White House Reflections: Part Two – Simultaneously improving Quality of Life and Saving Government Money
The first part of my talk addressed the ways that JCHE and other senior supportive housing providers are simultaneously improving the quality of life for older adults while saving significant government funds in four distinct ways:
1) Avoiding/postponing nursing home placement
2) Reducing government rent burdens by helping individuals protect income
3) Increased health via social engagement and
4) Spurring volunteerism
1) Avoiding/postponing nursing home placement: JCHE has 1200 apartments. Residents in all of these units have access to a rich array of services and programs that offer support. To make these available, we raise $1M/year in private philanthropic dollars. Only 3% of our residents move out to nursing homes each year. So if you live at JCHE, you are unlikely to end your life in a nursing home. For the 97% who remain at JCHE, about one-third have been deemed eligible for Medicaid funded nursing home care. However, for those JCHE residents who do go to a nursing home, they do so on average at age 88.25.* The average age of admission to a nursing home across the country is 79. For just our residents who actually go to a nursing home, those 9.25 years saves Medicaid over $9.8M (using HUD’s figure of $50K/year for nursing home care. Most studies cite costs twice as large, which would even further increase the savings). In the last 10 years alone, little JCHE, which serves only 0.00049% of the senior population of the U.S. avoided at least $98M in Medicaid nursing home costs. You can calculate the impact of replicating this scenario throughout the country! With the demographic tsunami projected and the incredible demands coming at Medicare and Medicaid, the JCHE model of supportive housing offers one way to make these demands more manageable.
And if that’s not persuasive, let me put a human face on this. Simon and Paulina have been married over 60 years. She has become increasingly frail and requires almost round-the-clock care. Simon is doing everything in his power to care for her but he’s suffering from some health challenges befitting his 89 years. JCHE arranged for home care workers to provide some basic services, although Simon believes in doing his part so they are receiving fewer hours than they are qualified for. He recently told us, “if I lived anywhere else, my beloved would be torn away from me at the time she needs me most – who knows how often I could visit her at a nursing home. Thank God for JCHE.”
[* The average age of JCHE residents upon entry to a nursing home was based on data from the past three years.]
2) Protecting Individual Income: We also save the government money AND improve lives by helping people secure all resources available to them. For example, Ruth lives at Golda Meir House and pays one-third of her income in rent. Part of her income is from a lifetime annuity that was abruptly stopped by her financial services company. Ruth was then in her mid-80s and the company reported that she had used up her allotment. Our resident services coordinator called the company and fought the good fight – and won! So that portion of her rent does not have to be covered by HUD. In this case, it’s probably $100/month – when you multiply that by the number of seniors who experience this, it adds up to millions! And Ruth breathes a bit easier and feels safe. Someone is on her side and we that’s priceless.
3) Health via social engagement: Folks living in senior housing and community settings where there are opportunities for regular social engagement live not only happier lives, but healthier ones. (and therefore, less expensive for Medicare). The Harvard School of Public Health found that social isolation is an important risk factor for cognitive decline in the elderly. Seniors with the highest social integration scores had less than half the rate of memory loss of those without such regular engagement. Neuroscientist John Cacioppo used brain scans, monitored blood pressure and analyzed immune function to conclude that chronic loneliness should be recognized as a serious health risk factor with consequences as life-threatening as smoking and obesity. He documented a rise in stress hormones, altered gene expression in immune cells and higher blood pressure. We all know that these morbidities have a high cost associated with them. Living in senior housing means daily opportunities for engagement (the best antidote) by just walking down the hall. As Edith pointed out: I came here because I saw my mother spend the last years of her life ‘aging in place’ where she had always lived. But those were years of bitter loneliness. Here I feel challenged. I have met people who have had very different experiences. I read books I never would have even looked at. I have attended lectures and listened to music I didn’t know would interest me. Now I’ve got it all – friends, safety, social activity, intellectual stimulation and financial peace of mind.”
And yet, about half of all women over age 75 and one-third of all baby boomers live alone without any close family nearby.
4) Volunteerism Adds Value: And with all the challenges facing society today, we can’t ignore the vast underutilized resource of our nation’s seniors, which is why we promote volunteerism. One resident, Natalie, points out that society tends to marginalize older people, but here everyone rises to the highest common denominator. She and her friends get on a bus twice a week and go to a troubled school in a poor section of Boston to tutor at-risk kids. And no one misses a single session all year. They not only love the experience of helping the children and the rewarding feeling of seeing progress in reading skills, the women love riding the bus there and back. They share experiences, offer tips to one another on how to reach the kids, and enjoy the camaraderie. At JCHE, more than 20% of our residents volunteer – that’s 300+ people adding value to society. Sari adds. “I once heard my daughter talking on the phone, saying wonderful things about tutors working in the inner city and making an impact – and then I realized she was talking about ME. In one instant, I went from the old lady who never graduated high school to a tutor worthy of respect.