In health care, continuity of care is important for keeping patients safe and giving them the best possible care. When transitioning patients from one setting or one type of care to another, mistakes can be made through miscommunication or lack of communication and patients suffer. Particularly vulnerable to this are older patients needing assisted living or nursing home care.
A growing trend in health care for older adults is continuity of care through retirement communities. Communities that offer a range of services and styles of living, from independent communities to assisted living to nursing home care and memory care, are trying to reduce errors made when people need to transition from independent living to more supportive types of care.
What Are Continuing Care Retirement Communities?
Also known as CCRCs, continuing care retirement communities, are centers that provide tiers of services and degrees of independence for seniors. Exactly how many levels there are depends on each facility, but most have an independent community. This is where seniors live largely independently, with services for things like lawn and home care, and possibly other support services like laundry, cleaning, or cooking.
Most CCRCs then have an assisted living facility and a nursing home facility. Residents in the independent community can transition easily to the assisted living rooms to get more care if it is needed. They can also transition to nursing home care. Having all these levels of care in one community allows residents to move more smoothly from one to the next. It also means that there fewer errors or omissions in care. Residents can also go in the other direction, staying in assisted living or nursing home care only temporarily and as needed.
Most CCRCs have at least three levels of care. The first is independent living. These are condominiums, homes, or apartments in which seniors can live independently, either singly or as couples. They get services and amenities, much like in other types of communities: lawn care, home care, and maintenance. Most independent living facilities also offer other services that residents can take advantage of if they choose, such as cooking, activities, transportation, and even classes.
The assisted living care at a CCRC is designed for residents who are not completely independent and need some degree of personal care in addition to the other support services offered in independent living. Personal care may include assistance with mobility, with meals, with personal hygiene, with getting dressed, and with bathing. There may also be basic medical care provided, including keeping track of medications and taking residents to doctor appointments.
Nursing Home Care
The highest level of care in most CCRCs is nursing home care. These facilities provide more care than assisted living, but are for people who do not need to be hospitalized. Residents in CCRCs may need nursing home care temporarily, if they are sick but getting treatment, or they may move into the nursing home facility indefinitely. Nursing home care provides more skilled medical care than assisted living, with more medical equipment available and skilled nurses. Some facilities also offer memory care, a specialized type of nursing home care for residents with dementia symptoms.
CCRC Care Contracts
Most of these retirement communities accept new residents with one of three types of contract signed. The most costly but also the most inclusive and extensive is the life care contract or the extended care contract. This includes all the levels of care provided at the community so that when a resident needs to transition to a new level, the contract will cover it. A modified contract is any modification of the life contract, usually for a set period of time. It can be renewed or expanded as needed. A fee-for-service contract includes a low initial cost to move in, but then requires that the resident pay for any services used.
Benefits and Popularity of CCRCs
Continuing care retirement communities are becoming more popular with seniors for a variety of reasons. One is that seniors want to get out of the burden of home ownership and care. The most recent housing collapse spurred a jump in interest in CCRCs for this reason. Seniors also like knowing that they will have some health care security and that they can age in place. They also want to make arrangements for themselves in advance so that they do not become burdens to their loved ones. CCRCs can provide all these benefits.
Issues with CCRCs
While a CCRC may seem like a great choice, there are some issues that may still need to be worked out with these care facilities. One is that not all states have regulations that govern CCRCs. While the assisted living and nursing home facilities are regulated, there is no regulation for the independent living communities. Some experts also worry that there is not enough transparency with CCRCs and that residents are put at risk when these businesses go bankrupt, as they sometimes do.
Choosing a CCRC
Even with these concerns, a CCRC is often a good choice for a senior, and it is possible to do thorough research and to find a community that is transparent, meets high quality care standards, and that is staffed by caring individuals. Important factors to consider when choosing a CCRC include licensing and certification, costs and insurance coverage, types of contracts available, amenities and services, staff training and competency, and others.
If you are choosing a CCRC for yourself or for a loved one, visit each facility on your shortlist. Visit more than once, and be sure to visit all levels of facilities, not just independent living. Talk with staff and with residents, and find out if people enjoy living there. Watch for how residents are treated, look for cleanliness, and watch for professionalism among the staff. Also ask to see the financial report for the last year. If a facility is not willing to provide it, consider that a red flag. You want to make sure the facility is financially sound and not at risk of going under and stranding you or your loved one. Above all, make sure you or the person moving in feels comfortable and that it is a good fit.
Continuing care retirements communities are the latest trend in senior living and the concept is a sound one. It helps to reduce the errors that can occur when transitioning between different levels of care, but there are concerns too. If you take your time and do your research, you can be sure that you will find a CCRC that provides excellent care and services.