When did you decide to move from your home to senior living?

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CULater
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When did you decide to move from your home to senior living?

Post by CULater » Tue Sep 18, 2018 10:41 am

Seems to me that one of the most difficult decisions as we age is when to move from our home to some sort of senior living accommodations - whether it be independent living or assisted living or some other option. For those of us who might be in the "zone" to be thinking about this, it would be helpful to hear the advice and stories of people who have already gone down that road or might be now - hopefully while it was voluntary. When did you decide to make that move, at what age, what were your reasons for doing so, were you reasonably healthy or did health play the major role, what about finances, has it turned out to be the right decision? How can you guide and instruct us folks who are thinking it might "be time" to seriously consider and plan for this move? One of my biggest concerns is waiting too late to make this decision as I fear many do.
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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lthenderson
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Re: When did you decide to move from your home to senior living?

Post by lthenderson » Tue Sep 18, 2018 10:49 am

No personal experience but I helped my grandparents move to an independent living facility with a common dining area a year and a half ago. My grandfather (age 88) was having a hard time getting around, especially navigating steps and long distances due to a breathing issue. My grandmother (age 84) was able to attend to his needs but it was having an effect on her social life outside of home. She wasn't able to attend functions because my grandfather didn't want to leave the house. Only when my grandmother finally said she was moving or they were getting a divorce did my grandfather agree it was time.

Since moving into the independent living facility, they both regret not having moved their sooner. My grandfather gets his wish of just sitting in his easy chair all day and the only walking he has to do is done the hall to the dining room with no steps to navigate. My grandmother is now socially active again with all the other residents and I haven't seen her this happy in a long time.

My grandparents are frugal people and have more than enough money to pay rent for the rest of their lives but they still complain about the cost of the facility. I am constantly reminding them all the services they get (and things they no longer have to worry about doing) and they always agree that it is well worth the price until the next time they write the check for rent.

Isabelle77
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Re: When did you decide to move from your home to senior living?

Post by Isabelle77 » Tue Sep 18, 2018 11:47 am

My parents are starting to think about it. Their children think it's time but they want to be in a specific place that has an extensive waiting list.

Their reasons are primarily my mom's loss of sight. She has advanced macular degeneration and a 6000sqft house is becoming difficult to manage, even with help. She can no longer drive. Otherwise, my parents are very healthy and active, my mom still hikes and even plays golf, although she can't see where the ball goes.

My parents are only 72 but have been retired for 20yrs so many of their friends are older and already living in the retirement community that they would like to live in. They are often there for bridge games and social occasions already. I do think that Florence may have convinced them to move up their decision, it was their third evacuation in three years.

I think there could be an interim step for them, maybe a smaller rental while they wait for a space in the community they want.

GmanJeff
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Re: When did you decide to move from your home to senior living?

Post by GmanJeff » Tue Sep 18, 2018 1:15 pm

As with the earlier posts, I can't comment from being in that situation myself but I can cite the lessons I learned from my parents' experience.

They are in their late 80s, and waited far too long to move, resulting in substantial challenges in adapting to their new environment. They were older than most of the other residents moving in at the same time, a distinction they noticed due to variances in levels of activity and physical capabilities which have made it harder for them to feel like they fit in well with those other new residents. Due to age-related worsening memories, learning the locations of places on the community campus, procedures within the community, the schedules for different events and services, and even how to operate the appliances within their living unit has all been much more difficult than it would have been had they moved earlier and become familiar with the environment sooner. I should note that this is in the context of the premier CCRC in the large metropolitan area within which they live, widely regarded as top-tier among communities of that type.

In short, it appears to have been a mistake to put off such a move rather than moving when doing so would have been less stressful (it won't get easier the longer you wait!) and when adapting to the new environment would have been less challenging both physically and cognitively. Some of the new residents are still employed, and the average age in the large community of around 1400 is 82, so many of the residents are a good bit younger than that.

Note that I am speaking of a CCRC (Continuing Care Retirement Community), which offers Independent Living, Assisted Living, Rehab, and Memory Care all on a single campus. If you're asking about a 55+-type environment which is strictly independent living with no provisions for increased support later in life, moving far in advance of the potential need for enhanced support, which might necessitate another move later, is something to consider.

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EddieGee
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Re: When did you decide to move from your home to senior living?

Post by EddieGee » Tue Sep 18, 2018 3:18 pm

DW and I are not quite ready to consider this age-wise but we are getting there...

I believe the "elephant in the room" is the issue of what happens if our health deteriorates. Obviously a CCRC is preferable; who wants to hunt down another facility as they become more dependent?

The big issue, of course, is how to pay for it. My parents and aunt chose communities run by a wonderful organization called ACTS which only operates on the east coast. You pay a big up front fee ($300K+) and a monthly fee that is somewhat above what a comparable apartment would cost, but then you are taken care of FOR LIFE regardless of your health condition, and your monthly fee is increased only for inflation but there are no additional charges for assisted living or nursing care. So if someone comes in at 65 and lives healthily to 85, ACTS makes a large profit. But if they come in at 65, need nursing care starting at 70 and live to 85, ACTS will take a huge loss. The system is intended to work this way, much in the same way as insurance cos. win big if you live long and lose big if you die early.

The other option, of course, is simply to pay for independent living with little or no upfront fee, and gamble that you won't need a lot of assisted living or, heaven forbid, nursing care.

Which of these two options to go with is a very difficult choice. The upfront fees would eat up a large chunk of our savings, and organizations that do this have been know to occasionally go bankrupt with the residents losing all. (Rumor had it that ACTS was having a tough time in 2008 and 2009 with people needing to sell their houses to pay the upfront fee and not being able to. But they have weathered the storm nicely and are doing well now.) It would be great if there were such a thing as affordable, comprehensive long term care insurance, but that ship sailed away 20+ years ago... <sigh>

wanderer
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Re: When did you decide to move from your home to senior living?

Post by wanderer » Tue Sep 18, 2018 3:34 pm

Similar to others - this is a perspective from watching/helping our parents. Family were all many miles away so they were on their own, but had a great network of friends.

Dad's Parkinson's dementia started showing up in his mid-70s. They are from the generation that grew up through the depression and WWII so no asking for help and Mom became the caregiver. At first, no big deal and she could keep up her own social life and commitments. But gradually his symptoms became worse and small accidents (fortunately no big ones) happened and she had to watch him more (daily assistance and adult "babysitting"). He stopped all of his activities. She was determined to do it all - help him and keep up with her life. But then she had her own health scare and realized she wasn't taking care of herself. So, with the help of friends she decided to find a place that had the progression of care. None were nearby, but a new one was being built - Independent living through full nursing care. She signed up and started to get the house ready to sell. But then dad fell and broke a hip before they could move. The surgery significantly impacted his dementia for the worse and he never really figured out how to walk unassisted again. So after a series of nursing homes for him and my mom trying to keep up visiting him and her social life they eventually moved into the new facility with him in nursing care and her in an independent living apartment. It was extremely hard on her. Fortunately, I'd just retired and my wife and I were able stay with her and help some. He survived 2 years in nursing care, and she moved near us to another semi-independent living for her last 2 years. Over these 5+ years we sadly watched them slip away, but also had the blessing to be with them, their friends, and many of other residents and families of these facilities.

We learned:
There is no neon sign for "when it's time". It sneaks up on us before we notice.
Independent living and the other living options have their issues, but the other residents are great people in similar situations. They can relate. This social aspect can lead to new friendships and be a real support in times of need.
Don't be afraid of the change. Do it while we still can.
Jointly agree on "trigger" events or conditions and share it with others who might become involved (I consider is sort of a IPS for where we might live)

Our plan is written and discussed with friends and family. We are in our early 60s. It is intended to be flexible, based on possible life-event triggers (broken hip, early-stage dementia, stroke, significant accident, etc).
We have already downsized and moved to a single-level home that can be handicap adapted as needed. We have contracted lawn care and while I am still the general handyman, we have neighbors who have already "contracted" these and cleaning services for references.
Our commitment is to each other and our family. We will move when/if a significant trigger event shows up that means a change in medical condition and lead to limiting our ability to get out on our own. But no later than 80 years old (family history). Potential location options have been chosen if it occurs soon, but are more general as time goes by. We have discussed these with our adult children and they know the "plans"/desires.

RudyS
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Re: When did you decide to move from your home to senior living?

Post by RudyS » Tue Sep 18, 2018 4:38 pm

EddieGee wrote:
Tue Sep 18, 2018 3:18 pm
DW and I are not quite ready to consider this age-wise but we are getting there...

I believe the "elephant in the room" is the issue of what happens if our health deteriorates. Obviously a CCRC is preferable; who wants to hunt down another facility as they become more dependent?

The big issue, of course, is how to pay for it. My parents and aunt chose communities run by a wonderful organization called ACTS which only operates on the east coast. You pay a big up front fee ($300K+) and a monthly fee that is somewhat above what a comparable apartment would cost, but then you are taken care of FOR LIFE regardless of your health condition, and your monthly fee is increased only for inflation but there are no additional charges for assisted living or nursing care. So if someone comes in at 65 and lives healthily to 85, ACTS makes a large profit. But if they come in at 65, need nursing care starting at 70 and live to 85, ACTS will take a huge loss. The system is intended to work this way, much in the same way as insurance cos. win big if you live long and lose big if you die early.

The other option, of course, is simply to pay for independent living with little or no upfront fee, and gamble that you won't need a lot of assisted living or, heaven forbid, nursing care.

Which of these two options to go with is a very difficult choice. The upfront fees would eat up a large chunk of our savings, and organizations that do this have been know to occasionally go bankrupt with the residents losing all. (Rumor had it that ACTS was having a tough time in 2008 and 2009 with people needing to sell their houses to pay the upfront fee and not being able to. But they have weathered the storm nicely and are doing well now.) It would be great if there were such a thing as affordable, comprehensive long term care insurance, but that ship sailed away 20+ years ago... <sigh>
The CCRC solution can be great. We are planning that for ourselves. Just a couple of comments: 1) not all CCRCs have "life care" which provides the continuum of care at no extra cost. In MA these are type A bgut there are also B and C which may have the higher level of care available on the same campus, but it is NOT included. 2) You will not qualify for the life care option is you are not in adequate health. You cannot wait till signs of dementia, etc, have started. Same as flood insurance. Someone said in another thread, "better 5 years too soon than 5 minutes too late." The better (or most popular) places have waiting lists.

Northster
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Re: When did you decide to move from your home to senior living?

Post by Northster » Tue Sep 18, 2018 4:49 pm

From my experience with my parents, it was important to move to a facility with a continuum of care. Having decided they could not keep up a house they moved to a townhome in a retirement complex and enjoyed independent living for a few years, then when it was necessary they moved to an assisted living apartment, and finally into a 'nursing home' -- all within the same institution. At each stage they had priority for the next step because they were already in the system. This was in Minnesota but I would assume the situation is similar elsewhere.

neilpilot
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Re: When did you decide to move from your home to senior living?

Post by neilpilot » Tue Sep 18, 2018 4:49 pm

Sorry if this represents topic creep, but...........Assuming that you have decently priced LTCI, how does that mesh with a CCRC? In other words, if you've paid up front for a CCRC will you essentially collect little or nothing from your LTCI policy if you later require assisted living within the CCRC?

InMyDreams
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Re: When did you decide to move from your home to senior living?

Post by InMyDreams » Tue Sep 18, 2018 8:48 pm

CULater wrote:
Tue Sep 18, 2018 10:41 am
One of my biggest concerns is waiting too late to make this decision as I fear many do.
My parents moved near me, to a condo, in their mid-eighties. To my relief, they did NOT go with the two-story condo that first caught their eye (no bedroom and only half-bath on the first floor). They had it together to manage their move and sale of their home themselves. But my father knew that the house was becoming too much for him, and he set the move in motion. The first year in the new city was still traumatic.

My aunt and uncle moved into a CCRC when they were 70.

My grandmother waited too long, and had to rely on family to move her. The new place wasn't really her home, I don't think.

But there's a difference between chronological and biological aging that begins to appear somewhere around 50. Some are ready for senior living at 65, some are still going strong at 85.

Wish I had an answer - but I think a CCRC (a "good" one) sounds like a reasonable choice for many.

InMyDreams
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Re: When did you decide to move from your home to senior living?

Post by InMyDreams » Tue Sep 18, 2018 8:50 pm

neilpilot wrote:
Tue Sep 18, 2018 4:49 pm
Sorry if this represents topic creep, but...........Assuming that you have decently priced LTCI, how does that mesh with a CCRC? In other words, if you've paid up front for a CCRC will you essentially collect little or nothing from your LTCI policy if you later require assisted living within the CCRC?
Not sure, but when I contacted a CCRC to find out their pricing, they asked if I had a LTCI policy. I wondered if they would take it over, given that they were an "A" plan.

ChrisC
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Re: When did you decide to move from your home to senior living?

Post by ChrisC » Tue Sep 18, 2018 10:51 pm

InMyDreams wrote:
Tue Sep 18, 2018 8:50 pm
neilpilot wrote:
Tue Sep 18, 2018 4:49 pm
Sorry if this represents topic creep, but...........Assuming that you have decently priced LTCI, how does that mesh with a CCRC? In other words, if you've paid up front for a CCRC will you essentially collect little or nothing from your LTCI policy if you later require assisted living within the CCRC?
Not sure, but when I contacted a CCRC to find out their pricing, they asked if I had a LTCI policy. I wondered if they would take it over, given that they were an "A" plan.
I think an LTCI policy dovetails nicely with a type B or C plan, especially if the assisted living or skilled nursing care is designed to be paid by the resident at a discounted rate and if the CCRC absorbs or provides for initial care that might correspond to a waiting period under the policy before LTCI benefits can be tapped. With a Type A plan and an LTCI policy, there is redundancy or overlapping care coverage -- in which case, I'd seek to negotiate the CCRC's entrance fees in light of the LTCI policy.

GmanJeff
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Re: When did you decide to move from your home to senior living?

Post by GmanJeff » Wed Sep 19, 2018 7:16 am

My father In law used his LTC benefits while in Assisted Living in a CCRC. As long as the criteria for benefits payments are met, typically relating to needing assistance with the so-called "activities of daily living", the venue where that assistance is being provided is irrelevant to the insurance company. The benefits did not fully cover the actual costs incurred, but did help substantially in narrowing the gap between the cost of Independent Living and the cost of Assisted Living. If a facility inquires into a prospective resident's insurance status, that probably is effectively an inquiry into the applicant's financial resources and ability to pay the fees for an indefinite period.

I'll echo the earlier caveat about the barrier to entry to CCRCs if an applicant is insufficiently independent upon admission. Most facilities will require financial documentation which provides assurance that the applicant(s) will likely be able to pay the fees indefinitely into the future, and will also screen for medical and cognition issues. If an applicant is deemed too medically frail or appears to have materially impaired cognition they will likely not be admitted to the Independent Living part of the community. Waiting until obvious signs of dementia appear, or until a person cannot walk very far by themselves may preclude relocation to a Independent Living facility even if an accompanying spouse is relatively healthy.

Dan999
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Re: When did you decide to move from your home to senior living?

Post by Dan999 » Wed Sep 19, 2018 10:24 am

My research showed that a type A CCRC does not care if you have LTCI. You must qualify on the assets you have on hand, and if you ever are in a position to need more care and qualify for payments under LTCI, then the payment is made directly to you by the insurance co. Of course it is a duplication and may not be necessary. I found that if there are 2 of you and one needs assisted living or nursing care, then you occupy 2 residences and have to pay the single rate for the independent residence. This is the reason to keep the insurance IMO.
If there is just one person in a Type A and they have an endowment, where you are guaranteed care for life, then the LTCI is somewhat superfluous.
Any payments received would just go into the estate, or be used for your care if you ran out of money.
The CCRC's I talked to did not have an interest in our LTCI.

ChrisC
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Re: When did you decide to move from your home to senior living?

Post by ChrisC » Wed Sep 19, 2018 12:10 pm

Dan999 wrote:
Wed Sep 19, 2018 10:24 am
The CCRC's I talked to did not have an interest in our LTCI.
I have no interest in Type A facilities. I'm looking more at Type B or C facilities with equity ownership in the unit you'd occupy. Thus far, these facilities, where the purchase price for the unit is very steep and monthly maintenance fees likewise high, also assess your financial ability to buy into the CCRC but would require separate payment of admission into their skilled nursing facilities, located at the CCRC campus. (The monthly maintenance fees cover independent and assisted living care in your unit, but once you enter their nursing facilities they charge you for that care at a discounted rate.) They look at LTCi coverage as bolstering your financial ability to cover long term care -- and their entrance fees are not designed for covering long term care, which in the one CCRC I'm following is 10 percent of the unit you'd buy.

IowaFarmBoy
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Re: When did you decide to move from your home to senior living?

Post by IowaFarmBoy » Thu Sep 20, 2018 4:44 am

More observations from watching the parents....

One conclusion we have drawn is that if we need to move into an assisted living facility as a couple, we would really like to find one that is continuous care so that the one who is not in the nursing home can easily visit the other. My FIL went into a nursing home about 20 miles from their home and my MIL tried to visit him every day and felt the need to stay for the entire afternoon. Fortunately, she was able enough to do this but feeling like she had to stay for the whole afternoon wasn't a good fit. But if she stayed less, she didn't feel it was enough. If we are on the same campus, it would be easy to go back and forth several times for shorter visits at good times of the day. Maybe meet up for some meals, leave at nap times, etc. It also solves the driving and weather issues when older.

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