July 18, 2017 by Jean
Several months ago, I began to think seriously about what I will do when the hassles and physical work involved in maintaining my rural house become more than I can manage. (See The Plan.) After my TIAA financial advisor expressed the opinion that my retirement savings were enough to support living in a fancy retirement community, I decided to visit some of those communities; and two friends, both also single homeowners without children, decided to join me for those visits.
Last week, the three of us toured two different retirement communities, each about an hour away from where we now live. We spent about three hours at each community, meeting with a marketing staff member, touring facilities (including a variety of living units), and ending with a complementary lunch. The two communities have quite different business models. The first was a nonprofit “lifecare” community, where a large buy-in deposit and hefty monthly fees buy you a guarantee of care for the rest of your life. The second was a for-profit business with a similar buy-in deposit, but much lower monthly fees, and no guarantee of care when you can no longer live independently.
I wasn’t familiar with the “lifecare” model, so quite a bit of our time at the first community was spent with the marketing manager, learning the basics. When you enter this community as an “independent living” resident, you are guaranteed care for life, even when you can no longer live independently and need to move into one of the community’s assisted living apartments or even into their skilled nursing home. Long-term care is then provided at the same monthly rate charged for the type of independent living unit you were previously living in (which is considerably less than the market rate for assisted living or nursing home care). In order to make this model work, the non-profit has strict financial and physical health qualifications for becoming a resident. Although my financial advisor had specifically recommended this retirement community as one I could afford, it became clear to me that this would be true only if I moved to a smallish apartment; I could not meet the financial qualifications for the kind of semi-detached “cottage” that I am interested in. One of my friends was also disappointed to learn that she would not be allowed to share an independent living unit with her disabled brother because he could not meet the medical qualifications to live there independently on his own.
Although this retirement community was located on a gorgeous stretch of Maine coast with expansive ocean views, it left me with a feeling of being hemmed in and restricted. As the resident who hosted us for lunch explained, once you decide to move there, you have to “bite the bullet” and realize that you are not going to move again. She hastened to add that she does not regret moving to the community, that she loves it and has made many friends through the activities she engages in. Nevertheless, I was aware that, once you can no longer drive, your life will be pretty much restricted to what is available on the retirement community campus and the off-campus activities for which they provide transportation. I also realized, as we talked, that life in the independent living units is restricted by condo-type rules, like not being allowed to hang clothes out on a clothesline to dry.
The second retirement community, which we visited the following day, seemed more relaxed. Because this community is not promising to care for you until you die, they don’t need to worry about how long your assets will last or about how long you’ll be able to live independently. Being able to come up with the big deposit for entering the community (similar to the deposits at the lifecare community) and being able to pay the monthly fee are the only financial qualifications. And because residents are not paying in advance for long-term care that they might need in the future, the monthly fees are much lower. If the time comes when you are no longer able to live independently, you get 100% of your initial deposit back (when your independent living unit is re-rented) and you can use that money to finance long-term care. Medical qualifications are similarly relaxed; all you need is a doctor’s note saying that you are able to live independently at the time you move in.
This sense of relaxation about rules seemed to extend to other aspects of living in this community. When I asked about clotheslines, the marketing staffer who showed us around seemed startled; of course, I could have a clothesline in the backyard of my cottage. When my friend asked about having her disabled brother live with her, she was similarly reassured and we were told about a case in which age rules were bent a bit so that an elderly couple could have their disabled son live with them. Some of the difference between these two retirement communities is a reflection of their different business models. But I think the more laid-back attitude at the second community also reflects the fact that it is older and more established and more secure that it can survive.
The older community is also larger, and with a greater ratio of semi-detached “cottages” to apartments than the lifecare community. The campus is made up of neighborhoods built at different times that branch off from a main road through the complex. At each intersection is a bus stop for the shuttle bus that connects the different parts of the campus. The community is near, but not directly on, the coast, with some ocean views. Mostly, it is nestled in the woods. In the neighborhood of older 1200 square-foot semi-detached cottages that most interested me, each cottage backs up to woodlands that provide both shade and privacy. Despite the country feel that the woodlands provide, however, the campus is just a short bus ride from Maine’s largest city, with city buses stopping regularly at the entrance to the retirement community campus.
I found my retirement community visits very enlightening. They helped me develop a better understanding of my own preferences, and I now have a better sense of what questions to ask when I visit other retirement communities. I learned that the lifecare community is probably not a viable option for me. And I left the second community easily able to imagine myself living there.
A very timely post for me. This afternoon I had an appointment with a guy who specializes in placing people in independent and assisted living facilities and nursing homes. (I’m not going anytime soon, but I wanted to know if I have enough money to last, if I do.) My Saturday blog will recap the highlights but as it relates to your post here, he said of those lifecare (continuing care it’s called around here) if you qualify financially then that’s a great indication that you have enough money to private pay in ANY place for the rest of your life, without all the strings. And those lifecare places, he said, don’t guarantee or necessarily tell you that the nursing homes they eventually move you down to will be on the same campus because they own facilities all over the place and they could move you to a lower quality place and you’d have no control over that.
Jean, That’s a very useful insight about the financial qualifications for continuing care communities. The one we visited is completely local and not part of a chain with facilities in other locations, which avoids the problem of being shipped off to some other campus (an issue the mother of one of my friends faced at a facility in Florida). We asked what would happen if you needed assisted living or rehab or skilled nursing care at a time when their facilities were full and were told that we would be placed temporarily elsewhere until the next space opened up.
Jean, please help me get directly into your blog. Years ago I joined…now I have no idea what a password could have been. I will message you on Facebook and request your email.
Interesting. Have you given any thought to the multi-generational co-housing communities that are springing up? There is one in Belfast that looks pretty interesting and I think there is one starting in Damariscotta. Here’s an article: http://bangordailynews.com/2015/10/16/next/why-cohousing-communities-are-attracting-midlife-mainers-3/.
Brenda, Thanks for the link to the article. I have long been intrigued by the co-housing model, but I’m not sure how well it will work for the “oldest old” (those 85+). For example, when I am no longer able to manage my current house, I don’t think I would be able to manage schlepping my groceries from the central parking area to my house, as required by the Brunswick community. I know the vision is that you will have younger neighbors who will “adopt” you and help with things like this, but having to rely on help that I could not reciprocate would make me anxious. Also, to be honest, after a career spent around 18-22 year-olds, I value quiet and would not particularly welcome living next door to noisy teenagers. 😉
Very enlightening Jean. Having dealt with my mom and Aunt in AZ and finding senior facilities these models are completely different than what is available there. They have apartments mostly in large complexes with lots of stuff going on and some have both independent and assisted living options…..the costs though can be out of sight. I like your second option….Here it seems it is similar to the AZ model of apartments.
Donna, As my friends and I visit different communities, we are discovering just how many different business models are out there. All of the communities I am looking at have both apartment buildings and semi-detached “cottages.” I think the apartments have much higher levels of sociability, which is why I think a cottage, which allows for more privacy and solitude, would be better suited to me. The fees at the lifecare community includes one communal meal a day, but the second facility has a no-meals option. (You can pay for a meal at one of their dining facilities when you wish, but are not required to eat there regularly.)
Thank you for the interesting and useful (to me) ethnography.
Charlie, Visiting and learning about these communities is fascinating.
Good article. We moved my mother into assisted living, having very few assets. She stays there now, paid for by Medicaid and her Social Security benefit. My sister and I looked at each other and simultaneously had the thought “and why are we saving for this?”
Craig, Many of the best facilities don’t take Medicaid at all or (more often) only accept it for residents who started out there as private pay. So saving for this gives you more options for the future. (For example, I have high needs for solitude and my idea of hell would be having to spend the rest of my life sharing a tiny room with a chatty roommate that I didn’t choose. I’d like to have enough resources to be able to get a private room or apartment in a long-term care facility.)
your second sounds like a more upmarket version of what we are looking at. Within the suburb so able to walk to shops, library, doctor, with a courtesy bus.
But our suburb is still bogged down in Cape Town’s public transport issues. They are slowly getting that sorted. Would be wonderful to have a bus to the city outside the main entrance!
Diana, Yes, that bus to the city really appealed to me! The next community we are planning to visit is a more downmarket version with lower buy-in deposits and monthly fees.
Inspired by you – we went on our first U3A hike this morning. A botanising group, slow pace, and pleasant conversation.