More than 49 million people age 65 or older live in the U.S., a number that is expected to more than double by 2060. As the older adult population increases, options for retirement living will follow. Decisions about where to live in retirement, and how to get the most from making the move, are commonplace as seniors and their families determine the best time to transition from a longtime home to a retirement community. A variety of needs can be addressed in an array of living options, including aging in place with in-home care, moving to independent living or active adult communities, or seeking a higher level of care in assisted living or memory care communities. The choices older adults enjoy today weren’t always available. There was a time when retirement living was considered a dreaded last step rather than something to look forward to. This notion is changing, especially in Dallas where living in a retirement community isn’t what it once was, and that’s a good thing.
With a lock-and-leave lifestyle, chef-prepared restaurant-style meals, concierge service, opportunities for travel, and a packed calendar of social activities, retirement living in Dallas has never looked so good. The face of retirement living is changing, too. Some seniors continue to work part time while enjoying the efficiency and convenience of an independent living community. Older adults who are single are now moving to retirement communities with a friend or a sibling. Many couples who trade their homes in exchange for retirement communities are in their second or third marriages, and there is a growing number of same-sex couples in today’s retirement communities. In short, there is an option for a variety of lifestyles, needs, and budgets. “There was a time when retirement living was considered more institutional,” says Jimmy Gross, administrator of Adora Midtown Park, a StoneGate Senior Living community in Dallas. “Today’s retirement communities cater more to the residents’ needs and goals. If they want to do something, we find a way to make it happen.”
Having someone else do the cooking and cleaning for you is one major advantage of retirement living. Another is socialization. For many seniors living at home, driving is either restricted or no longer an option. Other friends in their neighborhoods have passed away or have moved to retirement homes. Families become spread out, and isolation sets in. Arlene Kirkland, manager of branding and marketing with CC Young Senior Living, says studies have shown that isolation contributes to illness and death in older adults. Living in a retirement community is a built-in way to connect with peers while enjoying favorite activities and trying new ones. Many retirement communities offer day trips to cultural destinations, shopping, and entertainment. It’s a way to add life to your years and years to your life, she says. “There are so many benefits to living in a retirement community, but one proven and surprising finding is that it can extend your life,” Kirkland says. “Studies have shown that living in a retirement community can extend one’s life by seven years. You remain healthier because you have engaged with a community and are more active. Retirement living today is not like your grandmother’s nursing home that you remember. Those who are making the move today are doing so in healthy ways and can maintain, or even improve, their lifestyle.”
Timing is Everything
Of all the decisions to make when researching retirement community options, timing tops the list. If living at home and taking care of daily household tasks, such as cooking, cleaning, laundry, and yardwork, is still safe and enjoyable, now may not be the right time. However, if taking care of the house and yard has become burdensome, or if social isolation is becoming a factor, it may be time to start looking for a new living arrangement. Cost structures vary from one retirement community to another depending on a variety of factors, including levels of care. Therefore, industry professionals recommend organizing your finances, doing some research, and beginning the search early—even before you need care—so that once the decision is made, there is peace of mind throughout the transition.
“I hate to see someone back themselves into making quick decisions because they have an immediate need rather than having the time to make a more informed choice,” says Tim Mallad, CEO of Forefront Living, formerly Presbyterian Communities and Services. “People often wish they made the move into a community earlier once they are there and realize they have improved their lifestyle. When you have an urgent need to move, you are already at a disadvantage because your choices diminish. The process becomes overwhelming, and you don’t know what to look for. You’re forced to decide out of need rather than putting due diligence into the decision making. If you begin early, you can make this a multi-year commitment, starting with independent living and adjusting if your needs change. My recommendation is to give yourself time and move sooner rather than later, so that you can enjoy the perks of living well in a retirement community.”
Jennifer Atwood, managing director of development and communications for VNA Texas, recommends stating your wishes, or those of a loved one, on the front end so that when the time comes to move, the only thing left to do is pack. Having conversations about next steps with your family before there is a crisis is something so many families intend to do, but don’t get around to because the topic can be uncomfortable. “Make it well known what your wishes are prior to a problem,” she says. “This takes some intentional conversations. You may have to repeat yourself to all members of the family, so everyone knows and there are no assumptions made when the time comes. People think they will know what their loved ones want, but this isn’t always the case. We have seen a lot of anxiety-producing moments with families when assumptions are made. Have a plan in place and communicate your desires so you can execute the agreed-upon plan when there is a crisis as opposed to making a plan in the moment.”
Tammy Sandifer, global liaison with StoneGate Senior Living, says moving from a longtime home to any type of retirement community is not only a big decision, but often a difficult one, too. “The last thing people want to do is give up all their independence,” she says. “Look at it from a standpoint of how you can add to your life, rather than what is going to be taken away.” Outside of a catastrophic event or an abrupt life change, Sandifer says the following behaviors and signs may indicate it’s time for you or a loved one to consider a retirement community:
- Multiple falls
- Weight loss that indicates a poor diet or lack of interest in eating due to social isolation
- Medication errors
- Memory decline
- Increased isolation, particularly when this is not normal behavior
A Higher Level of Care
For most seniors, aging in place isn’t an option because of ever-changing health needs. Typical next steps following independent living include assisted living, memory care, and in-home and hospice care. For seniors who are already living in a retirement community, the decision is usually made between family members, loved ones, and physicians, and the move is rather simple to another building or area of the property. When daily care, such as bathing, dressing, eating, and independent movement, become more cumbersome, or when a senior has been hospitalized or perhaps injured from a fall, assisted living is often recommended for safety and a better quality of life.
Memory care communities for seniors with Alzheimer’s and other forms of dementia can provide peace of mind for family members who are struggling to keep their loved one safe at home. The Auberge at Plano is a senior living community that specializes in providing specialized memory care services to residents with cognitive impairment. “People don’t elect to live in a memory care facility, no matter how fabulous you make it sound,” says Samantha Hankerd, director of sales and marketing for The Auberge at Plano. “Making this transition is a process that a lot of families struggle with because they have guilt about the placement. Our job is to work with families to help them make the best decisions for their loved ones, so they have better quality of life, more social interaction, and the right programming and activities to address their individual needs.” Hankerd says first signs that indicate a memory care community may be needed include the inability to redirect a conversation when a loved one becomes fixated on a topic, finding yourself burned out from providing day-to-day care, and noticing that your loved one’s quality of life and health are suffering because of memory loss and confusion. “Repetition of behaviors, or behaviors that you aren’t able to manage are also indicators,” Hankerd says. “In this case, it’s in everyone’s best interest to get professional support and find the care they need in a setting that is designed exclusively for memory care. The biggest misperception about memory care centers is that they signal the end of one’s life. This isn’t true. No matter the diagnosis, there are still ways to get more out of your years.”
Older adults who are diagnosed with a terminal illness or who have long-term health issues resulting from an injury will need a higher level of care. To meet a variety of health needs, many retirement communities invite outpatient programs to assist their residents with services, such as physical therapy, transportation to and from doctor appointments, overall health monitoring, and hospice or palliative care. VNA Texas, the only Medicare-sponsored palliative care program in the Dallas area, is an option for seniors whose medical needs are changing, whether they are at home or live in a retirement community. VNA empowers individuals to age or recover from an injury or illness where they are most comfortable and provides hospice care when traditional medical treatments no longer offer the hope of a cure. Qualified and experienced doctors, nurses, hospice aides, social workers, chaplains, bereavement coordinators, and volunteers work as a team with the patient’s current doctor to provide care that meets the medical, psychological, social, spiritual, and practical needs of patients and families.
Atwood says there is a misperception that home health or hospice care means someone is in their final days or hours of life. Instead, both programs exist to help people who need the care get the most of life and feel as well and as comfortable as possible. “Oftentimes, our patients live longer than expected because they don’t have the stress that accompanies going in and out of a hospital or undergoing treatments that make them feel worse,” Atwood says. “Our care is designed to take some of the burden off the family so they can enjoy their time together outside of a hospital setting. Our team goes wherever the patient is and provides support not only for the patient, but also for their family members.”
Once someone is diagnosed with a terminal illness, and a doctor determines that disease will take its natural course and leaves their patient with about six months to live, VNA takes over much of the care coordination—any service needed for the patient to remain comfortable. In fact, most VNA patients, especially those on palliative care, continue to live normal lives and see their physician. Sarah Harris, director of hospice and palliative marketing with VNA Texas, says VNA’s services also include initiating discussions about advanced directives and life planning—anything a patient needs to handle their affairs and make educated decisions. So much of the hesitation about using palliative care and in-home care services are due to not understanding the costs and how it can be covered. “We have a lot of great resources to help families learn more about different types of care and eligibility, as well as a community liaison who can talk through their options and start the conversation,” Harris says.
Insider Tips: Shopping Around
One of the best aspects of living in a retirement community is choice. However, having too many options can become overwhelming. There are many types of retirement communities, and all have different pay structures. Choosing a community is first based upon what type of care you need and a close second, of course, is what you can afford. Retirement living means different things to people and is most often divided into categories based on level of care. Many communities will offer a continuum of care, and some are designed to focus on one aspect of care.
The Most Common Types of Retirement Communities Include:
- Continuing Care Retirement Community (CCRC). This is a community that provides all levels of care, including independent living, assisted living, memory care, and healthcare or nursing care (sometimes called skilled nursing) in one community.
- Independent Living. This is often a choice for those who are active, independent, and don’t need any type of health or daily living assistance. Residents typically live in apartments and create their own schedules.
- Assisted Living. This type of community provides housing options for seniors who may need assistance with daily living tasks, such as dressing, bathing, medications, meals, and activities. Fees vary depending on the level of assistance required. Care can be increased or decreased as needed.
- Memory Care/Alzheimer’s Care. These are secure communities that offer 24-hour support with a specifically trained staff that specializes in caring for patients with dementia or other types of loss of memory or Alzheimer’s disease. Structured activities and assistance with meals and healthcare and daily tasks are provided.
- Nursing Care/Skilled Care/Long-Term Care. Nursing care is typically designed for someone who requires a high level of care for a short period of time, such as recovering from a hospital stay or therapy services. Long-term care is for residents who need a high level of care with complex medical conditions who require a licensed nurse for a long period of time. Both levels offer around-the-clock care, meals, activities, and rehabilitative service under one roof.
There are several contract options to keep in mind when shopping for a retirement community. Because seniors want control over where they spend their money, more retirement communities are offering various contract and payment options to meet different financial and care needs. Some require an entry fee similar to a down payment on a home. Those who choose this option often use the proceeds from the sale of their home and apply it toward the community’s entry fee. In addition to this fee, a monthly fee is required that may cover a certain number of meals, light housekeeping, and other amenities. When the home is no longer needed, the community issues a refund on the entry fee to the senior or his or her estate, usually about 90 percent of the initial payment. The other option is a monthly rental, like an apartment lease, where the fee may cover dining, some level of care, and other amenities. The monthly rate in this scenario is often a little higher than the entry fee model, and there are no refunds.
“People are often surprised to learn that contracts aren’t only about pricing,” Mallad says. “When reviewing contracts, look at service offerings and think about the type of lifestyle and amenities you want. Determine what activities are important to you and look for a social network you can enjoy. Some communities are more care driven and some are more amenity driven. Look at what is and isn’t included in the price. There are many different pricing structures in terms of amenities and levels of care. In other words, the price isn’t always the price.”
Touring communities is the best way to get information about them, but you can begin your research by phone or with a virtual appointment. Initial phone screening questions should include asking about availability of apartments to ensure one will be available when you are ready to make the move, inquiring about the length of the waitlist for your desired size of apartment, pricing structure, an overview of activities and events, transportation services, dining options, and on-site health services. When touring communities, pay attention to the overall friendliness of the staff beyond the marketing professionals providing the tour. Do they regularly engage with the residents and seem happy? Do the residents look happy and well cared for? If possible, talk to some of the residents to get their experience about what it’s like to live there. Have a meal in the dining room to try the food and ask about meal service options.
Mallad recommends digging a little deeper into the ownership and management of the community. He suggests finding out who owns or sponsors the community and do some research to get a sense of its mission, vision, and values. Mallad also suggests asking about the community’s approach to overall wellness, including nutrition, brain health, and activities that provide the opportunity to improve your physical health while continuing to learn and grow. “When touring communities and making decisions, be realistic about future needs,” Mallad says. “You don’t think in your 60s you’re ever going to be 80, and then all the sudden, you’re 75. Put some time and thought into what you want your retirement years to look like. Look for a community that makes you feel excited to be there and make the move before time—and your home—become your enemy. Then you can expand your social network and avoid potential burdens.”
5 Steps for Retirement Planning
- Know your expenses and income. Before you retire, be sure social security, money from a pension, IRAs, and other assets will cover your expenses and determine what, if any, lifestyle adjustments will need to be made. Being debt free is always a bonus.
- Consider health insurance. If retiring before age 65, have a plan on how you will pay for health insurance before Medicare kicks in. Have professional advisors in your corner who can help with tax, investment, and Medicare questions. You have a limited amount of time to make mistakes and recover the closer you get to age 65.
- Define retirement. Don’t assume you want the same retirement as your neighbor. Stop to think about what retirement means to you. Is your idea of retirement your own dream or what you have been told retirement should be? If you want to work, the goal is to be financially prepared to take any job you want regardless of the pay, including volunteer work.
- How are you going to change the lightbulbs? This is a question from a MIT study. Your answer can help you determine when it’s time to move from your home into a retirement community. Be realistic about what you can—and shouldn’t—do and make decisions accordingly.
- Be prepared. The services and amenities in today’s retirement communities are incredible, but they are premium services. There are many ways to pay for retirement living communities, so you want to be saving as much as you can for as long as you can. This is something you are only going to do once in your life—maybe twice if you go through it with your parents. Take the time to plan well and understand your options.