Hidden Costs in Independent Living

Anonymous
Anonymous wrote:We are in the research stage with our mom and here are some things we are considering:

1) Some places will do an assessment of the elder & decide if they can lock in a rate for later more intensive care (ie they allow you to live in independent living for a certain monthly fee akin to rent, on top of the downpayment of $1Mish of which you get 10-20% taken off the top but the rest is returned when your parent's unit is eventually resold when they either move on to assisted living or to memory care or die). So, the rent you pay for IL is the same as the AL or MC monthly fee, but your parent has to be in pretty good shape to qualify for this and not all places have this model.

2) Lots of different places have different meal plan options just like different colleges and you can run the math on the various options

3) The reason to go into IL (primary one for us) is that those people get priority access to spots (which are vastly more limited at most places) in assisted living and/or memory care. If you wait until your parent has dementia, most MC places won't take them. Then you are looking at exorbitant costs for 24-7 in home care

4) FYI lots of the good places have multi year wait lists so it is good your parents are getting their thoughts together well before they might absolutely need to move into this type of place


+1

My parents entered a CCRC into IL in their mid 70s. They/we paid the higher entry fee and higher "monthly rent" so that if/when they require more advanced care, there are no extra costs (okay, one extra cost---to go from 1 meal per day to 3, so about $500/month). The other spouse gets to keep the apartment for no additional cost (if they can still be in IL). So we basically prepaid for the advanced care. It may cost us more over time, but we did it because we are 3K miles from parents and need to know if something happens they are well taken care of. They are guaranteed a spot in assisted living/memorycare/nursing care at ANY TIME, as long as they meet the conditions.
Another perk is the parent still in IL can easily visit the other daily, they can even bring them back to the apartment/to meals if that is safe. This is all done without ever leaving the connected complex of buildings.

If you try to enter this facility for advanced care without being on this plan/already in IL, there is often a long waitlist.

So my parents are loving life in IL, have no concerns as everything is taken care of, biweekly cleaning, all maintenance (if an appliance breaks, it's fixed within 24 hours typically), they have rides to the stores and if you prearrange it you can pay for rides to doctor appointments and other outside trips (for a very low fee). They get approximately 1 meal each per day, but oftentimes spend less (soup and salad bar is much less than the $ amount they get daily), so it amounts to 1.5 meals a day with leftovers from the dinner that are enough for 2 persons to have lunch the next day. So really all they need to do is breakfast on their own.

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:PP. Another post reminded me. In independent living, you had to pay someone if you needed someone to check on you. My mom was paying about $30 a day for a check-in who dropped in to make sure meds were taken and my grandma could get up and walk. Sometimes she had arthritic troubles getting out of her chair during the last year of her life.

My mom visited about 4-5 days a week so this person was an extra daily contact.


Well yes because the definition of independent living is that you don't need any extra outside help on a daily basis. If you need someone to ensure you take your meds, you must pay for that (if the facility themselves will even provide it---many require you to go to assisted living for that).


Then what makes it different from just a plain 'ol apartment?


If you fall down and shout for help, someone will likely hear you and come to help.


That's the only difference? So you are basically just paying rent?


Nope not the only difference. You get meals (varies by facility), cleaning, activities, shuttles to stores, organized outings, help available on site if you need extra services. All of this varies by place but my parents have been in 2 and both had all of this stuff. You get a "panic" button that you wear daily and press it if you need any sort of help while on the property. It's not just hoping someone hears you if you yell. The first place my parents were in also required them to check in each morning (via phone or iPad) or they would send someone up to check on them.

Their fees increased between 4-6% each year. Make sure you factor that in.


The panic button is a great feature. My parents have had to use it and someone is to wherever you are on property within 3-5 mins (the higher number is if you are outside on a walk on the expansive property---you could be .5miles from the main bldg easily).
My parents don't have the "checking in" but if nobody saw them for a full day, someone would stop by and check in.
Anonymous
Another thread just asked about holiday tipping in parents independent living. The suggested rate - $1 per day. So about $300 a year. This appears to be a hidden cost for some but not all facilities.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:PP. Another post reminded me. In independent living, you had to pay someone if you needed someone to check on you. My mom was paying about $30 a day for a check-in who dropped in to make sure meds were taken and my grandma could get up and walk. Sometimes she had arthritic troubles getting out of her chair during the last year of her life.

My mom visited about 4-5 days a week so this person was an extra daily contact.


Well yes because the definition of independent living is that you don't need any extra outside help on a daily basis. If you need someone to ensure you take your meds, you must pay for that (if the facility themselves will even provide it---many require you to go to assisted living for that).


Then what makes it different from just a plain 'ol apartment?


If you fall down and shout for help, someone will likely hear you and come to help.


Food, activities, secured entry, watchful oversight (most will check that they saw you alive at least once that day), limited scheduled transportation. And activities if you want them.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:PP. Another post reminded me. In independent living, you had to pay someone if you needed someone to check on you. My mom was paying about $30 a day for a check-in who dropped in to make sure meds were taken and my grandma could get up and walk. Sometimes she had arthritic troubles getting out of her chair during the last year of her life.

My mom visited about 4-5 days a week so this person was an extra daily contact.


Well yes because the definition of independent living is that you don't need any extra outside help on a daily basis. If you need someone to ensure you take your meds, you must pay for that (if the facility themselves will even provide it---many require you to go to assisted living for that).


Then what makes it different from just a plain 'ol apartment?


My mom lives in an independent /assisted living place. I visited her today and in the lobby area there was a small live music performance, in the library a group of women were playing cards together, waiting by the elevator an elderly man was hitting on an elderly woman (Single men are way outnumbered!), and on her floor in the lounge area women were playing some game with tiles at a table. The elevator also listed the activities that day and there was group exercise, art class, hearing aid check, etc. The meals are eaten in a restaurant like setting with others. There were nurses aids going around to apartments passing out medicine.

It is like a college dorm for old people. So what makes it different is the social aspect.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:PP. Another post reminded me. In independent living, you had to pay someone if you needed someone to check on you. My mom was paying about $30 a day for a check-in who dropped in to make sure meds were taken and my grandma could get up and walk. Sometimes she had arthritic troubles getting out of her chair during the last year of her life.

My mom visited about 4-5 days a week so this person was an extra daily contact.


Well yes because the definition of independent living is that you don't need any extra outside help on a daily basis. If you need someone to ensure you take your meds, you must pay for that (if the facility themselves will even provide it---many require you to go to assisted living for that).


Then what makes it different from just a plain 'ol apartment?


A lot! You are in a facility typically where everyone is 55/60+. There are activities planned, you typically have options to eat all meals in the "restaurants" and your monthly cost likely already includes approximately 1 meal a day. So that ensures social activity, as you at least go to 1 meal with others. Most IL facilities have shuttles that go to Grocery stores/Target/etc on a given schedule, so you don't have to drive as much.

There is a lot to be said for the benefits of "socialization" for elderly. Having dinner together or lunch daily is very nice. Knowing you can go play cards or knit with others or watch a show, etc is also a great way to ensure socialization.

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:PP. Another post reminded me. In independent living, you had to pay someone if you needed someone to check on you. My mom was paying about $30 a day for a check-in who dropped in to make sure meds were taken and my grandma could get up and walk. Sometimes she had arthritic troubles getting out of her chair during the last year of her life.

My mom visited about 4-5 days a week so this person was an extra daily contact.


Well yes because the definition of independent living is that you don't need any extra outside help on a daily basis. If you need someone to ensure you take your meds, you must pay for that (if the facility themselves will even provide it---many require you to go to assisted living for that).


Then what makes it different from just a plain 'ol apartment?


If you fall down and shout for help, someone will likely hear you and come to help.


Even in IL, many have the residents wear an alert item (pager or bracelet) so all you need to do is push a button and someone will come.
Anonymous
Anonymous wrote:
Anonymous wrote:How old are they? Any chance they will need more help than independent living in a few years? If so I’d consider a place that also has assisted living options.


This is my thought. It's also helpful if one parent needs more care than the other. One can move to AL or skilled/memory while the other stays in IL, but it's still very easy for them to visit and see each other a lot.


This is key! Because a married couple will diminish quickly if they don't see each other daily (in the elderly years). If someone has to come and drive them to see the other it might only happen weekly, or less. If on the same "campus" the healthy parent can walk daily to see the other. They might even be able to bring the parent in AL or memory care to the original IL apartment and/or meals for part of the day (if they can manage that parents needs for a few hours). Goes a long way to keeping everyone in much better mental health if they can easily visit
Anonymous
Anonymous wrote:We are in the research stage with our mom and here are some things we are considering:

1) Some places will do an assessment of the elder & decide if they can lock in a rate for later more intensive care (ie they allow you to live in independent living for a certain monthly fee akin to rent, on top of the downpayment of $1Mish of which you get 10-20% taken off the top but the rest is returned when your parent's unit is eventually resold when they either move on to assisted living or to memory care or die). So, the rent you pay for IL is the same as the AL or MC monthly fee, but your parent has to be in pretty good shape to qualify for this and not all places have this model.

2) Lots of different places have different meal plan options just like different colleges and you can run the math on the various options

3) The reason to go into IL (primary one for us) is that those people get priority access to spots (which are vastly more limited at most places) in assisted living and/or memory care. If you wait until your parent has dementia, most MC places won't take them. Then you are looking at exorbitant costs for 24-7 in home care

4) FYI lots of the good places have multi year wait lists so it is good your parents are getting their thoughts together well before they might absolutely need to move into this type of place


#1 is a CCRC. They are awesome if you find the right place and can afford the entry fees. We did that for our parents, as we are 3K from them and need to know they are taken care of in an emergency. Yes, you pay more upfront and a bit more in "monthly fees" but once you go to "advanced care" (Assisted, memory care or nursing care) you only pay the extra cost for 2 more meals a day. You have already prepaid for everything else. In my parents case, they cannot touch your SS (that is yours to keep and pay for any medical/other needs) and if you "run out of $$" you get to stay for free. My parents place currently has 5 people who have "run out of $$", all are widowed women in their late 90s or 100s. Another key perk, the one parent gets to stay in the original IL apartment without any additional costs either, so no forcing them to downsize to a studio or 1 bedroom if you were in a larger place.

Another key perk: you are guaranteed space in higher level care once you need it---no searching for a space required. So parent needs surgery and requires nursing care to recover for 1-4 weeks? Off to nursing care they go and when (if ) better they then return to IL. The healthy parent can spend all day with them still, you don't have to be there to drive them to the other parent
Anonymous
Anonymous wrote:Op, don't go looking for reasons for them -not- to do this ~ you will thank us later


+1 Take full advantage of whenever your parents are VOLUNTARILY making smart choices to make your life easier!

We jumped when my fiercely independent (and extremely frugal/do everything for themselves) parents suggested selling their house and moving into a CCRC in their mid/late 70s. All we had to do was pay the entry fee (we can afford and small price to pay to know they are well taken care of when we are 10-12 hour of flights away from them.

I also happily jumped for joy when 4 years later they ditched their 2nd vehicle.
And beyond thrilled when 6 years later (in early 80s) they happily decided to give up their final vehicle---couldn't show them how to use UBER fast enough. They have quickly adjusted to using the shuttles the CCRC provides, and prescheduling transportation with them to all doctor appointments (it's a fee, but very minimal if the CCRC takes you).

They are much more likely to give up driving and not doing dangerous things when they have "everything they need" easily accessible.

I will never have to have the "I'm taking the keys away" discussions, they self imposed that themselves
Anonymous
Anonymous wrote:In laws want to sell their home and move into an independent living facility. I am concerned they are making the decision too quickly. Looking at the costs, there is a flat fee and a few items like trash disposal (which apparently you don't have to pay if you take out your own trash). However, I assume they will need renters insurance? They hope to get rid of their car and the place says they will take them to doctor's appointments but I wonder if that is usually reliable or if they will need to take some sort of cab or car service.

If you are familiar with Independent Living facilities, what hidden costs may we not be thinking about?


Unless you are paying for it, how is this any concern of yours?
Anonymous
Anonymous wrote:
Anonymous wrote:In laws want to sell their home and move into an independent living facility. I am concerned they are making the decision too quickly. Looking at the costs, there is a flat fee and a few items like trash disposal (which apparently you don't have to pay if you take out your own trash). However, I assume they will need renters insurance? They hope to get rid of their car and the place says they will take them to doctor's appointments but I wonder if that is usually reliable or if they will need to take some sort of cab or car service.

If you are familiar with Independent Living facilities, what hidden costs may we not be thinking about?


Unless you are paying for it, how is this any concern of yours?


Don’t be stupid. When elderly people decline, they are helped by their children. Human beings need help at the end of their life. That’s just reality.
Anonymous
My mom lives at a Brightview facility in Independent Living. They also have Assisted Living and Memory Care.

For those asking what is different between Independent Living and a regular apartment, this is what you get at Brightview included in your rent:
- 2 meals per day (breakfast & dinner); dinner is in the dining room and my mom has a regular group she eats with
- daily exercise classes mainly focused on mobility plus weekly yoga, tai chi and other options
- a regular schedule of activities with usually at least 4 or so per day including live music, arts & crafts, movies, lectures on tops like art and local history
- monthly special dinners - recent options were an Italian dinner, crab feast, BBQ etc
- shuttle buses to doctor appointments with some limitations - generally need to let them know 2 weeks in advance to get on the schedule and there are some date/time limitations, but all workable
- weekly shuttles to shopping centers during the week and several churches on Sunday
- regular field trips that are usually an extra charge - things like visiting a large garden center and lunch at an Irish pub; dining at a waterfront restaurant; visiting museums in DC or Baltimore combined with a restaurant.

There's no medical care included in Independent living, but there's a button you have to press each day by 10am and if you don't they will call or come do a wellness check if you don't respond.

Many people have medical aides as a transition before going into assisted living, but you pay extra, of course (unless your insurance covers it).

Independent living is 2x or more compared to a regular apartment, but it meets almost all my mom's needs for food, activities, and transportation. She spends minimal arounts beyond this. Assisted living might be 4x or more but you're getting daily medical care, so of course that's the case.

My mom gets internet and cable included in her rent but if you want extra fast internet or extra channels, that's on you. There are charges to get food delivered to your room or to have guests eat with you but those are pretty reasonable. She also gets a housekeeping visit every 2 weeks.

The biggest thing in terms of cost is that they will raise the rent every single year by a significant amount - 5% or so. Most senior living facilities offer significant reductions on rent when you move in for 1-2 yrs but it can be a big hike when that ends. Some people game it by moving into other senior living facilities and getting another move-in discount but that's pretty disruptive.

For our family Independent Living has 100% been worth it for getting meals included and all the social activities that have helped my mom be so much more resilient. The daily exercise classes have been game changers as well - she really needs them to keep up her mobility and they have really helped.
Anonymous
Oh - also meant to add: my mom moved in at 84, which Brightview said was actually the median age for their new residents. So residents are quite elderly but may move in at a younger age if needed. It's also about 85-90% women. Many move in because of a decline in their health (losing ability to maintain a house) or becoming widowed. There are also many couples where one person needs more support but the spouse can't manage everything any longer. In terms of the huge differences between the amount of women and men, it's partly longer lifespans for women but perhaps also all the social supports and activities appeal more to women.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:PP. Another post reminded me. In independent living, you had to pay someone if you needed someone to check on you. My mom was paying about $30 a day for a check-in who dropped in to make sure meds were taken and my grandma could get up and walk. Sometimes she had arthritic troubles getting out of her chair during the last year of her life.

My mom visited about 4-5 days a week so this person was an extra daily contact.


Well yes because the definition of independent living is that you don't need any extra outside help on a daily basis. If you need someone to ensure you take your meds, you must pay for that (if the facility themselves will even provide it---many require you to go to assisted living for that).


Then what makes it different from just a plain 'ol apartment?


My mom lives in an independent /assisted living place. I visited her today and in the lobby area there was a small live music performance, in the library a group of women were playing cards together, waiting by the elevator an elderly man was hitting on an elderly woman (Single men are way outnumbered!), and on her floor in the lounge area women were playing some game with tiles at a table. The elevator also listed the activities that day and there was group exercise, art class, hearing aid check, etc. The meals are eaten in a restaurant like setting with others. There were nurses aids going around to apartments passing out medicine.

It is like a college dorm for old people. So what makes it different is the social aspect.


That plus availability for meals--my parents get approximately 1-1.5 meals a day in their fees. They eat dinner daily at the restaurant. Nor ally have enough leftovers for lunch the next day. One parent eats breakfast in the apartment and the other typically has enough to grab breakfast 4-5 days per week in the restaurant

No concerns they are not eating well
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