What Happens When Needs Change While Living in a CCRC?

February 11th, 2008 by Lori Deschene

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I recently wrote a post on aging in place that focused on staying in one's own home as long as possible. Aging in place isn't limited to deed holders and renters-residents in retirement communities want to age in place as well. These are people who, like most of us, want to stay right where we are unless we decide an assisted living or skilled nursing facility can best meet our needs-needs that will most likely change over time. The question is: are retirement communities on the same page as their residents?

Eighty-eight-year-old Sally Herriot could answer that question. As a resident of Channing House, a continuing care retirement community in Palo Alto, California, she was content living in a comfortable one-bedroom apartment with round-the-clock assistance from caregivers she hired personally. Frequenting the opera and staying abreast of current events, she refused to let her limited mobility or waning eyesight compromise her quality of life. Unfortunately for Herriot, according to the continuing care contract she signed years ago when paying the facility's $180,000 entrance fee, maintaining that lifestyle is not her choice-at least not when facility administrators and health care staff decide her care needs can best be met by a higher level of care.

According to an article in The San Francisco Chronicle, an AARP attorney has filed a lawsuit on Herriot's behalf, fighting for her right to decide what's best for her. In response to extensive media coverage, Channing House posted a response on their Web site regarding the legal proceedings. The statement expresses their legal right-and responsibility-to provide care and supervision to their residents in the milieu best suited to their individual health needs. Whether you think Herriot should not be forced to move, or whether you side with the nonprofit corporation, the reality remains: she won't be leaving without a fight.

If you or a loved one is considering moving into a continuing care retirement community, it's imperative that you clearly understand any contract you are asked to sign, and perhaps consult an elder law attorney first. Assisted living is not the only option for securing assistance with activities of daily living. First, there are adult day care centers, ideal for seniors who can still bathe and dress themselves but want to remain social and involved in their communities. In some cases, they may need rehabilitative services, readily available at adult day health care centers. For seniors who require greater assistance with the fundamentals of self-care-feeding, bladder management and personal hygiene, for example, an in-home caregiver can be hired without a physician's recommendation to provide nonmedical care in a person's home. (Read this recent post on when you might want to consider moving from home into a facility, and this post about the different ways of obtaining home care, with the pros and cons to each.)

If you decide to move into a senior community, you may want to consider a naturally occurring retirement community, or a NORC. As the name implies, a NORC is a community or neighborhood where residents remain for years, and age as neighbors. In some cases, an organization connected to the existing community develops a supportive services program to assist with aging in place; in other cases, residents form a board to arrange support and services the group can access. Services can include transportation, housekeeping, social activities, meals, case management, information and referral, and health screenings. In light of Sally Herriot's predicament, perhaps more seniors will lean toward this contract-free option for living independently-with support when they decide it's needed.

Posted in: Retirement & Life Care Communities, Weighing your Housing Options