A New Concept: Home-Based Assisted Living
As the number of Americans seeking to grow old in their own homes rises, the array of solutions aimed at helping them achieve this goal continues to widen.
One innovative new approach is to bring traditional assisted living offerings – including health and safety monitoring, personal care support services and opportunities for socialization – directly into the homes of older adults. The idea is to help seniors who may be experiencing physical or cognitive problems remain living independently without having to leave home.
This model is now available in parts of the Bay Area, pioneered by a Mill Valley-based venture called Living Well Assisted Living At Home. Founded in 2009 by two local leaders in the field of geriatric care, Doris Bersing and Tessa ten Tusscher, Living Well currently serves San Francisco and southern Marin County, with plans to expand into other regions of the Bay Area and Southern California.
Bersing, the company’s president, says she and ten Tusscher launched Living Well after concluding that most people who need help are not satisfied with the existing selection of care options.
“The vast majority of elders want to age in place; they don’t want to be dislocated from their communities,” explains Bersing, citing an AARP study which found that 89 percent of retirees hope to live the rest of their years in their own homes. Other surveys have found that aging baby boomers fear moving into a nursing home and losing independence more than they fear death.
“Our message is ‘Stop! You really can be safe and supported and well-cared for in the privacy and familiarity of your own home. You don’t need to be confined in a facility,’” adds Bersing, who formerly headed San Francisco’s Pacific Institute, a leading provider of senior services, education and research on topics related to eldercare. “Our goal as a company is to give elders and their family members a choice.”
Ten Tusscher, Living Well’s CEO, says the first question many people ask after moving to a senior residential facility is ‘when can I go home?
“In all my years of visiting older adults living in facilities, I’ve never heard anyone say they’re glad they did this, or that this is just how they would choose to age,” says Ten Tusscher, a former vice president at San Francisco’s Institute on Aging who directed programs in the IOA’s care management, assessment, psychology and homecare departments. “But it is common to hear residents say things like ‘I don’t belong here’ or that they moved here mostly to avoid becoming a burden for their children.”
Like traditional assisted living facilities, Living Well provides a one-stop service delivery system. Services include assistance with activities of daily living and household needs, administration and supervision of medications, transportation services and activities designed to promote health, wellness and social interaction. Services are delivered by an integrated team including care managers, home care providers, physicians and nurses.
What sets Living Well apart is its emphasis on individualized services. “We spend a lot of time assessing and getting to know the details and personalities and quirks of each client,” says ten Tusscher. “This helps us arrange the kind of personal assistance and social activities that match the person’s interests and personality.”
“One problem at many assisted living facilities is that residents are lumped into three or four levels of care, and then everyone in each group is treated the same way, which is depersonalizing” adds Bersing. “Living Well recognizes that people who are 65 have very different needs and interests than those who are 90. We do not have a one-size-fits-all approach to activities and programs for our members.”
Living Well offers concierge services similar to those found at luxury hotels and resorts. “We emphasize 24/7 customer service. You’re at home, so you can eat what you want, when you want. We can provide everything from oysters to ice cream in the middle of the night,” says Bersing. To help create a sense of community, Living Well’s clients are grouped into “clubs” consisting of people living in the same area. The size of these groups is limited to about 200 members to ensure that services remain personalized.
Members of Living Well have the opportunity to participate in a number of individual or group programs designed to address their cognitive, physical, psychological, social and spiritual needs. The company’s network of resources offers lectures, film screenings, Tai Chi, dance sessions, massage, exercise, lunches and cocktail hours to help members stay connected, meet new friends and maintain good health. The company’s wellness coordinators arrange trips to museums, theatres and fitness classes.
Clients have access to geriatricians and nurses who oversee their care at home and advocate for them with their primary care physician and during hospitalizations. Physicians are available for emergency calls and home visits to Living Well members at all times.
Living Well employs leading-edge technologies to help monitor and evaluate clients’ health, security and cognitive status around the clock, and to communicate medical and other information to physicians and relatives. Living Well also evaluates the layout of client homes, and when needed makes home modifications to promote mobility and security. The company also offers fiduciary and financial management services
“Some of our clients are active and only need some light personal and home care, or help with transportation,” says Bersing. “Other clients are more frail or have chronic physical illness, or they have dementia or severe memory impairments and need close supervision and 24-hour care assistance.” Fees are based on the level of care needed and range from a few hundred dollars to thousands of dollars per month. Like many upscale senior residential communities around San Francisco, Living Well targets clients with assets of at least $1 million.
Unlike most assisted living facilities, Living Well is able to serve clients with complex medical conditions and limited functionality. Assisted living facilities are generally considered non-medical, and many have no licensed nurse on staff. Even if there is a nurse on staff, assisted living facilities are not licensed to provide hands-on care, and residents needing this kind of care must move to a skilled nursing facility or other licensed setting.
In contrast, Living Well “can work with people with dementia until death,” says ten Tusscher. “A lot of people get moved to SNFs purely because they have dementia. We don’t believe this needs to happen. The amount of care that can be delivered at home is already quite large and it’s growing.”
People with advancing dementia “should be cradled and nurtured in their home environment. They don’t need to be in a locked facility where they’re segregated from the rest of society and surrounded only by other people with dementia,” adds ten Tusscher.
All of Living Well’s service providers, except its physicians, are company employees who undergo extensive background checks before they’re hired. The company strives to set itself apart from other home care agencies by hiring experienced care providers and paying them above-market-rate salaries and benefits. “We see our care providers as ambassadors for Living Well, and we want to retain them and reward them for quality work,” says Bersing.
Bersing and ten Tusscher acknowledge that Living Well’s services are similar to those offered by professional geriatric care managers, who also coordinate a range of support services aimed at keeping older and disabled adults living independently at home.
“One difference, though, is that geriatric care managers typically get involved with clients only when there are complications, such as a health crisis, in the client’s life. Living Well gets involved with some clients who don’t need a huge problem solved, but who may only need help with transportation or reducing social isolation,” explains ten Tusscher.
“Another difference is that Living Well is one-stop shop that has its own service providers in place. As a result, there is only one bill and one business interface for the client and the client’s family to deal with,” adds ten Tusscher. “When a geriatric care manager coordinates five or six service-providing vendors, the client and family have relationships with each of those vendors.
For information about Living Well Assisted Living At Home, see http://livingwellalah.com. The phone number for Living Well, based in Mill Valley, California, is (800) 805-7104. The company can be reached via email at info@livingwellalah.com.
(This article originally appeared in the Summer 2010 issue of Bay Area Summit)
< Back to "Lives" |
