Moving to independent living can be an exciting step for an older adult. There may be less home maintenance, more opportunities to socialize, convenient amenities, and a built-in community. But for many people considering a senior living move, one question looms large: What happens if I eventually need more care?
It is an important question to ask before choosing a senior living community. While some independent living communities focus primarily on housing and lifestyle, others are part of a broader continuum of care. Understanding the difference can help older adults and their loved ones make a decision that fits not only their needs today, but also the possibility of changing needs in the future.
Independent living doesn’t always include care
The term “independent living” is often used in retirement community marketing materials, but the definition can vary. Generally, it describes housing and services designed for older adults who can live independently, without needing supportive care or ongoing healthcare services.
Depending on the community, independent living residents might receive a certain number of meals (based on their chosen meal plan), housekeeping, maintenance, transportation, activities, and/or social opportunities. Some communities may also offer supportive services- generally considered non-medical care services- if needed later, or coordinate with outside care providers. Others may not.
The level of support an older adult needs can change significantly over time. If a standalone independent living community does not provide higher levels of care, a resident who develops significant care needs may eventually have to arrange services through outside providers or move to another senior living setting.
For example, an older adult in an independent living community might initially be able to manage all activities of daily living but later need help with bathing, dressing, medication management, or mobility. In some circumstances, those needs may be manageable with in-home care. In other cases, the person may eventually need assisted living or nursing care. If those higher levels of care aren’t available in their current community, the resident may need to move.
>> Related: What Does “Independent Living” Mean in Senior Living?
What is a life plan community?
A life plan community, also called a continuing care retirement community or CCRC, is structured differently than a standalone independent living-only retirement community. Life plan communities provide residents with housing, amenities, and social activities, as well as a continuum of care services.
New residents of a life plan community typically move into an independent living residence, but if their needs change, they have access to additional levels of care, often (but not always) within the same overall campus. Depending on the community, support can include assisted living, memory care, and/or full-time skilled nursing care.
Although transitioning from independent living to assisted living or another level of care within a Life Plan Community may not always be easy, a significant advantage is that residents can remain within a community they know, surrounded by familiar people, relationships, and resources, rather than having to move to an entirely new and unfamiliar setting.
This distinction is important for families to understand, too. Adult children may worry that a parent will eventually need more help and that they will suddenly have to find a new care facility, coordinate a move, and navigate unfamiliar care options. A life plan community can potentially make that transition much more manageable because the community already has multiple levels of care and established processes for moving residents between them.
However, it is important not to assume that a life plan community is right for everyone, nor that every life plan community operates the same way. Services, contract structures, entrance fees, monthly fees, residency requirements, and access to different levels of care can vary. Prospective residents should carefully review the terms of the community’s contract and ask what is and is not included.
>> Related: CCRC, Life Plan, Lifecare: What are the Differences?
A continuum of care can change the calculus
For someone who is healthy and independent today, thinking about assisted living or skilled nursing may feel unnecessary. But choosing a senior living community is not only about current circumstances; it is also about considering what could happen if circumstances change.
When evaluating senior living options, the National Institute on Aging recommends considering both the services an older adult needs now and the services that might become necessary in the future. This is where the distinction between a standalone independent living community and a life plan community becomes particularly relevant.
Imagine two people who are both 75 and in good health. Both want to move out of a single-family home and into a maintenance-free senior living environment.
- Person A chooses a standalone independent living community. Ten years later, after a series of health changes, she needs daily assistance with bathing and medication management. Her community does not provide assisted living, so she and her family must determine whether in-home care can meet her needs or whether she should move to an assisted living community elsewhere.
- Person B chooses a life plan community that includes independent living, as well as access to assisted living and skilled nursing. When his needs change in a few years, he is able to seamlessly transition to the appropriate level of care within the same broader community.
Again, neither choice is inherently right or wrong, and there are pros and cons to nearly every option. Ultimately, the better option depends on the individual … their preferences, health, finances, family situation, and expectations for the future. But the two decisions clearly demonstrate different approaches to planning for changing care needs.
>> Related: What is a “Continuum of Care” in Senior Living?
Does moving to a life plan community mean you’ll never have to move?
This is a key question, and the answer is: not necessarily.
Residents of life plan communities may enjoy numerous benefits, from conveniences and amenities to social connection, wellness programs, and community engagement options. But one common misconception about life plan communities is that moving into one guarantees that an older adult will remain in the same apartment or home regardless of how their health changes. In reality, residents may need to move from an independent living unit to the community’s assisted living or skilled nursing setting as their care needs increase.
It’s also important to acknowledge that having multiple levels of care on one campus can reduce some logistical challenges as needs evolve, but it does not completely eliminate the emotional aspects and stress of a move to a higher level of care. One 2009 study by Purdue University researchers found that life plan residents still described such transitions as “consequential” because they often occur at the same time as declining health and/or functional ability. Furthermore, there are a growing number of life plan communities that are offering higher acuity assisted living and memory care, but stopping short of offering skilled nursing due to economic constraints, including staffing challenges and lower medicare reimbursement rates.
The overall message for older adults is simple: Look beyond amenities and floor plans, and understand how a prospective community handles residents’ changing care needs.
What should you ask before choosing a senior living community?
Whether you are an older adult researching senior living options or an adult child helping a parent, it’s essential to go beyond what life looks like on move-in day.
For a standalone independent living community
- Find out whether residents can receive in-home care from a third-party provider if their needs change.
- Ask whether there are limits on the amount or type of care that can be provided within an independent living apartment.
- Find out whether the community has established relationships with nearby assisted living or skilled nursing providers and what happens if a resident eventually needs a higher level of care.
- Get a handle on the potential cost of in-home care services. If needed for a lengthy period of time, it can add up quickly, easily totaling thousands of dollars each month on top of regular housing and living expenses. (More on this in a moment…)
For a life plan community
- Ask which levels of care are available and whether they are located on the same campus.
- Ask how residents qualify for a move to another level of care, whether availability is guaranteed, if/how monthly costs change, and what happens if the needed level of care is temporarily or permanently full.
- Understand the financial implications. A life plan community may require an entrance fee (which can reach six-figures in some cases) in addition to monthly service fees, and different residency contracts can mean different financial arrangements for any future care needs. Prospective life plan residents should therefore review the residency contract carefully. It may be wise to have a financial professional or attorney review the agreement before signing.
The potential out-of-pocket cost of future care
Planning for future care isn’t just a retirement planning topic; it’s a financial planning issue. Many older adults assume that Medicare will cover the cost if they eventually need long-term assistance. However, in general, that is not the case.
Medicare does not pay for most long-term care, which can include assistance with activities of daily living like bathing, dressing, and using the bathroom. Medicare may cover certain short-term skilled nursing services when eligibility requirements are met, but that is different from ongoing assistive care.
According to CareScout, a room in an assisted living community averages $6,386 per month, while 44 hours of non-medical in-home assistance will average $6,873 monthly (costs may be higher or lower in your specific area). In most situations, these will be out-of-pocket expenses for the care recipient and their family, and the cost of this type of care is only going up.
So, whether you’re considering a standalone independent living community or a life plan community, it’s important to understand exactly what a senior living contract covers and what expenses remain the resident’s responsibility.
Choosing for today while planning for tomorrow
There is no single senior living option that is right for everyone. Some older adults may strongly prefer the flexibility, possible lower cost, and lower commitment of a standalone independent living community. Others may place a higher value on the peace of mind that comes with knowing multiple levels of care are available within a life plan community, should their needs change. The key is to make your senior living decision with a realistic understanding of what each option provides (and doesn’t provide).
For older adults, that means thinking beyond the question, “Where do I want to live now?” Instead, consider asking, “If my health or mobility changes, what choices will I have?” For adult children, that same question can help shift the conversation from reacting to a future crisis to planning ahead. An older parent may be completely independent today, but that does not mean potential future care needs should be ignored.
Choosing a senior living community is ultimately about more than selecting a residence. It is about understanding the range of services, care options, costs, and potential transitions that could shape the years ahead. By asking important questions before making a move, older adults and their loved ones can make more informed decisions and choose a setting that aligns with today’s lifestyle and tomorrow’s goals.
