After retirement:  Where to live?

by Don Kuehn

For growing numbers of Americans, retirement planning includes finding the place to live after leaving the world of work. Retirement communities are not just apartments for old people, they can be anything from lavish complexes that include haute cuisine meal service and state-of-the-art medical care, golf, fishing and other activities to bare-bones arrangements that are little more than low-cost housing. The best of the lot offer so many activities that they feel more like summer camp than a retirement community, and they cost a bundle.

Whether you are just starting to consider a long-term retirement community or are shopping for a place for your aging parents, here are a few things to consider:

First, take a look around. Get a feel for the scope of services offered by the industry. There's no law that says you have to move to another state or climate when you retire. But, if you have done your homework, checked out the community, the tax laws and the politics of the place, hit the Web. Check out the Web sites of the Retirement Living Information Center (www.retirementliving.com), New LifeStyles (www.newlifestyles.com) and The American Association of Homes' and Services for the Aging (www.aahsa.org).

You'll find a lot of terms that, at first, may seem interchangeable. Here's a brief glossary:

Resort communities are filled with facilities and amenities. These are ideal for older people with an active lifestyle and a solid investment portfolio--they're expensive. Some have minimum age requirements.

Active adult retirement communities are age-restricted developments with an overall master plan. Many are like self-contained cities with their own stores, hospitals and security forces.

Continuing care retirement communities provide different types of residential living and health care services in a campus-like environment. Many people begin in a small attached home or apartment (independent living) and then move to an assisted living unit or nursing home as needs change. Meals, transportation, activities and housekeeping services are usually provided.

These places aren't cheap, either. Entry fees are collected up front and range from around $30,000 to as much as half a million dollars ($75,000 seems average). Add to that a monthly fee that may or may not cover all of your health care. Some continuing care communities also require residents to purchase long-term care insurance.

Assisted-living facilities are typically licensed by the state. They combine a residence with support services designed for those who need help with daily activities such as bathing, dressing and taking medication. They have 24-hour supervision and are often part of a continuing care retirement community or nursing home.

Alzheimer's care facilities specialize in caring for patients with all forms of dementia. Some assisted-living facilities have a separate Alzheimer's unit.

Nursing care facilities provide skilled care for those who need constant or frequent nursing attention yet don't need to be hospitalized.

Making an informed choice among several communities is difficult because no two are alike. There is, however, an accrediting agency that approves such facilities: the Continuing Care Accreditation Commission of the American Association of Homes and Services for the Aging. Any community that doesn't have the seal of approval from CCAC should be taken off your list.

Plan an overnight visit "in season" and out. Chat with the residents you meet. Don't rely on the opinions of your "official" hosts or dinner companions. Wander about the facility and grounds and observe how residents are treated.

In addition, some of the things you should review before signing a contract include:

• a legal description of the living quarters, furnishings, utility charges and housekeeping responsibilities;
• the level of medical care provided. Does it offer on-site doctor and hospital services, are they contracted with a local facility, are nursing care and various therapies covered?
• transportation. If you're going to be hanging up your car keys, make sure you can get around. Does the community have a free shuttle service to the library, bank, doctor's offices, ballpark, movies?
• the tax situation. If the retirement community is in a different state, will you be paying more or less in taxes?
• are there surcharges for any of the recreational and educational activities?
• how's the chow? How many meals are served daily, can the staff accommodate special dietary needs, are meal costs included or charged separately?
• Finally, what is the refund policy in the event you want to leave the facility? Be sure you know your rights before you take the plunge.

A big part of your retirement nest egg is going to be invested. Don't be swayed by sales pressure. The best communities sell themselves and they will probably have waiting lists of at least several months.