This is part 2 of a multi-part series on CCRCs. To read the first installment, click here.
“I don’t know if I could live there. Everyone seems so old.”
I’ve heard this comment occasionally from clients after they’ve visited a Continuing Care Retirement Community (CCRC). I mentioned it to the marketing director at a CCRC I visited in 2017. She’d heard it before too. Often, she observed, visitors only see the less-mobile residents, since many residents are out shopping, traveling, or attending events off campus.
People have preconceived notions about CCRCs, but they’re essentially self-contained neighborhoods. At any given time, some residents are out walking, on vacation, swimming in the pool, meeting with their book club, taking a class, or sitting in their favorite chair, at home, watching Netflix. It’s a microcosm of life. A major difference between CCRCs and any other subdivisions is the age of the residents.
Of course, in the assisted living (AL) and skilled nursing (SN) wings, life moves at a slower pace. Staff are more involved in directing daily activities, fostering interaction among residents, and orchestrating mealtime.
What will I do there?
There is so much to do in these communities that staff create huge reference binders or newsletters full of the social, educational, and fitness options. Monthly calendars often include off-campus events, such as plays and concerts in nearby towns, as well. Here’s an example of some of the fitness classes offered by one CCRC I visited:
- Yoga
- Tai Chi
- Zumba (aerobic dance)
- Swimming and aquatic exercise
- Better balance
- Outdoor walking
- Strength training (using the gym equipment, facilitated by a fitness professional)
- One-on-One with personal trainer (by appointment, usually an extra charge)
I met a 92-year-old woman working with a personal trainer on one of the weight machines in the gym. She was in better shape than me. At the same community, a group of residents formed a walking club and met at a wildlife preserve. (It wasn’t the Serengeti. They were home for dinner.)
Residents can choose the fitness classes that appeal to them and fit into their busy schedules. They don’t have to take exercise classes or work out, but the staff encourage everyone to maintain a healthy lifestyle. The philosophy is that regular exercise keeps people healthier longer and delays the necessity of assisted living. The well-trained staff assists residents in developing an exercise program that fits their needs.
At another CCRC, my tour guide pointed out some of the residents’ art work (made in the campus art studio) proudly displayed on the corridor walls. To my left, there was a large auditorium complete with a stage and sound system. A group of residents were rehearsing a musical they planned to perform there. Recently, a university professor explained the latest advances in bioscience to a packed audience. Next week, I was told, a local art museum docent will lecture on the Impressionists. As we walked further, the guide pointed out a horticulture room, where residents with green thumbs grow plants and maintain flower beds, and a computer lab where residents take (or teach) computer classes. There was also a game room with billiard and card tables. The residents formed an events board to plan activities and gauge community interest in events and classes.
At still another CCRC, some residents were having lunch with their children and grandchildren in one of the casual dining establishments. The family’s conversation was lively as the wait staff quietly fussed over them. Another resident gave me a tour of her beautifully decorated 2-bedroom, 2-bath apartment and joked that she is so involved in the community that her own kids find it challenging to schedule time to see her. She is grateful she no longer has to maintain a large home.
Daily life is a bit different in the AL and SN wings, but staff still encourage residents to keep busy with hobbies and social groups for as long as they can. Staff prepare and serve meals in the common area kitchens, but residents who are physically able to can dine in the independent living dining facility. AL residents are encouraged to keep socially connected to their more independent friends. The highly skilled staff seem to genuinely care about everyone, including the residents who need the most support.
What’s included and what isn’t?
The more progressive communities provide most of the following services as part of a buy-in and/or monthly fee:1
| A private apartment or cottage | One daily chef-prepared meal |
| In-unit kitchen and laundry | On-campus events / activities |
| General maintenance of unit | Use of pool and gym |
| Bi-weekly light housekeeping | Fitness classes |
| Outdoor car parking | Shuttle service to local towns |
| Snow removal, incl. parking lot | Routine healthcare on campus |
| Heat and electricity | 24-hour security |
| Package delivery service | Emergency response service |
Additional chef-prepared meals cost extra in the independent living area. Independent residents may choose to prepare most of their meals in their own kitchens. The cost of admission to off-campus events is often the resident’s responsibility, as is transportation to areas beyond the pre-defined radius. Covered or garage parking is extra and is generally purchased at move-in.
Because most CCRCs accommodate all types of living (independent, assisted, and skilled nursing) on the same campus, residents can transition gradually from one type to another. Instead of moving to another wing, a resident who simply needs a little help getting ready in the morning but is otherwise independent can receive limited assistance in his or her current residence. This service, however, may be outside the scope of the contract and cost extra.
The cost of higher levels of care, namely assisted living and skilled nursing care, will depend on the type of contract the resident chooses. The most robust contracts will guarantee all levels of care for life (even if the resident runs out of money!), only charging extra for two additional meals. These contracts are more expensive but offer residents the most peace of mind.
What kind of CCRC is this? What’s their philosophy?
Aside from price and contract distinctions, communities differ less than you might think. One important difference is the philosophy of the CCRC. For example, one CCRC I visited places a strong emphasis on education and learning. The management even imposes an annual learning requirement on all mentally and physically capable residents, employing a point system to track residents’ progress. Learning, as defined by the CCRC’s board, can be formal education, volunteer work, acquiring a new skill or hobby, or another category. Residents are encouraged to take classes at a nearby college—often the same classes taken by college-age students, although with less stringent academic requirements.
While this emphasis on learning appeals to some seniors, it might overwhelm others. By contrast, another CCRC I visited made no mention of education or structured learning programs in the two hours I spent touring the campus. That community had no learning requirement or affiliation with any educational institution. Some seniors might want the structure of educational requirements, while others prefer choosing whether to pursue further scholastic or avocational goals.
When considering a CCRC, it is important to determine what values the community espouses, in terms of education, spirituality, or cultural identity. The CCRC will promote these values in its literature, and in campus tours. You will certainly experience them as a resident, so read and listen carefully to discover which CCRC fits in with your lifestyle and beliefs.
Be aware, though, that there may be a limit on what the CCRC staff can tell you for legal and regulatory reasons. You may need to spend more time at the community—maybe an overnight visit—to get a feel for whether this is the right place for you. CCRCs encourage you to spend more time there beyond the initial visit, and to talk with residents and ask questions. It’s in everyone’s best interest that you make an informed decision.
So, what’s not to like?
Is it all fun and games living at a CCRC? Of course not. Residents don’t always hit it off. Staff sometimes make mistakes or occasionally don’t deliver on promises, disappointing residents. Some residents become seriously ill or experience the loss of a spouse. A small percentage, for whatever reason, regret their decision and move out. As I said earlier, it’s a microcosm of life.
Why is community important?
Human beings are inherently social creatures. We need one another for companionship, validation, and intimacy. However, in the United States and elsewhere, people no longer feel the strong sense of community they once did in the mid-20th century.2 Remember the neighbor who knocked on your door just to say hello and chat over coffee? Ancient history. Facebook and similar technologies are not helping all of us feel more connected. Some of us feel more detached.
In 2010, The American Association of Retired Persons (AARP) conducted a national study of adults 45+ and found that 25% of survey respondents over age 70 reported being lonely (35% for all survey respondents), as defined by a perceived lack of social support and a shrinking network of friends.3 Lonely respondents were also less likely to be involved in activities that can help build a social network. A similar study conducted in 2012 by the University of California, San Francisco put this percentage at over 40% for seniors and found that loneliness and isolation were linked to serious health problems and death among the elderly.4
This loneliness trend is likely to continue as our friends and relatives pass on, our children and grandchildren scatter around the globe to pursue careers, and technology and automation continue to invade our lives. (Japan is now employing robots to help care for that country’s seniors. How comforting!) Given the nurturing, physically active, and intellectually stimulating environment offered by CCRCs, community living certainly seems to be an attractive option for some seniors.
Is a CCRC for you?
I must admit that I have personally found the CCRC concept to be very attractive. Remember that client of mine who wasn’t sure if she could move to a CCRC? I might take her spot on the waiting list.
However, you may be able to find the important elements that CCRCs provide (community, convenience, safety, and support) in other ways. Your home may already be set up so that you can “age in place.” You may have a close circle of friends near you. Your community may offer support services that are easy for you to access. Other conveniences you need may also be within easy reach. If this is true for you, a CCRC may not be your best option.
My objective for this article was to give you a sense of what life is like in a continuing care retirement community, and why CCRCs might be worth considering. In a subsequent article, I will describe the various types of contracts, pros and cons of each, relative costs, and why you might choose one type over another.
Endnotes:
1 All contracts come with annual inflationary increases in the monthly service fee.
2 Bowling Alone: The Collapse and Revival of American Community, by Robert D. Putnam, shows how we have become increasingly disconnected from family, friends, neighbors, and our democratic structures.
3 Loneliness among Older Adults: A National Survey of Adults 45+; AARP, September 2010.
4 https://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly.
Rick Fine is a Principal and CERTIFIED FINANCIAL PLANNERTM at Sensible Financial. Have a question for Rick about Continuing Care Retirement Communities? Ask in the comments section below. To speak with someone from our dedicated team about how we can help you plan for your financial future, click here!