Their concern — shared by many aging boomers even as they jest that “60 is the new 40” — was about the inevitable: Near the end of even the best-lived lives, bad and costly things can happen. And some of them, including long stays in nursing facilities or similar help at home, aren’t covered by Medicare or private health insurance. Only Medicaid offers significant government assistance as a provider of last resort for the impoverished.
This is a large and complex problem that has challenged academics, advocates, and policymakers for decades, but I’ll spare you most of the bigger issues today. The Dzubas recently offered to share their thoughts about the solution they chose seven years ago: following Michael’s parents into Friends Life Care, a “continuing care community without walls” — a concept the Quaker-run nonprofit pioneered three decades ago. If you haven’t weighed the issue yourself, their story may be a good place to start.
Because they provide both care and financial protection, programs like Friends Life Care offer an alternative to traditional continuing-care facilities and to conventional long-term-care insurance. They’ve been growing in popularity recently, driven partly by the widespread desire to “age in place,” and perhaps also by fallout from the recession and the housing bubble’s collapse. For many people, it’s no longer so easy or attractive to sell a home and move, say, someplace warm or nearer the kids.
Michael and Linda Dzuba have no desire to move anywhere. Their hope is to stay in their stone-and-brick twin, lovingly restored and upgraded over the last 40 years, as long as they’re able.
If the dozen steps leading to the front door become impossible to navigate, they’ll have to install a ramp. But for now, “our theory is, steps keep us young,” says Michael, who has been religious about exercise since his days as a high school wrestler.
“Michael wants to die in this house,” says Linda, who goes to the gym, too, and who has kept active lately by fostering a Labrador retriever puppy for a program that trains service dogs.
The Dzubas got their first exposure to Friends Life Care thanks to Michael’s parents, Albert and Selma, who lived in a condo on Washington Square and had no desire to leave home behind, either. Concerned about the costs of care, Selma Dzuba found Friends Life Care in the mid-1990s. And after Albert developed dementia, the couple made good use of it.
Though classified as a provider rather than an insurer, the program covers needs such as nursing and home health aides on much the same basis: When the need arises, it pays for whatever care a person requires, up to a preset daily maximum and for as many years as the member elected.
After he developed dementia, Albert Dzuba eventually required costly round-the-clock care, and then a move to a facility. Michael says Friends Life Care didn’t pay all the costs, but “it took out a lot of the sting.”
Carol Barbour, president of Friends Life Care, says the program currently has about 2,200 members, with fewer than 50 in care facilities. The nonsectarian program, developed with help from the Robert Wood Johnson Foundation and the Pew Charitable Trusts, began taking members in 1990.
“People join Friends Life Care because they really want to stay in their homes as long as possible,” Barbour says. “They are embedded in their communities, and they really want to maintain those ties.”
Barbour says the program’s costs are roughly comparable with long-term-care insurance, which now typically offers similar coverage for home-based care. As with insurance, you pick a daily benefit maximum, an inflation formula, and how many years you want covered. Costs and eligibility depend partly on your medical condition and history, and premiums rise based on your age when you enroll.
The Dzubas chose $125 per day, with 5 percent compound annual interest and no limit on the number of years of coverage. Their combined annual premium started at $3,649, and in seven years has risen to $4,014.
“The variables can be mind-boggling,” says Michael, who says the couple also considered similar coverage from a long-term-care agent.
Above all, what prompts them to praise Friends Life Care is its holistic approach to keeping them well, including annual calls from a “care coordinator” and access to programs that have taught them about topics such as nutrition and meditation.
The Dzubas believe the program’s dual role gives it the right incentive: to help them stay as healthy as possible for as long as possible, so that they don’t need more expensive care.
Contact Jeff Gelles at 215-854-2776 or firstname.lastname@example.org.