Hospitals & older patients, long term care costs, health care workers, and reputable senior professionals


Hospitals don’t always provide the best care to older patients.

Long term care costs have increased in some parts of the country.

There aren’t enough home care workers in the United States.

Not all senior housing professionals are alike; a watchdog group is going after less-than-reputable designations.

36/365: The Doctor Will See You Now” © 2009 Sweet Carolina Photography, Attribution 3.0 Generic

Ten Questions to Ask During your Visit

In case you missed it the first time, here’s a list of questions to ask during your visit to a CCRC:

There are a few things that you absolutely must know about a community that might not be included in the traditional sales routine. Here are the ten must-ask questions:

What is your policy for refunding my entrance fee after I move out or die? How long will my estate have to wait before getting the money back?

Regardless of how much money you have, entrance fees aren’t cheap. It’s in your best interest to understand how the community will process your refund when the time comes. This information is also outlined in the resident contract, which you should read thoroughly before signing.

What is your policy regarding permanent transfer into assisted living or nursing? In the event of a disagreement about my health, how will you decide if I move?

I have read about several residents who have had to sue their community because the community forced them to move to assisted living or nursing without their consent. Communities have an obligation to discuss permanent moves with the resident and the resident’s family, but it is sometimes difficult to reach agreement on when is the appropriate time to move to higher levels of care. You want to know in advance what the community policy is regarding a permanent move and how the community resolves disagreements.

How do you decide increases in monthly fees? Do you cap yearly increases?

By far the biggest complaint from residents has to do with annual fee increases. I have seen some communities that tried to pass large monthly fee increases only to have their residents move out in protest. Although most communities won’t guarantee a maximum annual increase, make sure to ask if the community has any policy regarding increasing fees.

Do you have a resident council? If so, how much authority does your resident council have to make decisions about the future of the community?

Most communities have a resident council that meets on a regular basis to accomplish any number of tasks. The most important of these is usually to discuss the community with members of management. This is especially important during times of renovation or redevelopment when residents might feel displaced by construction crews and want a means of voicing their concerns to the folks in charge.

What is your policy for residents that outlive their assets?

Although CCRC’s often have strict guidelines regarding resident income and assets, there are occasions when residents run out of money. This can be the result of several factors (outliving assets, poor investments, etc). Almost all nonprofit communities have endowments that will pay for residents that run out of money. For profit communities have varying policies.

At a minimum, residents that deplete their assets and income should expect to be moved to the smallest available apartment and to incur reductions in their eventual entrance fee refund.

What is the religious affiliation of the community, if any?

Most nonprofit communities have some sort of religious affiliation. However, in order to attract the largest number of qualified residents, most communities tend to welcome all religions. There will often be an on-campus chapel for worship services and the occasional memorial service.

However, religious affiliation might make a big impact in your daily routines if the community changes its meals to adhere to Kosher guidelines or Lent. There might also be resident activities geared to a specific religion or denomination. Also, since health care will be offered on the campus, expect to see a priest or minister on staff making rounds through the halls. Most communities keep one on staff.

What are you doing to keep the community competitive with other local providers?

Depending on your age, you might plan to live in the community for up to thirty years. In this case, your entrance fee is an investment, just like your home. The community must keep pace with maintenance, interior decorating and furniture, and general appeal. That means that throughout your time at the community, management must continue to maintain and improve the property. Expect to see renovations, expansions, and other changes to the campus that will keep it looking nice for years to come.

What is your pet policy?

This policy matters both for pet people and for people who hate animals; pet policies vary widely by community. Some communities will accept up to two or three small pets. Others do not allow any animals. Even for communities that allow pets, it might be a good idea to ask the community’s policy on dealing with pet owners who can no longer take care of their animals, have too many, or do not do a good job picking up after them.

What sorts of activities do you have?

If you have time, try to meet the social coordinator at the community. You want to make sure that the types of activities the community schedules are things that you would be interested in participating in. Try to attend one of the events if possible. If the events are well-planned and well-executed, then you know that your life at the community will probably be a lot of fun!

Do you have friends or family that live here? If not, why would you recommend that your family member or friend move in here? Would you move in here?

This question will tell you a lot about the sales person and give you some valuable information as to why he/she believes the community is the best. One woman told me that she would never move into her community because of the no pet policy. On the other hand, another sales person told me that her mother and grandmother had lived in the community and had been given exceptional care during times of illness. I had another sales counselor at a different community tell me that she was hoping to save enough money to put her sick husband in the community’s nursing home. The sales people know the campus inside and out. Their feedback, especially when it comes to their personal opinion, is very valuable.

Pets & retirement communities, CPR, nursing home costs, and diabetes & dementia


More nursing homes are allowing visits from your pets!

Do staff at retirement communities have an obligation to provide emergency services?

How much will an average nursing home set you back this year? $84,000.

Diabetes get dementia more than 2 years earlier than those without it

PUPPY” © 2010 my talking tree, Attribution 3.0 Generic


Green living in retirement, Boomers & savings, scams, and risk for dementia


Retirement communities in Houston are jumping on the Green living wagon.

Retirement as we know it may be in crisis; Boomers aren’t saving enough to cover the costs associated with old age.

Beware of scams related to Medicare and retirement!

African Americans have a slightly higher risk of Alzheimer’s disease.

RECYCLE REDUCE REUSE” © 2013 Kevin Dooley, Attribution 3.0 Generic

Paying for a CCRC

In case you missed it the first time, here’s an overview of how paying for a CCRC works:

Most senior housing communities require that potential residents prove their financial ability. This is usually done through an approval process questionnaire which asks about income from pensions or retirement plans, home value, and savings. Communities will also ask about any debt you have and the amount of monthly payments on that debt.

The worksheet helps the community evaluate two things: your annual income and your assets.


Annual income includes social security, pensions, retirement plans, and dividends or bond payments. The worksheet given to you by the community should make it easy to tally all of your income into one number. You might have to subtract out mortgage or other debt payments.

In general, most communities require that your income be at least 1.5 times the monthly fee. For example, if the community’s monthly fee is $2,500, your annual out-of-pocket expense is $30,000. Therefore, you would need at least $45,000 in annual income in order to qualify to live in the community.


Assets include your house (minus remaining principle on your mortgage) and other investments like stocks, bonds, businesses, royalties, and rental property. The community will require that you note all debt owed on these assets.

Most communities require assets in excess of 1.5 times the entrance fee. For example, if the community charges $200,000 for the apartment of your choice, you would need at least $300,000 in assets (including the value of your home) in order to qualify to live in the community.

How do communities know this is enough money?

They don’t. Changes in the stock market, low investment returns, or unforeseen expenses can cause residents to experience dramatic declines in their net wealth. However, having a cushion of 1.5 times assets and income allows most residents to weather even the toughest of financial storms.

What if I don’t qualify?

It is not uncommon for potential residents to have more assets than income or vice versa. In the case of a resident meeting one criterion by a wide margin but not the other, most communities will make an exception. This is solely at the discretion of the executive director. At the very least, communities will require a cosigner like an adult child or relative who promises to pay the balance of fees should the resident run out of money.

As stated above, income and asset requirements vary between communities. Some communities might have more lax or more stringent requirements. Especially since the recession, look for higher income and asset requirements, and expect some communities to ask for proof via copies of financial statements.

Love & marriage, shrinking with age, trailer park retirement, and Alzheimer’s costs


Love and intimacy after 60 years of marriage.

Scientists have figured out why we shrink with age.

The newest retirement community: trailer parks?

Caring for a patient with Alzheimer’s costs about $50,000 a year.

LOVE” © 2008 vl8189, Attribution 3.0 Generic