Looking at Continuing Care Retirement Communities? Look Closely.

December 3, 2010

There are a lot of benefits to Continuing Care Retirement Communities (CCRC’s), also called “Buy-In’s.” These are the places where you put down a substantial sum (maybe $250,000 or more) as an entrance fee, and you plan to stay there for life – they have independent apartments, various levels of assisted living, and skilled nursing (nursing home), all on campus. There is definitely something appealing about the promise of being cared for for life.

But will they really care for you for life? There are some big questions right now about the nursing home units at CCRC’s. For example, when describing the nursing home to you, a potential customer, the sales staff will explain that if you run out of money, they will help you apply for Medicaid. Well, as it turns out, sometimes the CCRC makes you spend down even further than the Medicaid rules do.

For example, for a married couple, if one spouse needs nursing home but the other is still in the community (ex. in her own apartment or in the assisted living), MassHealth rules permit the community spouse to keep about $110,000 to live on. But guess what – before letting the husband move into a MassHealth nursing home bed, the CCRC might make the wife spend her own money down even further than the $110,000, maybe allowing her to keep only $50,000 for herself. And what did they have her spend it on? The husband’s private pay bed in the CCRC nursing home. And how much longer can she last in the community with only $50,000 to her name?

The sales team might also tell you that if a couple really runs out of money, there is a benevolent fund that will help you pay your monthly fees. I’d be a lot more comfortable moving into a CCRC if I saw the balance sheet for that benevolent fund – is there really enough in it for all the residents who might need help? And do they ever really expend from the benevolent fund?

Before committing to a CCRC, do your research. Dig around to make sure that what the sales staff is telling you is true. Two sources of hands-on experience with the nursing home units are going to be (1) local families who have been through the nursing home, and (2) local elder law attorneys who have helped clients navigate the CCRC nursing home experience.

End of Life Wishes & Living Wills

August 25, 2009

Clients are always asking about living wills. Massachusetts law does not recognize a living will, and it’s also impossible to write a thorough, well balanced statement of your end of life wishes in just a few paragraphs.

I provide clients with a solution to their goal, but in a much better form. I give my clients a workbook called Your Way. It is published by a nonprofit in California, H.E.L.P.: Helping People Meet Aging-Related Legal & Care Challenges.

This workbook is twelve pages long and very thoughtfully walks the reader through various scenarios you could confront in an end of life situation and what kind of comfort and care you would like to receive. For example, what matters to you the most – being with friends and family? Listening to music? Being able to help dress yourself? Under various scenarios, would you want curative care or to be kept comfortable? Who do you want with you as you are dying? Where would you want to be? A twelve-page work book written by heath care professionals does a much better job elucidating your wishes than an attorney can do in a one-page living will.

If you are not a client of this office, then log onto the Your Way website and order a workbook. If you are my client, then you already have a copy. Complete the exercises and give your family the gift of knowing exactly what you would want them to do in a crisis situation.

Newton Health Care Center

December 4, 2008

Filed under: Health Care Facilities — Tags: , , , — Alexis @ 2:53 PM

On a beautiful December Wednesday, I drove to Newton to tour the Newton Health Care Center.  The owner, Healthbridge, also has the Weymouth Health Care Center on the South Shore.  From the outside, it looks like an old-fashioned, brick nondescript nursing home, but inside, there is a lot going on.  They offer an Alzheimer’s care unit, long-term care, short-term rehab, and post acute care.  

Most interesting, though, is their “orthopedic unit.”  This is a 22-bed wing designed for people who need a short stay while recovering from hip replacements, knee replacements, or other orthopedic surgeries.  It is such a change to see a unit built for baby-boomers – rooms are private, each has a flat screen TV, there is internet access, and the wing is spacious and tastefully decorated.  Very different from the usual institutional experience!

Through all the units, I noticed a few things that I liked.  One was sunlight – lots of it.  Plenty of natural light is key to mood and health.  Despite being right off the highway, there were also peaceful views out many of the windows, whether of trees or a neighboring gold course.  Again, soothing, natural sights help life mood and promote health.  The courtyard used by the Alzheimer’s and dementia residents is larger than at many other facilities.  And the two things I also look for when visiting facilities – the staff looked happy and calm, as did the residents.