Developers are building everything from gated communities with patio homes or condomiums to deluxe one-story apartment complexes with age restrictions to communities where aging people can get help with the nonmedical aspects of daily activities, and calling them all “retirement communities.”  

The result is a confusing array of choices for individuals planning their retirement and caregivers needing help for an aging relative. Before making what is a major lifetime decision, it is important to understand the distinctions between such terms as Independent Living Retirement Communities, Active Adult Retirement Communities, Continuing Care Retirement Communities, Assisted Living Centers, and the other terminology of the retirement care industry.

“Too many people don’t know the language,” says Debbi Lee, a regional long-term care ombudsman with the Centralina Area Agency on Aging. “It’s like going to a foreign country without an interpreter.”

Purchasing extended care, either for yourself or for a relative, is one of the major financial decisions people make and it should be approached in the same way as any other big purchase — with careful investigation and research.

What’s more, says Lee, too many people  try to make a decision in a crisis. “You need to start planning now when you first think your parent needs help, rather than two years from now when Mom’s burning the house down,” she says. “You need to be prepared and do your homework before the crisis.”

With a growing and aging population and a booming economy, many national retirement communities have targeted Charlotte as the place to be. In increasing numbers, people are retiring to the Carolinas every year — one source estimates the number at 30,000. Mecklenburg is one of the state’s top five counties in attracting relocating retirees.

According to statistics from the state’s Division of Aging, Mecklenburg County had 56,545 residents age 65 and older in 1996, representing 9.5 percent of the total population. By 2020, that figure is projected to grow by 102 percent to 114,409, equaling 13 percent of the total population.

“A lot of people have moved here, in banking, textiles, and education,” says Jonathan Howard, president of Resources for Senior Living. “A lot of retirees are moving here to be closer to their families.”

Within the last three years, a number of national companies have entered the Charlotte market. These include Alterra, Atria, Sunrise Assisted Living, Manorhouse and Brighton by Marriott. There has been a phenomenal growth of upscale communities catering to the growing population of retirees.

One recent example is The Cypress in south Charlotte, which features a grand ballroom, elegant dining, a fitness center, library, and indoor swimming in a 40,000 square foot clubhouse. The upscale retirement community is located on 60 acres and includes villas (apartments), cottages, a wellness center, and assisted living and skilled nursing beds. The independent living villas are designed without load bearing walls giving new owners greater latitude for future renovations.

“With the money flowing for real estate in all shapes and forms, the retirement community developers came out en masse,” says Dan Owens, president of Senior Living Associates, which publishes Senior Living Resource magazine and Retirement Lifestyles in North Carolina. 

“During the last three years, it’s as if someone flew over Charlotte in an airplane and dropped little assisted living seeds and the communities sprouted up,” says Tom Haselden, executive director of the Charlotte-Mecklenburg Council on Aging.

The growth in the number of centers has happened despite a state ban on the licensing of any new assisted living centers, according to Jerry Cooper, executive director of North Carolina Assisted Living Association, a trade association for all assisted living providers in the state. State authorities issued the moratorium three years ago. At the same time, they also issued exemption letters to companies which had already acquired land to build new centers, begun construction, or even spent money exploring the possibilities.  Afraid of losing their investments, several national companies, unsure of how long the moratorium would stay in effect or what its outcome might be, went ahead and built in order not to lose the opportunity.

“The unintended consequence of the moratorium was an explosion of beds and communities,” says Owens. “Charlotte and Columbia are now listed as two of the top five overbuilt cities  in the U.S.” While the Charlotte market may be saturated, it’s a problem which may solve itself. As baby boomers age, the number of retirees will soar. By 2020, the number of North Carolina residents 65 and older is expected to balloon to 1.6 million as compared to 927,586 in 1996, a 76 percent increase.           

“While beds exceed the need now,” says Lisa Jernigan, vice president of sales and marketing for Resources for Senior Living, “the demand will grow.  In five to ten years, the need will exceed what we have now.”

A Growing Number of Options

Fifty years ago, aging parents usually moved into their children’s homes. If they became too ill for their families to care for, they were moved to a nursing home which provided room and board, personal care, protection, supervision and medical care. Today, there are many more options.

“With 77 percent of all financial assets in the country owned by people over 50, the disposable income levels are incredible,” says Owens. “Many people in the 55-72 age bracket no longer need three acres and don’t want to have to cut grass and take care of a garden. They want to spend their free time traveling, taking classes and attending cultural events.”

Developers are ready to give this growing segment of the home buying market what they want. They are designing a variety of Active Adult Retirement Communities specifically for independent senior adults who want to live in a low maintenance residential community among their own peer group.  Communities can be either “age inclusive” or “age exclusive.” Age inclusive communities attract retirees, but do not have age requirements, whereas age exclusive communities do have age requirements, usually age 55 and older.

There is a wide variety of active adult retirement communities here in Charlotte. Many of them are being built near golf courses or lakes, while others offer amenities of their own to attract the empty-nester. Bonanza Development Company is building an age-restricted community on 40 acres on the Brawley School Road peninsula near Lake Norman in southern Iredell County.

The Villages at Oak Tree will have 174 attached or stand-alone patio type homes when it is completed. Buyers over 55 can choose a two or three-bedroom house with standard features including open floor plans, vaulted ceilings, large master suites, laundry rooms and covered porches.   Most of the houses have garages and are priced from $119,000 to $165,000.  Amenities include a fenced RV/boat storage area, a clubhouse, and a three-acre lake with walking trails.

“Our residents are a very social group with ages ranging from the late 50s to 92,” says Kathy Doster, Marketing and Administrative Assistant.  “They want to be closer to their grandchildren and to downsize, but they aren’t ready to move to a continuing care facility.”

People who want to actively retire, but don’t want to have to move again if their health fails, may be more attracted to a Continuing Care Retirement Community (CCRC) than an Active Adult Retirement Community. Continuing Care communities, sometimes called Lifecare communities, offer seniors the promise of an independent lifestyle now with health care when and if they need it. In addition to providing cottage homes or apartments with planned activities and recreational opportunities,  meals, housekeeping, grounds maintenance, transportation, utilities and special care during illness, CCRCs also offer a continuum of care that increases to assisted living and nursing care for those who become frail or ill.

Southminster Retirement Community is a CCRC that was founded in 1987 by the leaders of Christ Episcopal and Myers Park Baptist Churches. Open to people of every faith, this nonprofit provides four levels of care from cottages and apartments for active adults, to Magnolia Place for those needing some assistance with daily living, to Camellia Court for those suffering from memory loss, to skilled nursing care for those needing 24-hour-a-day medical attention. Residents who enter the independent living area of South-minster are assured that their needs will continue to be met as they mature in life.

“The perception is that only the wealthy live here,” says Breta Crumbacker, Southminster’s marketing director, “but that’s not the case. We have a number of studio and one bedroom apartments that aren’t that expensive.” 

Payment at Continuing Care Retirement Communities is a combination of entrance fees, monthly rent and medical fees. Residents at Southminster do not buy their cottage or apartment.  Instead, they pay a one-time entrance fee, ranging from $31,500 to $194,500 and a  monthly fee, ranging from $1,405 to $1,925. Although Southminster retains ownership of the property, residents are entitled to live in and enjoy their cottage or apartment for life. They are also entitled to use all of the public and common areas and have access to more supportive levels of care. 

Several other Continuing Care Retirement Communities opened in the Charlotte area in the 1980s, including Plantation Estates in Mathews and The Pines in Davidson. The Carriage Club of Charlotte offers a continuum of care in a slightly different format. It calls itself the “only rental retirement community offering independent, assisted and skilled levels of care.” Because no entrance fee is required, it is similar to the Independent Living Retirement Communities, such as Wilora Lake Lodge, Carmel Place, The Dorchester Apartments and others which offer meals, laundry service, transportation, and 24-hour security along with recreation programs and other amenities. Most of these communities charge a monthly fee which varies depending upon the services provided. In general, the monthly fee ranges from about $1,300 to $3,400.

The Latest Approach

The newest approach to social, residential care emerged on the national scene about 15 years ago, the Assisted Living Center. This has been the fastest growing segment of the retirement community industry in Charlotte in the last five years, attracting a number of national chains to the market. Atria, which operates more than 100 communities in 26 states, opened MerryWood South and MerryWood-Charlotte. Alterra, which operates over 470 residences in 28 states, opened Wynwood of Charlotte and Clare Bridge of South Park. Sunrise Assisted Living,  one of the nation’s oldest providers of assisted living care and the operator of 162 communities in 24 states, opened  three locations in Charlotte: Sunrise at Eastover, Sunrise on Providence and Sunrise at South Charlotte.

According to Mary B. Young, regional manager for sales and marketing at Sunrise, “In accordance with our ‘aging in place’ philosophy, providing care for the frail while preserving the dignity, independence and freedom for the healthy, our three centers include assisted living, independent living and reminiscence care for those with Alzheimer’s and/or dementia. We also provide short term and respite stays to seniors following surgery or while their caregivers are away on business or vacation.”

Assisted Living Centers are for those who need some help with nonmedical daily living, but don’t need around-the-clock skilled nursing. Most of them provide private rooms or suites, with common living rooms and dining rooms. The centers usually provide meals, transportation, assistance with bathing and dressing, reminders to take medication, and scheduled activities.

One locally owned and managed firm, Resources for Senior Living, has opened two Assisted Living Centers in the past two years, The Laurels in Highland Creek and The Laurels in the Village at Carolina Place.

“We were the first to go into a master planned community,” says Howard.  “Highland Creek has the golf course and a range of housing opportunities. It has worked out well. We are an amenity for them and they are for us.” 

Both Laurels offer a choice of studio, one and two bedroom apartments and individualized care plans. Residents enjoy restaurant-style dining, assistance with medications, and nurses on site 24-hours a day, seven days a week. There is a base rate for the rental and then a charge depending upon the required level of care, with the total charge ranging from $1,950 to $4,500.

“Charlotte is one of the biggest and most competitive markets for Assisted Living Centers,” says Jernigan. “We have the advantage of being headquartered in Charlotte. We never plan to become as large as a Sunrise or Brighton by  Marriott. Our niche is ‘service and care.’ We don’t want to lose sight of that.”

In many cases, Assisted Living Centers offer services for those in the early stages of Alzheimer’s Disease, a progressive, degenerative disease that attacks the brain, resulting in impaired memory, thinking and behavior. As knowledge of the disease and how to treat it has grown, many of the Assisted Living Centers have opened new floors or sections to deal specifically with those patients. Others have opened free-standing centers designed to offer safe and secure residential care for those who need 24-hour assistance.

“Many of the people suffering from Alzheimer’s or other dementia need very different programs, and even buildings, from those in assisted living situations,” says Cooper. “The staffing requirements are much higher, and the security and layout of the building have to be considered.  The cost of care is considerably higher.”

Howard, who once owned a nursing home in New Jersey, considered it a personal mission to come up with a better solution for Alzheimer patients. He researched the disease and visited a number of programs before designing The Haven in the Village at Carolina Place.  Another Haven, at Highland Creek, is under construction.

“A lot of places recognize this kind of need, but they take the existing infrastructure and try to turn it into an Alzheimer’s unit,” says Diane Payne, executive director of The Haven. “There’s lots of theory out there on how to enhance the quality of life for those with memory loss and we’re really trying to put it into practice.”

At The Haven, patients are separated into living units by the stages of their dementia. Those who have mild dementia, who maintain the social graces, but can’t remember what they had for breakfast, are not in the same living center with those in the latter stages. The Haven features a 24-hour-a-day activity program utilizing the nationally recognized Main Street life skills area. Twenty-four hour nursing care is provided at a six to one ratio. Costs at The Haven range from $3,200 to $3,600 a month.

The final option in retirement centers is the nursing home. Senior Living Resource Magazine lists 25 nursing homes in the Charlotte area and there are undoubtedly more. Nursing homes provide hospital-like attention in an institutional setting for those who are recovering from serious injuries or surgery or who have a chronic illness. Average annual nursing home costs are about $34,000.

Planning Ahead

People today are living longer than ever. Seventy-seven million baby boomers are approaching retirement age.  In 30 years, the number of America’s population age 85 and older will double to 8.5 million. 

“Fifty years ago, the only option to home care was a nursing home,” says Jane Abel, senior care coordinator at Novant Health Seniorcare Consultation and Referral Service. “Now there is a continuum of care. You don’t go right from your own house to a nursing home.”

With the wide variety of options across the landscape of retirement communities, today’s consumer has an almost bewildering number of choices, making it important to plan ahead. “Planning isn’t just for people who are sick or infirm or in a crisis,” says Abel. “You don’t want to get caught in a crisis.”

And, while all the choices may be confusing — making an informed choice is important. “It’s a financial, lifestyle and emotional decision,” says Jernigan.“There’s no easy answer to what is the best alternative. Every situation is a little different.”