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Successful Aging: I don’t have children; where will I live as I get older?

Dear readers,

Last week, we discussed some options for S.K., who is in her mid-60’s, lives alone and has no children. She wants to know about her options when the time comes that she may need help, knowing there are no children or grandchildren to look after her. This week, we’ll talk about opportunities for relocating.

Continuing Care Communities (or CCRCs): Sara Zeff Geber, author of “Essential Retirement Planning for Solo Agers,” recommends these, which are also known as life care communities, particularly for those without children because they provide safety, security, community and care. CCRCs offer a tiered approach of independent living units, assisted living units and skilled nursing facilities that accommodate residents’ changing needs for their lifetime. CCRCs attract older adults who want to live independently when entering but also want the security of knowing they can receive needed care without leaving. The arrangement also allows residents to stay close to their spouse, partner and friends as they may move through different levels.

Of all of the long-term options, CCRSs are considered the most expensive, requiring a hefty entrance fee as well as monthly charges. Entrance fees can range from $100,000 to $1 million — an upfront sum to prepay for care as well as to provide the facility money to operate. Monthly charges can range from $3,000 to $5,000. Fees depend on a variety of factors including your health, the type of housing, whether buying or renting and the type of service contract.

Most CCRC’s have a policy that requires new residents to be relatively healthy and able to live independently when they move in. Many continue to work and drive.

Here are three types of contracts; the details vary according to the facility.

  • Life Care or Extended Contract: This is the most expensive, which requires an entrance and monthly fee with unlimited assisted living, medical treatment and skilled nursing care. The contract guarantees the facility will provide care as needed for the rest of the resident’s life.

  • Modified Contract: This contract typically offers a lower entrance fee and monthly rate than the life care contract. Although residents are guaranteed access to a higher level of care, the contract typically limits the amount of health care services that may be accessed without an increase in the monthly fee.

  • Fee for Service Contract: The initial enrollment fee for this type of contract may be lower. Assisted living and skilled nursing costs would be paid at the facility’s market rate. The risk of large long-term-care expenses remains with the resident not the facility.

Assisted living residences: These are for older adults who do not need medical care but do need assistance with activities of daily living such as eating, bathing, dressing, bathroom visits and walking. Housekeeping, transportation, medication management and enriching activities also are provided. Some have recently offered independent living; some others are licensed for memory care.

The average cost of assisted living in California in 2018 is $4,070 a month. Based on the geographic region of the state, the average monthly cost can range from $1,020 to $10,720.Board and Care Homes. These are private dwellings, which typically are converted homes. The homeowner, usually with paid staff, provides care for individuals who have some limitation or need help with activities of daily living. Board and Care homes are less institutional and less expensive than CCRC’s and nursing homes. They provide a safe and supportive environment. Most states have their own licensing requirements.

Nursing homes: These also are called skilled nursing facilities and are the only facilities licensed to provide medical care and attention around the clock. Some serve as rehabilitation facilities. Nursing home residents require a higher level of care than provided by assisted living residences. According to a 2016 National Nursing Home Survey, a semi-private room ran $225 daily or $82,125 per year. The average nursing home stay was a little over two years.

Finances can be an issue. With the 85-plus as the fastest growing segment of our society, we are faced with a challenge of caring for those who need care, who do not have family and who cannot afford care. This is a topic for another conversation.

S.K. I hope these descriptions are helpful in your planning. And kudos to you for thinking ahead.

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