CCRC - Continuing Care Retirement Communities

CCRC - Continuing Care Retirement Communities

Continuing Care Retirement Communities

A continuing care community is the "one-stop shopping" of the retirement world - a campus-like setting (or an urban high-rise) that offers a variety of rooms and apartments designed for independent living, assisted living, or skilled nursing care, designed for individuals with declining conditions and those that want to remain in a single location. The original CCRCs, often called life communities, were usually set-up and managed by religious communities. In return for all their worldly possessions, participants were promised care for the rest of their life. Today, the typical resident pays a one-time entrance fee plus monthly fees. 

The CCRCs that offers life care is, in essence, an insurance pooling. The entry and monthly fees are set based on actuarial calculations to cover the expected lifetime costs of each resident. In exchange for the entry and monthly fees residents of life care communities are guaranteed care no matter how long they live, even if one’s personal funds run out. 

Normally, the new resident initially occupies either a detached (garden) apartment or moves into an apartment building. As the need arises for more protected and assisted living, residents may move progressively from a detached unit, to an attached apartment, to “sheltered” care (assisted living) and as needed, into full-time nursing care.

The biggest benefit of continuing care retirement is that once your loved one moves in, she can remain, even if her health status changes. A continuing care community (also called life-care-community or CCRC) is also a good choice for couples where one spouse needs more care than the other.

Generally, a continuing care retirement community will expect an older adult to move in when he's still healthy enough to live independently. As residents age and their needs change, they can get a greater level of care without having to uproot themselves. They can also stay within the community and receive short-term nursing care if they need it after an illness or injury, then move back to their apartment once they recover. If a couple moves in, they'll be able to remain near each other, if not in the same apartment, even if one becomes ill and requires much more care than the other. CCRS are residences that provide a continuum of care from independent living to assisted living to skilled nursing. These are designed to enable seniors with progressively declining health to remain in a single residential location or give healthy seniors the peace of mind that all their future needs are covered.

Meals, housekeeping, activities, and some medical care are usually included in the contract -- although this varies from one community to another, so be sure to check. Because CCRCs are an "all-in-one", there is a greater level of comfort for residents. And children of the parents enjoy a greater piece of mind knowing that all their parents' needs from housekeeping to medical care are taken care of.

What do you get at a CCRC?

At the core of every CCRC is independent living in cottages or apartments. Each community includes at least one level of care, such as assisted living, and many provide a full range of assisted-living, memory-care, and skilled-nursing services. Residents segue to more care when needed. For couples, one spouse may move to a care unit while the other stays in independent living.You'll typically be charged an entry fee. And there are monthly charges that usually include most activities and some meals in the dining rooms.

Independent Living in a CCRC

Residents usually move into CCRCs when they're active and independent. In the independent living area, you can expect to find apartments with full kitchens and standard amenities. Many CCRCs offer highly engaging social outings, classes and cultural events, and a full program of activities. You can also expect healthful, flavorful meals in a nice dining room. 

Assisted Living in a CCRC

As your loved one begins to need help with activities of daily living, the CCRC will provide care similar to that in an assisted living community. CCRC caregivers can help your loved one with dressing, walking, grooming, toileting, bathing, and other activities of daily living. CCRC caregivers can also remind your loved one to take medications. (Note that your loved one may be asked move to a new apartment within the CCRC to receive this additional level of support.)

Skilled Nursing in a CCRC

It's not uncommon for aging seniors to experience a health emergency: a fall, broken bone, stroke, heart attack, or serious illness. If your loved one experiences this type of acute health need, he may move into the CCRC's skilled nursing wing. Unlike assisted living communities, CCRCs can provide skilled nursing on-site. Once your loved one has recovered, he can move back to his assisted living or independent living apartment. 

In addition, many CCRCs have a fourth level of memory support care, in addition to assisted living and skilled nursing; some offer home- and community-based care, expanding their reach into the greater community; and a few provide the last level of end-of-life care.

Who should move to a CCRC?

A CCRC is a good option for people who value security. Knowing that no matter how their health changes down the line, their needs will be met and they won't have to move can bring great peace of mind. A CCRC can also be a great choice if your loved one is becoming socially isolated as he ages and would welcome an opportunity to make new friends and share in group activities.

If, on the other hand, your loved one values independence over security, continuing care may not be his best option. To join such a community, he'll likely be handing over a large chunk of his assets to secure a spot, and CCRC administrators will play a big role in deciding when he needs to move from one level of care to the next.

Nearly 90% of people 65 and older surveyed by AARP said they would like to "age in place." And yet the hard truth is that a beloved house in a familiar community can become both physically impractical and socially isolating over time. A Continuing Care Retirement Community (CCRC) may represent a strategic aging in place solution for parents even where they do not begin the continuum of care in independent living.  Under certain circumstances, the successful placement of aging parents into the CCRC environment, even where one parent may require a higher level of care than the other, can sometimes resolve major issues concerning cost of care, housing, and lifestyle, providing longer-term stability and emotional security in situations where physical separation of the spouses (different living locations) and financial uncertainty would otherwise ensue.  While CCRCs are not the right choice for everyone and must always be carefully evaluated prior to entry, they are enjoyed by many for their general benefits and can also be utilized as a specific planning tool in elder care. 

How to find a CCRC?

To find a CCRC near you, search by zip code here in the Continuing Care Retirement Directory. Be sure to look for reviews of CCRCs written by other family caregivers.

Once you've narrowed down a list of CCRCs that you want to talk to, call to schedule tours. While there, be sure to ask for licensing reports, which give you an idea of how the CCRC has fared on past inspections and whether there have been any substantiated complaints. Look at the activity calendar and see whether it matches your loved one's interests. Also make sure you visit all three wings or areas -- independent living, assisted living, and skilled nursing -- to get an impression of whether they're clean and pleasant, whether residents seem content, whether enough staffers seem to be present for the number of residents, and so on.


As with any senior care option, there's no substitute for spending time there, joining residents for meals, and talking with them about their experience. (If administrators discourage you from talking to current residents, this may a red flag.) The whole idea behind continuing care is that this is a place your loved one will spend the rest of his life, so invest some time in getting to know the community and making sure he feels comfortable there before making a commitment.


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