Continuing care retirement communities (CCRCs) are increasingly expanding options for older adults who wish to remain in their own homes while still accessing professional support and long-term care guarantees. This emerging model, often referred to as “continuing care at home,” offers an alternative to traditional CCRCs, which require residents to move on-site and typically involve significant upfront and ongoing fees.

Joan Brasier and her husband, Paul Wilczynski, both retired and living in Asheville, North Carolina, are among those who have embraced this approach. They enrolled in Givens Choice, a program launched three years ago by Givens Communities, which blends regular health monitoring and care management with the option to move into the affiliated facility if their needs increase. The program aims to provide flexibility and financial predictability, allowing members to receive as much or as little help as needed without giving up their homes.

Enrollment fees for Givens Choice vary based on age and health, generally ranging from $33,000 to $77,000 for individuals entering at age 65 in good health. Monthly fees begin at around $570 and cover care coordination and wellness services, though members remain responsible for the cost of in-home aides or housekeeping. If members need to transition into the residential facility later, they pay only the monthly fee they have been maintaining, adjusted for inflation.

The model addresses a growing desire among older Americans to "age in place." A 2024 survey conducted by AARP found that approximately 75 percent of adults prefer to remain in their homes as they age, though only a minority consider traditional CCRCs a likely option due to high costs and the requirement to relocate. Nationwide, entry fees for on-site CCRCs typically range from $400,000 to $700,000, often exceeding the median home equity of older adults, which limits accessibility.

Currently, only 37 of nearly 2,000 CCRCs in the United States offer at-home care programs, but interest is rising. Industry leaders note that these programs function as a form of long-term care insurance combined with ongoing wellness management. They pool resources from relatively healthy members to help cover potential future care needs, benefiting both individuals and providers.

Enrollment in at-home programs typically requires passing comprehensive physical and cognitive assessments, which are more stringent than those for on-site residents. Consequently, participants tend to join these programs in their mid-70s, roughly eight years younger than the average on-site resident. Early enrollment not only improves acceptance chances but can also reduce initial costs.

Despite the flexibility and potential savings, this model places some responsibility on members to maintain their homes and cover daily living expenses such as meals and utilities. Experts advise prospective members to carefully compare programs, clarify contract terms, and realistically assess their ability to manage and finance in-home care, especially for couples with differing health trajectories.

As baby boomers seek affordable and personalized late-life care, continuing care at home represents a growing sector of the retirement care market, aiming to bridge the gap between aging preferences and economic realities.