Multiple choice

“The first thing that struck me was how active most of the residents are here. You have your choice of what you want to do and when you want to do it. You can be busy for 18 hours a day or sit and talk with people—or you can sit by yourself and just read.”

“She said, 'You get three meals a day, your laundry done, your room cleaned.’ I said, ‘It sounds like the place for me. I just want to retire, relax and enjoy life.’ Which I do.”

Let’s assume that you’re looking seriously at senior communities. So how do you go about ranking your priorities, or even defining what your criteria should be? Here are a few suggestions to help you organize your thoughts:

• Location: Do you want to be close to family and friends—maybe closer to some than you are at the moment? What about connections to your current community: shops, restaurants, services, doctors, church? Or maybe you’re ready for a change and want to see what other communities have to offer.
• Amenities and services: Every community will give you a detailed list of all they have to offer. The key is to assess that list from your perspective: What do you actually want and need? Three meals a day, or just dinner? Housekeeping services? Underground parking? It all comes down to what’s meaningful to you. It might be fun to point out the billiard room to friends, but will you ever set foot in it?
• Activities: Is there a pool, and would you actually use it—if not today, then maybe if you find they have a good swimming or aquatics program? What about a fitness center? Any walking or biking paths? Tai chi? Yoga? Are there organized groups for people with shared interests—bridge, chess, investing, books, crafts? What about classes in, say, painting or pottery or music or computers? The list can be impressively long—but again, think in terms of what really interests you. And try to talk to some of the people involved to get firsthand feedback.
• Ambience: This one is trickier to define, but often you get a sense of a place in a short time during your visit. Are the interior spaces nicely decorated and well maintained? Are the dining and living areas comfortable? How about the furniture? Does the property have gardens, mature trees, a courtyard, patio or other spots where people can chat and relax? Overall, does the community feel right for you?
• People: Once again, the key is to pay a visit—and not just for a quick tour and a conversation back in the office. Take some time to stroll around the place, see what people are up to, how they greet each other, what the prevailing mood seems to be. Talk to a few residents if you’re outgoing; do a bit of innocent eavesdropping if you’re not.  And, of course, get a feel for how staff members interact with residents and among themselves. There’s no way to be completely scientific about this, but everyone has a keen sense of what they value in other people. Do what you’ve always done in checking out a new social situation: follow your instincts, and keep an open mind.

What kind of support will you need?

A senior community by our definition offers residents varying levels of support, depending on individual needs. Most offer one or more of the following options:

• Residential living: You take care of your own home within the community but don’t have to worry about heavy housekeeping, yard work or maintenance. While you may prepare your own meals, you also can take advantage of centralized dining. You also typically have access to amenities such as a fitness center and perhaps on-site shopping and other services.
• Assisted living: If you need help with some routine tasks—preparing meals, bathing, dressing or managing medications, out-of-home activities such as shopping and transportation—the community’s trained staff can provide this extra level of support.
• Skilled nursing: For residents with health issues that require basic, ongoing medical attention, many senior communities offer round-the-clock nursing services.
• Memory care: Some communities also include secure, specialized facilities for the care of residents coping with Alzheimer’s disease and other forms of dementia.

For many people, the ideal route is to choose a senior community that can provide several support options along a continuum of care. A designated continuing care retirement community, or CCRC, offers residents a long-term contract covering housing along with graduated levels of personal support and nursing care, if or when they’re needed. Most CCRCs are operated by nonprofit organizations.

Financing Options

If you’re thinking of moving to a CCRC, it’s best to put some thought into your financing options before making a final decision.

CCRCs require a one-time, upfront entrance fee before you move in. You also sign a long-term contract that covers services and amenities, as well as health care options for your current and future needs. This contract, which you pay by the month as you would rent, guarantees continued access to the comforts and services you choose on entering the community and/or arrange over time. Some contracts allow you to finance a full range of health care and personal care services—including assisted living, skilled nursing and specialized memory care—if and when you need them, without a substantial rise in your monthly rate.

Generally speaking, there are three types of CCRC contracts: extensive care, modified continuing care and fee-for-service. Monthly rates vary according to the level of care provided, with extensive care being the most comprehensive.

Extensive Care contracts cover accommodations, services, amenities and unlimited long-term nursing care, should it become necessary. Your monthly payments may be adjusted slightly over time to reflect changes in the level of care; but your housing and living costs remain fixed, other than possible adjustments for inflation. This contract option provides a high level of long-term security, guaranteeing necessary care levels regardless of how much your current circumstances may change. You also can realize significant tax benefits by financing future health care options in advance.

Modified Care contracts cover the same core services and amenities as extensive care contracts, but in this case you pay only for a prescribed amount of nursing care as outlined in the contract. Should you require higher levels of care in the future, any required fees will be your responsibility at that time. Modified care contracts are best suited to residents who have sufficient financial assets to absorb future medical costs, or for those who don’t foresee substantial changes in their personal health. Because some care is included in the contract, tax deductions can be made against future costs.

Fee-for-Service contracts cover your accommodations, services and amenities, but you’re responsible for all additional health care costs, including daily long-term nursing. This type of contract can be risky if you lack the financial resources to handle all health care contingencies. Also, you do not receive a medical tax credit from the agreement.