For the last year I've been a participant in a Facebook private group focused on communal living in retirement. The idea intrigues me, but the truth is that it's about all I can do to live cooperatively and gracefully with my husband and some occasional house guests. I don't even get along with the condo association. If my retirement planning had to include living in proximity to a larger group of grumpy old people, I think I'd be in big trouble.
Sam Roberts/Times-News Burlington/Associated Press
Jeff Petty, CEO of Wesley Enhanced Living, a nonprofit, faith-based organization that manages continuing care retirement communities, thinks that my view of aging in a group setting is all wrong. "Everybody says, 'I don't want to go to a nursing home,' and they all picture four beds in a room. That’s not what we're talking about. We're talking about one or two-bedroom apartments with common space," Petty says.
Done right, Petty believes that group living could help people stay healthier longer, and if Medicare and Medicaid were redesigned to encourage this kind of group living, the change would make these financially floundering programs solvent for the long haul.
Attracting younger seniors
Right now, Petty says, residents of his continuing care communities tend to be older than age 80. "We'd like to get people who are in their mid-70s, while they are healthy, and start working with them before it is too late," Petty says. "If we get a patient at 70 who has high blood pressure and we can help her follow a very low-salt diet and make sure she is taking her medication and she's exercising, we're aren't going to be sending her to the hospital in five or six years."
Here's what Petty estimates Medicare could save if it were structured to pay for the daily observation of the health and activities of its recipients:
- Reduce hospital admissions by 19 percent. He's basing this estimate on the experiences of the Veterans Administration, as well as Mercy, the sixth-largest Catholic health care system in the U.S.
- Lower the cost of routine doctor visits by 40 percent. Physicians and nurse practitioners would see patients daily during meals and social activities.
- Eliminate most hospice costs by making in-home care routine.
In all, he believes at least 33 percent of total Medicare spending could be trimmed and maybe as much as 40 percent.
Persuading people that he is right is like "pushing a rock up the hill," Petty says, but he's confident that his organization's approach is correct.
"People say they want to stay in their homes, but actually, if you look at the data closely, I think that's not really true," Petty says. "At 75 or 80, people lose their social networks, and they start to realize that they don't have friends anymore. The upkeep on the house gets to be draining. ... I think continuing care communities are the best alternative. When we get people to move into our communities, they say, 'I should have done this years ago.'"
Learn about a different comprehensive community-based service model called NORCs -- for Naturally Occurring Retirement Communities.