New York Estate Planning & Elder Law Blog
Very few people look forward to living in a nursing home the last years of their lives. There is a growing segment of the population that wishes to remain in their homes as long as possible. To do so however, assistance is needed from medical professionals and home health aides.
Continuing care retirement communities
Continuing Care Retirement Communities, also known as CCRCs, are well known to retirees. The premise is that residents live on a campus-like setting in facilities that change as their care needs increase. For example, a CCRC resident may begin at independent living facility, shift to assisted living, and enter a memory-care unit or nursing home. Where a resident starts depends on their overall health, mental faculties, and mobility level.
Continuing care at home
Contrast CCRCs with continuing care at home programs. Here, the resident stays in their own home as long as possible, living independently. A care giver is assigned to the resident who checks in with the resident regularly to monitor needs. When the resident begins to need assistance performing daily life activities, such as bathing, dressing, and cooking, a home health aide is assigned to the resident. When the resident is not able to live at home safely – the resident enters one of the facilities at a CCRC.
At the high end of the cost spectrum
CCRCs on paper sound like a long-term care solution that provides individuals with appropriate care and/or assistance based on their overall heath and living needs. They key to these communities is overall health and mobility. To join one of these communities there is an extensive vetting process to confirm that the applicant is healthy and can afford the long-term care solution. Individuals that suffer from progressive neurological disorders, like dementia or Parkinson’s Disease, are not eligible to live in CCRCs.
Usually, there is a one-time entrance fee to join the community plus monthly fees to cover long-term care costs. According to the New York Times, presently, there are 2,000 CCRCs in America serving 745,000 residents. Only 32 of these facilities have a continuing care at home program. Continuing care at home is an affordable option to CCRCs, that price many individuals out of such end-of-life care. The entrance fee at a CCRC is high – between $107,000 to $427,000 and then monthly fees ranging from $2,100 to $4,200. Continuing care at home programs, in contrast, have a much lower entry fee – $55,000 to $60,000 and monthly fees of $525.
The lower cost is due to the residents health and ability to care for themselves. Residents also join earlier. People join CCRCs in their 80s. The continuing care at home program starts when individuals are in their 70s.