Do you know anyone unhappy in a CCRC?

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Dan999
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Do you know anyone unhappy in a CCRC?

Post by Dan999 » Tue May 08, 2018 11:31 am

I have been researching CCRC's for a couple of years and have made a list of the downsides to living there, but even with this list, I have yet to meet or hear of anyone who was not happy. Other than a lady who moved in and could not sell her house and had to move out and a lady woman who moved back to her home state because she missed her family.
So, although everyone says they are happy and move in as soon as you can, have there been people that moved in where it is not working? All the comments on this board on the subject appear to be very positive.
This is a big lifestyle, and financial commitment, and I do not want to regret it.
Anyone?
Thanks
Dan999

Ninnie
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Re: Do you know anyone unhappy in a CCRC?

Post by Ninnie » Tue May 08, 2018 11:33 am

What is a CCRC?

Dan999
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Re: Do you know anyone unhappy in a CCRC?

Post by Dan999 » Tue May 08, 2018 11:38 am

Continuing Care Retirement Community.

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Christine_NM
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Re: Do you know anyone unhappy in a CCRC?

Post by Christine_NM » Tue May 08, 2018 11:49 am

I know of a man who tried out a CCRC at age 90 with his wife at the insistence of his kids, and moved back into his own house after a month, getting full refund. A few years passed, wife passed, and in 2018 the kids tried again to get him to move. He sold off furniture and belongings, but not the house. Told his children he had paid for the apartment (but he had not, so he "lost" his place in line as was his intention all along).

He's now in his house again, and bought new furniture. :D He's where he wants to be and has sufficient help.

Moral of the story: Don't let kids dictate your retirement decisions.

Another neighbor of mine got the same pressure from her kids in her 90s but is doing OK with help and has resisted all attempts to pry her out.
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blackburnian
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Re: Do you know anyone unhappy in a CCRC?

Post by blackburnian » Tue May 08, 2018 12:19 pm

My mother lived in one for about 8 years after my father died. It was a good decision for her, as she wouldn't have been able to stay in her house, but there were definitely things she didn't like. The marketing materials are always very shiny and beautiful, but there may be some rot beneath the surface. A few things to consider:

1. Find out how financially sound the place is. The one my mother moved into was just being built, so she got to pick the apt she wanted, but then the housing crisis hit, people couldn't sell their houses to move in, and the place was losing money. The gourmet meals in the dining room became not so gourmet. The good physical therapist was replaced with a bad physical therapist. The place went bankrupt. After my mother died, the facility delayed returning the deposit (but eventually they did). Of course you can't predict an economic downturn, but you can check our their current financial situation and see how often they raise prices. Have a lawyer check the contract.

2. Take a good look at the assisted living and nursing home areas and if possible talk to people in them. Although they were touted as being top of the line in my mother's case, they were not adequately staffed and were depressing places. After short stints in both, after falls, she declared that she would never go back to either one under any circumstances. For the last year, she had 24-hr care in her apt (at $20,000/mo) and died at home.

3. Find out what kind of in-home health care is available and how much it costs. The agency that this place used had very low paid and improperly trained staff. There were problems with theft, and many of the helpers didn't know how to cook at all, though they were supposed to prepare meals.

On the other hand, my mother loved her large apartment and knew many of the other residents. The CCRC staff were friendly and helpful. I don't know that she had any better options (this was the best CCRC in her area). Most of the residents seemed pretty happy except the ones who moved there to be near their children, and then the children never visited. It was possible to be either social or not, and the facility provided rides to concerts, the grocery store, and medical appts.

Overall, think about the things you like to do and whether you would still be able to do them there, and what life would be like under different health conditions. And what your alternatives are.

NotWhoYouThink
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Re: Do you know anyone unhappy in a CCRC?

Post by NotWhoYouThink » Tue May 08, 2018 12:27 pm

I think my mother wishes she didn't need to be there, but that is not quite the same as regretting moving in.

- There are cliques. There just are, even with all the staff does to try to encourage people to welcome newcomers and socialize with many different people.
- Everyone there is old. All your friends are old. "A room full of white heads" is the phrase she uses to describe events there.
- There is less privacy than in your free-standing home.

There are many advantages, including meeting new people and having many more social opportunities because you don't have to drive at all, and especially after dark.

Part of the problem is just the fact of getting old. When you can't drive at night, or just can't drive, your world gets so much smaller. It's not the fault of the CCRC, just a hard adjustment.

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Re: Do you know anyone unhappy in a CCRC?

Post by delamer » Tue May 08, 2018 1:41 pm

NotWhoYouThink wrote:
Tue May 08, 2018 12:27 pm
I think my mother wishes she didn't need to be there, but that is not quite the same as regretting moving in.

- There are cliques. There just are, even with all the staff does to try to encourage people to welcome newcomers and socialize with many different people.
- Everyone there is old. All your friends are old. "A room full of white heads" is the phrase she uses to describe events there.
- There is less privacy than in your free-standing home.

There are many advantages, including meeting new people and having many more social opportunities because you don't have to drive at all, and especially after dark.

Part of the problem is just the fact of getting old. When you can't drive at night, or just can't drive, your world gets so much smaller. It's not the fault of the CCRC, just a hard adjustment.
My mother had never lived in any kind of group housing before moving to an independent apartment in a CCRC and some of her complaints reminded me of how I felt about my college dorms — people, food, etc. It was interesting.

The last point above is important. Aging is tough no matter where you live, and a CCRC is not a cause of nor a cure for many of those issues.

I know of one man who left my mother’s community. He sounded like a control freak type who was not well-suited to community living. There are rules and you don’t get to live exactly as you want. He wasn’t liked by the other residents; people get tired of complaints/disruptions all of the time.

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Re: Do you know anyone unhappy in a CCRC?

Post by Fallible » Tue May 08, 2018 1:49 pm

NotWhoYouThink wrote:
Tue May 08, 2018 12:27 pm
I think my mother wishes she didn't need to be there, but that is not quite the same as regretting moving in.

- There are cliques. There just are, even with all the staff does to try to encourage people to welcome newcomers and socialize with many different people.
- Everyone there is old. All your friends are old. "A room full of white heads" is the phrase she uses to describe events there.
- There is less privacy than in your free-standing home.

There are many advantages, including meeting new people and having many more social opportunities because you don't have to drive at all, and especially after dark.

Part of the problem is just the fact of getting old. When you can't drive at night, or just can't drive, your world gets so much smaller. It's not the fault of the CCRC, just a hard adjustment.
This well describes much of what I've learned about CCRCs from three relatives who lived in different ones in different states. While visiting them fairly often, I could see the advantages and disadvantages, and how content they were seemed to depend mainly on personal preference, general adaptability, and their health.
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grok87
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Re: Do you know anyone unhappy in a CCRC?

Post by grok87 » Tue May 08, 2018 2:09 pm

blackburnian wrote:
Tue May 08, 2018 12:19 pm
My mother lived in one for about 8 years after my father died. It was a good decision for her, as she wouldn't have been able to stay in her house, but there were definitely things she didn't like. The marketing materials are always very shiny and beautiful, but there may be some rot beneath the surface. A few things to consider:

1. Find out how financially sound the place is. The one my mother moved into was just being built, so she got to pick the apt she wanted, but then the housing crisis hit, people couldn't sell their houses to move in, and the place was losing money. The gourmet meals in the dining room became not so gourmet. The good physical therapist was replaced with a bad physical therapist. The place went bankrupt. After my mother died, the facility delayed returning the deposit (but eventually they did). Of course you can't predict an economic downturn, but you can check our their current financial situation and see how often they raise prices. Have a lawyer check the contract.

2. Take a good look at the assisted living and nursing home areas and if possible talk to people in them. Although they were touted as being top of the line in my mother's case, they were not adequately staffed and were depressing places. After short stints in both, after falls, she declared that she would never go back to either one under any circumstances. For the last year, she had 24-hr care in her apt (at $20,000/mo) and died at home.

3. Find out what kind of in-home health care is available and how much it costs. The agency that this place used had very low paid and improperly trained staff. There were problems with theft, and many of the helpers didn't know how to cook at all, though they were supposed to prepare meals.

On the other hand, my mother loved her large apartment and knew many of the other residents. The CCRC staff were friendly and helpful. I don't know that she had any better options (this was the best CCRC in her area). Most of the residents seemed pretty happy except the ones who moved there to be near their children, and then the children never visited. It was possible to be either social or not, and the facility provided rides to concerts, the grocery store, and medical appts.

Overall, think about the things you like to do and whether you would still be able to do them there, and what life would be like under different health conditions. And what your alternatives are.
Thanks
Sounds like Erickson
https://en.m.wikipedia.org/wiki/Erickson_Living
Ther was a recent nytimes article that basically read like marketing material for ccrcs.

viewtopic.php?t=248400
The journalist quoted a guy from Erickson but somehow failed to mention that they had gone bankrupt.

Cheers,
Grok
"...people always live for ever when there is any annuity to be paid them"- Jane Austen

Mitchell777
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Re: Do you know anyone unhappy in a CCRC?

Post by Mitchell777 » Tue May 08, 2018 2:28 pm

blackburnian wrote:
Tue May 08, 2018 12:19 pm

2. Take a good look at the assisted living and nursing home areas and if possible talk to people in them. Although they were touted as being top of the line in my mother's case, they were not adequately staffed and were depressing places. After short stints in both, after falls, she declared that she would never go back to either one under any circumstances. For the last year, she had 24-hr care in her apt (at $20,000/mo) and died at home.

Completely agree with this. In the facility I am familar with (non profit faith based), when you walked through the independent living area you almost felt like moving in at any age. People seemed very happy with the facility especially if they are on the more sociable side. Lovely homes and apartments. Beautiful dining area. Then when you walked through assisted living/personal care, it was not quite as enticing. I recall my mother looking at the small living area and saying it reminded her of jail. Dining area fine but nothing like independent living. Then in the nursing area, everything was much plainer. Double occupancy so tight that two TV's are blasting within six feet of each other. Dining area like that of an independent hamburger establishment. Of course, due to health issues the people are less and less happy as they move from one region of the facility to the next. Definitely visit the assisted living and nursing areas. Ask to see all nursing areas or they will show you the "nicer" section with the healthier patients. Especially at meal times and in evening. Things can change when all the admin staff and visitors leave for the day. Very difficult decisions.

CULater
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Re: Do you know anyone unhappy in a CCRC?

Post by CULater » Tue May 08, 2018 2:29 pm

Seems like the critiques offered thus far are not unique to CCRCs. Senior independent living apartments and assisted living also have the same downsides, as they are group/community living facilities as well. Biggest problems I've seen with my mother is that everyone is old and majority are not terribly social except with their "buddies", the food, the food, and the food. The rules, the rules, and the rules. Generally these places are warehouses for the elderly; some of them have some nice tinsel, a few of them have decent food. The only thing about a CCRC is that you're kinda stuck with the place once you've bought in, so it better turn out well. I would agree strongly that people should check out the assisted living and nursing care sections of the CCRC. You move into these places in the independent living section, which often is nice, has good food, and amenities. But the reason you're in a CCRC is so you can receive a continuum of care with out the hassle of moving to different facilities and the theory that the quality of care at higher levels will be better than the run-of-the-mill.
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

DippityDoo
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Re: Do you know anyone unhappy in a CCRC?

Post by DippityDoo » Tue May 08, 2018 3:41 pm

blackburnian wrote:
Tue May 08, 2018 12:19 pm
The marketing materials are always very shiny and beautiful, but there may be some rot beneath the surface.
Oh, amen to that! Not just the brochures, but the marketing people can be slick too. Be sure EVERY detail important to you is in writing, just as you would if you were buying a car. The process is rather similar. The CCRC sales rep gets a bonus if you sign a lease and the facility's goal is to extract as much money from you as possible. While you look for quality care, be mindful that you're dealing with a business that has a profit motive like any other.
Find out how financially sound the place is.
Yes, and know that rent increases may have nothing to do with financial stability. My mother was in a facility that was in good shape financially but raised rates (and cut services) in order to finance expansion. It was maddening to pay more for less.
Have a lawyer check the contract.
Yes, absolutely!
Take a good look at the assisted living and nursing home areas and if possible talk to people in them. Although they were touted as being top of the line in my mother's case, they were not adequately staffed and were depressing places.
Sounds like our experience. All facilities are short-staffed at times but at some places it's an ongoing problem. I also recommend visiting at odd times or visiting unannounced. Sometimes when we weren't expected by staff, we would encounter situations that made us shudder. Also, if you anticipate a possible need for dementia care, find out if there is a memory care unit on site. Memory care (ideally) has more activities and dementia-specific programming than you'll find in the intermediate or skilled nursing wing of a CCRC. You can use the Nursing Home Compare tool at Medicare.gov to check out survey reports and deficiencies in the nursing home part of the CCRC.
Find out what kind of in-home health care is available and how much it costs. The agency that this place used had very low paid and improperly trained staff. There were problems with theft
Another good point. Most facilities will contract with various agencies for home care, hospice care, and perhaps physician visits. We encountered quite a bit of turnover in agency staff because of change in facility administrators. Medicare.gov also has a tool for getting info about Home Health agencies that may contract with the facility. Because administration and other staff at CCRCs tend to have a high turnover rate, things that are presently satisfactory may not be so in 6 months time. We ran into problems with theft too. Unfortunately, if there isn't family to monitor things closely, it's a vulnerability that's hard to avoid.

My experience with CCRCs and my parents' care left me a bit jaded. I'm not sure if my experience reflects poor ability to select facilities or general problems in the industry.

ncbill
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Re: Do you know anyone unhappy in a CCRC?

Post by ncbill » Tue May 08, 2018 4:38 pm

There's no control over price increases, no matter what you're promised.

You might get the same surprise my grandmother did.

Lived in her CCRC for 20 years in a two-bedroom freestanding cottage.

About a decade in, shortly after granddad died, the CCRC told her (and all the others who bought in at the same time) paraphrasing:

"You're only paying half what new residents pay, so we're doubling your monthly fee effective next month."

sbaywriter
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Re: Do you know anyone unhappy in a CCRC?

Post by sbaywriter » Tue May 08, 2018 4:53 pm

Not much new to add to comments above but will share my mom’s experiences, since she left a CCRC. She was in her mid 80s but still active and in good health, and worked part time. She lived in an apartment close to public transportation and within walking distance of stores and services. But the apartment was too expensive for her and my siblings and her looked for alternatives that would fit her budget and provide support she would need as she aged. They chose a CCRC outside city in kind of small town/suburb. It was also closer to one of my siblings.

Within a year or so she left the CCRC and moved back to another apartment in the city, to a building with services for seniors, although no assisted living, and was happy to be back.

Here’s what her main complaints were at the CCRC:

She didn’t like the enforced “pay for 2 meals a day” because she was still cooking her own meals and she was a vegetarian and there were almost no vegetarian options on the menus.

The residents were mostly in worse shape than her, less sharp mentally, less energetic – she didn’t like being around a bunch of old sick people when she was still active.

In the city she had more mobility - she could walk or take public transit most places – still had car but only used it for occasional shopping. Whereas at the CCRC she had to drive everywhere, and longer distances to get to stores and it was difficult driving conditions. There was a van for shopping but she was commuting into the city 4 days a week since she kept her job so she usually wasn't there when the van made its runs.

Aside from that, even if the CCRC had been in the city, I don't think she would have liked it - because not a community or group oriented person.

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Munir
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Re: Do you know anyone unhappy in a CCRC?

Post by Munir » Tue May 08, 2018 5:22 pm

Be prepared for loss of autonomy- much bigger deal than one imagines beforehand.

The management mostly cares about the bottom line. Try and organize the residents to be more involved in management -which mangement will resist.

CULater
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Re: Do you know anyone unhappy in a CCRC?

Post by CULater » Tue May 08, 2018 5:52 pm

One important indicator for any facility for the elderly is the staff turnover rate. The better places tend to be ones with low turnover and staff who have years of tenure. My mother has lived in two assisted living facilities. The first was a new facility, very upscale looking. Didn't know to ask at the time, but should have chatted with staff to find out about them. Had I done so, I would have learned that the turnover rate was high and that most of the staff came from a staffing agency and were not actually employed by the facility. Bad and bad. The second was an older facility kept nicely. Just about everyone I spoke with had been there for 8, 10 years or longer. And they were all employees of the facility. Big difference in the quality of care provided to my mother. It was also a non-profit, while the first AL facility was for-profit. One important staff person is the maintenance guy/gal. In the first place, we would ask that something be fixed/tweaked and wait for days. In the second place, I asked for a tweak to the room A/C and the guy was there almost before I could finish my sentence. This has continued to be the case with other items I've asked him to take care of.
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

JoeRetire
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Re: Do you know anyone unhappy in a CCRC?

Post by JoeRetire » Tue May 08, 2018 6:16 pm

Dan999 wrote:
Tue May 08, 2018 11:31 am
So, although everyone says they are happy and move in as soon as you can, have there been people that moved in where it is not working? All the comments on this board on the subject appear to be very positive.
I don't personally know anyone who has been unhappy with the move after giving themselves time to settle in.
This is a big lifestyle, and financial commitment, and I do not want to regret it.
I don't see how fishing for unhappy folks with a poll in a web forum can ease your mind.

Clearly, you are worried. So don't make the move now. Perhaps at a later date you'll feel more comfortable.

delamer
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Re: Do you know anyone unhappy in a CCRC?

Post by delamer » Tue May 08, 2018 6:40 pm

JoeRetire wrote:
Tue May 08, 2018 6:16 pm
Dan999 wrote:
Tue May 08, 2018 11:31 am
So, although everyone says they are happy and move in as soon as you can, have there been people that moved in where it is not working? All the comments on this board on the subject appear to be very positive.
I don't personally know anyone who has been unhappy with the move after giving themselves time to settle in.
This is a big lifestyle, and financial commitment, and I do not want to regret it.
I don't see how fishing for unhappy folks with a poll in a web forum can ease your mind.

Clearly, you are worried. So don't make the move now. Perhaps at a later date you'll feel more comfortable.
Later isn’t always an option. Most, maybe all, facilities require that you be in good health in order to enter.

My in-laws have a friend that just was rejected by a CCRC because its required physical revealed early stage dementia.

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Re: Do you know anyone unhappy in a CCRC?

Post by Pajamas » Tue May 08, 2018 10:28 pm

Dan999 wrote:
Tue May 08, 2018 11:31 am
This is a big lifestyle, and financial commitment, and I do not want to regret it.
It won't be perfect.

What other options are you considering? Comparing it to your alternatives may be more useful.

Might help to research particular problems and frustrations that you might encounter rather than asking if anyone is unhappy generally.

https://www.google.com/search?q=problem ... unity+ccrc

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Re: Do you know anyone unhappy in a CCRC?

Post by plannerman » Wed May 09, 2018 7:06 am

Every CCRC is different. You have to do your homework.

One of the more compelling reasons we chose the CCRC we did was because every resident we talked to was generally happy. We were fortunate because several acquaintances from our community had previously moved to the same CCRC and had shared their experiences with us. But we also found that when we were touring the facility the residents were also more than happy to share their experiences with us as well. We arrived early one morning for an appointment with the marketing people. So to kill some time, we asked if they had a place to get a cup of coffee. We wandered down to the cafe and the residents recognised we were strangers and invited us to join them. It turned out to be a great way to gather intelligence unvarnished by the marking folks.There were complaints, mostly related to giving up control, but the bottom line was the pros far outweighed the cons.

plannerman

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mrc
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Re: Do you know anyone unhappy in a CCRC?

Post by mrc » Wed May 09, 2018 7:47 am

My in-laws removed my MIL from an upscale CCRC as her dementia worsened. When my FIL/MIL sold their home and moved into their apartment, life for them was great. Meals in the dining room or cooked in the apartment. Activities galore. In-house medical staff available 24x7. Assisted living and nursing units available if necessary. FIL died not long after move in. Over the next 10+ years, the facility ran into financial troubles. The complex was sold to a different management company.

Inevitable staff cuts and turnover—and obvious cost-cutting—changed the environment. Care and service levels rapidly deteriorated. For example, medical care was provided by a weekly visiting practitioner, with a monthly visit by an MD. Emergent problems handled simply by a call to EMS and a trip to the local ER. MILs monthly "rent" doubled then nearly tripled while in the higher level of care wings, which was expected. However, after the move to assisted living first, then the memory unit, it was clear to family that MIL was warehoused and improperly medicated. They were not trying to help her improve, or enriched, but stowed away with minimal care at maximum cost.

MIL's apartment did not sell (releasing the funds from a substantial initial deposit) for over two years. Family moved her out of the CCRC to a dedicated memory care unit—farther away but for a much lower monthly fee—where she received proper medical and better social attention. Family had to threaten legal action to complete the sale of the apartment and recover the initial six-figure deposit. My FIL chose the facility with the idea that they were both taken care of, and paid handsomely for that peace of mind. Unfortunately, that isn't how things turned out.

This episode demonstrated to my wife and me that even with prodigious planning and more than adequate financial resources, CCRC life may not end up as we hope. We are much less likely to engage a CCRC as a result of our observations.
Honor to the soldier and sailor everywhere, who bravely bears his country's cause. Honor, also, to the citizen who cares for his brother in the field and serves, as best he can, the same cause. —AL

Dan999
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Re: Do you know anyone unhappy in a CCRC?

Post by Dan999 » Wed May 09, 2018 10:30 am

OP here,
Thanks fellow bogleheads. This is good food for thought.

We are inclined to move into one of 3 facilities, and will most likely go with the one that is a religious affiliated Non Profit that has been around for decades and has a good track record. It is the most expensive, but our instinct is that this is the one we should pick. Staff is long term, with minimal turnover, on site chef and medical staff, rate increases 3% for several years. I go to gym there regularly and get a good vibe from the staff and residents. Medicare rating is 5 star for years.
One of the driving factors is that we do not have any family support close by, so we are kind of on our own in case something happens to one of us.
I know we will give up some independence and have rules to follow, which I have read and ok with. I also know there will not be an inheritance for our child if we live to 95.
Our only hesitation is that we are about 5 years younger that the average age, but we are also concerned that if we wait, we could get a nasty medical surprise in the next few years.
So, we are reluctant to leave out beautiful, one story home in an adult community, but the time is right. Health is still good, housing market is hot, and the economy is good.
We are looking forward to new friends and activities, and hopefully after we settle in, we will not look back at the old place. That was our experience when we reluctantly moved from our colonial house, to our active adult community house we are in now.
Thanks much everyone for your input.
I will post updates to this as time goes by. We may not be moving for a year or two, since we have to wait until the right apartment opens up.
Dan999

ChrisC
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Re: Do you know anyone unhappy in a CCRC?

Post by ChrisC » Wed May 09, 2018 4:48 pm

Dan999 wrote:
Wed May 09, 2018 10:30 am
Our only hesitation is that we are about 5 years younger that the average age, but we are also concerned that if we wait, we could get a nasty medical surprise in the next few years.
I've been told that "it's better to be 5 years early than 5 minutes late" when deciding to enter a CCRC that may offer everything. One of the drawbacks I see with us entering into a CCRC is that "we're just not ready," a refrain voiced often for the many people on the 5-year-long wait list for the CCRC we like. We've been mulling over placing our name on the wait list for this highly demanded and expensive CCRC -- and we also would be much younger than the average age of residents, which is another reason we're reluctant to proceed with adding our names to the wait- list. We're 66 and 64 and figure most at the CCRC are late 70's to 90's.

How old are both of you?

delamer
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Re: Do you know anyone unhappy in a CCRC?

Post by delamer » Wed May 09, 2018 5:21 pm

ChrisC wrote:
Wed May 09, 2018 4:48 pm
Dan999 wrote:
Wed May 09, 2018 10:30 am
Our only hesitation is that we are about 5 years younger that the average age, but we are also concerned that if we wait, we could get a nasty medical surprise in the next few years.
I've been told that "it's better to be 5 years early than 5 minutes late" when deciding to enter a CCRC that may offer everything. One of the drawbacks I see with us entering into a CCRC is that "we're just not ready," a refrain voiced often for the many people on the 5-year-long wait list for the CCRC we like. We've been mulling over placing our name on the wait list for this highly demanded and expensive CCRC -- and we also would be much younger than the average age of residents, which is another reason we're reluctant to proceed with adding our names to the wait- list. We're 66 and 64 and figure most at the CCRC are late 70's to 90's.

How old are both of you?
At my parents’ CCRC, they were able to stay at the top of the wait list when they’d declined an apartment and so did not have to move until they were ready. They wanted a two bedroom unit, and those did not become available frequently.

Whether they could have done this indefinitely and/or if their health had declined, I don’t know.

Unless there is a specific health issue that leads you to feel that you won’t qualify later, I agree that mid-60’s is too young. With a 5-year wait list, early 70’s would be about right for the wait list.

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Re: Do you know anyone unhappy in a CCRC?

Post by Mitchell777 » Wed May 09, 2018 5:34 pm

delamer wrote:
Wed May 09, 2018 5:21 pm
At my parents’ CCRC, they were able to stay at the top of the wait list when they’d declined an apartment and so did not have to move until they were ready. They wanted a two bedroom unit, and those did not become available frequently.

Whether they could have done this indefinitely and/or if their health had declined, I don’t know.

Unless there is a specific health issue that leads you to feel that you won’t qualify later, I agree that mid-60’s is too young. With a 5-year wait list, early 70’s would be about right for the wait list.
There is a CCRC close to me that is similar. Many of the wealthy people I worked for over the years go to the facility at some point. They do not accept Medicaid so you need to have some wealth to go direct from home to nursing care. Otherwise people go from home to apartments although they also have some very expensive homes, some with three bedrooms which I never understood. There is a fee to be on the list but I do not know what it is. I think it includes some meals so you can eat there to get a feel for the place.

delamer
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Re: Do you know anyone unhappy in a CCRC?

Post by delamer » Wed May 09, 2018 5:38 pm

Mitchell777 wrote:
Wed May 09, 2018 5:34 pm
delamer wrote:
Wed May 09, 2018 5:21 pm
At my parents’ CCRC, they were able to stay at the top of the wait list when they’d declined an apartment and so did not have to move until they were ready. They wanted a two bedroom unit, and those did not become available frequently.

Whether they could have done this indefinitely and/or if their health had declined, I don’t know.

Unless there is a specific health issue that leads you to feel that you won’t qualify later, I agree that mid-60’s is too young. With a 5-year wait list, early 70’s would be about right for the wait list.
There is a CCRC close to me that is similar. Many of the wealthy people I worked for over the years go to the facility at some point. They do not accept Medicaid so you need to have some wealth to go direct from home to nursing care. Otherwise people go from home to apartments although they also have some very expensive homes, some with three bedrooms which I never understood. There is a fee to be on the list but I do not know what it is. I think it includes some meals so you can eat there to get a feel for the place.
I believe my parents made a $1000 deposit that was not refundable.

The 3 bedrooms doesn’t surprise me anymore. My in-laws each use a bedroom in their house as an office/hobby room.

Dan999
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Re: Do you know anyone unhappy in a CCRC?

Post by Dan999 » Thu May 10, 2018 7:28 am

ChrisC wrote:
Wed May 09, 2018 4:48 pm
Dan999 wrote:
Wed May 09, 2018 10:30 am
Our only hesitation is that we are about 5 years younger that the average age, but we are also concerned that if we wait, we could get a nasty medical surprise in the next few years.
I've been told that "it's better to be 5 years early than 5 minutes late" when deciding to enter a CCRC that may offer everything. One of the drawbacks I see with us entering into a CCRC is that "we're just not ready," a refrain voiced often for the many people on the 5-year-long wait list for the CCRC we like. We've been mulling over placing our name on the wait list for this highly demanded and expensive CCRC -- and we also would be much younger than the average age of residents, which is another reason we're reluctant to proceed with adding our names to the wait- list. We're 66 and 64 and figure most at the CCRC are late 70's to 90's.

How old are both of you?
We are in our early 70's. The wait list is very long for 2 BR apts.
Why not get on the list and just decline if you are not ready? Some facilities let you stay at the top of the list, and some give you 2 chances, then you move to the bottom of the list. All are refundable deposits that I know of.
Dan 999

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Re: Do you know anyone unhappy in a CCRC?

Post by ChrisC » Thu May 10, 2018 8:41 am

Dan999 wrote:
Thu May 10, 2018 7:28 am
We are in our early 70's. The wait list is very long for 2 BR apts.
Why not get on the list and just decline if you are not ready? Some facilities let you stay at the top of the list, and some give you 2 chances, then you move to the bottom of the list. All are refundable deposits that I know of.
Dan 999
I'm thinking we might do that after we do more investigative work about this CCRC and others in our area. The wait list deposit is refundable but the application fees aren't and I suspect the financial review process would be very intrusive. As for now, I just think we're not even ready to make a deposit and go thru the application process. Besides, we think of the CCRC as our Plan B and our Plan A is currently working well -- we live in a home that we can age-in-place (it's our retirement/permanent home we moved into 4 years ago) and we have LTCi and assets to take care of ourselves in homecare for worse case scenarios. We're very fortunate. We might sour on Plan A as we might get tired of home maintenance 5 years from now and seriously engage in activating Plan B.

CULater
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Re: Do you know anyone unhappy in a CCRC?

Post by CULater » Thu May 10, 2018 9:01 am

What are the presumed benefits of a CCRC? Why go through the process of financial commitment to such a facility, as opposed to the other route of moving into a month-by-month senior independent living and assisted living facility?
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

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Re: Do you know anyone unhappy in a CCRC?

Post by Dan999 » Thu May 10, 2018 9:13 am

Without going into the many facets of the CCRC's, I will summarize our decision to do this.
Once we move in we will be taken care of the rest of our lives through life's various stages, We will not have to depend on family to make decisions for us in a crisis situation and find a place for the surviving spouse that may be subpar when your options are limited because of health issues.

As we decline in our physical abilities, driving ability, and incur social isolation, you will need help from someone. We have seen how this works or does not work in trying to get reliable outside help for the elderly.
It would be easier to stay where we are, but someday, in1 year or 10 years, I know we would have regretted it.
It all depends on your support network.
Dan999
PS, the facilities we are familiar with do not require extensive financial disclosure to get on the waiting list.

delamer
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Re: Do you know anyone unhappy in a CCRC?

Post by delamer » Thu May 10, 2018 10:32 am

CULater wrote:
Thu May 10, 2018 9:01 am
What are the presumed benefits of a CCRC? Why go through the process of financial commitment to such a facility, as opposed to the other route of moving into a month-by-month senior independent living and assisted living facility?
One common financial arrangement is that in return for a large deposit, the base fee that you pay for independent living does not increase if you need to move into assisted living or skilled nursing care. (There are annual COLAs on the base fee however.). An outsider paying for higher-level care would pay a much higher rate — for my mother the difference was $4,200/month versus $12,000/month. So your costs become more predictable. You also get bumped to the top of the waiting list (over outsiders) should you need to move to more skilled care. Space in well run places can be scarce.

Also, if you are in an independent apartment and need to move to nursing care due to a temporary illness/condition, your apartment will be held without you paying an extra fee.

And the staff who knew my mother well from her many years in her apartment were invaluable in keeping me informed as her health deteriorated and in making the transition to skilled nursing.

CULater
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Re: Do you know anyone unhappy in a CCRC?

Post by CULater » Thu May 10, 2018 10:54 am

Dan999 wrote:
Thu May 10, 2018 9:13 am
Without going into the many facets of the CCRC's, I will summarize our decision to do this.
Once we move in we will be taken care of the rest of our lives through life's various stages, We will not have to depend on family to make decisions for us in a crisis situation and find a place for the surviving spouse that may be subpar when your options are limited because of health issues.

As we decline in our physical abilities, driving ability, and incur social isolation, you will need help from someone. We have seen how this works or does not work in trying to get reliable outside help for the elderly.
It would be easier to stay where we are, but someday, in1 year or 10 years, I know we would have regretted it.
It all depends on your support network.
Dan999
PS, the facilities we are familiar with do not require extensive financial disclosure to get on the waiting list.
This is important to me, since I will likely be on my own as I age with no-one to make decisions and facilitate moves to higher level of care facilities. For the most part, it would seem that CCRC integrate independent, assisted, and nursing levels of care within the same facility. I've noticed that there is some integration in some facilities that are not CCRCs. For example, some non-CCRCs I've run across integrate independent living with assisted living, usually by means of providing in-house homecare that you can receive on an ala carte basis as needed. So, you would be able to stay in place in such a facility until the point that you require skilled nursing care. There are several non-CCRCs in my areas that offer both independent living and assisted living and moving from one to the other. One non-CCRC that I've recently become aware of has all three levels of care in the same facility. You can enter at any level of care; I don't know if you would have priority if you were moving from one level of care to a higher level within the facility, but I can't see why you wouldn't. I wonder if this is going to become more common as new facilities are being developed and built? I do worry about the lifetime buy-in required by CCRCs. You pay a very large up-front sum that you can't redeem. I know this is handled differently by different CCRCs. In the one I looked at, you must purchase your independent-living apartment up-front for a large amount and there is no equity share. I assume you'd be able to bail out later if you wanted, but you would forfeit that large sum to do so.
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

Mitchell777
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Re: Do you know anyone unhappy in a CCRC?

Post by Mitchell777 » Thu May 10, 2018 11:42 am

I've wondered what happens if the CCRC does not have a nursing bed when a resident needs to move from independent or assisted living to nursing. Or, when a bed is available but there are one or two people who will come from their personal home to nursing, paying $12K per month vs. The $4.5K per month the CCRC resident will pay. Having dealt with a CCRC with a parent, I guess I'm a bit gun shy. I recall sitting in a meeting with the admin as they were selling me on an assisted living room as my parent came from rehab. She had no date on rehab release but they told me if I do not take the room now I might only have 48 hours to get her out of the facility should she be released from rehab. It was the first time in my life I ever felt I was under a really hard-sell. The facility being a non profit faith based institution, it surprised me. Not saying anyone else would be surprised but I was. I was afraid not to take the room so I took it. Weeks later they decide she needed to go from rehab to nursing and she never spent a minute in the assisted living room.

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Re: Do you know anyone unhappy in a CCRC?

Post by Dan999 » Thu May 10, 2018 11:47 am

Some facilities have a 90% refund policy if you move our or die. My experience is that this does not allow you to go to assisted living or nursing at the same price. They could not possibly afford the refund and provide the care. The entry fee and high monthly rental is your payment for your future long term care.
You could live in your apt. and use in home visiting caregivers that they would help you find, at your cost. But when nursing care is needed be ready for up to $140,000 per year depending on the region of the country.

Some facilities with the non refundable upfront fee, allow you to move out and get a partial refund on a sliding scale say over 3 years, and you can find somewhere else to move to if you wish.

Dan999

delamer
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Re: Do you know anyone unhappy in a CCRC?

Post by delamer » Thu May 10, 2018 12:22 pm

Mitchell777 wrote:
Thu May 10, 2018 11:42 am
I've wondered what happens if the CCRC does not have a nursing bed when a resident needs to move from independent or assisted living to nursing. Or, when a bed is available but there are one or two people who will come from their personal home to nursing, paying $12K per month vs. The $4.5K per month the CCRC resident will pay. Having dealt with a CCRC with a parent, I guess I'm a bit gun shy. I recall sitting in a meeting with the admin as they were selling me on an assisted living room as my parent came from rehab. She had no date on rehab release but they told me if I do not take the room now I might only have 48 hours to get her out of the facility should she be released from rehab. It was the first time in my life I ever felt I was under a really hard-sell. The facility being a non profit faith based institution, it surprised me. Not saying anyone else would be surprised but I was. I was afraid not to take the room so I took it. Weeks later they decide she needed to go from rehab to nursing and she never spent a minute in the assisted living room.
My mother was still in her independent apartment and needed to move to MemoryCare. She was at the top of the waiting list but there were no vacancies. She was managing OK until she had a health issue unrelated to her dementia and ended up in skilled nursing.

I obviously had no way to prove that an outsider paying higher fees wasn’t getting preference for assisted living, but I had no reason to think their written policy was being violated either. (Remember too that most people aren’t going to be able to pay full freight for long and are going to end up on Medicaid.)

One advantage of being on site is that the staff had identified her need to move before it reached crisis level, so the delay wasn’t a big problem. Too many of these decisions are made by families at the 11th hour when they realize that Mom Isn’t safe in her long time home and they are scrambling for options.

You might have gotten a hard sell, but you may have been told the absolute truth.

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Re: Do you know anyone unhappy in a CCRC?

Post by ChrisC » Thu May 10, 2018 1:26 pm

CULater wrote:
Thu May 10, 2018 10:54 am
I do worry about the lifetime buy-in required by CCRCs. You pay a very large up-front sum that you can't redeem. I know this is handled differently by different CCRCs. In the one I looked at, you must purchase your independent-living apartment up-front for a large amount and there is no equity share. I assume you'd be able to bail out later if you wanted, but you would forfeit that large sum to do so.
The CCRC I have been touring and investigating provides for equity ownership of the unit (apartments or single family homes) one purchases on the campus. You purchase your unit from the CCRC and pay a membership fee equal to 10 percent of the purchase price -- that's your entry fee. You own the unit but the CCRC has the right to repurchase it from you when you no longer need the unit; the CCRC sells it to the next person on the wait list desiring and capable of buying your unit. There has been substantial equity upside to these units -- the campus is 20 years old and units have increased significantly over that time. You can customize the inside of the unit to your liking, including knocking down non-support walls -- and there's some limited additional exterior add-ons (patios/gardens) one can do to homes on the campus. There is a monthly membership/maintenance fee driven by the square footage of the unit you own and whether one or two people are occupying the unit.

When one is functioning at high levels, the CCRC is almost like living on a college campus, with resort style dining, numerous activities, total housekeeping and transportation services, etc. So, the benefits of the CCRC for high functioning people are substantial. As one becomes functioning at lower levels, there's assisted living and home care services available, and at the most dependent care level, there's skilled nursing facilities on campus.

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Re: Do you know anyone unhappy in a CCRC?

Post by mouses » Thu May 10, 2018 1:45 pm

My aunt is in a CCRC and likes it very much. She is ninety and mentally alert, but needs some help physically. It seems like a clean, nice, bright place to me, with cheerful staff.

I would be miserable there, because the activities they have, and there seem to be a lot of them, are things like playing bingo or doing low level crafts. If I were not able to drive, I'd go out of my skull with boredom.

I read some long time ago that college towns are good places to be in some sort of retirement community, as the resources of the university are available. There are likely to be community classes and just the more interesting surrounding environment.

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Re: Do you know anyone unhappy in a CCRC?

Post by ChrisC » Thu May 10, 2018 1:55 pm

mouses wrote:
Thu May 10, 2018 1:45 pm
My aunt is in a CCRC and likes it very much. She is ninety and mentally alert, but needs some help physically. It seems like a clean, nice, bright place to me, with cheerful staff.

I would be miserable there, because the activities they have, and there seem to be a lot of them, are things like playing bingo or doing low level crafts. If I were not able to drive, I'd go out of my skull with boredom.

I read some long time ago that college towns are good places to be in some sort of retirement community, as the resources of the university are available. There are likely to be community classes and just the more interesting surrounding environment.
I don't think most of us would be bored with this array of activities at the CCRC we've toured. https://www.thecypressofcharlotte.com/w ... 8_CYPC.pdf. And off-campus, there would still be plenty of stuff for us to do, assuming we're able to drive and get around.

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Re: Do you know anyone unhappy in a CCRC?

Post by CULater » Thu May 10, 2018 2:00 pm

One of my biggest concerns is dementia. I think that is a bigger risk than physical debilitation for us elderly. How is the facility going to provide care for that? My friend's parents moved into an upscale CCRC and then the mother developed Alzheimer's. Fortunately for her, the father was able to provide 24-hour care in their independent-living apartment, but was always under the gun to move her to the nursing care unit. They have their rules and regulatory obligations you know. Finally, he was forced to do so but was quite unhappy with the quality of care for her being given. Observed that staff would not spend time with her to see that she ate at mealtimes. That's a typical problem in most memory care places and long term care facilities. So, he went every day to have meals with her and feed her like he used to do when they were together. I'd like to think that an upscale CCRC has better staffing and patient-staff ratios than the run-of-the-mill, but I doubt it. This will be an important check point for me about any place I'm contemplating living in.
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

Mitchell777
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Re: Do you know anyone unhappy in a CCRC?

Post by Mitchell777 » Thu May 10, 2018 2:50 pm

CULater wrote:
Thu May 10, 2018 2:00 pm
One of my biggest concerns is dementia. I think that is a bigger risk than physical debilitation for us elderly. How is the facility going to provide care for that? My friend's parents moved into an upscale CCRC and then the mother developed Alzheimer's. Fortunately for her, the father was able to provide 24-hour care in their independent-living apartment, but was always under the gun to move her to the nursing care unit. They have their rules and regulatory obligations you know. Finally, he was forced to do so but was quite unhappy with the quality of care for her being given. Observed that staff would not spend time with her to see that she ate at mealtimes. That's a typical problem in most memory care places and long term care facilities. So, he went every day to have meals with her and feed her like he used to do when they were together. I'd like to think that an upscale CCRC has better staffing and patient-staff ratios than the run-of-the-mill, but I doubt it. This will be an important check point for me about any place I'm contemplating living in.
Everyone can have a different experience but you are correct to "doubt it". Meal time was difficult in my experience. There could be 4 or 5 people in the little dining area that could not feed themselves. I fed my mother when I was there. Otherwise there were 2 CNA's to feed people and maybe one volunteer. I asked the administrator if they could get some additional volunteers or pay some people a small stipend since there were well over a thousand healthy people on campus. Was always told they were working on something. If the resident cannot speak up for what they need or have a family member regularly there to do it, you can end up with hind teat.

CULater
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Re: Do you know anyone unhappy in a CCRC?

Post by CULater » Thu May 10, 2018 10:33 pm

Mitchell777 wrote:
Thu May 10, 2018 2:50 pm
CULater wrote:
Thu May 10, 2018 2:00 pm
One of my biggest concerns is dementia. I think that is a bigger risk than physical debilitation for us elderly. How is the facility going to provide care for that? My friend's parents moved into an upscale CCRC and then the mother developed Alzheimer's. Fortunately for her, the father was able to provide 24-hour care in their independent-living apartment, but was always under the gun to move her to the nursing care unit. They have their rules and regulatory obligations you know. Finally, he was forced to do so but was quite unhappy with the quality of care for her being given. Observed that staff would not spend time with her to see that she ate at mealtimes. That's a typical problem in most memory care places and long term care facilities. So, he went every day to have meals with her and feed her like he used to do when they were together. I'd like to think that an upscale CCRC has better staffing and patient-staff ratios than the run-of-the-mill, but I doubt it. This will be an important check point for me about any place I'm contemplating living in.
Everyone can have a different experience but you are correct to "doubt it". Meal time was difficult in my experience. There could be 4 or 5 people in the little dining area that could not feed themselves. I fed my mother when I was there. Otherwise there were 2 CNA's to feed people and maybe one volunteer. I asked the administrator if they could get some additional volunteers or pay some people a small stipend since there were well over a thousand healthy people on campus. Was always told they were working on something. If the resident cannot speak up for what they need or have a family member regularly there to do it, you can end up with hind teat.
Well, that's the way it is in all these places I'm afraid. You would think for $200 + per day you could at least have someone to help you eat. But the story is to minimize staff expenses to increase profits. Plus, it's difficult to hire people to do this kind of work for the pittance they are paid.
May you have the hindsight to know where you've been, The foresight to know where you're going, And the insight to know when you've gone too far. ~ Irish Blessing

Mitchell777
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Re: Do you know anyone unhappy in a CCRC?

Post by Mitchell777 » Fri May 11, 2018 4:57 am

CULater wrote:
Thu May 10, 2018 10:33 pm
Mitchell777 wrote:
Thu May 10, 2018 2:50 pm
CULater wrote:
Thu May 10, 2018 2:00 pm
Everyone can have a different experience but you are correct to "doubt it". Meal time was difficult in my experience. There could be 4 or 5 people in the little dining area that could not feed themselves. I fed my mother when I was there. Otherwise there were 2 CNA's to feed people and maybe one volunteer. I asked the administrator if they could get some additional volunteers or pay some people a small stipend since there were well over a thousand healthy people on campus. Was always told they were working on something. If the resident cannot speak up for what they need or have a family member regularly there to do it, you can end up with hind teat.
Well, that's the way it is in all these places I'm afraid. You would think for $200 + per day you could at least have someone to help you eat. But the story is to minimize staff expenses to increase profits. Plus, it's difficult to hire people to do this kind of work for the pittance they are paid.
This is where it varies so much. I was writing checks amounting to $378 per day The CNA's were unionized and started at $18 per hour with full benefits in a low COL area. Interestingly, the elder law attorney told me the county nursing facility by far had the best care but I could not my parent in. Now, the county is looking to sell it off as has happened in other surrounding counties, to some extent due to the Medcaid rate never increasing.

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