Continuing care retirement communities (CCRCs): What they offer, who might benefit

As the years go by, you or a loved one may find that living independently is no longer realistic. You may need assistance with daily responsibilities, self-care, and health needs. One senior living option to consider is a continuing care retirement community.

What is a CCRC?

A continuing care retirement community, or CCRC, provides housing, residential services, and health care for older people. CCRCs are also called life care communities because they offer a continuum of care as the needs of their residents evolve. You might start out living independently in your own home or apartment, for example, then graduate to a higher level of care — like assisted living or a skilled nursing facility — as your needs change, without having to move out of the community.

The goal is for residents to stay as independent as they can while still having their personal needs met as they age.

Continuing care retirement communities vary in the types of housing and services they offer. The residences can range from individual houses to apartments. At the entry stage, CCRCs may look similar to 55+ or "active adult" communities, although there usually is no age restriction. Most CCRCs offer skilled nursing care and help with day-to-day activities, which residents may come to need over time. Many have a nursing home where residents can move to if they need advanced care in their later years.

Services offered in a CCRC

Continuing care retirement communities often provide meals, maintenance, and light housekeeping, as well as nurses and aides available 24/7 to assist with routine and emergency health needs. If you eventually need more services, you can transition to a higher level of care within the same community, often with no need to move.

Some facilities also have services such as a hairdressing salon, post office, bank, fitness center, library, and spaces dedicated to outdoor activities, such as putting greens or hiking trails.

For couples, there is the advantage of being able to stay together in the same location but with different services based on level of need. For example, one partner can live independently while the other taps into more personal and health care services.

Benefits of living in a CCRC

Among the benefits of living in a continuing care retirement community is that you no longer need to worry about home maintenance and repairs. You don't need to do regular grocery shopping or house cleaning, since meals and cleaning services are usually part of the CCRC's included services. Medical services and wellness programs are available to you.

CCRCs also offer a stimulating environment with social activities and recreation, which are important as people age. A study published in the journal PloS One reported that older adults often say loneliness and social isolation are among the main reasons why they moved to a CCRC. The study found that living in a community setting fosters close ties among CCRC residents.

In addition, research conducted at the University of Chicago found that older adults who live in senior retirement communities live longer, receive more home health services, and benefit from more rehabilitation services and preventive care in the two years following move-in than those who do not.

A CCRC also offers reassurance to the adult children of aging parents that their loved ones are living safely and being cared for, with help available if they need it.

CCRC costs and contracts

One factor to consider with CCRCs is cost. They can be expensive. You typically "buy in" to a continuing care retirement community. This means you purchase your residence and then pay a monthly maintenance fee.

Entrance fees can range from $100,000 to $1 million, and monthly charges average between $3,000 and $5,000. The terms vary widely among facilities. You generally pay most of these costs yourself, although Medicare, Medicaid, and long-term care insurance may cover some services.

Moving to a CCRC requires that you sign a contract. Contracts vary among CCRCs, but they usually include how much you pay up front in addition to monthly fees, and what you get in return, such as unlimited access to any type of care you require, all provided in the same community.

What to consider when choosing a CCRC

If possible, tour any CCRCs you are considering. Here are some questions you may want to ask when choosing a continuing care retirement community:

• What are the up-front costs and the monthly charges?
• What services are included in the monthly fee?
• What happens to your unit after your death?
• Can you provide a sample of your facility's contract?
• What levels of personal and health-related services are available as a person's needs evolve (assisted living, skilled nursing, memory care, etc.)?
• What recreational activities does your facility offer?
• How many homes or apartments are there for each level of care?
• How are minor and more extensive home repairs handled?
• What is the policy for pets?

The U.S. government offers a free Eldercare Locator to provide information on senior housing options and other services for older adults and their families.