Joan Brasier, 74, and Paul Wilczynski, 78, of Asheville, N.C., enrolled in Givens Choice, a "continuing care at home" program operated by Givens Communities in western North Carolina. This model allows seniors to age in place while securing future facility care at a fixed cost. About 75 percent of U.S. adults in a 2024 AARP survey want to stay in their longtime homes, yet only 29 percent would likely choose a traditional continuing care retirement community (C.C.R.C.), which requires moving and hefty entry fees. Only 37 of the nation's 1,911 C.C.R.C.s offer at-home programs, up from 26 a decade ago, per Leading Age.

Givens Choice charges a one-time fee of $33,000 to $77,000 for healthy 65-year-olds, plus monthly care-management fees starting around $570. The program provides a geriatric care manager for regular check-ins and coordination of in-home services like aides or meal delivery, though the fee doesn't cover the cost of that hands-on help. If members eventually need facility care, they pay only their inflation-adjusted monthly fee.

When Brasier injured her shoulder in a fall, her care manager quickly arranged at-home services and meal delivery, covered by the monthly fee, while Medicare handled medical costs. This hybrid approach addresses the "holy grail" of affordable late-in-life care for millions of families.