By Lindsay Nixon, RN, BSN – Guest Contributor
“We have medicalized aging, and that experiment is failing us.” – Atul Gawande, Being Mortal
One of the inevitable, yet rarely discussed, aspects of aging is the loss of independence. While society idolizes youth and the idea of being self-sufficient, the process of growing older and asking others – even our children – for help can be an emotional experience. For many, the loss of independence and the fear of becoming a burden weighs heavy on our minds.
90% of seniors prefer to stay in their own homes rather than move into a retirement community, assisted living, or nursing home. The cost of assisted living facilities can average $8,000 per month and skilled nursing facilities charge nearly twice that. With health insurance only covering a rehab stay after a qualifying hospitalization, many members of our community are left trying to manage home ownership and deteriorating health at the same time.
For the past 11 years, Evangelical Homes of Michigan (EHM) has offered a program in Washtenaw County that aims to provide the missing pieces to this puzzle. Julia Wellings, the Chief Operating Officer of EHM, took the time to speak with me about the LifeChoices program and its history. She explained, “The goal of LifeChoices is to keep members as well as possible for as long as possible by supporting them in their homes and allowing them to age in place. We assign each member a wellness coach and immediately begin working together to achieve that goal.”
LifeChoices provides home care nurses and caregivers, housekeeping and maintenance services, exercise physiologists, and massage therapists. When necessary, the program will provide transportation to and from medical appointments, and you could even find staff grocery shopping for members during the height of the pandemic. Members are allowed to utilize certain services that may be needed, at a minimum of two hours per week, immediately upon enrolling in the program.
Members like Jamie Dylenski of Ann Arbor, who only uses the personal trainer service, for now, mentions she has peace of mind knowing that as she ages, she will have supportive services for both her and her children. She explained, “I don’t need much more than [the trainer] right now, but I know that I will eventually. And when the time comes, I’ll have what I need.”
When originally hearing about the program, Dylenski was skeptical and took the agreement to her lawyer and financial planner. After both advised her to enroll, she and her husband signed up for their membership. Years after their initial enrollment, her late husband was diagnosed with Parkinson’s disease.
Jamie explained that during his illness, the LifeChoices program was a saving grace. “The team that came to our house was incredible. I don’t think anyone is prepared to be a full-time caregiver, and children – even adult children – often aren’t prepared for all that it entails.”
After a hospitalization, her husband needed a skilled nursing facility to provide rehabilitation services before returning home. The case manager at the hospital told her that the EHM skilled nursing facility could be difficult to get into – then returned a few hours later and asked how Jamie was able to get accepted. The wellness coaches through the LifeChoices program had already been on the phone with Jamie, working on his transfer to their facility before the hospital had even made the request.
In his final days, Jamie’s husband needed medication every two hours. “I thought – I can’t do this, I’m so exhausted! So, I called LifeChoices – the only number I ever had to call – and told them what was going on. Within a few hours, they had someone at our house who was going to spend the night and give the medication when needed so that I could get some rest.”
Initially, members pay an enrollment fee based on their current age and are charged a monthly membership fee in addition. The enrollment fee ranges from $25,000 to $50,000 depending on the member’s age when enrolling, with the monthly fee ranging from about $250 to $500 per month. There is a discount for couples who register together. The average age of the members is around 70, but when I spoke with Jamie, she made it clear – “the sooner you can sign up, the better off you will be.”
Wellings added, “Some people are concerned with such an initial investment, that there is a question of where the money is going if they aren’t using all of the services right away. LifeChoices is not just an EHM program – it’s overseen and regulated by the state. The enrollment fee is escrowed, refundable, and amortizes over time. Once people realize that we have the state overseeing how we are managing the funds of the program, it changes things.”
If a diagnosis such as dementia or a physical disability creates an unsafe living environment for a member to stay in their home, the cost of moving to an assisted living facility or skilled nursing facility is covered by the LifeChoices membership. Wellings gave an example of a member who was diagnosed with dementia a couple of years after joining the program. “She didn’t have anyone to care for her at home, so she moved into assisted living, and now she is in the skilled nursing facility and has been for years.”
I hear her punching the keys of her calculator, whispering the monthly figures she and I had calculated for care in a nursing home earlier in our call. “All in all, outside of the program her care could have cost $750,000, with that number going up every month.”
“And LifeChoices is covering all of these costs, outside of the enrollment and monthly membership fee?” I asked. “Completely covered,” Wellings replied.
For more information on the LifeChoices program, visit the EHM website at www.ehmss.org. A free informational session on the LifeChoices program is scheduled for October 25th at the Kensington Hotel. Registration is required, which can be completed online through the EHM website or by calling 734-295-9292.