Retirement communities: socialization, assistance

It's easy as pie to age well when you're healthy. The friction comes when you lose your health. Sometimes it's self-inflicted.

While most of us want to stay at home as long as we can as we get older, many do it wrong. Isolation, poor eating habits, lack of physical activity and falls all are common problems for people who age in their homes but don't plan it correctly. The result can be premature disability.

Which is why I have a special fondness for retirement communities.

Living in a retirement community involves moving from your home, but not to a dungeon, as many older people seem to believe.

Designed with convenience and hospitality in mind (it's no accident that many people who work in retirement communities come from the hotel business), they offer private apartments or cottages with an array of options and prices, studios, one- or two-bedroom units, private baths, kitchens, weekly housekeeping, van service to shops and doctors, activities, washers and dryers and hair salons. Urban areas like ours offer a wide variety of options.

But that's not why I like them.

I like retirement communities for exactly the reasons home care often fails. Activities with other people (including staff) keep residents from feeling alone and isolated. Exercise programs keep muscles moving. Bathrooms are set up to prevent slipping, and call buttons in the rooms can get help in emergencies 24 hours a day.

But the main reason I like them is that, by my definition, a retirement community provides at least one meal a day in a common dining room. This is important for several reasons.

Meals are highly labor-intensive, requiring you to drive to the store, buy the food, put it away, cook it, eat it and clean up afterward. Retirement communities greatly reduce these tasks, encouraging residents to eat. Plus, by providing regular meals, they boost their residents' nutrition and keep them social. You can be in your room alone all day, but eating one meal (or more) a day with other people is what distinguishes home care from retirement communities and makes them a worthwhile option.

Retirement communities aren't for everyone, and they vary significantly in style, size, location, price and ambiance, so it's important to ask questions to find the right fit. Here's a basic outline of what's available in the Puget Sound area. (In a later column, I'll provide a checklist of the questions to ask.)

There are three types of retirement communities. The most common type operates month-to-month, meaning you live there until they can no longer meet your needs, then you must move. Where each draws the line varies significantly. Some offer a few additional services in-house, such as help with medications or bathing; others require you to move to a different part of the building where there's a higher level of staff. Others allow you to hire your own caregiver. Others require you to be totally independent.

The second type, called Continuing Care Retirement Communities (CCRCs), provide a range of care — from independent to nursing home all on one "campus." You must be healthy when you move in; then, as you need care, you may have to move to a unit that provides it, but you'll remain close to spouse and friends.

CCRCs can be pricey, usually requiring a sizable upfront fee, plus a monthly fee. But in most cases, you'll never have to move again. True CCRCs will care for you until you die. Religious groups operate most CCRCs, but for-profit companies are entering the market.

The third type of retirement community is subsidized, usually by the federal government, and is similar to the first category, meaning you stay as long as the facility can meet your needs. More Spartan in services, they also cost a lot less, which can be a significant benefit to older people of modest means.

Unfortunately, only a handful of subsidized retirement communities exist in our area, and the federal government stopped building them in the late 1960s. While low-income housing for older people continues to be built (see below), none has common dining rooms — a shortsighted public policy, in my opinion.

Which leads me to two other choices:

• A variety of public and private nonprofits build and operate housing for healthy older people of low and moderate income. Built primarily as apartments, they provide no meals in a common dining room, nor do they offer van service, weekly housekeeping or the other amenities often found in retirement communities. What they do offer is privacy, safety and opportunities for keeping active and social with other people, at a subsidized rate.

• In exchange for using bond financing to build market-rate retirement communities, some developers offer some of their apartments at discount to older people of modest means.

To learn about these options, including income-eligibility requirements, contact your county's Senior Information & Assistance office. In King County, call 888-435-3377 or go to www.seniorservices.org. To find an office elsewhere, call the Eldercare Locator office at 800-677-1116) or www.eldercare.gov.

Liz Taylor's column runs Mondays in the Northwest Life section. A specialist in aging and long-term care for 30 years, she consults with families and their elders. E-mail her at growingolder@seattletimes.com or write to P.O. Box 11601, Bainbridge Island, WA 98110.