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    Continuing Care Retirement Communities (CCRC)

    At some point in the coming year or two I believe it will be necessary to move into an independent living facility that provides access on campus to various stages of assisted living etc.

    I have been researching online and have requested and received price info / apartment variety / amenities availability info, etc.

    I have some idea on what is involved but would appreciate any first or second hand information.

    Important: Transition from independent to assisted living knowledge?

    How much say the individual maintains vs the facility?... that kind of thing.

    My criterior is headed by a comprehensive gym, exercise pool, concierge and decent menu.

    Oh, 70, male, single, PPMS, no DMD, healthy except for the MS

    #2
    I have never been interned in one of those places but I researched it thoroughly. You sell your house and turn over your Social Security to put in a fund for them to draw on. In other words, you will no longer have control of your money. For an alert person, losing that basic adult responsibility would be very uncomfortable.

    The apartments are $3000/month for rent only, well above the market rate for a one bedroom and they are small. everything else is extra. Meals, housekeeping, caregivers...all a la carte. I met a woman with MS who turned her home over to the company and in watching her time dwindle like an hour glass. She was in despair and didn’t want to live anymore.

    Once you go in you cannot leave without some authorized family member signing you out.

    The places have central dining rooms with gothic decorating. It makes me feel like I am already buried. The brochure shows a glowing swimming pool but in reality it is only a jacuzzi size pond.

    Three times a week you spend in a van riding around while everyone is dropped off and picked up from their doctors appointments.

    Of course, these are just the things I observed by researching them all over California.

    Another thing I would worry about is Covid. It really spreads in those communities just like nursing homes.

    The good thing about it is that there is companionship.. They have activities but I don’t think they would satisfy the intellect of a healthy person.

    I had an aunt that had a very severe case of MS and died like Annette Funicello. Her son has a dream to build a special community for people with MS. We talked about the details. We think being around nature is the most important thing. We imagined little cabins dotted around in a forest with sidewalks that link them all so people could get in their scooter and visit anyone they want. It would have housekeepers, caregivers, meals could be communal or in their cabins, they would have gardens where they could work to cultivate their own food. There could be A swimming pool, pt gym,library, could be a neurologist, an MRI machine, an IV center, a pharmacy and maybe a little grocery store.

    There could be entertainment like music or theatre. A chapél. There is no dreám too lárge.

    The point of this is that people with MS have a different set of needs than the demented, deaf, extremely elderly who would be happy with bingo.


    My cousin said that he found á site in eastern Montana and is raising money from his church tó make it happen. What would you want in your perfect environment?






    Comment


      #3
      Palmtree, it sounds like your aunt raised a very special person. You must be very proud of your cousin. I hope your cousin realizes his dream and that you are one of his first occupants.

      502E79, thank you for posting. This is a very important topic. My wife and I, (she is the one with MS) looked at one such place and left in a hurry. I found everything Palmtree said is absolutely true and I would add one other concern and that is BANKRUPTCY. Please be sure your money is in escrow and can in no way be included in a bankruptcy filing.

      I could never sell our home, take our savings and turn it all over to a third party. There must be alternatives.







      Comment


        #4


        Thank you both for responding to this CCRC thread. Your experiences are eye-opening and valuable, certainly important to be aware of before making such a commitment. Some small local facilities are vaguely similar to what Palmtree described, I had my mom in one 15 years ago. Nice enough place but not a CCRC.

        To clarify my concerns (and my knowledge) on CCRCs.... (I will leave out extraneous info)

        Usually life styles on campus consist of Independent living, assisted living, Alzheimer or dementia care. Some also have rehabilitation and even hospice care.

        A person or couple usually enter as independent living through the purchase of a home or an apartment (sq. footage choices). Some facilities have rental apartments. Some are all rental.

        Amenities, covered by a monthly maintenance fee, come with purchase or rental agreement (too long to list the variety of amenities). A choice of meal plans may be extra or included. Yes, the monthly fee can be a low of 1.5k to nose bleed.

        Every facility that I have looked into operated nationwide with from 8 or 10 to over 100 campuses. Applications request basic financial info. They do need to see if you can afford what you are interested in. The facilities probably have an algorithm to enter data (age, income, SS, equity, etc etc) which certainly works in their favor. But you arrange for monthly payment (check or EFT). You, not the facility, receive your SS monies, investment income, annuity income, etc, and then you pay one monthly fee. At times the fee may be higher… you have guest for lunch, take a facility sponsored excursion, a special seasonal event on campus, that sort of thing.

        My questions or information requests:

        Any first or second hand (think A Place for Mom) transition from independent to assisted living information. I am aware of the significantly higher cost.

        Usefulness of an elder care attorney…?

        Thank you Robert152 for the Covid reminder. Sad but needs to be considered.

        Comment


          #5
          A friend's parents were in one for close to twenty years. As you described, they made a down payment and retained responsibility for their finances and monthly fees. It was a large campus that keeps expanding still. They started out in independent living, probably for 15 years. They loved it. Lots of educational, cultural, and other activities. Gym facilities, indoor swimming pool. They had community gardens, putting green, bocce, and other outdoor options. They had a restaurant as well, which if you used and brought guests, added to the monthly bill. They also had a few retail shops, shuttle buses to take to appointments. They made many new friends.

          They did transition to assisted living for a few years, but did not need dementia care before they passed. They received good care, both medically and with daily living, the family was really happy with them. They did have some issues settling the estate after his parents passed. But overall, it was a good experience.

          My Mom was actually there for rehab twice. My father was also there for a few weeks after Mom passed and we went away - respite care in assisted living. Not sure if that is an option for you to check in and get first hand experience. That usually is based on availability, as residents who need temporary assisted living are first priority.

          I would want to know what their retention rates are with nurses and aides. If it is a good place, they will value their staff and incent them to stay. I would also want to know ratio of nurses and aides in assisted living. Oddly, my nephew is a nurse and now works at this place. He said they are chronically understaffed, so a different perspective.

          Given the cost and commitment, it may be wise to consult with an attorney. What happens if you aren't happy and want to leave? What happens if you are no longer able to manage your finances? What happens if your money runs out.

          lots of luck as you research your options.
          Kathy
          DX 01/06, currently on Tysabri

          Comment


            #6
            My husband's parents are in an independent living home on the campus of a nursing home that offers assisted living and health care. They had a choice between
            1. the purchase, at full price, of their home, which they could then sell back upon leaving (ie: to more care, or upon their deaths), or
            2. purchase at 1/2 price and then relinquish property in the future.
            They chose #2.

            I believe they also pay a monthly fee -- covers lawn care, etc. They have access to lots of social events, exercise, rental of facilities, etc (maybe not during COVID, I don't know). I don't think they have access to meals until they have upgraded care to living in the facility.

            My MIL has had Parkinson's for over 20 years. Uses a rollator for ambulation and my FIL often pushes her in it. She has a W/C but doesn't use it. I think getting it in and out of a vehicle is likely too difficult for my FIL. They are ages 87 and almost 83. My MIL would likely need to be in health care (not just assisted living) if not for her hubby's assistance.
            ~ Faith
            MSWorld Volunteer -- Moderator since JUN2012
            (now a Mimibug)

            Symptoms began in JAN02
            - Dx with RRMS in OCT03, following 21 months of limbo, ruling out lots of other dx, and some "probable stroke" and "probable CNS" dx for awhile.
            - In 2008, I was back in limbo briefly, then re-dx w/ MS: JUL08
            .

            - Betaseron NOV03-AUG08; Copaxone20 SEPT08-APR15; Copaxone40 APR15-present
            - Began receiving SSDI / LTD NOV08. Not employed. I volunteer in my church and community.

            Comment


              #7
              Originally posted by pennstater View Post
              I would want to know what their retention rates are with nurses and aides. If it is a good place, they will value their staff and incent them to stay. I would also want to know ratio of nurses and aides in assisted living. Oddly, my nephew is a nurse and now works at this place. He said they are chronically understaffed, so a different perspective.

              Given the cost and commitment, it may be wise to consult with an attorney. What happens if you aren't happy and want to leave? What happens if you are no longer able to manage your finances? What happens if your money runs out.
              Hi Pennstater,

              Thanks for your thoughts.... I never even considered the assisted living staff available vs the assisted living population, or staff turnover rate. Since I have questions regarding transition from IL to AL, it would be an ideal time to ask. Thank you. There appear to be different levels of assisted living care available, and they must be reflected in different costs. The place I am currently looking into has 5, I think Level 1 being minimal... not sure what that means, but level 5...!? This should be addressed before any commitment.

              Originally posted by pennstater View Post
              Given the cost and commitment, it may be wise to consult with an attorney.
              I reluctantly agree regarding legal consult.

              Originally posted by pennstater View Post
              What happens if you are no longer able to manage your finances?
              This needs to be addressed, appreciate you bringing it up. A month ago I lost my trusted Executrix / Financial / Tax consultant and friend of over 33 years. She was 12 years my junior and her demise came out of the blue. I am in the process of asking another friend if he would be willing.

              Will keep you posted as I learn more. I am in no rush but declining abilities may force the issue.

              Jer





              Comment


                #8
                Originally posted by Mamabug View Post
                My husband's parents are in an independent living home on the campus of a nursing home that offers assisted living and health care. They had a choice between
                1. the purchase, at full price, of their home, which they could then sell back upon leaving (ie: to more care, or upon their deaths), or
                2. purchase at 1/2 price and then relinquish property in the future.
                They chose #2.
                Hi Faith,

                This arrangement is similar to one place I looked at. Apartment A is available at three different prices. Same apartment but the price difference reflects the money back upon leaving (or death) with the lowest price translating to zero refund. The highest price means 90% refund regardless of when you leave or pass (estate would collect). Middle price % refund is linked to years living at facility, refund dropping as time goes by.

                Originally posted by Mamabug View Post
                I believe they also pay a monthly fee -- covers lawn care, etc. They have access to lots of social events, exercise, rental of facilities, etc (maybe not during COVID, I don't know). I don't think they have access to meals until they have upgraded care to living in the facility.
                Meal plans are varied from place to place, sounds about right.

                Originally posted by Mamabug
                My MIL has had Parkinson's for over 20 years.
                I'll add them to my prayers this evening Faith. Parkinson's may be a heavier burden....

                Jer



                Comment


                  #9
                  If money is no object There are probably some very nice ones.

                  The way I look at it, for what it would cost me to live in one of those places, I could create myself a pretty good care plan. Essentially, that is what I have done. I chose a place I wanted to live, an apartment that I love and I independent helpers. I can afford to pay them more than they would get in a facility and less that I would pay if I hired an agency. If they are happy they take better care of you. Agencies claim to be safer but if the caregiver steals from you they won’t help out.

                  i get individualized care and companionship at the same time. There may come a day when I can no longer manage staff but maybe my family can help then.

                  Comment


                    #10
                    Originally posted by palmtree View Post
                    Essentially, that is what I have done. I chose a place I wanted to live, an apartment that I love and I independent helpers. I can afford to pay them more than they would get in a facility and less that I would pay if I hired an agency. If they are happy they take better care of you.
                    i get individualized care and companionship at the same time. There may come a day when I can no longer manage staff but maybe my family can help then.
                    Hi Palmtree,

                    Thanks for your perspective, it has been similar to mine. I have adjusted and over the last few years yard work, some shopping and housekeeping are handled by outside people. And, like you I can handle their management well enough. And I do enjoy their company.

                    I still have the house / property and you have an apartment that you love. I see clearly the pressing need swap the house that I still love but cannot handle for an easier life.

                    Finding an apartment (either rent or purchase) may simply be adding an extra step... as I see a CCRC or some such thing, in my future regardless.

                    I'm not going to stress over it. It will work out as it will work out.

                    Looking for potential stumbling blocks (the reason for my thread) can't hurt.

                    Comment


                      #11
                      An elder care attorney may be able to prevent them from making you sell your home. They would also be able to set up a trust that will prevent you from losing money by allowing them to take your entire check. It is worth looking into.
                      All sunsets are beautiful, but the most amazing sunsets have a few clouds.

                      Comment


                        #12
                        I like all that I have seen posted. A living trust is something to ask a legal consultant about to help with finances and protecting your assets.

                        I also would like to suggest that you find a community that has a skilled nursing section. Say you need your hip replaced. These days you are only there overnight and that is it. Either you have the capability to go home or you go to rehab facility or skilled nursing. Eac of them have different requirements. Rehab tends to be more intense and hard to qualify for. But, if the place you choose has skilled nursing section. You get first dibs on them beds. Or, they could possibly do it at your apartment with their PT. Depending how the community has it set up. One particular one I know used an unused portion of a farm (not able to raise crops and not really grazable except to goats) to start this kind of community. It is still in the developing stage. I, too, am looking for your basics. Pool is my main goal. Said pool needs to have a deep section for me. That is hard for me to find in my area.

                        Keep us informed of your findings. Right now, I am looking more for a snowbirder (winter in the south summer in the north) kind of thing. But would loved to find one that would possibly be this kind of community.
                        God Bless and have a good day, Mary

                        Comment


                          #13
                          Originally posted by sulphur kennel View Post
                          An elder care attorney may be able to prevent them from making you sell your home. They would also be able to set up a trust that will prevent you from losing money by allowing them to take your entire check. It is worth looking into.
                          Hi Sulpher Kennel & kelm10,

                          Thanks for echoing pennstater and her suggestion regarding legal counsel. Since a new will and executor appointment are in the near future, as I mentioned above, I will ask my attorney his thoughts or recommendations regarding an elder care attorney.

                          I spoke of swapping my home which is becoming harder to take care of. This would allow purchase at any level into a CCRC apartment. After that, the monthly (maintenance) upkeep would be my responsibility as all general maintenance and staples are mine currently. The potential transition to AL from IL remains, along with pennstater's nurse / turnover / etc reminders... and with kelm10's comments....

                          I asked the questions regarding Rehab of two facilities on my list! So, kelm10's confirmation that "first dib's" would go to an on campus resident before an outsider was right on, as were her other nursing / PT suggestions.... Cost are another matter entirely. I have no idea what the future holds and expect a CCRC to be limited to general financial comments only.

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