The Foreign Service Journal, February 2010

ties, in part because retirees have had such difficulty selling their ex- isting homes. But as the economy recovers, the actuarial tables are bound to renew the pressure upon this market. Common Characteristics of Senior Living Facilities There are three basic levels of accommodation: Independent Living: A private apartment or cottage on the premises, from a one-room studio up to three bed- rooms with a study and two-and-a-half baths; living es- sentially on your own; usually must take at least one meal per day in the compound’s restaurant facilities. Assisted Living: More modest quarters, typically with- out a kitchen; some dependence upon nurses or thera- pists; perhaps reduced mobility; all meals normally taken in the compound’s dining facilities. Skilled Nursing: Resembles hospitalization, often re- quiring round-the-clock attendance; usually there are separate wards for Alzheimer’s patients, sometimes two or more degrees of dementia care. Most senior living facilities include all three levels and are termed “continuing care.” Some, often linked to a hospital, have only assisted living and skilled nursing. An attractive feature of the continuing care arrangement is that a couple can acquire an independent living apart- ment; then, if one of them suffers from, say, Alzheimer’s, and shifts to a dementia corridor, the other can remain in their apartment and easily visit and take meals with the cared-for spouse. The initial focus is upon independent living. There is usually a minimum age of 60 or 62. In some cases apart- ments are sold as condominiums, in others as coopera- tives. In another model, a substantial initial payment, $500,000 or more, secures permanent occupancy (but not ownership) of an apartment and includes whatever medical support is required; on departure or death, the quarters revert to the institution and there is a partial re- fund, according to varied formulas. A few establishments offer separate cottages. And some communities are af- filiated with universities, which can offer real cultural ad- vantages. Senior living facilities always have apartment floor plans and pricing charts available for review, and you can arrange to visit various models. Typically, there will be 150 to 250 apartments with com- mon recreational, health and sports spaces. The health center, providing many hospital services, is normally a separate wing. Of course, prices vary among facilities and among the apartments in each; senior living establishments run from the bare-bones to the truly luxurious. There are normally one or more dining areas, fitness centers, libraries, hobby workshops and studios; some sort of auditorium or theater; a swimming pool, a garage and game room. Often, one also finds gardening plots, a business center with computers, a hairdresser/barber shop, a bank branch and a convenience store. All the re- tirement facilities we have visited provide shuttle service to public transit; trips to shopping centers and churches; and outings to museums, sporting events, art galleries and concerts. Most also schedule concerts, lectures and movies weekly in the facility’s auditorium. All places we reviewed permit cats or dogs, although with ground rules on number and size. A sense of community evolves, reinforced by volun- tary activities (e.g., books, bridge, gardening, art, wood- working, theater clubs and dogwalking) and by the fact that monthly fees cover a certain number of meals where friendships develop. Resident committees arrange for outings and for cultural events in the facility, and you have the impression that if the quality of the food falls off, a committee will spring up to put pressure on the management. There are standard monthly fees that cover utilities, maintenance of grounds and public areas, use of sports and recreation facilities, taxes, security, garage space and so forth. These monthly payments always include either about $600 toward meals or perhaps 30 meals per month, apparently a way of assuring sufficiently steady income for food services. All establishments vaunt the quality of their cuisine; but it is best to try it out, which you can do as a guest. Monthly fees, depending upon the size of the apart- ment, generally run from under $2,000 to $4,000, with about $900 more for the second resident. When we added up the bills we had paid at home the past year for electricity, natural gas, water and sewage, painting, roof- ing repairs, general maintenance, lawn and tree care, fire- wood, exterminators, driveway repaving and a security F E B R U A R Y 2 0 1 0 / F O R E I G N S E R V I C E J O U R N A L 21 F O C U S Another reason to plan ahead is the chore of downsizing.