Ccrc--good bad and ?

[athena53]

My Dad's assisted living they do administer the prescription medicines to the residents, and all aides have the training to administer injections as well.

My understanding is that if there was a fall, they would call the paramedics to check the resident out, and only send the person to the hospital (just down the highway) if the paramedics advised it.

They also have a philosophy of aging in place, and will help with hiring sitters if needed (family pays, not included) so that someone doesn't need to move if they need extra care. They consider it perfectly normal for someone to live there until they die.

That's the kind of support I'd want. A fall CAN be serious but frequently it's not. Heck, I'm only 64 and one night last month after donating whole blood + plasma and getting out of bed a little too quickly to go to the bathroom, I suddenly found myself on the floor. Not even a bruise the next morning. (My BP is at the low end of normal, which is good 99% of the time but the fluid loss probably reduced it.) I'd hate to be someplace where they over-reacted. DH fell regularly in his last months; one, a week before he died, left him pretty much unable to stand on his own, but at that point he was getting hospice care. The others had no lasting effects and taking him to the hospital, with his severely compromised immune system, would have done more harm than good.

 

[AllDone]

My Father bought into a ccrc in Florida about 15 years ago, He is 99 now and still lives in a two bedroom cottage on the property. Paid about 250K up front and he and my Mother paid about 5k monthly. Now Dad is alone and I think he pays about 3.5k/mth. Lovely place in the midst of a Spanish Oak forest, parents were very happy there until they replaced the chef (who opened a restaurant in town and now he will only eat breakfast in the grill room. For the money I will just live here on the Pacific Ocean with a household staff and bring in skilled nurses if I need them at about $60 for a 12 hour shift.

The problem is organizing your own care. It may seem easy enough now, but it can be overwhelming when you are elderly. I had a patient who was in very good shape, playing golf 4-5 times per week, and was mentally fine, but organizing care and seeing to his wife's medication for Alzheimers was just too much. They moved into Emeritus and he was able to relax. He was really stressed before the move and so much happier after the move.

I've talked to a lot of people, not just my own patients, and they are pretty enthusiastic about living in the higher-end places. We bought our current house from a healthy appearing couple in their mid-80s who were moving and they are quite happy in the big CCRC here in north county. I would probably wait until 80ish as my parents are doing reasonably well at 80+ unless I were to lose my husband which would make me want to move sooner. We are counting on our fancy house as our reserve to pay for the CCRC.

 

[samclem]

As I understand LTC insurance, to qualify you will need assistance to carry out a minimum number of "activities of daily living". Nords documents well the battle he had with the insurer over his father's situation. Nords prevailed, but it was a battle.

I'd guess that once a person goes to a facility, the
folks there would go to great lengths to assist with any recurring documentation needed by the LTCI company. They know that's where the money is coming from.

 

[NYEXPAT]

The problem is organizing your own care. It may seem easy enough now, but it can be overwhelming when you are elderly. I had a patient who was in very good shape, playing golf 4-5 times per week, and was mentally fine, but organizing care and seeing to his wife's medication for Alzheimers was just too much. They moved into Emeritus and he was able to relax. He was really stressed before the move and so much happier after the move.

No problems there! My Wife is almost 30 years younger, works as an administrator in the best private clinic in Peru and my twin SIL's are both nurses in the same facility. In addition we are thinking of setting up an agency here to do the same for the retired ex-pat community.

 

[ocean view]

My mom lives in a CCRC in Sacramento. She's lived there for 25 years, still in independent living (1200 sq ft, 2br/2ba apt) at 84. We expect her to be there for another 10-15 years. It's like living on a cruise ship. Her CCCRC sounds different than those others have described - my folks had a significant upfront payment (not sure of the amount), but it gave them an equity interest that we can sell when she dies. She told me recently that all residents must also pass a financial means test when they apply. As a result, no one will be kicked out if they run out of money before they die, they'll be given scholarship, if you will. They may ask you to move to a smaller unit, but that's a small sacrifice if you ask me.

 

[Huston55]

CCRC Reference Material/FAQs

Thanks much to NWSteve for starting this CCRC thread. I think this topic very important and, personally, it's timely. Although it's many years in the future for DW & me, a CCRC (likely a "Life Care" contract) is our current plan for later in life.

I think it's important to lay some basic groundwork so we have a common reference point when discussing CCRCs, and the many options & variables available within the CCRC universe, including: levels of care, for-profit or not-for-profit, contract types, financial qualifications, certifications, etc. And, that doesn't even get us into discussions of "quality" of care, which is also extremely important.

I've decided to structure this post like a FAQ because, that seems most useful for readers and, honestly that's how my little brain works. Note that since I live in California, several of the links & references are for California; however, most of the information is applicable to any state and, the methodology/terminology seems to be largely universal.

I think subsequent posts with additions/edits to this CCRC FAQ would be most useful if done in the same format & continuing the numbering system.

1. So, what's a CCRC?

Here's what I I think is a useful definition for a Continuing Care Retirement Community (CCRC); it's from the California Advocate for Nursing Home Reform (CANHR).

"Continuing Care Retirement Communities (CCRCs) offer housing, meals, transportation, activities, and provide a continuum of care including assisted living and nursing home care, usually in one location, and usually for the individual’s lifetime. Increasingly, CCRCs have health clinics, wellness programs, and specialized dementia care services."

Note my emphasis on "continuum of care" and "usually in one location", which I think is the distinguishing feature of CCRCs when compared to other senior living/care facilities. In other words, a CCRC can provide Independent Living (IL), Assisted Living (AL), Skilled Nursing Care (SNC), and Memory Care (MC) all in one location or on one campus.

The CANHR document is independent of the CCRC industry and is full of great info; the link to the CANHR site is below, from there you select the PDF document entitled: "Continuing Care Retirement Communities: Is One Right for You? (2009)".

Continuing Care Retirement Communities (CCRC) – CANHR

2. Why should I select a CCRC versus other options like: aging in place at home, Living with Relatives, Assisted Living, Nursing Home, Hospice, etc.?

The answers to this question are as individual as each of us but, here are some of my reasons for planning to select a CCRC:
- Continuum of care provided in a single location; and, in a single community
- Ability to transfer late life/end of like health care risk to the CCRC (only with a "Life Care" contract; also call "Type A" contract)
- Control; ability to "move" to a CCRC community instead of "being transported" to assisted living or nursing care.
- Ability to make friends and establish a personal network while still relatively independent

Here's a good Kiplinger article profiling an older couple who moved to a CCRC, and outlining many of the factors to consider.

Retire in Style at a CCRC Continuing Care Retirement Community

3. What levels of care do CCRCs provide?

Typically, they provide: Independent Living, Assisted Living and, Skilled Nursing Care, in ascending order of care. "Memory Care" is also a specialty feature available in many CCRCs. All levels of care are normally provide at one location or on one campus.

4. What kinds of contracts are there to enter a CCRC?

There are three basic kinds of contracts, with variables available for many of their features, which can result in dozens of variations. These three basic contract types are described below(note that only "Life Care" or "Type A" contracts completely transfer risk to the provider).

A. Life Care Contract (Also referred to as “Extensive” or “Type A” Contracts): Establishes a standard monthly fee rate for all levels of care with only annual monthly rate increases allowed and guarantees care for life, even if the resident’s funds become inadequate to cover the full costs of future services and care. Care services include primary and acute care, and higher levels of care (i.e., assisted living and nursing home care) that must be provided on site or adjacent to the facility. This is usually the most expensive option, with high entrance fees, and in some instances requires the transfer of most of one’s assets to the facility and high monthly rates. Entrance fees are usually not refundable beyond the 90-day trail period. It offers the most security as it transfers future risks to the CCRC provider for agreed upon fees

B. Modified Contracts (Also referred to as “Type B” Contracts): This option involves entrance fees and monthly fees with a guarantee of access to higher levels of care usually at a reduced rate or for a set period of time before market rate fees come into play. There might be options for full, partial or proportional refunds of entrance fees. The modified contract is usually less costly than the Life Care Contract from an entrance fee and monthly fee standpoint, but the resident shares the risk of future care costs with the provider.

C. Fee-for-Service Contract (Also referred to as “Type C” Contracts): This option involves entrance fees and monthly fees with a guarantee of access to higher levels of care. There might be options for full, partial or proportional refunds of entrance fees, and some discounts on monthly fees compared to non-CCRC contract residents. Residents pay for higher levels of care at the prevailing market rate. The resident assumes the risk of future level of care costs directly.

Here's another good reference on the types of CCRC contracts:

Three Types of Contracts CCRCs Offer Prospective Residents

5. What's the difference between "for profit" and "not for profit" CCRCs?

In California, the vast majority (>80%) of CCRCs are "not for profit", which is supposed to mean that they prioritize residents' needs over profits. I cannot say whether that's true or not. There also seems to be some blurring of the border because some "not for profit" CCRCs are managed by private entities. So, it seems that what's probably more important is quality of care and fiscal soundness.

6. How do I evaluate CCRCs & select one?

Here are some of the key factors to evaluate & suggestions on how to evaluate them.

A. Quality of Care: check state inspection reports & other industry overview websites which are public and available online. Examples below:
- California Dept of Social Services: https://secure.dss.ca.gov/CareFacilitySearch/Search/
- Lucille's List ( Inspection Reports | Lucille's List ).
- Kiplinger: a good overview of some key topics to consider.
Risks and Rewards of Moving to a CCRC

B. Financial Soundness of the CCRC: ask for copies of audited financial reports. You can also find the CCRC's (or parent organization's) IRS Form 990 on-line, which contains basic financial info (assets, liabilities, cash flow, top executive salaries, etc.). Other key metrics are: occupancy >90% and, having fees which cover ongoing operating expenses (not having to dip into "entry fees" to pay ongoing operating expenses).

C. Cost: here's a great website with average state-by-state and city-by-city costs for various levels of care
https://www.genworth.com/about-us/industry-expertise/cost-of-care.html#

D. Rules-Pay careful attention to these items:
- Level of Care transfer rules
- Self Determination rights
- Atmosphere of respect & dignity
- The experience & transparency of management

7. How do I know if I will qualify for entry into a CCRC?

- Financial: You first have to decide what type of contract (A, B or C) you want. But, a common rule of thumb used by the CCRCs to evaluate potential residents is that monthly income must be at least (Monthly CCRC Fee X 1.6) and assets of 2X the Entry Fee. This is just a rough rule of thumb.

-Physical: Typical is an assessment from your doctor that you can perform all the Activities of Daily Living (ADLs), like eating, dressing, using the toilet, etc. Plus, some locations require a mental acuity test.

8. What is the optimum (or most common) age to enter a CCRC?

Personally, I think this is a very individual decision. However, on the "young" end, most CCRCs seem to have a minimum age of 60 or 65 to be eligible. On the "old" end, it's beneficial (sometimes required) to enter the CCRC in "Independent Living." So, that's likely 70s or 80s for many/most; the average national CCRC entry age is 80.

 

[bmcgonig]

I don't know how they do the math on figuring out the differences in entry fees. For example one place I was looking at charges X to get in with no return of X after 5 years (pro-rated monthly up to then) and then charges 2X if you want 90% returned after you leave/die.

X varies widely depending on type of apartment/bungalow selected.

How would you evaluate those choices? Lots of variables there.

 

[Huston55]

So the cost could be interpreted as 5100 x 12 = $61,200 plus 455k * .04 = $18,200 for a total minimum expense of $79,400 per year and they get to keep your $455k when you die. I think the assisted care facility I would look into first is not more than that and I would enter at a later time which would suit me. I also would not have to fork over the $455k which would suit my heirs. I am not saying one is better than the other. It would be a personal decision depending on what you want.

Agree that it's a personal decision based on one's/couple's own situation. But, the calc above is not apple-to-apples. Your calc of equivalent annual costs ($79,400/yr) is for Assisted Living, whereas the situation you compared to is guaranteed "all levels of care" at that price. For an apples-to-apples comparison, you'd have to do some actuarial guessing for your situation (how long you/couple will live, what kinds of care you'll need & how long you'll need it), then add those costs to the comparison calc.

 

[Huston55]

Agree that it's a personal decision based on one's/couple's own situation. But, the calc above is not apple-to-apples. Your calc of equivalent annual costs ($79,400/yr) is for Assisted Living, whereas the situation you compared to is guaranteed "all levels of care" at that price. For an apples-to-apples comparison, you'd have to do some actuarial guessing for your situation (how long you/couple will live, what kinds of care you'll need & how long you'll need it), then add those costs to the comparison calc.

Here's a link to two articles referencing data showing the chances of needing long term care and, on average, for how long.

In summary:
- Those 65 or older have a 50-70% chance of needing long term care
- The average length of care is 4-5 yrs

http://www.mylifesite.net/blog/post/what-are-the-odds-of-needing-assisted-living

While these are averages (actuarial & cost), it's a good starting point for one/a couple to begin their own evaluation. It's also data that could be used to make the calculations necessary for the comparison in the referenced post above to be apples-to-apples.

 

[Just_Steve]

Link to CCRC's by region.
Directory of CCRCs Continuing Care Retirement Communities

 

[nwsteve]

I don't know how they do the math on figuring out the differences in entry fees. For example one place I was looking at charges X to get in with no return of X after 5 years (pro-rated monthly up to then) and then charges 2X if you want 90% returned after you leave/die.

X varies widely depending on type of apartment/bungalow selected.

How would you evaluate those choices? Lots of variables there.

One of the things I have noticed in looking at several properties is that new properties tend to offer higher percentage returnable and few lower cost options. They obviously need the higher upfront deposits to help establish occupancy, give positive cash flow early, and build an endowment foundation for the future. The five year amortized options is attractive to majority of folks since the buy-in is significantly lower without any penalty in loss of services. The facilities, of course, get the benefit of a significant positive cash with little no risk of paying much of the funds back.
The Kiplinger article referenced in earlier post offered an excellent metaphor that living in a CCRC was like living on a cruise boat. All the services plus the benefit of really getting to know all the folks on your "cruise".
For me the real benefits is locking in the majority of your healthcare costs while still enjoying an enhanced living environment.

 

[Hermit]

Here's a link to two articles referencing data showing the chances of needing long term care and, on average, for how long.

In summary:
- Those 65 or older have a 50-70% chance of needing long term care
- The average length of care is 4-5 yrs

What are the Odds of Needing Assisted Living?

While these are averages (actuarial & cost), it's a good starting point for one/a couple to begin their own evaluation. It's also data that could be used to make the calculations necessary for the comparison in the referenced post above to be apples-to-apples.

If you take these numbers at face value, LTC insurance is a bargain!

 

[nwsteve]

If you take these numbers at face value, LTC insurance is a bargain!

Assuming, of course, your provider is still in business and willing to pay in a timely manner. Note Nord's journey to get an A rated provider to cough up the benefits.

 

[audreyh1]

Here's a link to two articles referencing data showing the chances of needing long term care and, on average, for how long.

In summary:
- Those 65 or older have a 50-70% chance of needing long term care
- The average length of care is 4-5 yrs

What are the Odds of Needing Assisted Living?

While these are averages (actuarial & cost), it's a good starting point for one/a couple to begin their own evaluation. It's also data that could be used to make the calculations necessary for the comparison in the referenced post above to be apples-to-apples.

Assisted living is not quite the same thing. Most people think about skilled nursing, either at home, or at a facility when they think about expenses that need to be covered by an LTC policy. Assisted living provides no (or very minimal) skilled nursing care.

So to me that statistic really muddies the waters when it lumps in any kind of elder assistance, even basic housekeeping, with much more expensive stays in nursing homes. We know that nursing home stays aren't anywhere near 4-5 years on average.

 

[Huston55]

Assisted living is not quite the same thing. Most people think about skilled nursing, either at home, or at a facility when they think about expenses that need to be covered by an LTC policy. Assisted living provides no (or very minimal) skilled nursing care.

So to me that statistic really muddies the waters when it lumps in any kind of elder assistance, even basic housekeeping, with much more expensive stays in nursing homes. We know that nursing home stays aren't anywhere near 4-5 years on average.

Correct. The article in the link says 835 days (2.3 yrs) is the average period for needing skilled nursing care. The 4-5 yrs is the total of Assisted living + Skilled Nursing Care.

 

[Huston55]

If you take these numbers at face value, LTC insurance is a bargain!

Assuming, of course, your provider is still in business and willing to pay in a timely manner. Note Nord's journey to get an A rated provider to cough up the benefits.

LTC insurance is typically not a bargain at all. In fact, as noted by an earlier poster, LTC insurance is not really "insurance" at all but, instead is "prepayment" of Long Term Care costs. That's because almost all LTC policies are for a finite period of time, not as long as you live. So, it's really a NPV analysis to see if it's worth the premium...and the hassle with the insurance company.

Darrow Kirkpatrick ("Can I Retire Yet?") has a great blog post on this.

Long-Term Care Insurance: Why We Aren't Buying It - Can I Retire Yet?

 

[samclem]

When considering LTCi or a CCRC, I didn't find the "average" or "median" stay length to be a very useful statistic. After all, I wouldn't plan my withdrawal rate for a 50% probability of failure. It looks like about 10% of those who check in to a nursing home are still alive 5 years later. The numbers are from this study from the UK, but their average stay length matched the US fairly close, so I'm guessing the "longest lived 10% number is also fairly close.
Now, if we add that about 30% of people over 65 won't go into a nursing home at all before they die, then we have something like 8% of the population of people over 65 will be in a nursing home for more than 5 years.

FWIW.

 

[Fedup]

I checked and my plan is pretty inexpensive. 90 days waiting period. So far, I've paid less than $1000 per year, this year might be slightly more. Total benefit is $350k for 3 years. Assume I pay another 20 years or 25 years at about $1500-3500 a year, comes out to $80k total, rough estimate. I should come out ahead. I did sign up when I was much younger.

 

[samclem]

I checked and my plan is pretty inexpensive. 90 days waiting period. So far, I've paid less than $1000 per year, this year might be slightly more. Total benefit is $350k for 3 years. Assume I pay another 20 years or 25 years at about $1500-3500 a year, comes out to $80k total, rough estimate. I should come out ahead. I did sign up when I was much younger.

You've got enough benefits to cover about 3.8 years at $250/day, right? If you don't also have automatic inflation increases, then the benefits could buy significantly less in 20-25 years--maybe about 1/2 that amount. It's nothing to sneeze at, but it may not be enough to cover the whole tab, either.

 

[Huston55]

So the cost could be interpreted as 5100 x 12 = $61,200 plus 455k * .04 = $18,200 for a total minimum expense of $79,400 per year and they get to keep your $455k when you die. I think the assisted care facility I would look into first is not more than that and I would enter at a later time which would suit me. I also would not have to fork over the $455k which would suit my heirs. I am not saying one is better than the other. It would be a personal decision depending on what you want.

Agree that it's a personal decision based on one's/couple's own situation. But, the calc above is not apple-to-apples. Your calc of equivalent annual costs ($79,400/yr) is for Assisted Living, whereas the situation you compared to is guaranteed "all levels of care" at that price. For an apples-to-apples comparison, you'd have to do some actuarial guessing for your situation (how long you/couple will live, what kinds of care you'll need & how long you'll need it), then add those costs to the comparison calc.

Hermit's post & my response (above) got me to thinking about how to evaluate the cost of various options that each of us might be considering. So, I performed a rough NPV analysis for two potential scenarios for DW & me. My result is below.

Basis: I am 2 yrs older than DW and we have no children or other family who will care for us in old age. I assumed we will be "average" consumers of LTC in that we will begin to need it when I reach age 79 (near the average entry age of 80) and will use Assisted Living first, then Skilled Nursing Care for the average total duration of 5 yrs. I assumed 5% annual health care cost inflation & used a 3% discount rate to convert future values to present values. Your chosen factors will almost certainly vary but, this will at least provide you with a reference point.

Description: I compared two scenarios that are likely alternative choices for DW & me. Scenario #1 where we proactively enter a Life Care contract at a CCRC and; Scenario #2 where we remain at home as long as we can, using home care until we have to move to Assisted Living then Skilled Nursing facilities until we both die.

Scenario #1: DW & I move to a CCRC & select a "Life Care" contract, which fixes our costs (except for annual health care inflation). We start out in Independent Living, then move to Assisted Living and subsequently Skilled Nursing as needed. The duration of this scenario is 10 yrs.

Scenario #2: We remain at home until I (older & male) need paid home help, then move into an Assisted Living facility and Subsequently Skilled Nursing as needed; paying the market rates for these services as we use them. The duration of this scenario is 10 yrs.

Results:

- The NPV of both scenarios is in the low 7 figures (SF Bay Area)
- The CCRC "Life Care" scenario is ~20% more expensive (if the "averages" hold true)
- A crude sensitivity analysis shows that if we need care for ~2yrs more than "the average", the CCRC "Life Care" approach becomes cheaper (Note "samclem's" post above illustrates that 30% of Nursing Home residents stay >3 yrs.)

Preliminary Conclusion: Because of the potential for significant down side risk (if we use more care than "average"), and because we prefer to "proactively" select our living environment, and because there are multiple soft social/emotional benefits to remaining in one's chosen community until the end of life, we will almost certainly choose the CCRC "Life Care" option, since the nominal 20% premium seems a small price to pay for certainty & stability.

I need to do some more work on this but, it's a preliminary result for our situation. I hope it's useful to you as you evaluate your options.

 

[Fedup]

You've got enough benefits to cover about 3.8 years at $250/day, right? If you don't also have automatic inflation increases, then the benefits could buy significantly less in 20-25 years--maybe about 1/2 that amount. It's nothing to sneeze at, but it may not be enough to cover the whole tab, either.

I remember it was $350 a day and only 3 years because that's what I remember signing up for. I'm at the point, I could discontinue but not sure if I want to. I'm sure it's not going to cover the whole tab because I'm not sure I might even use it. It's just I was presented with an opportunity to buy it as part of employment, so I took it. The last five years has been pretax, so it's relatively cheap. This last year, I finally had to pay with after tax money, but I get to deduct as part of medical expense.
But I do budget a 6-figure income when my husband turns 78 or I turn 70, so that should help shoulder some cost.

 

[youbet]

So, I performed a rough NPV analysis for two potential scenarios for DW & me. My result is below.


Scenario #1: DW & I move to a CCRC & select a "Life Care" contract, which fixes our costs (except for annual health care inflation). We start out in Independent Living, then move to Assisted Living and subsequently Skilled Nursing as needed. The duration of this scenario is 10 yrs.

Scenario #2: We remain at home until I (older & male) need paid home help, then move into an Assisted Living facility and Subsequently Skilled Nursing as needed; paying the market rates for these services as we use them. The duration of this scenario is 10 yrs.

Results:


I need to do some more work on this but, it's a preliminary result for our situation. I hope it's useful to you as you evaluate your options.

Nice work and interesting thoughts. But, it is necessary to realize there's quite a bit of "apples to oranges" in comparing scenario #1 to scenario #2. For example, in scenario #2 did you include the cost of maintaining full independent living for DW (apartment, car, traveling expenses to visit you, etc.) during the time you preceeded her into full NH care? Having each spouse at different stages of care (one fully independent playing golf daily while the other is in full nursing care or similar) is covered with a CCRC Type A contract. In the DIY scenario, you have to find, manage and pay for the separate living arrangements.

While I see some significant downsides to CCRC's, one advantage is that costs are (almost) fixed even if spouses become "out of synch with one another in terms of care needs and resources to cope with the situation are at hand. For example, say DW and I are living in a CCRC 2 bed - 2 bath independent apartment and keep one car in the enclosed parking facility. I have a serious stroke and am moved to full nursing for five months and eventually back to the apartment but need the assistance of aides several times per day. During all this, DW stays in the apartment, lives her normal life, can visit me in the full nursing area by taking a short walk and when I'm back at the apartment, doesn't have to make all the arrangements to hire aides, etc. I think those are advantages that are hard to cost out in a DIY scenario. Especially if you don't have willing and able family/friends to help you make it all happen.

 

[Huston55]

Nice work and interesting thoughts. But, it is necessary to realize there's quite a bit of "apples to oranges" in comparing scenario #1 to scenario #2. For example, in scenario #2 did you include the cost of maintaining full independent living for DW (apartment, car, traveling expenses to visit you, etc.) during the time you preceeded her into full NH care? Having each spouse at different stages of care (one fully independent playing golf daily while the other is in full nursing care) is covered with a CCRC Type A contract. In the DIY scenario, if have to come up with and pay for the separate living arrangements.

Excellent point and, yes I did include "essential" monthly expenses for DW while I preceded her on the care curve in Scenario #2. I suppose I could have used more than "essential" expenses but, I don't want her having too much fun without me.

If I did include both essential & discretionary expenses for DW during that period, it would make Scenario #2 even less attractive; at least from a cost standpoint. I guess I'd have to ask DW how much partying she'd plan to do.

 

[Scuba]

One thing to consider is annual rate increases. Many CCRC's increase monthly rates 3-5% every year. For residents who move in fairly young, say 75-80, and live a long time, the compounding of the annual increases can become a serious issue. If I were analyzing this, I would assume at least 4% cost increases each year, 6% if you want to be really conservative.

Another consideration for me is the lifestyle impact. CCRC's, at least those I'm familiar with, are nowhere near as diverse as the broader community and by definition, you're surrounded by elderly people. For some, that is appealing. Others prefer more diversity and more interaction with younger folks.

The penetration rate for CCRC's is only about 5% nationally. This is partly due to the pricing as the majority of people can't afford CCRC's. It's also due to people waiting to move in feeling they aren't ready yet, and then having serious health issues pop up and no longer being able to qualify.

As others have said, it's a very personal decision. I can understand the appeal but am not sure it's for me. Luckily since we're in our 50's, DH and I have time to decide.

 

[youbet]

The penetration rate for CCRC's is only about 5% nationally. This is partly due to the pricing as the majority of people can't afford CCRC's. It's also due to people waiting to move in feeling they aren't ready yet, and then having serious health issues pop up and no longer being able to qualify.

Yeah, finding that "sweet spot" age to move to a CCRC is going to be tough if that's what we decide to do. We're taken a number of tours and definitely feel too young and active (70ish) to move into one now. Yet, we know people whose lives changed rapidly health-wise and who struggled to find appropriate accommodations after the set-backs occurred. There seems to be a window you need to hit......

As others have said, it's a very personal decision. I can understand the appeal but am not sure it's for me. Luckily since we're in our 50's, DH and I have time to decide.

It's really a hard decision. But we would like to find some answer that provides for self-determination of our future if negative life changes occur rapidly. We didn't "get it" in our 50's either. But as the years go by, you begin to understand the vulnerability of aging and develop a desire to set yourselves up for comfortable/dignified living if things start to go against you.