“The time to begin thinking about a retirement community isn’t when you have to have it,” advises Terry Martinez with Parmer Woods Retirement & Assisted Living.

“Think about it when you don’t need it. There are a wide variety of alternatives available for every level of activity, health and need. Today’s Baby Boomers who are in or approaching their retirement years are taking advantage of active retirement communities where residents are vigorous and involved. Or, they are finding senior care housing communities that employ medically trained staff, provide housekeeping and meal preparation services, as well as transportation for shopping, medical visits, and social outings. Or, they are seeking a more physically and medically supportive environment. Whatever choice is best for you, it’s out there, but should be considered without stress.

And the prices vary. “When you’re trying to stay within a particular price range, you want to match your living requirements with services offered,” says Martinez. “If youare very independent and don’t need assistance – just want a meal plan, for example – then the associated costs are much less than for someone who requires more care.” Also, Medicare generally does not pay for long-term care, only for services deemed medically necessary that are provided by a skilled facility or home health care center. Medicaid will pay for certain health services and nursing home care for older people with
low incomes and limited assets.

The place you choose should facilitate life at a level of independence that is comfortable for you or for your loved one.


If you’re a healthy, independent senior, you may find that you simply want to live in a community where you can enjoy the company of others and your own personal interests. Moving to an active independent living retirement community might be the best fit for your budget and lifestyle, where options include renting an apartment or purchasing a property.

Many active senior communities have information packets and offer tours. A personal visit will give valuable, firsthand information and an opportunity to meet current residents who can share their own experience and insider’s view. Ask about health and fitness programs, organized activities, sporting options, and social opportunities. Other day-to-day living arrangements should also be considered, such as shopping centers and grocery stores within easy walking distance, and the availability of transportation services. Where is the community located in proximity to major health care providers? What security measures are in place for residents? For ultimate peace of mind, you might opt to rent a home under a short-term agreement at first to make sure the community provides for your needs and lives up to your expectations.


A Continuing Care Retirement Community (CCRC) offers care in a residential facility for seniors, with a full menu of services and living situations. Residents may go from independent living, to assisted living and nursing home care, depending on their individual, changing needs and abilities.

A CCRC (also called Life-Care Facilities or Communities) generally offers a contract that covers a continuum of care, including access to housing, services, and health care for more than one year, or the balance of one’s life. It is a wise idea to move into a CCRC sooner rather than later, as most require that new residents live independently when they first move in.

There is a range of contract options offered by CCRCs. An extensive-care contract is the most expensive, but carries the least risk, providing unlimited long-term nursing care at little or no additional cost for as long as nursing-home services are required. A modified-care contract comes with medium financial risk, and provides long-term health or nursing services for a specified period, after which, the senior or guardian is responsible for additional costs. A fee-for-service contract offers an a-la-carte approach, requiring that residents pay separately for all health and medical services provided by the facility, as well as long-term care. Most CCRCs expect an entrance fee, plus monthly fees thereafter. Some require an equity agreement where seniors purchase a condominium or co-op apartment on the property instead of paying an entrance fee. Less commonly found are CCRC contracts where residents pay monthly fees only.

Before signing a contract with a CCRC, conduct a thorough review of the facility’s services, operations and finances, and determine if it is appropriate to your needs, lifestyle and expectations. It’s also a good idea to ask a family attorney or accountant to review the contract. If the contract is found agreeable, ask to spend at least one night and two days at the facility, to test drive the community and make sure it is a
good fit. Some points to consider include:

• Are pets allowed in your residence?
• What social, recreational and cultural activities are offered?
• Is food prepared onsite? If so, how is it?
• Are there fitness facilities onsite?
• Is the staff friendly and knowledgeable?
• What healthcare and personal care services are available?

• What preparations have been made for handling medical and evacuation emergency situations?
• Is there easy access to offsite activities such as shopping and is transportation provided?

CCRCs can be anything from high-rise apartments, to cottages, townhouses or single-family homes, and are an excellent option for those who are independent and in good health, but might need some assistance with daily living needs or require skilled nursing care.


An Assisted Living Community (ALC) bridges the gap for those who need assistance with daily activities a nursing home might offer, but wish to live independently. Residents in an ALC are unable to live completely by themselves, but don’t need constant supervision. An ALC offers its residents assistance with eating, bathing, dressing, laundry, housekeeping, and keeping track of medications. They often have centers for medical care, but typically do not offer the extensive medical services
provided by a nursing home. An ALC is not a substitute for a nursing home, but rather is a stepping stone between complete independence and services provided by a nursing home.

Often, an ALC will create an individualized service plan for seniors upon admission, detailing personal services that will be provided. This plan is then periodically reviewed and updated to ensure changing needs are met. Housing in an ALC may be studios or one-bedroom apartments with small kitchen facilities. Typically, ALC housing units have group dining facilities and common areas where residents gather to enjoy social and recreational activities.

As with other options, a visit to the center is a must. Pay attention to first impressions:

• Are the grounds well maintained?
• Is the staff friendly?
• Are the residents properly dressed?
• What activities are available?

ALCs that competently provide required services without forgetting about little details will give the same care and attention to residents.


A Nursing Care Facility (NCF) is a state licensed, private-care facility that provides 24-hour skilled hospital care for residents who do not require hospitalization but cannot stay at home.

It pays to shop around when selecting an NCF. Consult with a trusted doctor or health care practitioner for recommendations of nearby facilities. Plan on visiting at least four or five area facilities, and make an appointment with the administrator or director of nursing. Check to make sure that information provided is consistent with information gathered during the facility tour. The home should have clean floors and smell fresh.

Ask to see the compliance survey report prepared by the State of Texas. It will list deficiencies found in resident care during routine inspections, and the facility’s effort to correct them. Under Texas law, nursing homes must make this and other survey compliance reports available upon request, as well as a well-lit place for review.

Another option available is to contact the Texas Department of Aging and Disability Services (DADS) at 800-458-9858. While state law prohibits agency employees from recommending one facility over another, they can answer the following recommended questions about any facility:

• Have there been any proposed license terminations in the past two years?
• How many complaints have been filed in the past year?
• How many complaints in the past year have been found to be valid?
• How many deficiencies have been cited in the past two years?
• How many “quality of care” violations have been cited in the past two years?
• When did DADS last visit the facility, and what was the purpose of the visit?
• Has the owner of this facility had other facilities recommended for license termination?

The answers to these questions, combined with observations and impressions made during facility tours and staff interviews will allow you to select the right nursing care facility.


Seniors diagnosed with Alzheimer’s disease or another form of dementia need specialized care. While some Assisted Living Communities offer services and separate facilities for residents with early onset symptoms, because of the progressive nature of the disease, it may become necessary to transfer the resident to another facility that can give the right level of service.

Facilities specializing in the care of Alzheimer’s and dementia patients should provide a treatment plan that considers not only the resident’s medical needs, but also the needs of the entire family with social services, professional consultations and individualized treatment reviews, all set within a calm, soothing environment that is sensitive to the needs of the patient. Please visit www.agingcare.com for additional information on care for the elderly.