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11 keys to choosing the right retirement community
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11 keys to choosing the right retirement community

Continuing care communities with apartments, dining facilities and a wide range of services have become popular because they offer independence. Here’s what you need to know and the questions you have to ask.

Article Index By Liz Pulliam Weston

Most seniors say they would prefer to remain in their own homes as long as possible. But many aren't sure how they'll manage if debilitating illness strikes.

Retirement communities where the available options range from independent living to 24-hour nursing care are the answer for an increasing number of seniors. Choosing the right community, however, can be daunting.

Lyle Larsen saw firsthand what can go wrong when seniors fail to plan for poor health. When Larsen's elderly parents needed care, they had to leave their home in Portland, Ore., to move in with him in coastal Coos Bay. After his father died, his mother moved back to Portland -- only to move again to a nursing home when she could no longer care for herself.

All the moving was stressful and isolating, Larsen said. That's why Larsen, 84, opted six years ago for a retirement community that promises to care for him if he falls ill.

"I saw it was really important to be in a place where you didn't need to leave and go somewhere else to get care," said Larsen, who lives in Portland's Holladay Park Plaza. "I want to be in a place where my friends can visit me, and I can have all the care I want."

As much help as you need

So-called "continuing care retirement communities" aim to provide just that: a wide range of residential and medical services that can change according to the senior's needs. Most communities include:

  • Independent living quarters -- usually apartments, although sometimes single family homes -- for seniors who need little if any help with their daily activities.

  • Assisted living facilities for people who require aid to bathe, dress or perform other basic tasks.

  • Nursing facilities for those who need full-time skilled nursing care.

These communities are growing in popularity with aging Americans who want to ensure their future care -- typically while living in a place that more closely resembles a college campus or resort than an old folks' home.

The high-rise with a pool

Holladay Park Plaza, for example, is a high-rise in downtown Portland that features a gym, a spa, an indoor pool and an outdoor walking track to keep residents fit, along with a library, art studio and woodworking shop for pursuing hobbies. That's in addition to onsite services like a beauty parlor, a barber shop and a travel agency, plus shops and restaurants across the street at Portland's Lloyd Center mall. (For more information, you can take a virtual tour. Click on the link above or at the left under Related Sites.)

Most retirement communities offer similar amenities, although the facilities, settings and culture can vary enormously.

Some communities cultivate an elegant, formal atmosphere, while others strive for casual friendliness. Some encourage communal living with family-style meals and required activities; others offer single-family homes and an emphasis on privacy. A few are restricted to members of certain professions, faiths or organizations.

In fact, many retirement communities started as affiliates of religious or fraternal organizations to provide care for their members as they aged. But a growing number of for-profit corporations are starting retirement communities, typically aiming for the well-heeled elderly.

The 3 key things you must remember

If you think a retirement community might be a good option for you, here's what you need to know:

  • Retirement communities aren't cheap. Most have hefty entry fees that typically range from $20,000 to $200,000 or more, depending on the size and location of the apartment or home you choose. Ongoing monthly fees are usually about $2,000, although the toll can rise if the facility charges extra for medical care.

  • The community will want to make sure you can afford its ongoing costs, as well. Holladay Park Plaza likes to see applicants with assets equal to at least three times the entrance fee, which ranges from $44,000 to $200,000, and incomes at least twice the monthly fees, which range from $1,100 to $3,300, said spokeswoman Vassar Byrd.

  • Included services vary widely. Some facilities provide unlimited medical and nursing home care for the same monthly fees. Others include a certain amount or level of care, but you'll pay more if you exceed the limits. Still others are "fee-for-service," with the charges depending on the care you need. Cornwall Manor in Cornwall, Pa., for example, charges $1,200 to $1,800 a month for its independent living apartments, depending on their size and location. Residents who need assisted living are charged an additional $88 to $155 a day, while nursing care runs $173 to $193 a day, said Jennifer Margut, the manor's marketing director. Cornwall Manor is located east of Harrisburg.

  • You should apply while you're still healthy. Many retirement communities require potential members to pass rigorous physical and mental checks, and reject applicants with cancer, strokes or dementia. Even facilities that accept people who aren't healthy, such as Cornwall Manor and Holladay Park Plaza, do so only on a space-available basis, with priority going to their own current residents. People who wait until their first health crisis to apply to a retirement community might not get in.

The last can be a deal-killer. Many people are reluctant to leave their homes when they're still perfectly capable of living independently. As one retirement community executive put it: "It's a major lifestyle change at a point in your life when change is not easy."

Of course, not every senior sees it that way. Gerry Larsen, 84, says she had few qualms about selling her West Hills-area home in Portland after her husband had a stroke 15 years ago. She was happy to let Holladay Park Plaza do the housekeeping, linen service, grounds-keeping and maintenance after years of handling those tasks herself.

"I could spend time with my husband," Larsen said, "because I didn't have all these extra duties."

The community also provided companionship after Larsen's husband died seven years ago. In fact, it's where she met Lyle Larsen -- the gentleman at the beginning of this column. They married two years ago.

Do your homework before committing

You'll probably be happiest with your retirement community if you do plenty of research first to ensure you've made the right choice.

Once you've got that background, you can:

  • Pay in-person visits to the facilities you're considering. Many retirement communities encourage potential residents to stay overnight and have meals in the dining facility.

  • Talk to residents. Take the tour that's offered, but also try to stroll around on your own and talk to as many people as you can. A few spontaneous conversations can give you a far better feel for a place than a canned tour.

  • Check out the assisted living and nursing facilities. You'll want to make sure these areas are pleasant, clean and not isolated from the rest of the community.

  • Review the contract. When you join a retirement community, you sign a long-term agreement that spells out what you're paying for, from the size and location of your apartment to how many meals are included in your monthly fee. Items like maid service, laundry and transportation may be part of the package, or you may have to buy them a la carte. Ask for the fee schedule for services that are provided but not covered by your monthly payment.

Finally, before making a decision, here are some of the questions you need to ask:

  • Is the facility accredited? The Continuing Care Accreditation Commission is the only accrediting agency for continuing care retirement communities. A list is available on the CCAC's Web site.
    • How is medical care provided? Not all facilities have assisted living or nursing home care on site. Some have both, plus on-site or on-call doctors and nurses. Some are affiliated with nearby hospitals, while others are independent.

    • Is the entry fee refundable? Some communities will give you back up to 90% of your entrance fee if things don't work out, and you want to leave. Others say "tough luck."

    • What happens if I run out of money? Many nonprofit retirement communities pride themselves on taking care of residents who can no longer pay for their care. (They reduce the risk of that happening, of course, by requiring those financial checks discussed above.) Other facilities might throw you out on your ear, or transfer you to a much less desirable nursing home. Know the risks before you commit.

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