It takes a (retirement) village. Or does it?
January 18, 2014 3:32 PM   Subscribe

My dad-in-law and his wife are getting ready to chunk out the $ to move into a retirement place. I'm looking for input about these kind of "all inclusive" retirement places, their financial setups, and possible alternatives for them.

My wife's dad (83) and his wife (67) are planning on moving to a retirement "village". It's basically small apartments in a hotel-like setting with dining and amenities provided (pool, fitness area, some services etc.). The way these places work is that they require a large entrance fee (in this case $250,000) and then you pay monthly rent as well ($3K/mo). The fee is 90% refundable when they give up the place -- though it has to be secured to new owners before the $ is refunded. Demand is fairly high right now. We toured it today. It's a nice place. As I said, a lot like a fairly nice big hotel. Overall, it's pretty expensive, but they can afford it (just) and would not have to worry about any upkeep, utilities, maintenance, security etc. There is also available basic assistance and transportation in the retirement facility (slight extra $). There are also other buildings that provide assisted living and nursing care. They'd have to move out of one and into the other if that's what they needed. They seem convinced this is the way to go. Father-in-law's health is declining, and his wife is not terribly capable of looking after him as this happens. Also, I'm sure he wants her provided for after he's gone. She could stay there as she would continue to receive his pension. The place appears to have a clean track record.

All well and good, but just to do due diligence, I'm wondering what the alternatives might be. They're in a 3 bedroom, 2-story house now, with yard etc. They do not want to continue with it. Perhaps they could move to a low maintenance townhome for about the same $250K, and use what they would have been paying in rent to hire in services as needed? That way they'd own the place 100% and not be beholden to refundable fees (which I'm leery of). They'd have more upkeep and more to manage, and would not have the "community" the retirement village supposedly has.

Does anyone have experience on either end of this type of place? Or with alternatives?

posted by ecorrocio to Work & Money (22 answers total) 8 users marked this as a favorite
My father-in-law's only regret about moving into one of these places was that he hadn't done it sooner. His wife had died years earlier and he loved the new-found companionship. It was like a college dorm for old folks; the sense of community was very real.
posted by Johnny Wallflower at 3:37 PM on January 18, 2014 [4 favorites]

Both of my mother's parents have dementia, and my family had to struggle to get them into a place like this when it became patently obvious that they could no longer care for themselves.

Not only is there no maintenance to do, but there is someone there to administer medications, make sure they eat, etc. My grandmother at this point has severe Alzheimer's symptoms, and is able to live on site downstairs from my grandfather in a special "memory ward" where she can get the proper care.

I really can't speak to the finances at all, but having them in a retirement community has taken a massive load off for everyone. I'm frankly envious that your in-laws are considering making this move before something dangerous happens.
posted by Sara C. at 3:43 PM on January 18, 2014 [1 favorite]

One of the up sides to places like that is that whole "you don't have to worry about it" thing, especially with regards to the point where they might need to transition to assisted living. But my family's found that a large chunk of that matters less when you have kids who are actively involved and can help with a lot of things--if both kids and parents are okay with this arrangement, which is obviously a question mark. Like, who's making sure the cleaning service gets paid? What arrangements are you making if they do start to need a full-time caregiver? Who's going to get someone in to install stuff like more accessible bathroom accommodations, that kind of thing, when they become needed? Who's going to be checking in regularly to make sure that household maintenance is done, that they're happy and comfortable?

It can work. Theoretically. But the other thing that retirement places provide is a built-in social life, and I think that if my grandparents weren't so active in their church (or for that matter if there was actually a decent place in town and not just an hour's drive from said church) then they might have wanted to make the move for that reason alone. And it would have been easier on all the rest of us by a huuuuge stretch. It's expensive, but when you have the money, there's a lot going for it.
posted by Sequence at 3:45 PM on January 18, 2014

My wife's grandmother lives in a place like that, and overall it's pretty good. She just moved into the assisted living facilities there, and the care that they provide there (help with medicines especially) is great. The only downside is that the food in the assisted living part of the facility is not as good as the unassisted place - it's more picky-kid foods like chicken tenders, mac and cheese, etc. So one thing you might do is to see if you can sample the food first. Eating is a big part of life, and if the food sucks then that's going to be miserable for your folks.
posted by number9dream at 3:58 PM on January 18, 2014 [2 favorites]

My parents had looked into a similar arrangement. One of the common benefits is that residents are given first priority when they need to move to assisted living or skilled nursing, even on a temporary basis (such as rehabbing from a hospital stay). You might want to verify that for the place they're considering. Also, what happens if one needs assisted living or nursing care while the other is still able to live independently. Given their age difference, that's a real possibility.

Most of the places I've seen with substantial entrance fees don't issue refunds, especially if one or both passes away while living there. Be sure to check that out as well.

In the end, my parents decided that the entrance fee was too high given their ages (mid-80s at the time), and instead moved into an independent living apartment building that provided similar amenities as well as two meals per day. It was *much* cheaper, while still having assistance with meds and so forth available for residents.
posted by DrGail at 4:03 PM on January 18, 2014

My grandparents recently moved to a place like that, and it's been wonderful. Their health has improved greatly, too; I think they were more stressed out living alone than they let on.
posted by ThePinkSuperhero at 4:24 PM on January 18, 2014

There are levels of care in most retirement facilities. There are places for those who are just tired of cooking and mowing; there are places for those who need a little help with e.g., dressing but are healthy (assisted living); there are places for those who need quite a bit of help with daily living: there are places for those who need medical supervision and care. Some facilities have several levels available, but some do not. Read the brochures, talk to some residents if you can. Ask your father-in-law's doctor if he can offer a prognosis of your fil's health expectations. Information will help set your mind at ease, and perhaps influence the choice of facility.
posted by Cranberry at 4:31 PM on January 18, 2014

I live in a low-maintenance townhouse and while I do not have to mow the lawn or fix the roof, there is plenty of maintenance to be done. Stuff breaks, appliances need to be replaced and new ones chosen, favorite cleaning people move away and new ones hired, plumbers need to be called and called back when the sink still leaks. More upkeep and more to manage are no small things. That "more to manage" will fall to you -- or more likely, your wife -- when your inlaws can't do it anymore. Do you want a phone call from them when they need a light bulb changed? Or would you like your wife's dad to climb on a ladder to do it himself? If they are currently capable of making their own decisions, I'm not sure why you would be looking for alternatives. These setups are basically ideal for those who have the money. When my dad died, my mom absolutely could not handle their condo herself. What a relief it would have been if she had been situated in the kind of facility you're describing. I think she might have lived longer.
posted by Wordwoman at 4:53 PM on January 18, 2014 [1 favorite]

One thing to keep in mind about your alternative scenario is how capable your in-laws will be of managing multiple different services providing the care and assistance they'll need. Will you or your wife or other family be there to make sure that all the bills get paid and that they aren't being taken advantage of? Even if they're in a town home, they'll still need maintenance stuff done and maybe need housecleaning services and so forth.

If your father in law needs serious medical assistance in the future, will his wife be able to manage all of that on a day to day basis if it's done in their home? What if he needs to go into assisted living and she's suddenly living by herself? The benefit of places with multiple levels of care available is that they won't need to move far or seriously disrupt their lives if they need a higher level of care.
posted by MadamM at 5:30 PM on January 18, 2014

That $250,000 up-front fee on top of $3,000 per month rent sounds pretty steep even if it is partially refundable under certain conditions. I'd definitely have a lawyer take a look at the agreement before signing anything.
That said, I'm in the process of moving an elderly aunt from the home she has lived in since birth to an assisted living place. Her rent of $2,800 per month covers her 2 bed, 2 bath apartment with a full kitchen, dinner served nightly in the communal dining room, housekeeping, laundry, heat and light.
The only extras are phone and cable and she's on her own for breakfast and lunch.
Most of her old friends and neighbours are gone now so she's looking forward to meeting some new people and having someone to talk to (and boy, does she like to talk). Best of all it's in her old neighbourhood, just a few blocks from her present house. When we first visited the place we checked out the dinner menus which looked good and spoke to some of the residents who raved about the food and seemed quite happy about the place in general. It took nearly a year on a waiting list to secure a place for her and she's quite looking forward to moving.
It don't know what the market is like where you live but if they could find a place without the big move in fee an assisted living arrangement seems like a good move.
posted by islander at 6:18 PM on January 18, 2014

In your scenario, what happens when they need, say, an on-call medical team? Do they move to assisted living or a nursing home then? What will it be like to move and adjust to a new place at that time?

The benefit of there being all levels of care in one community is that even as their abilities decline, they will still be in the same general place and near the same friends. It would be worse to wait until they are very incapacitated, because then they won't be able to meet people, tour the grounds, figure out what they like about the new place, build a reputation among staff as great people, etc., while still fairly active and healthy. They might end up moving when they are more physically challenged, disoriented, grouchy (if illness makes them grouchy), or otherwise less able to make the most of the new place.
posted by slidell at 6:19 PM on January 18, 2014

My older aunt has lived in a popular retirement community in Southern California for years, and she loves it there. There's plenty of activities and socializing to be had, if she wants it.

For comparison to what your in-laws are looking at: Hers is a 2bd/2ba condo. There are several floorplans in the community, and prices can be anywhere from $100k to as much as $450k, depending on the floorplan, and any upgrades (granite countertops, etc) the owner has done. A unit has to be bought and sold privately, like any other condo or house. There is a monthly HOA, which is reasonable (a few hundred a month), and there is an income requirement so that the association can be assured that the owner will be able to cover the HOA for as long as they live there. The HOA covers EVERYTHING, down to maintenance coming in every few years and replacing appliances, for "free". No upkeep to the resident, other than what they own personally. If there's a problem with electrical in the unit, or the roof, maintenance just comes and fixes it. They are very responsive.

So, based on that information, it sounds like the place your in-laws are looking at is fairly steep. But, maybe it's competitive for your location. Maybe they should tour a couple more places, just to see.
posted by vignettist at 6:43 PM on January 18, 2014

I'm a nurse in a continuous care retirement community. Based on the high entrance fee and your description of the setup it sounds like your in laws are looking at a CCRC. What makes a CCRC different from a regular nursing home is the ability to age in place. At my facility residents move into the community when they are fairly young and able bodied. It's a requirement, actually. Then, from there on out, we adapt our care to their changing healthcare needs. They will never be "kicked out." Any problems that arise with their Health are pretty much in our hands. If they fall and break their hip, they will come back to our skilled nursing unit for rehab and then either move back to their independent residence or to assisted living, if the care team decides they need a bit more help.

CCRCs are fantastic. There is a tremendous sense of community. It is a shame that the model is so expensive. If they can afford it, GO FOR IT.
posted by pintapicasso at 7:33 PM on January 18, 2014 [2 favorites]

Or, basically what Sequence says above.
posted by pintapicasso at 7:35 PM on January 18, 2014

Yeah, I had two older relatives who lived in a facility like this and it was absolutely the right decision for them. The thing that I've learned from witnessing the declining health of my family members over the years is that the time when a person needs to move into a nursing home or assisted living facility is the worst time to move.

Someone who is stressed and scared because of declining health and losing the ability to care for themselves is someone who is going to be extra stressed and unhappy about completely changing environments. CCRC's really smooth the process and make getting extra care a convenience instead of a painful transition.

I can't comment on the financial aspects really. The numbers you've quoted sound similar to what my relatives paid. If I were you I would get quotes from other comparable facilities to put this one in perspective and make sure it's reasonable in your area.
posted by telegraph at 7:42 PM on January 18, 2014

Echoing everyone else who is saying it's a blessing your inlaws are thinking of doing this of their own volition. The fact that this place has a good rep and is well run makes me think they should go for it. I would not recommend they do something like downsize to a townhouse and hire various people to take care of maintenance stuff. Part of what you pay for in these places is not having to worry about things like that at all, not even hiring and remembering to pay people etc. Realistically speaking, if they merely downsize, those tasks will quickly fall to your wife and you.

The elderly people I know who have gone this route just wish they'd done so sooner. And in my own family I can think of several people who vigorously resisted moving into places like this before their eventual decline, but their final years would have been much less painful, sad and stressful had they made the move about a decade before they died.
posted by hurdy gurdy girl at 8:50 PM on January 18, 2014

That $250,000 up-front fee on top of $3,000 per month rent sounds pretty steep even if it is partially refundable under certain conditions.

I don't think it's steep at all, assuming this is a CCRC. You are buying into a lot of very, very expensive services for that price and alongside that comes tremendous peace of mind. Echoing everyone else, it worked out brilliantly for my grandparents.
posted by DarlingBri at 12:14 AM on January 19, 2014

A downside: the only people who live there are elderly so if your in-laws enjoy hanging out with a variety of people with a variety of interests, it may be not ideal.

Also, if you're close by, do some volunteer visiting at the nursing home level to see what the quality of care is there as well as the general mood of the place.

My grandparents joined a CCRC and went from a small house to nursing home care there. There were positive aspects and negative aspects. They found it socially confining - they were intellectually curious people and found few friends in the community with similar interests.

I do not feel comfortable talking in public about an extremely negative aspect that concerned medical care but will memail you that information.
posted by sciencegeek at 4:58 AM on January 19, 2014

My great-aunt lived in a CCRC and so did a couple of other older people I knew.

One of the pluses, in addition to no maintenance worries, ability to move to a higher level of care, and other things that posters have touched upon: all the CCRC's I've known about have had shuttle buses to take their residents shopping and to the doctor's, AND to places like the theater, symphony, craft fairs, wine tastings, etc. Many CCRC residents don't, or shouldn't, drive, or can only drive during the day and on surface roads; having those free shuttle buses ensure that no-one becomes an involuntary shut-in. My aunt got to experience art showings, the symphony, nice restaurants and other outings even though she couldn't drive anymore.

Obviously this depends on where your in-laws live. My aunt lived in a college town, the couple of other folks in a CCRC that I knew lived in an affluent suburb. Both offered lots of cultural and recreational activities. But even if your in-laws choose a place where there are fewer cultural enrichments, almost all cities/towns have a Parks and Recreation department, including a senior center. When they are unable to drive, having a shuttle to take them there (or to grocery shopping, etc.) will be an absolute godsend for them and your wife (who won't have to play chauffeur).

The main downside of a CCRC is the expense. It's a lot more expensive than just buying a small condo or even a free-standing "over 55" community. You want to check that your in-laws are getting value for the money they spend.

Another downside, at least in my aunt's CCRC, was that the food wasn't very good, at least to my palate! Meatloaf, string beans, and jello for dessert kind of thing. :/ Again, YMMV, as that CCRC catered to a generation and location that didn't have a sophisticated palate. (And my aunt was the pickiest eater known to mankind even in her 80's.) I'm pretty sure that the food is better now at least at the higher-end CCRCs.
posted by Rosie M. Banks at 7:28 AM on January 19, 2014

A family member of mine moved into assisted living on more of an emergency basis-- something that particular facility allowed in a limited way. As I understood it, the facility was a CCRC for most people who participated. Definitely it would have been nice to do this when it was not an emergency and when the person did not feel pushed to move.

One thing I found surprising-- it turned out that people who needed a lot of care and didn't have capable family members showing up to pitch in (or at least keep an eye on things) often had hired nursing helpers coming in, just as you would at home. It really seemed like this was, if not an expectation on the part of the facility, very desirable. That adds a LOT to the expense, and it's a responsibility for whoever is hiring and communicating with the helpers. Your father-in-law's wife may or may not be able to ride herd on people who are caring for him, or there may be someone else in the family living nearby. Once he is gone, there may be the same issues for her down the road. So I would make an effort to find out if most people in the facility are hiring additional help once they are on the level of medical treatment, and factor that into your planning.
posted by BibiRose at 8:12 AM on January 19, 2014

Get a list of any and all ancillary fees. My family's experience with this sort of thing (I say 'sort of thing' because I'm not sure my grandmother lived in a CCRC exactly and in any case she ended up living in two different facilities) was that there were fees in addition to the upfront/monthly rent for things like manicures/hairstyling/optional self care but also for more necessary things related to health as it declined.

It's important to get down down to brass tacks on this: what DOESN'T the $250,000 upfront/monthly rent cover, are those things going to be something your in-laws want now or in the future, and will they have enough money to do so once they've spent the $250,000? If that all checks out, then I'd say your in-laws should go for it.
posted by librarylis at 8:57 PM on January 19, 2014

From my own experience(s): If they can afford it, do it.

My grandparents moved to a CCRC and while, resistant at first, said they should have done it sooner. They partook of all the levels of care - starting in independent living moving into skilled nursing and the Alzheimer's unit until they both passed. It was a great comfort to the family, who was close by and visited often, that they were able to receive the care they needed as they aged. The facility also had financial assistance for residents, which fortunately, they did not need to use (but they came close).

In contrast, my father-in-law, chose to live in a facility that was only independent living, then when he needed more care, and his finances were starting to diminish, we had to scramble to find a decent facility that would take him. As we found out, if he had started in independent living of a CCRC, he could have smoothly transitioned into the higher levels of care, in a nicer facility - which he would have been more familiar with. The CCRC's wouldn't take him as he no longer had the requisite income/assets and also because he would be coming into the facility at a higher level of care.
posted by sarajane at 3:35 PM on January 20, 2014

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