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Minding our Elders: Retirement communities contracts may require expert to understand

Carol Bursack of Minding Our Elders

Dear Carol: My husband and I are trying to help my brother select a retirement community that would also offer assisted living for his future needs. He's 74 and has early Parkinson's disease so he wants to make this move soon.

Our experience with trying to decipher the pricing structures of the places that we visited has been enormously frustrating. Is there some sort of resource that covers retirement living contracts that transition to assisted living and perhaps even nursing care? We really need some guidance. Thanks for any help that you can provide. — TL

Dear TL: You aren't alone in your frustration. I've been through some of this myself and I've heard from others who are in a similar situation.

In defense of the facilities, the reason people choose to move to these communities is that, as we age, change is inevitable, and along with those changes generally comes the need for more assistance from staff. Many people will age well and won't need much assistance for a significant amount of time, but others, like your brother, already see that their requirements will begin to increase quite soon.

The facilities must put pricing structures in place that can change with the needs of their residents. In doing so, the language that explains cost increases can become nearly incomprehensible if only because, in trying to state all of the instances where there will be extra charges, the original statement can become skewed beyond the reach of anyone not trained in legal terminology.

I don't know of any one resource that can guide you through this. My advice is to start with Thoroughly research this site. It has information on long-term care services which may be of use. Then, from the homepage, choose "Services Near You." Here you'll find a state-by-state listing. Click the link for the state that you want and you'll see a list of local links. Freely click on any link that looks promising. I'd try several different resources. You should gain some valuable contacts while doing this and, in the process, perhaps find exactly what you need.

Each state has a version of the National Family Caregivers Support Program (NFCSP). This program should be on this state's list, however the name of the program varies by state, so experiment. The NFCSP should be a solid resource where you could find state specific help.

If you've taken this search as far as you can and you don't feel comfortable with your level of knowledge, or if you simply want more reassurance before you sign a contract, find an elder law attorney who knows this issue well. You might have to interview several before you find a comfort level.

Make certain that the attorney routinely works with your state's Medicaid laws because your brother may need Medicaid in the future. The whole elder care field can be so confusing that having an attorney look over contracts can, in the end, mean money well spent.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at She can be reached at