I recently had someone ask me what sorts of things residents of existing CCRCs can do if management isn’t doing a good job of managing the community. Frankly, I had never really thought about it.
Usually when a community is encountering financial difficulty, the bank that holds the community’s debt will require that outside consultants come in to help. The consultants will try to improve the community’s marketing pitch, cuts costs, and get rid of staff members who aren’t contributing to the community. Residents are generally left out of the process and usually don’t hear about problems until things are really bad.
State laws also usually require that the community keep a lot of cash on hand as reserves. This helps provide a cushion if there isn’t enough money during certain times.
Ultimately, though, the community needs to make more money than it pays out in expenses. That sounds easier than it is, especially in a down markets like the recent recession. For residents who are already in the community, there isn’t much that can be done. Your best bet is to advocate for a resident to join the board of directors. This will help improve communication and shorten the amount of time it takes for information to filter down from management. Some residents in CCRCs that have gone bankrupt have taken a more active role in choosing potential buyers, pushing for large nonprofit purchasers as opposed to for profit investment groups.
It is also possible for disgruntled residents to push CCRC owners to select new managers. Although I’m not aware of any examples of this, a concerted effort by residents would likely force out bad management and spur owners to make better decisions regarding the daily oversight of the community.
But, overall, residents of CCRCs that are in trouble have a limited ability to influence the decisions of management when the community is in financial trouble. As my uncle says, “Sometimes you just tied a knot and hang on.”
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Photo courtesy of wwarby on Flickr.
First of all, welcome to SeniorHousingMove.com! Thanks for visiting the site.
If it’s your first time to visit the site, you’ll want to start with understanding senior housing. Second, you might read a little bit more about continuing care retirement communities (CCRCs). If you’re still wanting to learn more, check out the links of the top of the page. We’ve got information on CCRCs, independent living, and much more!
If you decide that you want to learn even more, check out the book, Continuing Care Retirement Communities: An Insider Tells All. It’s available on Amazon Kindle, and we’ll have print copies soon!
Photo courtesy of Dru Bloomfield on Flickr.
I recently spoke to a senior housing policy expert who hated the concept of a continuing care retirement community (CCRC). Her reasoning was: You give up all of your rights with regard to your own care when you enter a CCRC. It caught me by surprise since it wasn’t an argument that I had heard before. In my experience, most people are worried about spending such a large chunk of money on an entrance fee. No one really worries about their right to select their own caregiver.
So, I gave it some more thought. Are you really losing your right when you move into a CCRC? For me, it breaks down into a few questions:
- How is your right to choose caregivers different in a CCRC than in your own home? Certainly, care in a CCRC is delivered on a more systematic basic. Whereas you might be tempted to hire a housekeeper and piece together home health visits if you were at home, a CCRC might require that you either purchase a specific package of services or move to a higher level of care. Living at home makes it easier to hire and fire caregivers. However, all of this depends on who has power of attorney and whether or not you are capable of making your own medical decisions.
- Can you fire unsuitable caregivers? If you live at home and receive care, you have some ability to modify the caregivers who come to help you. However, your rights depend on whether or not other family members have power of attorney and share your views as to the unsuitability of caregivers. Additionally, you might be beholden to the company that provides the services. Disagreements can be settled, but that might involve you not receiving services for a long time while you search for replacements.
- Can you decline more care if you don’t want it? In CCRCs, the answer is usually “No.” There are strict procedures (spelled out in the resident agreement) that outline the mechanisms by which a resident is allowed to stay in his/her apartment. Although the procedure behind forcing a resident to move from independent to assisted living varies, the end result is this: management of a CCRC can require a resident to move into a higher level of care if enough “experts” decide that the resident is no longer fit to live alone.
- Can you leave if you want? Again, in CCRCs, the answer is usually “No.” Unfortunately, most seniors have the bulk of their assets tied up in the entrance fee. If there is a major disagreement with management, residents generally don’t have very much recourse in the selection of a treatment plan. That being said, word spreads quickly in communities; people who have bad experiences share them with friends. Therefore, communities that do not offer good care are generally boycotted by potential residents due to the poor reputation of their health care facilities.
The answers to these questions make a somewhat damning case for CCRCs. However, I would counter with this: Has any senior ever willingly gone to an assisted living or nursing community? The answer is generally, “No.” Most people think that they are ok to live alone, ok to cook for themselves, ok to drive to the store. Unfortunately, this isn’t always the case. Whether at home or in a CCRC, seniors do give up a lot of their rights as part of the aging process. The right to refuse a caregiver is an important right. It shouldn’t be ignored by management or by family members. However, I’m not sure that living in a CCRC makes an appreciable difference in the rights of the individual. Residents can still request new caregivers. Additionally, more and more communities are embracing the “aging in place” concept and allowing residents to remain in their apartment for longer. In general, I’m not sure that a senior living at home has that many more rights that a senior in a CCRC.
The other benefit to CCRCs is their relative expertise in dealing with patients who have ongoing medical conditions. Whereas someone living at home might need a case worker or medical advocate, CCRCs generally have an on-site nurse and doctor’s clinic. They can afford to bring in experts on a regular basis. This is something that only the most devoted family caregiver can provide in a home setting.
So, while I definitely don’t want to minimize the loss of rights that seniors experience as they age, I also don’t want to paint CCRCs as the culprit. While there are communities that offer substandard care to their residents, most are aware of the needs of their residents and rise admirably to the occasion.
Photo courtesy of no3rdw on Flickr.
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Photo courtesy of Half Chinese on Flickr.
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Photo courtesy of .reid on Flickr.
Most seniors who go shopping for a retirement community have someone else with them who is helping with the decision. If you find yourself in that position, I have some tips for your visit:
- Don’t get too caught up in the bells and whistles. It’s tempting to pay attention to the amenities in the community, those are only half of the picture. You’ll want to make sure that the quality of care is the best in the market. I’ve seen several towns where the high-priced CCRC wasn’t the best in the area. So, don’t get distracted by the fancy dining room and indoor swimming pool.
- Visit the nursing home, even if Mom doesn’t want to. Lots of seniors find it uncomfortable to walk through a nursing home, so they’ll skip that part of the tour. But, that’s the most important thing! You owe it to your family members to see the higher levels of care. Are residents comfortable? Does the building have an unpleasant smell? Is there anything that makes you uncomfortable? If so, suggest that they go elsewhere for their housing.
- Talk to the other residents and families. You want to hear about the community from someone other than the marketing agent. You also don’t want to hear a scripted answer from a chosen resident. Instead, talk to people that you see in the hallway or the nursing home parking lot. You can even ask employees about their experiences with management. The goal is to confirm whether or not people enjoy living and working in the community, and that’s not something that you can get during a normal tour.
Being there to help your family member with a transition to senior housing is important. If you have get some comfort with the community and the process, you can help your loved one make a better transition!
Photo courtesy of JoeDuck on Flickr.
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Photo courtesy of dyobmit on Flickr.
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Talk about best friends forever: two Florida men celebrated 91 years of friendship last week.
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Photo courtesy of Yos C. Wiranta on Flickr.