Seniors planning for their housing needs have traditionally had a fairly limited set of choices. They could age in place, remaining at home, which is the preferred route of the vast majority of aging adults. They could move in with family or with friends. Or they could choose to live in a retirement community, surrounded by residents their own age. Many of these are what have traditionally been called CCRCs, or continuing care retirement communities, where seniors can start out living with complete independence and then transition into assisted living and nursing care when they need it.
An In-Home CCRC Helps You Stay Independent and Avoid Becoming a Burden
Now there seems to be another “hybrid” choice, featured in this recent New York Times article by reporter Paula Span. Span calls this “another option in long-term care offered by a few pioneering continuing care retirement communities: a CCRC without walls.” The article leads off with the story of a New Jersey woman named Ann Basso who had experienced the “craziness” when caring at home for her disabled husband and her ailing parents, all three of whom were receiving in-home hospice care simultaneously. After her loved ones had passed away and Basso had moved to a smaller, less expensive town in Delaware, she wanted to find the kind of independent lifestyle that would keep her from becoming a burden to her adult children, but her resources and income were limited. It was there in that Delaware town that she learned of this new hybrid choice.
“Typically, a CCRC operates a complex or campus where residents shift from independent living to assisted living, a memory-care unit or a nursing home if their health and mobility decline,” says Span in the New York Times. “But in continuing care at-home programs, members essentially spend the independent living years in their own houses.” Ann Basso lives in her own home and is visited by a “care navigator” who checks in regularly to monitor her needs, under a program called Springpoint Choice. “With luck, Ms. Basso, now 76, may remain in her home for years — or for good,” the article explains. “If she eventually requires help with bathing, dressing or other so-called activities of daily living, the program will provide home aides.” Then, if at some point she can no longer live on her own, she has the option of moving onto the campus of the affiliated CCRC just a few blocks away. The costs are covered by a one-time entrance fee and monthly fees, and she also has her own long-term care policy. Medicare and a supplemental policy pay for Basso’s medical needs.
The In-Home CCRC is Still a Rarity in the U.S.
According to the Times article, the in-home/CCRC hybrid concept has been around for 25 years, but there are still very few across the country. In the U.S. there are almost 2000 CCRC’s (which are gradually being re-labeled as “life plan communities”), most of which are nonprofit, serving about 745,000 residents. Still, fewer than three dozen CCRC’s have added at-home programs, in only 12 states. “But,” says Span, “more senior living organizations are considering this approach, a possible answer to a perpetual conflict: Older Americans are very likely to need long-term care, but often loathe the thought of leaving their homes.”
In the words of one Florida manager of an in-home program connected to a CCRC, these hybrid living arrangements have “a strong future.” But getting accepted as a member is fairly stringent, he says, with potential residents required to provide extensive medical records and financial documents to prove they are physically and fiscally healthy. Program administrators operate under the presumption that residents won’t need assisted living or nursing care for at least five years, says the New York Times, although that seems to be a guideline and not a requirement. Generally, those with progressive neurological diseases, like dementia or Parkinson’s disease, are disqualified.
The In-Home CCRC Attracts Younger, Healthier Residents
One program administrator explained that these programs work financially in part because residents tend to move in at a much younger average age – in their 70s, instead of waiting to move to a community in their 80s. “They’re paying into the program for a longer period than if they had moved into a facility, allowing the programs to invest for members’ later years, when they’re more apt to need care,” says the article. “Some [of these programs] have high buy-in fees, refundable to varying degrees after a resident’s death; others function more like rentals. Depending on luxury and geography, they tend to serve seniors who are financially comfortable.” But the New York Times article notes that fees for an in-home program are far less than for a traditional CCRC: programs cited in the article charge between $30,000 and $60,000 entry fees and roughly $300 to $500 per month. That may seem like a lot at first, and fees may gradually go up, but if that amount buys you the skilled nursing care you may one day need at no extra cost to you, it’s a bargain.
According to the Times, “It’s unclear whether at-home options will gain popularity. Some state regulations won’t allow them, so advocates are working to amend the laws. And these communities have to explain how it all works to prospective members.” Also, hybrid programs don’t offer services such as scheduled transportation, meals and housekeeping that residential programs can offer. Still, “at-home arrangements may be more appealing to those older adults – not a paltry number – who vow that the only way they’re leaving their home is feet-first.” As one housing expert put it, “we’re going to need lots and lots of long-term care options” to meet the needs of an aging population. “We need to be experimenting and finding new models, and this is one more.”
Housing is Important – but It’s Not the Only Aspect of Retirement Planning
Housing is an extremely important facet of retirement planning, but it’s only one element. At AgingOptions, we take a truly comprehensive view of retirement planning, and that is why Rajiv Nagaich pioneered the strategy called LifePlanning. “No matter how old you are or what your circumstances,” he emphasizes, “a solid retirement plan is the answer to dispelling fear of the unknown. A LifePlan can show you the way forward toward a better retirement than you thought possible.” Only a LifePlan from AgingOptions weaves together, not just your long-term housing strategy, but all the essential elements that matter most, including legal protection, financial planning, health preservation and family communication. With a LifePlan prepared, fear of the future can be replaced with confidence and a sense of security.
If you’re ready to find out more, we invite you to join Rajiv at an upcoming LifePlanning Seminar – a great way to begin the retirement planning journey. To see a calendar of these popular free events, visit our Live Events page and register for the location that works for you. It will be our pleasure to greet you and to share with you and your loved ones the power of an AgingOptions LifePlan. Age on!
(originally reported at www.nytimes.com)