Whether or not I do anything about a retirement community any time soon — and it clearly isn’t going to be now — I’ve learned a lot by going around looking. There are different financial models. Some require a big upfront buy-in, part of which your estate gets back assuming the soundness of the underlying business model of the facility and whoever owns it — a big and often poorly documented assumption unless you really dig into the financials. Some require a smaller buy-in, and you get little or nothing back. Most offer a continuum of care, so you can go from independent living to assisted living to memory care or skilled nursing if and when you need it. There’s no necessary equivalence among the levels of care in any one facility. You might like the independent living part well enough, but find that the skilled nursing gets panned in reviews. But if you are part of the independent living community in a facility, there are likely financial incentives for you to get other levels of care there too.
My big conclusion, as I said in the previous post, is that you can’t outsource the uncertainties of aging, even if you have piles of money. All the promises depend on the financial stability of the place, which is hard to predict over time and actually hard to model. It’s not that easy to predict with a high degree of reliability how many people will live a long time and need complex and expensive care, creating a drain on the system. Therefore it’s hard to make accurate financial projections.
We’ve seen that unpredictability with the long term care market, where policies were initially underpriced relative to the actual risk. People who pay annually find their premiums going up at a much faster rate than anticipated.
Another big conclusion: most of the day to day care, if you need it, is provided by low-wage, possibly undocumented workers who, no matter how kind and compassionate they are, have far too many vulnerable people to care for and far too little time in which to do it. With Trump’ immigration crackdown, that problem will get worse.
On a more personal level, should you go into a facility like this sooner rather than later, when you can take advantage of all the things that are offered? Or, will you tire of the same relatively small group of active people over time, and age faster because you are surrounded by people mostly older than you?
Is it inspiring to see aging people surmount their infirmities and continue to lead fulfilling lives? Or is it depressing to go to dinner when half the room is using canes, walkers, or trailing oxygen?
I think it’s hard to know the answers.
Tomorrow: deciding what you really want.