How do "Independent Living" communities work? Do you need to be in good health to get into one? Or is it simply much more expensive to do so if you are declining physically? Do you pay the same price no matter how intensive the services you require, or does the price increase as the services do? As someone in my early 50s, this is only barely on my radar screen.

Hello Please Explain from College Terrace: Thanks for your questions. There are various types of retirement communities, starting with 55+ communities like The Villages in San Jose, built for an active lifestyle, centered around a golf course. Folks who live there are around 55-75. No care is provided (though you could hire outside caregivers, the same as if you lived in your own private home.) Then there is Independent Living. Some of them are stand-alone month to month IL rentals, also with no care provided (some care can be brought in from the outside) but meals, transportation, housekeeping, and activities are often included. Next up is Assisted Living where you'll generally see more folks in walkers or wheelchairs, receiving assistance with Activities of Daily Living (ADLs). Then there is Memory Care which is usually a secured environment to prevent folks from wandering, generally on a month-to-month basis, same as AL. There are also Continuing Care Retirement Communities (CCRCs) that usually provide all of the various levels of care. Folks generally start out in the IL level (their own apt-homes, villas, condos) and then as their care needs increase they move through the various levels (continuum of care), moving from their IL home to smaller AL units... To get into IL you need to be in relatively good health and have no need for any kind of assistance. AL will cost more than IL if it's on a month to month basis. There's a number of financial models to discuss so I won't try to cover them all here. Memory Support will cost more than that, and Skilled Nursing Homes more than MS. Generally the prices increase as the care increases, though there are LifeCare Communities that can keep the cost even as you go through the levels. In those you generally are pre-paying for that increased care whether or not you use it. It's good to keep up on what's available now and what's coming down the pike. There are senior living couselors and referral agencies that can help when the time comes, assessing your needs and providing a list of communities that can meet them.

Max, thanks so much for the helpful clarification.

Thanks for this blog.

I am 63+, most of the things you wrote, make a lot of sense.

Yesterday, the Wall Street Journal featured retirement options to live in Amsterdam, Netherlands.

Sounds like one of many good options without having to break my bank.

Respectfully

Sea Seelam: Thanks for your comment. I lived in Rotterdam at one point as a lad (23) and loved the Dutch life, though Rotterdam is not Amsterdam! If the prices quoted don't break your bank then there are still some options available for you in the US, even in CA. It is quite exciting to live in another country and it can give you a new lease on life feeling. I would think a place like Greece might be more affordable and have a more agreeable climate to offer. My wife and I have been thinking about spending a good period of time after we have retired abroad before settling back down in CA to be closer to family. All in all, there are a lot of retirement options out there. Readers: please share some you've heard of, plan to go to, or are there now.

The basic problem retirement communities is cost. I hope you will outline some basic fees inorder for your suggestions to be more acceptable. Maybe you did on an earlier blog, sorry if I missed it. Also, can you also include ways to allow a parent to be in their home or in the home of thier child. Perhaps creating an "granny unit" for a parent. I realize you work for a retirment community, but please try not to discuss the options outside pricey communities. Also staying close to family is important, there can be ways to promote families to take care of their elders.

Currently we have set our parents in a living situation where it will be more economically reasonable to have live in help,( including family members as assistance), versus a retirment community. I guess if they had a high financial base they could afford a "nice" retirement community.

Their very small home has been slowly upgraded to meet their physical limitations. If health is very poor I realize a nursing home may be needed one day. However we find our priority is to allow them the peace of their home, as long as possible.

Resident: Great questions, I'll try to provide some useful answers, and perhaps other readers have some of their own.
There are various kinds of retirement communities (RCs) catering to various levels of care needed, or no care at all like what's called 55+ Active RC (perhaps built around a golf course.) After 55+ Active RC you have Independent Living (IL), Assisted Living (AL), Memory Support (MS) and then full scale Skilled Nursing Facilities (SNF). SNF usually have two components, one being short term rehab units, and then the other is the nursing home.
It?s easy to confuse the various kinds of RCs due to the multitude of labels they have and misconceptions as to what each kind will provide. I often get a call from someone (senior or their baby-boomer adult child) saying the senior is interested in assisted living, which is often misused as a catch-phrase for all retirement communities. So the first thing is to clearly define the senior?s current needs as well as near term future needs to help pick the right community and level of care.
Cost is obvioiusly a huge factor in accessing these communities, and they aren't getting cheaper. Some communities provide all the various levels of care on one campus and as a resident?s health needs dictate they can move through the various levels, usually entering at the IL level. Those communities, called CCRCs (Continuing Care RCs) usually involve a relatively large upfront outlay of cash (no mortgages at this time of life) plus a monthly services fee. But there are numerous month-to-month rental IL and AL communities that can prove to be more affordable. Much is dependent on location. A one bedroom apt in a typical IL rental in Sunnyvale or Santa Clara will run around $2000-2500/month. Included will be 2 or 3 meals per day served in the communal dining room, various social and exercise related activities and classes, transportation to outings and doctor?s appointments, and most utilities. The same in Palo Alto or Los Altos can run twice that, though the food may be a step up in quality.
Regarding staying in your own home, modifying it for ease of access and safety, and bringing in home care aides (and/or family to fill in the gaps) is certainly an option in many cases. Avenidas, Palo Alto?s senior organization, provides great resources, referrals and information to help folks stay in their homes. From my perspective, I think that the senior and their family need to look at the many factors to assess the best options for the senior to live as active, healthy, social, mentally stimulating and satisfying a life as possible. (There are senior living counselors who can help with this assessment, with knowledge of the various RC options.) To pre-judge that the optimum quality of life is best provided by remaining in their home, or by moving into an RC, before researching all the options and assessing both financial means and options to obtain assistance (from family, Veterans Administration etc.) does not necessarily serve the senior?s needs. I can say from my experience that the concept, seemingly set in stone, of aging in place and ?never leaving my home except in a box? can be the result of a fear of the unknown and belief that if I can just bunker down in my home I can postpone the inevitable. Knowledge, information and a supportive ?team? (family, friends, consultant) working together can make all the difference in quality of life, health and even longevity.

This really must be a tricky thing to time. I've never really thought about that before. I would be so frustrated if I couldn't qualify for independent living anymore because I had waited too long. Hopefully everything works out for this woman. She sounds incredibly healthy for someone of her age.
www.crimsonridgeseniorliving.com

Thanks for your comment Rose. Yes, that woman I met with is in very good health for her age (or even for someone 10 years earlier.) I hope she can decide to make the move before that "something" happens,because odds are it is coming sooner than later. Do you work in a retirement community?