Plans ... for a Retirement Location
If, like us, your concern is to try to save your children the worry and time involved in what might not be a permanently healthy and capable future, you might be looking for a situation that can provide something with increasing levels of assistance. A well regarded guide for this kind of decision is A Guide to Continuing Care Communities (An Insider's Guide) by Bernice Hunt, who with her husband learned by looking for themselves and decided to fill in the gap they discovered when trying to find information.
The online option is probably not your best choice because the listings are remarkably limited at this time. It would seem that most listings are really commercial if they include anything more than a name and address. Become familiar with the acronym CCRC, for Continuing Care Retirement Communities and life gets a bit simpler, but don't depend on the computer to tell you what you really need to know.
There is a wide variety of models available, from blatantly luxurious and for-profit to church owned and operated to non-profits of a number of kinds. They are springing up like proverbial mushrooms all over the country. One caveat: try to research the state regulations. Some states have virtually none, and some have excellent ones.
Included in this variety are a number of financial models, though the one offered us is becoming rarer. In our case, for a hefty entrance fee to be amortized over the actuarial life-span of the new residents, plus a monthly fee that includes a meal a day, we are guaranteed life care. One can pay a higher buy-in and recover from 90% to 50% of your estate or if you leave. Once health care in graduated degrees of care becomes necessary full time, the monthly fee remains the same, but naturally there is a charge for two meals, medication, and all the other extras. Graduated or progressive degrees of health care includes assisted living, special care which includes those who are experiencing dementia and skilled nursing.
Fee for service seems to be becoming the most popular arrangement nowadays, which saves money up front, but without giving too much idea of how much you might have to spend later on. Such an arrangement may not be quite a full a retirement for the household cleaner, since you may be charged for regular cleaning, meals, and other everyday living requirements except for outside upkeep.
There are facilities that accept Medicare and/or Medicaid, and others that don't. Be sure not to rule out automatically those that don't accept Medicare, but instead find out what their rationale may be. In the case of the place where we live, it has to do with Medicare charges vs. our contract rates and the size of our community. Medicare is an expensive proposition for an institution that may have two or three people a year who can qualify for that aid for a maximum of only 21 days. Don't forget that Medicare doesn't cover long-term nursing care.
One other factor to think about if you're hale and hearty and looking forward to many years of active living: don't forget to investigate the health care part of any facility, and consider the nearness to hospital(s) and specialists. Accidents can happen at any time (I smashed an ankle into many little pieces after just a year and was glad of excellent orthopedic surgery), and no one goes on forever as if in the prime of life. It's helpful to have readily available assistance for a short period. My husband experienced a fairly long hospitalization several years ago, and the social worker and available nursing assistance after he came home were of great help. Or after surgery, it might be necessary to have some help for a limited amount of time, and the assisted living section would be an option if you can't manage in your apartment.
We live in a "cottage" (pets aren't allowed in the main building) and like having minimal responsibility for outside maintenance. It's up to us how many of our own plants we want to put in. We have regular inside cleaning and maintenance as needed. We don't have to climb a ladder to wrestle with the entry light fixture and replace a burned out bulb. The meal a day is a great convenience that allows the culinary spouse to be retired in truth and provides an easy way to meet people and have regular social contacts in addition to activities provided.
The varied assortment of other residents has yielded plenty of interesting and close companionship. Fortunately, this residence has no more than 60 % drawn from the immediate neighborhood, though it is small and in a small town. That's another factor to try to determine ahead of time if you can. We didn't think of it at the outset. Since we came from New England to North Carolina, we found a population from many states, and at least one from another country appealed to us much more than finding ourselves surrounded only by locals would have.
A decision to pull up roots and change from the locale of a lifetime may not be an option for everyone, any more than the financial commitment may be. However, as one of our new acquaintances put it, we are glad to "give a gift to our children." If it weren't for the distance we had to travel to be able to do it, we would have no regrets at all. It was fine while an 850-mile drive for a graduation or Christmas holiday was feasible. Now the burden falls on them to get to us. The up-side is that they know that emergencies can be properly managed and that we're being, as the Brits say, "looked after." That's worth a lot.
©2009 Joan L. Cannon