Guide to Retirement Living and Senior Living

As parents, loved ones and partners begin to age, it becomes increasingly important to have a plan in place to provide for their medical, social and cultural needs. Each senior living community is unique and offers different amenities and support options. We asked a number of senior living executives from around the state to provide some advice about what to expect, and what makes their community unique.

Shannon Lynch, Executive Director, Summit by Morrison – Part of The Morrison Communities, Whitefield, NH

What makes Summit by Morrison unique?

Lynch: “Those who have always called beautiful northern New Hampshire home now have an option to retire to a senior living community in the location they love! Building off the five-star rating and legacy of The Morrison Skilled Nursing Facility and Sartwell Place Assisted Living, Summit by Morrison is the new, second campus of The Morrison Communities. Summit is a private pay facility that offers independent living cottages and apartments, assisted living studios and secure memory care units. Our living options are month-to-month agreements with special respite and day program rates. The Morrison Skilled Nursing Facility can accept Medicaid and offers long- and short-term care, skilled nursing, and physical and occupational rehabilitation services for both inpatients and outpatients. With these two campuses, we can offer a continuum of care to our residents without the buy-in fees associated with Continuing Care Retirement Communities.”

What types of housing options are available?

Lynch: “At Summit, the living options include independent living, assisted living, a secure memory care community and respite care. Our independent apartments and cottages provide residents with freedom from the challenges of homeownership in a beautiful scenic setting with fabulous amenities. All our assisted living apartments (equipped with kitchenettes) and our memory care studios are private living options with private bathrooms.”

What are some of the design elements included in the Memory Care Household?

Lynch: “Summit’s Memory Care Community was designed to provide residents with a welcoming, homelike environment while providing family members peace of mind that their loved ones are in a safe and secure environment. This community features an open-concept living room with fireplace and dining area and a fully equipped kitchen. Recently, we added an enclosed outdoor garden that residents and family can enjoy. With a maximum of twelve residents in our memory care program, our staff can specialize in providing individualized care, including a full activities calendar. All employees of Summit by Morrison are trained using the Alzheimer Association’s Habilitation Training, which is a person-centered approach to dementia care.”

Maria Byrne, Director of Sales at The Baldwin, in Londonderry, NH

When should I consider a Continuing Care Retirement Community (CCRC)?

Byrne: “You don’t have to wait until your health needs increase to move to a CCRC. Many CCRC residents are very active and independent and see a move to a community as a way of freeing themselves from the responsibilities of home maintenance so they can spend more time pursuing the activities they love. Many Continuing Care Communities, such as The Baldwin, offer rightsized apartment homes with modern features and services that complement the desire for low-maintenance living, as well as convenient access to amenities that make it easier for residents to engage in the arts, fitness and wellness, lifelong learning and more.

“We’ve seen that the people who tend to get the most out of their experience living at a CCRC are the ones who make the move while they are still in great health. They’re able to enjoy all the community has to offer with the peace of mind that higher levels of care, such as assisted living and memory care, are available to them on campus should they need them in the future. The sooner you move to a CCRC, the longer you’ll benefit from all the lifestyle and wellness choices and services the community has to offer.”

What type of CCRC is The Baldwin, and what are the benefits of this type of CCRC?

Byrne: “There are generally three types of CCRC contracts: Type A, Type B and Type C.

Type A (lifecare) contracts offer unlimited healthcare services with minimal increases in residents’ monthly fees.

Type B (modified) contracts offer a set amount of healthcare services residents can access for a set period. Any services received over the set amount will likely cause the monthly fee to increase.

Type C (fee-for-service) contracts include housing, resident services and amenities, like Type A and B contracts, but don’t include the costs of healthcare services. Residents pay market rates for any health-related services they need.

“The Baldwin offers Type B and Type C contracts. This ensures that monthly fees are kept low for residents who are not having to prepay for health services they may not use for years, if at all. Given that The Baldwin’s future residents are all making the move to the community as Independent Living residents, they’ll enjoy lower monthly fees compared to if they had moved to a community offering Type A contracts.”

What are some of the amenities I can expect at The Baldwin?

Byrne: “Life at The Baldwin will include a variety of state-of-the-art amenities designed to enhance our community’s ‘live-work-play’ philosophy. There will be an art gallery and studio for our community of creators; indoor and outdoor fitness centers for athletic aspirations; a library, classrooms and auditoriums for lifelong learning; a swimming pool and salon and spa for rest and relaxation; walking trails and raised gardens for the outdoorsy types; and countless other areas for socialization.

“We believe that retirement is when the fun starts and want The Baldwin lifestyle to be a reflection of that. The community’s amenities have been carefully thought out to ensure that diverse residents with diverse interests can create the lifestyle they desire with ease.”

What would someone be surprised to learn about life at a community like The Baldwin?

Byrne: “I think people are often surprised at how active and resident-driven the lifestyle at a Continuing Care Community, such as The Baldwin, can be. There’s this stigma that life at a CCRC is slow-moving, monotonous and lacking excitement. There may have been some truth to that in the past, but many modern CCRCs, such as The Baldwin, have turned that notion on its head. In the past, I’ve had the fortune of working with CCRCs where team members went above and beyond to provide avenues for residents to pursue their interests. Residents felt empowered to pursue their hobbies and step out of their comfort zones to try new ones. It was rare that two days were ever alike, and we hope to bring that same spirit to The Baldwin and take it to the next level.”

What is unique about The Baldwin’s location, and how will that benefit residents?

Byrne: “The Baldwin is being built in an ideal location in the ever-growing Woodmont Commons neighborhood in Londonderry. This means that residents will be within walking distance or a short drive from dining, retail, wellness, social and cultural attractions in the larger community. So not only will they have plenty of opportunities to engage in all there is to do on campus, they’ll find even more opportunities to be active and involved in and around Londonderry as well.

“Our community’s close proximity to Boston and Manchester makes venturing into the city a breeze for residents. And for more far-reaching adventures, residents can lock and leave — with the peace of mind that their homes will be looked after for as long as they are away — and head to the nearby airport to begin their travels.”

Paul Charlton, Vice President of Marketing, Taylor Community, in Laconia and Wolfeboro, NH

What are the different levels of care at Taylor Community, and as a resident, can I transition from one to the next?

Charlton: “Like other CCRCs, Taylor Community offers independent living cottages and apartments, assisted living, memory care and full nursing. This continuum is at the core of the CCRC model where seniors can move into vibrant and active retirement living while enjoying the peace of mind that they have access to different levels of care as they age. Often that peace of mind is just as important for the resident’s children as much as for themselves.”

When or why should I consider a CCRC?

Charlton: “As far as when, the short answer is better sooner than later. I don’t think anybody ever said they made the move too soon but have certainly heard from many people, ‘We should have done this years ago.’ Those who move in when they are younger and more active take full advantage of all the CCRC offers. As far as why, there are so many answers that it would be impossible to list all the benefits. Key reasons include having access to the full continuum of care providing best options now and in the future and living in a community with friends and neighbors who enjoy other’s company and really look out for one another. Maintenance-free living is also very appealing. It’s not that people aren’t capable of maintaining their own homes, they simply prefer to do other things that aren’t such a chore. That leads to another aspect of CCRC living that appeals to many: There are many amenities like the pool, gym, movie theater, library, billiards lounge, bistro and outdoor parks and recreation. There is also a robust schedule of trips, activities and events, ranging from speakers to zip lining to superb classical, jazz and blues concerts, pub night, fire pit gatherings and more.”

What are some of the recent upgrades at Taylor Community?

Charlton: “Taylor is just now completing construction of six new cottages. These are larger, open-concept design, each with a two-car garage. We are nearing completion of phase one of the creation of a pavilion and outside park and recreation area. Phase two will finish up in spring 2020 to include outside cooking, bocce court, putting green, walking track and expanded garden areas. Longer term, Taylor is pursuing other expansion as part of its overall strategic plan. Future projects have been defined to include adding independent living, assisted living and memory care in both Laconia and Wolfeboro.”

Cathleen Toomey, Vice President of Marketing, RiverWoods Exeter, RiverWoods Durham and Birch Hill, in Manchester, NH

What is CCRC/Life Care and who would it be right for?

Toomey: “A Continuing Care Retirement Community ( CCRC) is a retirement community that generally accepts people 62 years old or better, who are able to live safely on their own. Living at a CCRC as an independent resident means you enjoy many services and amenities, such as one meal a day, housekeeping, transportation, 24-hour emergency response, inside and outside maintenance, and a host of interesting programs and activities. Once there, if you need additional care in the future, it is available to you, right on campus, at a significantly discounted rate. Although all CCRCs in New Hampshire are nonprofits, the contract types are different, and therefore it is important to understand what is being offered. (For an Insiders’ Guide that provides more in-depth information on contracts, go to riverwoodsrc.org/what-is-a-ccrc/).”

What type of CCRC is Birch Hill, and how does it differ from other types?

Toomey: “Birch Hill, a member of the RiverWoods Group family is a Type B contract CCRC. The advantage to a Type B contract is that it provides targeted insurance, and therefore you are not paying for care you don’t need. Birch Hill offers a lower entrance fee and a lower monthly service fee than its Type A counterparts, but the same high-quality level of healthcare and amenities.

“Birch Hill is also the only CCRC in New England that offers a 70% Flex Contract — this contract provides 70% of your entrance fee back to you, to use during your lifetime, which helps defray healthcare costs. All other refundable contracts provide refunds after you have left the community, or passed away.”

What’s unique about Birch Hill’s location?

Toomey: “Although Birch Hill is just 10 minutes from downtown Manchester, its wooded location in north Manchester is idyllic. Situated on 29 acres, off Hackett Hill Road near Hooksett, Birch Hill is across the street from a 600-acre nature sanctuary.”

What are some of the recent renovations at Birch Hill?

Toomey: “The community has invested $14 million in renovations to the physical plant in the last two years. A brand-new, light-filled fitness center has been added, as well as a spacious resident event space. The dining rooms have been completely renovated, as have the halls, lighting and carpeting. Now, all private homes feature granite countertops, stainless steel appliances, new lighting and open-plan kitchens, as well as updated washers and dryers. Many homes have private balconies.”

What types of living options are there at RiverWoods Exeter? Can I transition from one to the next should it become necessary?

Toomey: “RiverWoods Exeter offers independent living, assisted living, memory care and skilled nursing. Once you are a resident in independent living, you can transition to any level of support you need at any time.”

What is RiverWoods Exeter’s ‘Speaking for Myself’ program, and what are its benefits for memory care patients?

Toomey: “RiverWoods Exeter residents have the opportunity to participate in the ‘Speaking for Myself’ program when they enter the community, where they identify specific preferences and desires they have. This document is used in the event that a resident may at some point require memory support or assisted living, so that we can personalize their care. For example, if they are an early riser, or a late riser, if they have a nickname, or a preference for what activities bring them the most joy. It is captured in that document while they are still able to speak for themselves, so all care staff know and honor their individual preferences.”

What can I learn from The Insider’s Guide, and how can I get a copy/read it?

Toomey: “We offer the Insider’s Guide for free, to help consumers understand what questions to ask when considering a CCRC. It is available online at riverwoodsrc.org/
what-is-a-ccrc.”

Joanne Rizzo, Director of Community Relations, Bedford Falls, in Bedford, NH

What is the best way to introduce the idea of moving to a senior living community, assisted living or memory care facility to a loved one? Who should be involved in the discussion?

Rizzo: “These situations need to be handled delicately as they can be filled with a myriad of emotions, including fear of losing one’s independence and what’s familiar to them. It should be a somewhat gradual process depending upon how urgent of a situation it is. The first conversation should be reassuring and focused on planting seeds, introducing concerns, preferences and priorities. You want your loved one to feel that you are on their side and they are ultimately in control, but that you want what’s best for them. In that initial conversation, you want to uncover what’s most important to them and walk away with some sort of plan, even if it begins with baby steps, that most everyone agrees on. We recently launched an Open Conversations educational blog series that tackles these topics and other pressing concerns.”

What might someone be surprised to learn about senior living communities?

Rizzo: “Many people still equate senior living with nursing homes because that’s what most people who are considering senior living now grew up with. When, in fact, there is a night and day difference between a nursing home and a community like ours. They are often surprised to see how active our community is, how connected and a part of the greater Bedford community we are, and by all of the services and amenities we offer. For example, many of our residents still drive and every day we offer a ton of on- and off-site experiences to keep our residents active, engaged and connected to what matters most in their lives. For us, the surprises really begin from the moment people walk in the door and they see how vibrant and hotel-like our community is with the fine furnishings they are accustomed to.”

What is something unique about the memory care approach at Bedford Falls?

Rizzo: “Every day we give our residents a sense of purpose, a reason to contribute and feel valued. By tapping into each person’s individual interests and passions, they are able to experience successful days and minimize some of the symptoms that can occur with dementia, such as mood changes or confusion, and help them stay connected. For example, recently for Veterans Day, we created cards for veterans on hospice to thank them for their service and also hosted a pinning ceremony to honor all of our veterans and their spouses, which made them feel very special. Off-site activities, like trips to the farm to pick pumpkins to decorate, keep our residents connected to cherished childhood memories. Bringing purpose and meaning to the lives of those with dementia and Alzheimer’s is key to giving them the satisfaction they need and that is our focus every single day.”

When should I start planning to transition to a senior care community?

Rizzo: “Most of us will need assistance as we age so it’s never too early to start planning. The easiest transitions are those that have involved a good deal of planning for the future. Short-term, when it gets too difficult for an individual to live on their own, living on their own is compromising their health or wellness and they can benefit from a more socially rich environment, then we suggest planning a transition. Making the necessary financial plans can take some time so it’s best to start assessing one’s financial situation first to determine affordability and if changes need to be made. Our free Financial Concierge Program can provide needed assistance and resources, including assistance securing VA benefits, short-term bridge loans and other alternative financial solutions.”

When and why should I consider a CCRC?

Rizzo: “The ideal candidate for a Continuing Care Retirement Community (CCRC) is someone who is on the younger side and does not currently need a high level of care. Most CCRCs operate on a buy-in model that requires the resident and/or family to pay an entry fee and, in exchange, they receive access to a wide array of services, amenities and activities within the community as they age and need an increased level of care. By investing in one’s future, a CCRC provides peace of mind that, as you need additional care over time, you won’t have to move to receive it and are able to maintain a continued link to the greater community. Those who are younger and in relatively good health who don’t yet need assisted living, skilled nursing or rehab generally reap the most financial benefits from investing in a CCRC-type living situation.”

Lynda Brislin, RN Executive Director, Windham Terrace, in Windham, NH

What is your No. 1 tip about the moving process?

Brislin: “Seniors are sometimes under the impression that all communities are the same and that they offer the same levels of care, the same standards, or the same accommodations. This is most definitely untrue. They’re sometimes afraid that they will lose their freedom or Independence and that remaining in their home is the best place to live as you age. In actuality, it is the environment that provides safety, more freedom and convenience along with more care and certainly less stress or worry than perhaps staying alone in your home can provide. Another misconception is that you will lose connections with family or friends. The reality is that families and friends visit more frequently, and those visits are more enjoyable as they’re not providing care that was needed before moving into a community.”

What are some of the important elements to consider when choosing a retirement community?

Brislin: “Location can be an important consideration, given that quite often the simple objection about moving is to be close to family and friends. Consider the size of the facility; services that are offered for your current needs, as well as the services you may require in the future; costs are always something to consider, and then consider the culture of the community. The culture can be simply defined as the way a facility ‘feels.’”

What is something unique about the approach to memory care at Windham Terrace?

Brislin: “Millstone Inn is a smaller, personal wing — within the same overall community — separated by a keypad code that prevents wandering of those who may have this symptom as part of their dementia. It is a specially designed, lovely and secure unit with an outdoor enclosed courtyard as well as a large, bright three-season sunroom. The goal of our Millstone Inn is twofold: to provide a sense of security and belonging through specially trained staff, within surroundings that look and feel like home; and to add quality of life through a daily routine which incorporates music, laughter, smiles and exercise along with conversation, creativity and reflection.”

How do you recruit and retain top healthcare staff?

Brislin: “Make certain from the start to hire selectively. Also:

• Offer adequate pay-salary-benefits — must be competitive. Flexibility.
• Offer praise and recognition to let employees know their worth. Rewarding for attitude not just skillset. It’s not always about the money.
• Make new employees feel welcomed by all.
• Be the manager that communicates effectively, be a leader not a boss!
• Seek staff input and suggestions.
• Provide employee opportunities to develop their careers.
• Most importantly and simplest — know your employees.

What’s something new at Windham Terrace?

Brislin: “We have recently changed our dining to open seating versus scheduled, timed dining per the request of our residents. We also serve breakfast all day. It is very important to listen to what your residents are asking for. Younger residents expect and demand a different experience than their older counterparts.”

Kerri Elliot, Director of Business Development, Silverstone Living – Hunt Community, The Huntington at Nashua and At Home By Hunt.

When should I begin planning for life in a retirement community?

Elliot: “You should begin planning for life in a retirement community before you need it. Life Plan Communities benefit those individuals who are active and independent while wanting the security and peace of mind of knowing they will have the amenities and resources needed in their later years.”

What are the primary benefits of a Life Plan community?

Elliot: “By leaving the stresses of home maintenance and upkeep behind, you will finally, at long last, be focusing on yourself. With a wide variety of living options, you are still able to maintain your own personal space with peace of mind, knowing if your circumstances change in your later years, you will have access to assisted living and nursing care. Most Life Plan communities offer lifetime care as well.”

What type of Life Plan community is Silverstone Living, and what are the primary benefits of that type?

Elliot: “Silverstone Living has two active Life Plan communities — Hunt Community and The Huntington at Nashua — and a revolutionary Continuing Care at Home program known as At Home By Hunt. Silverstone Living provides comprehensive living options based on the individual preferences of adults aged 62 and better.”

What are some of the recent upgrades at Silverstone Living communities?

Elliot: “Silverstone Living’s Hunt Community finished an $11 million dollar renovation in 2018 that upgraded our historic building to include many of the community spaces around our campus. In early 2019, The Huntington at Nashua enhanced their bistro experience in response to resident feedback. Silverstone Living will continue to make enhancements to improve the resident experience for years to come.”

What do you find most people are concerned about when they first relocate to a retirement community? How can I ease a family member’s concerns?

Elliot: “There are many different concerns for people when they relocate to a retirement community — as with any other big decision in a person’s life. However, the peace of mind people experience almost immediately upon arrival in a Life Plan community quickly helps alleviate those concerns. Knowing you have a team of individuals available to support your transition, as well as an entire community offering friendship and social opportunities, helps people quickly acclimate to the new lifestyle.”