Understanding a CCRC’s “permanent transfer” policy

There are three things that I think everyone should understand about their move into a CCRC: the community’s amount of debt, the community’s entrance fee refund policy, and the community’s policy on permanent transfers to assisted living or nursing.  Today we’ll talk a bit more about the third one: permanent transfers.
When you move into a CCRC, you agree to move to a higher level of care in the event that you can’t stay in live alone anymore.  It’s called “permanent transfer” because they assume that you will never move back into independent living and thus can resell your apartment to someone else.
There are a few things you should note about CCRCs permanent transfer policy:
The community will decide when you have to move. By and large, almost all CCRC contracts have policies regarding residents who can no longer live on their own.  Due to the sensitive nature of the decision, most contracts require that the community’s executive director and its director of nursing sign off on the transfer.
You don’t have much say in the process. While the community will often consult you and your family about the move, you generally won’t have too much of a say.  This makes sense if you think about it.  Especially for residents who have dementia or other cognitive problems, it can be hard to spot one’s own inability to live independently. However, some seniors bristle at the idea of someone else telling them when they must move out of their independent living apartments.

Read your contract.  Policies vary from community to community, so read your documents carefully. In most cases, your doctor, the community’s head nurse, and administrators must “vote” in favor of your permanent move.  If you disagree, then you’ll have to either prove your independence or move out.  It sounds drastic, but that’s the way it’s handled in most places.

The benefits to the CCRC are many.  For one, the community can ensure resident safety by moving people who need more care to assisted living or nursing.  They can also resell the apartment, which improves their bottom line.

While permanent transfer policies help residents who are in denial of their conditions get the additional help that they need, sometimes there are disagreements.  Unfortunately, they usually work out in favor of the community.  So, if you’re not moving into a community that allows aging in place, it’s in your best interest to read and understand the permanent transfer policy.  It’s probably one of the most important things that you can do before signing on the dotted line.

Want to learn more about senior housing? Check out these posts:

Is it cheaper to stay at home or move into a CCRC?

How do I time my move into a CCRC?

Thoughts on the Frontline documentary about assisted living.

The naked truth about entrance fee refunds.

Aging in Place: Friend or Foe?

In case you missed it the first time, here are some thoughts on “aging in place” at a CCRC:

The term “aging in place” became popular several years ago to describe a particular type of senior housing whereby residents were allowed to remain in their independent living apartments, even though they required higher levels of care.

The main benefit of aging in place is that you don’t have to move if you become sick. Your bedroom remains your bedroom. You don’t have to worry about moving to a smaller assisted living apartment. It is a huge benefit for seniors that might need to make several moves during the last years of their lives. Once they move into the community, their apartment becomes their home.

The main disadvantage of aging in place is that communities have trouble marketing units that turned over (in other words, the units vacated due to resident death). Aging in place is an attractive marketing technique for younger communities that attract younger residents, but it is very difficult for a community that has been open for several years to resell units to younger residents.

Imagine this: You go into a CCRC, and during the tour, you notice health care workers coming in and out of the rooms. In the hallway are seniors that would normally be in a nursing home. They are all sitting in wheelchairs, and most of them are asleep. Would you want to move in here?

When the independent living residents are mixed with the assisted living residents, it makes it hard for the community to sell units to younger seniors. If the community is known as being an aging in place community, then it is probably fine. Most Holiday Retirement Communities, Sunrise, Belmont, and Atria communities (which are not usually CCRC’s) are marketed for independent living and assisted living needs and allow residents to remain in their apartments as long as their needs do not become too acute.

But, if you are considering a CCRC that markets aging in place, make sure the community has some policies that help attract younger residents to fill vacated units. Otherwise, you run the risk that your estate might have a long delay in receiving the refund portion of your entrance fee (while the community tries to resell your unit).

In summary, there is no problem with aging in place. It is a fine idea, and it creates a lot of security for seniors that are worried about being bused from place to place as their needs progress. However, the policy can be detrimental to CCRC’s that are trying to maintain a young, vibrant resident population.

What happens when seniors try to sell their home? What happens to home values when the home has been modified for safety?

This post is part of a series of Q&A’s with AccessibleConstruction.comIf you’re interested in providing articles for SeniorHousingMove.com, please see our submission guidelines.

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Many times, a home will increase in value based on the safety modifications that have been installed. Adding a home elevator will increase the value of the home, no matter who is buying it.

Many modern bathroom modifications use grab bars and showers that are elegant in design and don’t look like the industrial products that were common ten years ago. The industry has become very sophisticated in the look and functionality of products.

Some modifications may need to be removed, such as a stair lift, if the new owners don’t need it and want to reclaim the space on the stairway. Often, the original installer will remove it and may be able to sell it as used to reclaim some of the original investment. It’s always best to discuss this before installation to see if anything can be salvaged or resold should the equipment not be wanted at some time in the future.

Selling a home as “modified for seniors” may be in demand in a few years as more baby boomers retire. Many seniors are already looking for these types of homes as they downsize or move into homes that better fit their needs.

Accessible Design & Consulting is California’s leading Barrier-Free Specialist; they provide residential and commercial barrier-free designs and accessories for seniors and people with disabilities. Contact Accessible for more information about your next renovation: (866) 902-9800 (Toll Free) or (310) 215-3332 (Local).

How much does a normal renovation/remodel cost? What sorts of services are included?

 

This post is part of a series of Q&A’s with AccessibleConstruction.comIf you’re interested in providing articles for SeniorHousingMove.com, please see our submission guidelines.

 

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The cost varies widely for a renovation or remodel and relies on a variety of factors. The bathroom might be completely remodeled by adding a three or four wall wheelchair accessible shower, wall-hung sink, raised toilet, widened door, and all the trimmings. Typical charges can run from $4K to $40K. While this may seem high to some people, many times these home modifications will allow a senior to remain in their own home instead of moving to an independent living facility which would cost much more in the long run.

Another popular modification is the installation of a stair lift.  Straight runs can start as low as around $3K and more complex runs on curved or spiral staircases can run in the $18K – $22K range.

Each case requires a cost that varies depending on the size of the installation, the equipment or Brand used and the disability or challenge that one is dealing with.

Most services will include a complete assessment of the person’s abilities and needs, measurements of the area and a recommendation of equipment to be installed and pricing. With a stair lift, there may be two or three models that would be adequate but they differ in levels of performance and price.

For remodeling a room or a home, blueprints and permits may be required.   This is often a lengthier process as there are many facets involved in a project of this magnitude such as:  Ordering/Receiving of the products and/or equipment, scheduling, installation, possible inspections, and finally customer demonstrations and Q&A time.

Accessible Design & Consulting is California’s leading Barrier-Free Specialist; they provide residential and commercial barrier-free designs and accessories for seniors and people with disabilities. Contact Accessible for more information about your next renovation: (866) 902-9800 (Toll Free) or (310) 215-3332 (Local).

What are the benefits of hiring a consultant? How much do consultants charge?

Note: This post originally appeared at AccessibleConstruction.com. If you’re interested in providing articles for SeniorHousingMove.com, please see our submission guidelines.

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A handyman or home remodeler can be found anywhere in the country and will be able to perform many duties such as installing handrails and grab bars. A senior home modification or accessibility consultant will be able to perform the same services more effectively because they specialize in modifications for seniors.  The best ones however, are the ones that offer a one-stop approach – ones that do BOTH medical equipment AND construction.  This is advantageous as they can offer a vast array of possible solutions and often can offset some construction costs by offering different types of DME (Durable Medical Equipment) that may offer the same functionality as construction would.

Specialists know that it’s important to check for a stable backing before installing grab bars. They can also counsel/advise on more complex installations such as stair lifts, elevators, ceiling lifts, or modular or custom ramp systems etc. In addition, they are skilled in matching complementary items such as walkers, wheelchairs, car mobility products and items outside of the scope of a handyman or remodeler (who typically tend to be very specialized in just their specific area of expertise).

It’s important for seniors to search for a consultant that is a Certified Aging-in-Place Specialist (CAPS) by the National Association of Home Builders (NAHB). This certification by the NAHB means that the home modification specialist has taken classes and learned the essential skills of modifying a home for “aging-in-place.”

Some consultants will do a free home assessment but these are usually minimal assessments. Many good consultants charge several hundred dollars for a home assessment but provide a complete blueprint of services (and respective costing. It’s worth the cost for a complete assessment as often they can make cost-effective recommendations on products and/or services that might have been overlooked (or not known about) by a layman.

Accessible Design & Consulting is California’s leading Barrier-Free Specialist; they provide residential and commercial barrier-free designs and accessories for seniors and people with disabilities. Contact Accessible for more information about your next renovation: (866) 902-9800 (Toll Free) or (310) 215-3332 (Local).

What are some easy things that seniors can do on their own to improve their home’s safety?

This post is part of a series of Q&A’s with AccessibleConstruction.comIf you’re interested in providing articles for SeniorHousingMove.com, please see our submission guidelines.

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There are quite a few things seniors can do on their own to make their home safer, often costing little or no money:

  • One of first areas to examine is walkways. This includes the area at the front door of the home, the hallways inside, stairways, and general walking areas in all of the rooms. Make sure there is a clear path in all of these areas being careful to look for things that might cause somebody to trip and fall. Tack down loose carpets or rugs, (we often use double-sided carpet tape). remove cords, and general clutter that may impede safe movement around the home. Remove tables or objects in the path of travel that have pointed corners or sharp edges.
  • Proper lighting is a must, as many seniors can’t see as well as when they were younger. Sometimes it’s necessary to use brighter light bulbs to increase lighting, or adding new lights in dark areas. Nightlights should be used in bathrooms and kitchens.
  • Non-slip Shower Strips are very affordable and easy to install in the bathtub, or shower floors, and help prevent slipping while in the shower or bathtub.
  • Furniture Risers lift chairs, sofas, or beds up a few inches to make it easier to stand up and sit down and they can be installed easily without incurring a big cost.
  • Store frequently used items in the kitchen and other rooms lower down to prevent reaching and straining.
  • A shower chair with a high back is recommended in the shower as a safety measure. It allows the person to sit down if they have balance issues or feel light-headed, instead of standing in the shower.
  • Keep a telephone in the bedroom, bathroom, and kitchen in case of a fall or other emergency. An emergency call service (such a Life Alert) is always a good thing to consider.
  • A Bedrail/Cane combo is easy to install and not only keeps seniors from falling out of bed in the middle of the night but the cane portion of the rail also assists them in getting into and out of bed.

Accessible Design & Consulting is California’s leading Barrier-Free Specialist; they provide residential and commercial barrier-free designs and accessories for seniors and people with disabilities. Contact Accessible for more information about your next renovation: (866) 902-9800 (Toll Free) or (310) 215-3332 (Local).

Aging in Place: Friend or Foe?

In case you missed it the first time, here’s an overview of “aging in place,” a popular offering at retirement communities:

The term “aging in place” became popular several years ago to describe a particular type of senior housing whereby residents were allowed to remain in their independent living apartments, even though they required higher levels of care.

The main benefit of aging in place is that you don’t have to move if you become sick. Your bedroom remains your bedroom. You don’t have to worry about moving to a smaller assisted living apartment. It is a huge benefit for seniors that might need to make several moves during the last years of their lives. Once they move into the community, their apartment becomes their home.

The main disadvantage of aging in place is that communities have trouble marketing units that turned over (in other words, the units vacated due to resident death). Aging in place is an attractive marketing technique for younger communities that attract younger residents, but it is very difficult for a community that has been open for several years to resell units to younger residents.

Imagine this: You go into a CCRC, and during the tour, you notice health care workers coming in and out of the rooms. In the hallway are seniors that would normally be in a nursing home. They are all sitting in wheelchairs, and most of them are asleep. Would you want to move in here?

When the independent living residents are mixed with the assisted living residents, it makes it hard for the community to sell units to younger seniors. If the community is known as being an aging in place community, then it is probably fine. Most Holiday Retirement Communities, Sunrise, Belmont, and Atria communities (which are not usually CCRC’s) are marketed for independent living and assisted living needs and allow residents to remain in their apartments as long as their needs do not become too acute.

But, if you are considering a CCRC that markets aging in place, make sure the community has some policies that help attract younger residents to fill vacated units. Otherwise, you run the risk that your estate might have a long delay in receiving the refund portion of your entrance fee (while the community tries to resell your unit).

In summary, there is no problem with aging in place. It is a fine idea, and it creates a lot of security for seniors that are worried about being bused from place to place as their needs progress. However, the policy can be detrimental to CCRC’s that are trying to maintain a young, vibrant resident population.

What makes a home dangerous for seniors?

This post is part of a series of Q&A’s with AccessibleConstruction.comIf you’re interested in providing articles for SeniorHousingMove.com, please see our submission guidelines.

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Many times it’s a combination of the physical and mental abilities of the person, coupled with the layout and design of the home or rooms in the house that can make a home dangerous for a senior.

Younger people in good physical shape have no problem going up and down stairs or getting in and out of the shower safely. Seniors have diminished eyesight, balance, and stepping abilities, which can make stairways difficult to use, and slippery bathroom floors problematic. Getting out of bed can be difficult for seniors with limited mobility and tripping over loose area rugs is another concern.

Most accidents in the home happen in the bathroom followed by kitchens, stairs and hallways. Even one or two steps leading into the home from the outside can pose a serious challenge if balance, eyesight, and mobility are impaired. While there are many areas in the home to consider, bathrooms, stairs, kitchens and hallways are usually considered the most dangerous areas of a home.

Accessible Design & Consulting is California’s leading Barrier-Free Specialist; they provide residential and commercial barrier-free designs and accessories for seniors and people with disabilities. Contact Accessible for more information about your next renovation: (866) 902-9800 (Toll Free) or (310) 215-3332 (Local).

Aging-in-place ideas for your bedroom

Note: This post originally appeared at AccessibleConstruction.com. If you’re interested in providing articles for SeniorHousingMove.com, please see our submission guidelines.

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When remodeling a home for aging challenges, the bathroom is an obvious first place to start, followed by the kitchen. These rooms are extremely important because most of the accidents in the home happen there.  Yet, bedrooms also pose a challenge for aging residents.  Here are several ways to make bedroom safer for occupants:

Add a touch light next to the bed. When getting up from a sound sleep in the middle of the night to get out of bed, chances are good the lights are off and its difficult to see. Keep a touch light next to the bed that is easy to reach and find in the dark.

Create a pathway. Speaking of walking in the dark, always have a clear pathway for walking around the bedroom. It’s easy to see area rugs and carpets during the day but at night they’re a tripping accident waiting to happen. Keep them out of the bedroom if at all possible.

Rest before standing.  Even for people with few mobility issues, getting out of bed from a sleep or rest can cause blood pressure spikes or dips and can be accompanied by dizziness. Always take a moment to sit up for a minute before standing.

Buy the right accessories. There are plenty of ways to make a bedroom barrier-free. If you’re planning to live in your own home for years to come, here are a few products that can help:

  • Bed Cane Bed Rail. There are plenty of products that can be used near the bed to aid in standing or sitting. One of our favorites is a combination Bed Cane Bed Rail. It serves as a bed rail when sleeping to keep from falling out of bed. It also swivels out to act as a bed cane to help with standing.
  • Designer Hospital Bed Rails. Designer Hospital Bed Rails serve the same purpose – to keep you in bed. People get used to staying in bed when they have a hospital visit and the beds are all equipped with bed rails. Most people don’t think about it but you can have the same protection at home.
  • Designer Hi-Low Hospital Bed. On the subject of hospital beds, we’ve been offering Designer Hi-Low Hospital Bed to our customers for years. They function just the same as what you use in an actual hospital but the quality is top notch. There’s a reason hospitals use this type of bed and it will serve you well at home too.
  • Bed Caddie Bed Pull-up Strap.  If you don’t have a hospital bed or lifting mechanism but have trouble sitting up, the Bed Caddie Bed Pull-up Strap aids in sitting up in bed or even simply rolling over. Some even use it for light exercise. It’s very inexpensive, easy to install, and provides something to grab when trying to sit up in bed.
  • Super Pole – Floor to Ceiling Support Pole. The Super Pole can actually be used in any room in the home but we see it used in the bedroom more than any other room. It works great for getting in and out of bed but can be outfitted with a bedside tray or trapeze bar for added functionality. It won the Supplier’s Choice Award at Medtrade in Atlanta in 1996 and 1997.
  • Bedroom Overhead Ceiling Lift. For those who need quite a bit of help getting out of bed, a Bedroom Overhead Ceiling Lift is a lifting mechanism that supports an entire person. While some use it to aid themselves, it can be used by a caregiver for moving a person in and out of bed completely. We’ve done installations that can lift a person out of bed and move them to a bathroom for bathing and then back to bed again. The entire system runs on an overhead ceiling track.
  • Pull Down Closet Rack. Do you have trouble reaching clothes in the bedroom closet? A Pull Down Closet Rack brings the clothes down to your level for easy reach. When finished just move the clothes back up to their original position. This can be used for a closet in any room and is popular with people confined to wheelchairs.
  • Offset Door Hinges. This is an item that can be installed on any doorway in the home to widen it an extra two inches just by changing door hinges. Widening every doorway probably isn’t necessary but if a wheelchair or scooter is needed to move in and out of the bedroom, you will probably need to widen the doorway. It’s usually easy to see by checking the door or doorway for scrapes where the wheels or handrests fit through. Offset Door Hinges are a cheap and easy alternative to tearing out the doorway.

There are so many products available to making a bedroom safer and more accessible. These are some of our favorites and many can be installed without expert help. Take a look around at your own bedroom or the bedroom of your parents to see where things could be improved.

Accessible Design & Consulting is California’s leading Barrier-Free Specialist; they provide legant residential and commercial barrier-free designs and accessories for seniors and people with disabilities. Contact Accessible for more information about your next renovation: (866) 902-9800 (Toll Free) or (310) 215-3332 (Local).

Continuing Care Retirement Communities: An Insider Tells All AVAILABLE IN PRINT

If you’re still holding out on your Kindle purchase, have no fear.  The book is now available in print.  (Check it out on Amazon.com!)

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Continuing care retirement communities (called “CCRCs” by industry insiders) are retirement communities that offer multiple living options (independent living, assisted living, and nursing). In exchange for an entrance fee and ongoing monthly fees, CCRC’s agree to care for residents for the rest of their lives.

Written by a former senior housing consultant, “Continuing Care Retirement Communities: An Insider Tells All” is a sweeping overview of the popular senior housing product. The book shows you:

• What services are offered for seniors
• How to find communities in your area
• What to look for during your visit
• How to read the contracts and disclosure statements
• Why some communities go bankrupt
• Some warning signs for potential residents of CCRC’s

You deserve the best coach when searching for the community of your dreams! “Continuing Care Retirement Communities: An Insider Tells All” shows you the good and the bad in the industry and offers advice on how to make the most of your move into senior housing.