Over the past ten years, assisted living communities have sprung up all over the country. But just what IS “Assisted Living?” Most people understand it to mean all retirement communities, but not all of them are assisted living even if they have that component as part of choice of services.
Below are general descriptions of the various types of retirement living options. There are many differences in the same type of community all over the country but this information will arm you with enough information to make an educated decision about what type of community to consider and to ask the right questions.
Planned Adult Community
The best example of this type is a Sun City. It is an area that is usually built around a golf course. It has a clubhouse, single-family homes, town houses, and condos, but no medical care is offered. It is for independent retirees generally in their early 60’s and 70’s and you must be at least 55 to live there. No children can live there permanently and you own your own home.
Independent Retirement Community
An independent community is one that has meals, some activities, and limited transportation. You have your own apartment, but they are almost always rentals. No Medical care is provided, but if you need additional care, you can hire your own caregiver.
Continuing Care Community (with and without equity)
A continuing care community with equity is like a condo. You own your apartment and pay a monthly assessment. In most places, you must pay cash for your apartment, property taxes and for services as they are needed. These communities can have as little as independent living and assisted living up to skilled nursing, Alzheimer’s, and Adult Day Care centers. When you pass away, your estate sells the apartment.
A continuing care community without equity is different. You pay an entrance fee to move in and then a monthly assessment. As you need additional care, you may pay a little extra for it. If you stay in the community for five years, you will most likely get nothing back on your initial entrance fee. If you leave before five years (not pass away), you will get back your entrance fee, minus 20% per year. Some communities have a program where you can pay more of an entrance fee, but then get back some money upon your death. You must have Medicare A & B to move in to these communities and be 65 years of age. There is usually no age cap in this type of community.
Life Care Community
A Life Care community is much like a continuing care community in that you pay an entrance fee and a monthly assessment. There are new contracts in place in most Lifecares that allow a family to get back a large percentage of the entrance fee. They can be different in each community so check it out. The difference is that when you need additional care, you do not pay any more for it. You can be living in two different areas of the building and still be paying only one monthly assessment. These communities have at least three levels of care and sometimes four:
The only things that Life Care does not provide are prescriptions, eye care, and dental care. You must have Medicate A&B and be 65 years of age. There is usually an age cap of 82 or 84.
Assisted Living Communities
An assisted living community is one that provides all the “assistance with daily living” that a senior may need. The population is usually a little more frail, however, there are many independent people who move into assisted living communities, knowing that they may, at some time, need a little help every day. In most of these communities, there are tow or three levels, depending on your needs and you are charged accordingly. In most assisted living communities you will pay an up front facility fee that can vary by 20,000.00 dollars. In some communities, the charge is a flat fee from the beginning, so you are really paying for services you don’t need at the time you move in. Most of these communities have an Alzheimer’s wing or floor.
Skilled Nursing Facilities
Skilled nursing is sometimes what people have in mind when they think of “nursing homes”. This type of facility is for sub-acute care, care that cannot be provided in the other types of communities, whether it is physical or mental. You can be bed-ridden, have a respirator, need shots, be wheelchair bound, have severe dementia etc.
Free Standing Alzheimer’s Facilities
These facilities can be wonderful places. They are dedicated to one purpose: Alzheimer’s and dementia patients. They are usually bright and cheerful and have wonderful art programs. They should have an outdoor area where the patients can go and a “dog run”, as some call it, for the patients to walk around in circles or back and forth.
Six and Under Board & Care
These are individual homes in residential areas that have a maximum of six residents. Some have private rooms, but most are shared rooms. There is a person who sleeps in the home at night to care for the residents, and another who comes during the day to bathe and feed the residents. These can be a good alternative to skilled nursing when a person can no longer live in an assisted living community, but is not appropriate for a skilled nursing facility. You can have beginning stages of dementia, Parkinson’s etc. and still be able to live there. Some are government subsidized and others are private pay. Look closely.
Questions to Ask When Visiting Communities
- What is the maximum amount of care your community will be able to offer me as I become more frail?
- What are the extra services you provide?
- How many meals do you offer per day and if I am gone for an extended period of time, do I pay for them?
- Do you have a non-occupancy fee if I won my apartment and I pass away?
- How long do you hold my apartment if I have to go to another level of care? Do I pay for both places simultaneously?
- Do you have a grace period where I can decide if I like the community? Do I get back all my money if I decide to move out?
- Do you allow pets, and if so, how big?
- Is a condo in a retirement a good real estate investment?
- Can you use your own real estate agent if you own your unit when you pass away?
- What has been the inflation increase in the monthly assessment over the past three years?
- Can you do what you want to your apartment?
- Is there a second person fee?
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