Aging in southeast Iowa: Finding the perfect place to settle down

When 80-year-old Clyde Pearce and 77-year-old Fran Victor were thinking about retirement and long-term plans several years ago, they knew they wanted to move out of Alaska. The couple had been living in Anchorage for 20 years when they began considering whether it was the community and place they wanted to spend their final years.

'It was hard to leave. We miss it,” Pearce said.

Where to settle long-term was a decision that included an enormous amount of research for both Pearce and Victor, who ultimately decided on southeast Iowa.

The main drivers of their decision were proximity to family as well as access to affordable housing and health care. The pair have lived at Halcyon House, a senior-living facility in Washington for nearly two years.

'My sister lives in Woodhull, Illinois, so moving closer to family was a big one. And then because Alaska is about 30-50% higher for medical expense,” Victor said. Even though Victor spent most of her youth in Illinois, just across the Mississippi River, she recalled spending a large amount of time in Iowa.

'In a way, I grew up in Iowa,” Victor added.

At the Halcyon House, the pair paid a large lump-sum buy-in to become residents and they continue to pay monthly rent. Their costs will grow depending on the level of care that they need.

Many older transplants to Iowa, like Victor and Pearce, have connections to the state. Being surrounded by familiar faces and places can often be comforting for people as they age and settle down.

'A lot of people have roots in the area. Most people are here because they've lived here and loved here … we seem to be more globalized and it's nice to be able to confront that world with people who share similar values or similar stories,” Dell Hammond, an administrator for Savannah Heights, a skilled nursing care facility in Mt. Pleasant, said.

'It's interesting, whenever we bring a new person in, they're like ‘hey, I know you, I know you.' That happens a lot,” Hammond said.

Iowa has a large number of skilled nursing facilities in relation to its population size, which often means access to long-term care is more readily available in smaller communities than it is in other places, Hammond said.

Both Pearce and Victor noted accessibility was another reason they decided to move to Washington. The couple had seen friends and parents begin looking for senior housing and long term care too late, and wanted to avoid that pitfall.

'Within a week, at Halcyon House there was a spot that fit our needs and we were able to move in … some of the other places we were looking at in Colorado and Washington state would have taken three to five years to get into,” Victor said.

Brent Willett, president and chief executive officer for the Iowa Health Care Association (IHCA), explained that across the state, Iowa has about 440 nursing homes, which surpasses the national state average of 300 facilities. Many of Iowa's skilled-nursing facilities were built in the 1970s and 1980s to meet the needs of an aging rural population.

'We have a large number in rural Iowa communities. Relative to other states, where it's more concentrated in larger facilities, primarily in urban areas, in Iowa, access to long-term care is close to communities, which is a driver for high patient satisfaction,” Willett said, explaining the higher numbers.

However, with an aging population and an influx of older people deciding to settle within Iowa, nursing facilities are expected to reach capacity within the next ten years.

'Iowa is aging, we expect to see more demand in the future … it's really a ten-year issue and we have space today but we need to be looking to expand existing facilities or build new ones,” Willett added.

When it comes to funding for skilled nursing facilities, Willett said one out of every two clients receiving care are on Medicaid. Facilities lose about $13,187.74 loss per bed annually through Medicaid reimbursements according to statistics collected by the IHCA calculated. That deficit has put many facilities under financial distress.

'The average cost for care at a skilled nursing facility is $213 a day in Iowa, close to $6,400 a month,” Hammond said, 'People just don't realize how much it costs to provide 24 hour care.”

As the number of patients using Medicaid continues to climb, for-profit facilities, like Savannah Heights, have had to consider ratios of payer-mixes, including seeking business from individuals who have private insurance or are paying for their care on their own, which make up lost costs from Medicaid patients.

With long-term care, the issue of budgeting and planning is complicated by uncertainty around how long an individual will live.

It's something Pearce and Victor keep in mind and try to budget for.

'I began saving in 1975,” Victor said.

Pearce also explained the couple are only able to afford their current apartment at Halcyon House due to his ability to collect both social security and a pension from a government job at which he spent 20 years.

'Without both, I don't think we would be able to afford it,” Pearce said.

Pearce and Victor are very careful to continue monitoring their finances especially after hearing about instances in which acquaintances have been removed from long-term living facilities when funds ran out.

'Some places really help you to stay as long as you can but we've had friends who, because they couldn't afford the rent, got pushed out … finances is a big part,” Victor said.