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I’m in the process of helping my 81-year old mother apply to a continuing care community, which will include their own physical and mental health screenings. I’ve noticed my mom’s memory decline over the past few years (forgetting common words, names, and misplacing things), and more recently am seeing loss in executive function (calendar management, forgetting the day of the week, unable to learn new things or follow simple instructions, use her iPhone and computer effectively). The community will require that my mom initially be able to live independently to be accepted, and certainly, she can still bathe, dress, cook, shop, drive, walk without help, go up and down stairs holding a railing, etc. So I wonder what degree of mental decline will keep her from being accepted. Does anyone have experience with having gone through this?

My mother applied for, was accepted, and moved in to her CCRC at age 79. She was (and still is) in good health with little cognitive decline. This doesn’t answer your question directly, but it was our experience that the value of the assets you bring to the table matters. They will overlook minor cognitive or health issues if her resources are robust. They accepted my mother based only on her initial meeting with the sales staff, medical records and balance sheet. They told us the tests were “perfunctory” and, in fact, skipped one interview altogether. I am not being critical of CCRC’s; they never claimed to be “low income.” They want to be assured that the resident has plenty of resources for increasing levels of care, won’t complain too much when they raise prices, and might make contributions to the foundation or resident fund. I would think about the whole package your mom brings to the CCRC, not just her cognitive limitations.
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Reply to DShigley
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The more she can do, the less work for them, will improve her chances of being accepted.
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Reply to cover9339
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Cook?
Is she applying for Independent Living or ALF?
Because typically you do not cook in ALF. Meals are provided as is cleaning, laundry, medications if needed.
It is unlikely that mom will fail. My brother, with his early Lewy's was fine, did very well.
Forgetfulness and mental decline is fine. But certain things such as wandering of campus is not.
Attend with her. Allow for exam without you present as well. They will love your input and to interview you regarding her limitations and so on. Very valuable.
From all you say I think she will pass with flying colors.
I hope you will update us.
When you go in be sure to ask about levels of care and what they consist of.
Ask about raises in price, how often and what to expect.
Ask about notifications of injury and how that is done should fall occur.
Just feel free to ask a lot of questions and to get their packet on what they provide and what the cost is.
Good luck.
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Reply to AlvaDeer
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TBSmith Nov 25, 2024
Thanks for your response—I feel somewhat relieved! I don’t see her as a flight risk, so we should be good. I will take your advice and attend her screening exams.

It’s a CCRC, so she will go in living independently, then move up through care levels as needed through end of life. Monthly fee only increases about 4% per year. 1 meal per day is included, so she will need to prepare other meals she wants, or pay out of pocket to get them at the various dining spots on campus. Lots of amenities and activities included.
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If the CCRC is the type that has a fixed monthly fee, regardless of level of care, they want to make sure that new residents are able to be independent as long as possible and won't very shortly need to move to a higher level of care. This model of CCRC is kind of like buying an insurance policy--they count on having a certain percentage of the population costing them less (i.e., the independent level). This is why they have the screening for potential residents.

Another type of CCRC also has differing care levels, and you are guaranteed a spot as you need to move, but monthly charges differ based on care level: e.g., independent, memory care, assisted living, nursing home. The independent living entrance fee may be 80-100% refunded when the person dies or moves to a higher level of care. For some of these CCRCs, people can enter directly from the community to their memory care, nursing home, or assisted living if there is a vacancy, though priority is given to folks who are already living there. These types of CCRCs will also have screening for prospective independent living residents, but this is more to insure that they can truly function as needed in that environment, e.g., get themselves to the dining room, live alone safely in their apartment, etc. I've visited friends in one of these places, and there are a lot of independent living residents using walkers, even a few in wheelchairs. Some people who aren't necessarily ready or wanting assisted living will hire some extra personal care help while still living in the independent section, much as one would do if living at home. (That often happens when there is a couple and one has care needs and the other one doesn't.)
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Reply to newbiewife
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My dh works for a ccrc. Here’s how it works.

1. You pay from 200k+ plus for a condo.
2. You then prepay another 300k, which is about 5 years of “hoa” at 7000k a month. It’s nonrefundable. You can opt to pay 650k, 80 percent of which would be refundable if you happen to die or need to leave.
3. There is no locked mc. There is a tiny al that consists of small rooms, which you have to pay double for. Otherwise, it’s on you to hire aides from wherever to help with adls.
3b. The whole community is geared toward independent living.
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Grandma1954 Nov 25, 2024
The continuing Care Communities that I am familiar with have Independent, Assisted, Memory Care and Skilled Nursing.
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I am sure mom will pass the interview process. What I am concerned about is the fact that mom is still driving. You can that you have seen a loss in executive function, follow instructions, misplacing things this makes me nervous that she is driving.
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Reply to Grandma1954
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Is your mom trying to enter as IL or AL? Even if she can pass, I would advise thinking long and hard about facilitating a move to independent living if she's borderline. I have a relative (not the Aunt I've written about before, someone else) who managed to get accepted in independent living in a CCRC and really shouldn't have. Now she's paying for a part-time caregiver and also calling me frequently about every perceived problem, due to the same sort of executive functioning shortcoming you describe. The CCRC doesn't have support for IL residents to meet these needs.
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Reply to HollyIvytwo
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My dh’s ccrc requires you buy a condo from them, then prepay another condo worth in “hoa” fees. You then have to pay your own aides unless you go into one of their al rooms where the fees double. If you’re a wanderer or start defecating in the flowerpots, they’ll call the hospital to get ya and then say you’re an unsafe discharge as they made it clear they don’t supply mc or snf. Which leaves you with no money for private pay until you sell the condo, which can’t be rented.
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Reply to PeggySue2020
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I wouldn't get my mother into such a community personally. She's not capable of Independent Living so why try for such a thing? If this were my mother, I'd get her into a nice Assisted Living residence that also has a Memory Care attached. No buy in's or requirements to pass tests.....just an appropriate care home where she won't feel like she has to jump thru fiery hoops to remain living there. Elders with cognitive decline struggle enough as it is w/o having to prove they possess abilities they no longer do. It'll be only a matter of time before she's asked to leave, most likely.

My mom lived in AL with early dementia until it became moderate and her mobility declined at the same time to where she was in a wheelchair full time. Then I was able to segue her easily into the ALs Memory Care building across the parking lot that she was already familiar with.

Best of luck to you and mom.
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