This blog has been adapted from an article originally published in the New York Times.
Carole Ann Basso had spent years tending to her ailing parents and disabled husband; at one point, all three were receiving hospice care in her northern New Jersey home. “It was so incredibly stressful,” recalled Ms. Basso, a retired high school history teacher. “I didn’t want to give my children that craziness.”
She relocated to the small bayside town of Lewes, Deleware, after her parents’ and husband’s deaths, and her own future weighed on her mind. At 69, Ms. Basso had a long-term care insurance policy and a modest pension, but scant savings, which had prompted her move to a lower-cost region. She wondered, “How am I going to take care of myself?”
In Lewes, she heard about another option in long-term care offered by a few pioneering continuing care retirement communities: a C.C.R.C. without walls. Typically, a C.C.R.C. operates a complex or campus where residents shift from independent living to assisted living, a memory-care unit or a nursing home if their health and mobility decline. But in continuing care at-home programs, members essentially spend the independent living years in their own houses.
In 2015, Ms. Basso joined a program called Springpoint Choice that allows her to stay in her comfortable ranch house with her English setter named Princess Leia. Diane Willoughby, her “care navigator,” checks in regularly to monitor her needs. With luck, Ms. Basso, now 76, may remain in her home for years — or for good. If she eventually requires help with bathing, dressing or other activities of daily living, the program will offer home aides.
If she can no longer live safely at home, Ms. Basso also has the opportunity to move onto the campus of The Moorings at Lewes, the affiliated continuing care retirement community a few blocks away. Her one-time entrance fee and monthly fees will cover her long-term care costs, at home or on campus, while Medicare and her supplemental insurance pay for medical care. “It gives you a feeling of security,” Ms. Basso said.
To enroll, applicants must provide years of medical records and extensive financial documents showing that they’re healthy and can afford the fees. In order to qualify, “We assume they won’t be needing any services for at least five years,” said Cecily Laidman, executive director of Springpoint Choice. But that need could arise in 15 years or the next month.
At Springpoint Choice, which has about 270 members in New Jersey and Delaware, initial fees run $30,000 to $65,000, with monthly charges of $300 to $500. All the fees are tax deductible. “If in a year they have a life-changing event, they could be paying $400 a month for skilled nursing, which on the East Coast typically costs $13,000 a month,” Ms. Laidman said.
Ms. Basso joined Springpoint Choice at a bargain rate. Because she has good long-term care insurance, her entrance fee was a discounted $25,790; she paid it with the sale of her New Jersey house and her parents’ condo. Her $128 monthly fee has since increased to $146.
She needed help far sooner than anyone had foreseen. Months after signing her contract, she had open-heart surgery at Johns Hopkins, followed by two weeks in intensive care. Ms. Basso then spent five weeks in rehab at The Moorings, doing physical therapy twice each day, with daily visits from Ms. Willoughby, her care navigator. Finally strong enough to go home, Ms. Basso still needed an aide for three weeks to help with shopping, laundry and meals.
“They took total care of me, and I never had to pay one cent beyond my monthly fee,” said Ms. Basso, now back to her independent life. “I’m not as agile as I was, but my goodness, I’m blessed.”
She’s also discovering another advantage to a C.C.R.C. without walls: Members are encouraged to join community trips, participate in activities, use the campus gyms and pools and get to know residents and staff.
With an aging population, “the bottom line is, we’re going to need lots and lots of long-term care options,” said Ruth Katz, senior vice president of public policy and advocacy at LeadingAge. “We need to be experimenting and finding new models, and this is one more.”