The Deupree House in Hyde Park offers independent
living with the option for more care in the future.
Independence. Everybody wants to hang on to it for as long as possible, especially when facing the post-60 years. But as people age, unplanned events and health matters often push seniors into a rushed decision-making process leaving them feeling "stuck" or lacking alternatives.

The desire to hang onto hard-won independence yet still have support for unplanned rough spots is what's driving the popularity of Continuing Care Retirement Communities or CCRCs, also known as life-care communities, that provide assistance based on a resident's need over time that may include active retirement living, assisted living, rehabilitation therapy and full nursing care.

Patricia and John Donaldson, both 82, are one such couple. Two years ago, when caring for their family home in Milford became too much of a chore, they called a family pow-wow with their children to look at living options.

"They said, 'don't wait until you have to move. Move while you can enjoy the many things a good place has to offer,' " she says. After looking at several options, they chose an apartment and independent living at the Deupree House in Hyde Park, owned by Episcopal Retirement Homes Inc. They moved in during the spring of 2009.

"At 82 we knew we could need more services down the road, but we feel we still have a lot of living to do. This just felt right the minute we walked in," she says. "We've made very good friends quickly."

The words "retirement community" get a bad rap sometimes, says Becky Schulte of Mapleknoll Village, a nonprofit continuing care community in Springdale.

"When people say they don't want a retirement community, they aren't aware of everything that's offered. Yes, we have nursing care for those who need it, but we have tons of activities. There's so much to do here," she says of the 54-acre campus with townhomes, villas, apartments and a nursing and rehab center. "To me it's like coming to college where you are with a bunch of people your age, to experience living together."

"I do believe that continuing care is something consumers want," says Laurie Petrie, communications director for the Southwest Ohio Council on Aging. "They want to have a lot of
 
Adult children can take comfort that their parents will
be taken care of in continuing care facilities, as care
levels can be adjusted as life circumstances and health change.
options, and there's definitely some convenience to being on one campus, knowing that if you need more care it will be there and you will be able to move fairly seamlessly through the community."

And that reassurance spreads to adult children knowing their parents have needed care at their fingertips as they age.

"It's good to be able to age in place," says Mary Day, managing long-term care ombudsman at ProSeniors, a nonprofit that provides free legal and long-term care help to older adults. "That's what people tell us they want. That said, people define that differently so you need to closely read the continuing care contract to see exactly what you are getting so there are no surprises."

People choose facilities based on their needs and preferences, and some may not need more care after assisted living. Others might need another level of care sometimes requiring a move to another community ... and that may be something they don't want to do. That's the advantage of continuing care.

Another big advantage of continuing care is that the staff gets to know you as you move through the levels, and the family tends to be more comfortable. "We not only care for our residents, we take care of the families, too. It's a big change for families and the person. We are there every step of the way," says Kelly Martin of Mercy Health Partners, which operates four continuing care communities in the area.

"The convenience is that you know where you are going to be," Petrie says. "And everything is there in one place and children know that mom and dad are going to be taken care of and not worrying about where they are going next."

 
Before moving, seniors and their families should
consider what amenities and activities are offered, as
well as how close the facility is located to family members.
But continuing care communities can be costly. There's often an entry fee, the cost of purchasing a unit and a monthly payment. Some require entry fees, a portion of which is refunded if the resident withdraws. Others require a security deposit of one month's rent plus basic room and board and extra services. Much of the cost depends on the level of care.

Choosing the right plan is determined by the contract you choose, from service-based to modified or extensive. As the level of care goes up, the monthly fee goes up.

"There's not one answer for everyone," Day says. "You need information based on the loved one's needs and personal preferences. You need to look and form your own impression and make a list for yourself, what experience are you looking for, what services, activities, closeness to loved ones. It's a very personal choice."

Both ProSeniors and Southwest Ohio Council on Aging can assist, free of charge, seniors in determining their needs and preferences in order to search for long-term care options.

"We try to help people develop their own criteria and narrow the options to fit their needs," Day says.

"Having the conversation early is the best approach," Martin says. "Planning ahead is the key."
 
Information: ProSeniors, www.proseniors.org; Council on Aging of Southwest Ohio, www.help4seniors.org; Advocate of Not-for-Profit Services for Older Ohioans, www.aopha.org; Commission on Accreditation of Rehabilitation Facilities, www.carf.org; The Continuing Care Accreditation Commission, www.ccaconline.org; Maple Knoll Village, www.mapleknoll.org; Mercy Health Partners Senior Health and Housing Services, www.e-mercy.com/seniorliving; Episcopal Retirement Homes, www.episcopalretirement.com.
 

 
WHAT IS CONTINUING CARE?
 
 Continuing Care Retirement Communities, often called CCRCs or life-care communities for seniors, are living settings that offer different levels of assistance and care based on an individual's needs. They often include independent living for active seniors "” sometimes in townhomes or individual homes "” as well as assisted living and skilled nursing. All services are provided on the premises of the community, and the individual usually signs a contract that identifies the range of services to be covered by the initial entry fee and/or monthly fee. Fees vary from community to community and depend largely on the level of care.
 

 
TIPS ON CHOOSING A CONTINUING CARE COMMUNITY

Ask for a financial report on the facility to make sure it's on solid ground.

Read the contract closely to see exactly what services are offered. Can you choose some services and not others? Is there flexibility built into the offerings?

Look at financial options. Almost all have monthly fees based on service. Some have a non-refundable entry fee with a 90 percent amortization. Others might have a percentage refund if an individual leaves.

Size. Do you prefer a large facility with many options and services or a smaller community?

Atmosphere. Are you looking for a more casual environment or more formal surroundings?

visit several locations to get a feel for the atmosphere and the people who work and live there in order to find a place where you feel most comfortable.

Find out if the CCRC is accredited by CARF-CCAC, the only accrediting body for CCRCs.

Before signing a contract, have your accountant or lawyer review it.

Ask to talk to residents of the community. Try out some of the activities and look at the options available.

Add up your present total monthly expenses including food, transportation, utilities, yard work, housekeeping, maintenance, meal preparation, special assistance etc. and see how many of those services will be met in your monthly fee to get the big "cost" picture.