Page 120 - Encyclopedia of Nursing Research

ConTInUInG CARE RETIREMEnT CoMMUnITIES n 87

topics independent of each other. A consen- residents’ monthly fee; (2) Type B CCRCs do
sus of the readers would indicate the study’s not guarantee unlimited nursing home care
reliability. but have a contractual agreement to provide C
validity in content analysis can be a specific number of days per year or lifetime
achieved by determining the extent that the of the resident in the nursing facility; and
topics represent what they are intended to (3) Type C CCRCs are based on a typical
represent. If the topics are based on a concep- fee-for-service approach. Financial stability,
tual framework or a particular focus, they particularly of Type A and Type B CCRCs,
must be justified, described, and explained depends on high occupancy rates in the inde-
in terms of being representative of that con- pendent living apartments and maintaining
ceptual framework or focus. Therefore, top- residents’ in optimal health and function so
ics that are developed to reflect a conceptual as to need fewer health care services.
framework or focus must be consistent with The number of CCRCs continues to grow,
the original definitions described by that and there are more than 725,000 older adults
framework. However, because content analy- living in more than 2,240 CCRCs. The major-
sis is often used in exploratory and descrip- ity of CCRCs are located in 12 states. Because
tive research, a conceptual orientation may of the dramatic increase in assisted living
not be appropriate. facilities, CCRCs proportionally account for
a smaller percentage of senior housing than
Kathleen Huttlinger previously. Given the anticipated increase in
number of older adults, it is expected that the
number and occupancy of these settings will
likewise increase.
Continuing Care Generally, older adults who live in
CCRCs are those who were never married, or
retireMent CoMMunities married without children, are well educated,
and health conscious (American Association
of Homes and Services for the Aged, 2006;
A continuing care retirement community Lewis et al., 2006; Zalewski, Smith, Malzahn,
(CCRC) is a type of facility that provides vanHart, & o’Connell, 2009). Initially
housing, meals, and other services, includ- CCRCs were for affluent older adults; how-
ing nursing home care, for older adults in ever, CCRCs are becoming more affordable
exchange for a one-time capital investment or and attracting those with more moderate
entrance fee and a monthly service fee. Most incomes (Anderson, Michelman, Johnson, &
CCRCs are sponsored by religious or other Quick, 2008). The decision to move into a
nonprofit organizations, but for-profit orga- CCRC requires a good deal of planning and
nizations have entered into the retirement adjustment for older adults, especially if they
business as well. The CCRC is usually con- are relocating to another city or state and/
structed as a village or community, and the or moving from a large home to a smaller
individual remains within this community apartment.
for the remainder of his or her life. All CCRCs Residents in CCRCs overall use of
have a written contract that residents must Medicare-covered medical services is no
sign. The terms of the contract vary and have different from older adults who live in tra-
been separated into three categories by the ditional community settings, with the excep-
American Association of Homes and Services tion of lower expenditures for hospital care
for the Aged: (1) Type A homes are “all inclu- (Ruchlin, Morris, & Morris, 1993). The types
sive” as they offer guaranteed nursing care of health care services provided vary on the
in the nursing facility at no increase in the basis of the facility. Most facilities have a