Ep. 262 – Aging Gracefully at Home in Retirement

CLICK HERE TO SUBSCRIBE

In this Episode of the Secure Your Retirement Podcast, Radon and Murs speak with Lynne Moore about the concept of aging in place, comparing it to continuous care retirement communities (CCRCs). Lynn has an extensive background in geriatrics and now works with ThriveMore, an organization specializing in helping people age in place.

Listen in to learn how ThriveMore’s program supports seniors in staying at home as they age while receiving necessary care. You will also learn the differences between aging in place and living in a CCRC, as well as the benefits of joining the ThriveMore program earlier.

In this episode, find out:

• Lynne’s career background in geriatrics nursing and leadership and how she ended up at ThriveMore at home.
• The similarities and differences between continuing care at home and living in a CCRC.
• How ThriveMore’s program focuses on bringing care services into individuals’ homes.
• The ThriveMore program details about membership fees, eligibility criteria, and benefits.
• The benefits of joining the program early and the inflation protection of coverage.
• Why the age-in-place program is best suited for introverts, plus how ThriveMore handles couples.
• ThriveMore’s vetting process for care providers and their emphasis on quality care.
• Information on how you learn more about ThriveMore and explore the program.

Tweetable Quotes:

• “We’re arranging, coordinating, navigating, and overseeing care to ensure quality care is provided as the person needs more. And it may be short term, it may be long term, but we’re bringing that care in, and in addition to that, the long-term care insurance component is underwriting the cost of that care.”– Lynne Moore
• “Getting in our program earlier saves you money and helps you be ready in case something unanticipated happens with your health.”– Lynne Moore

Get in Touch with Lynn:

• Website: https://www.thrivemoreathome.org/
• LinkedIn: https://www.linkedin.com/in/lynne-moore-rn-lnha-cmc-caps-3a899237/

Resources:

If you are in or nearing retirement and you want to gain clarity on what questions you should be asking, learn what the biggest retirement myths are, and identify what you can do to achieve peace of mind for your retirement, get started today by requesting our complimentary video course, Four Steps to Secure Your Retirement!

To access the course, simply visit POMWealth.net/podcast.

Here’s the full transcript:

Radon Stancil:	Welcome everyone to Secure Your Retirement Podcast. We are excited today. As you know, in our podcasting, we talk a lot about retirement planning. We talk a lot about the financial side of things and taxes and all those good things, but every now and then we do one that’s really kind of around lifestyle. And today we have a special guest with us, her name is Lynne Moore, and she works with an organization that I think is going to be very interesting where basically we’re able to talk about if we’re going to age in place, stay at home, how do we do that?
	You know that we have had some episodes in the past where we talked about what are called continuous care retirement communities and she’s going to talk about a different approach. And so let me just say this first, thank you very much for coming on and talking to us, Lynne.
Lynne Moore:	Certainly, and I appreciate the opportunity.
Radon Stancil:	All right, we got our first question.
Murs Tariq:	All right, so Lynne, so we know you work at Thrive More, which is kind of specialized in helping people decide on how do they age, where do they age, and it’s really customized around aging in place. So could you just give us a quick little background so people understand who you are? Give us a little background on where you came from, what was your work life before this and how you know so much about this industry in general?
Lynne Moore:	Okay. I became a geriatric registered nurse more years than I care to admit to, and I’ve always been drawn to the geriatric population. So my entire professional career has been in geriatrics. Very quickly after beginning my role as a geriatric registered nurse, I took a leadership role in skilled nursing, which is a nursing home. And I became a director of nursing in a nursing home for eight years and was very successful and loved that role and felt that I did a great job taking care of people in long-term care facilities.
	That was followed by a promotion to be an administrator in a long-term care facility. And I did that for 15 years. I was the administrator in a long-term care nursing home, short-term rehab and assisted living and dementia care and loved that role as well. And then when it got time for another advance in the career, I moved into what’s called senior living, which is continuing care retirement communities.
	So that’s a campus that has not only the healthcare that I had the background in but also adds that component of independent living. And so I became an executive director for continuing care retirement communities for several years. I was leading a big campus of a continuing care retirement community during COVID and we had 250 residents and 250 employees and we got through COVID very well, pretty much unscathed. But during that time really learned a lot about the ability to bring care into the independent living setting and how much actually easier that was able to be facilitated, especially during COVID because with all the regulations everybody remembers it was shut down. You couldn’t go visit your people in the long-term care facilities, they couldn’t go out to appointments.
	It was very complicated in that type of setting, but I could actually care for people in the independent living setting much easier and do a better job quite honestly, I felt. So shortly after that in 2021 I became a geriatric care manager and was working with people privately in their homes to help them bring in care to their homes and to actually give them that opportunity, which led to my opportunity with Thrive More At Home, which is the continuing care at home division of Thrive More, which was previously known as Baptist Retirement Homes of North Carolina.
Radon Stancil:	Excellent. Well thank you for the background. So it’s nice that one of the things that we kind of got excited about when we learned a little bit about you was that you have both sides. So it’s not like you’re just looking at one part of the picture, because we have talked a lot and we’ve helped a lot of our clients plan to go into a CCRC and so it’s a very familiar part of our firm of what we do, but we do get a lot of questions about, “Well what if I don’t want to do that? What if that’s not really my goal?” And some people are like, “Nope, this is what we’re going to do.” Some people are like, “No, I don’t know that I want to do that.”
	So could you maybe give us then a picture of what the difference between continuing care in all essence at home versus continuing care in a community where we’re going to reside? Could you kind of tell us the difference between those two programs?
Lynne Moore:	They’re actually very similar and I always like to point out that we are not anti CCRC because our company Thrive More owns four CCRCs and are building two more in the future. So we’re not anti CCRC. However, we do recognize that there is a large percentage of the older adult population that says, “I would prefer to stay in my home.” And so this is an additional program in addition to what we call brick and mortar CCRC. So we have brick and mortar CCRCs, but for those people that are adamant or really feel strongly, “Hey, I want to stay in my home,” we know that these programs have proven over 40 years that 96.5% of participants are able to stay in their homes for the remainder of their life through support and planning ahead.
	So this is a program for those people and the difference is it’s in your home as compared to selling your home to get that entrance fee to move into the continuing care community. You retain your home and you maintain your home as part of that CCRC contract, but we’re bringing those services into your home as opposed to you selling that home and moving into a community.
Murs Tariq:	Okay. Well good. Well, those services, I know if you think about some of the CCRCs in this area, those services are rather robust and obviously there’s a large entrance fee to it. There’s a monthly rent in all essence, so you’re paying for it, but in some cases clients talk to us like, “Hey, this is kind of like a resort in retirement, right? It’s got pretty much everything you need.” But we do have, in those meetings with clients, we do have the person that says, “No, I love my house. We downsized to this first floor master years ago for this purpose of aging in this house,” but they’ve got the question of, “Well, how does this all work if we decide to do that?” So can you give us an idea of what the services are that are now brought into the house? Is it just getting the house set up for it or what’s the ongoing looking like as they need it?
Lynne Moore:	I like to explain the program as you’ve essentially adopted really good daughters that have a healthcare background. And so we start from the very beginning. We do aging in place assessments of their homes and as you say, we need a first floor bedroom or we need at least a plan for a first floor bedroom. We need widened doorways. Both I and my partner go in, we’re both certified aging in place specialists, so we’ll go into a home and we’ll make an assessment and make recommendations. They’re not required.
	The people that join our program initially do not need assistance with care and order. It is an insurance-based program. So in order to participate initially, you can’t need care services. So initially we’re doing planning and listening to goals and listening to what our members want in place. And then as time progresses we are also pulling in care.
	We’ve got components similar to long-term care insurance, but geriatric care management as well. And then we also arrange and coordinate home care services. A little different from long-term care insurance is we’re going to bring people in sooner rather than later. We do not have a requirement of minimum numbers of activities of daily living that have to be deficit. We just know they need some help and support. I actually was arranging care earlier this morning for a gentleman in the care area. So we do that in the beginning and then as people’s needs progress, then we bring more care into the home. But we are arranging, coordinating, navigating, and then also overseeing that care to ensure it is quality care being provided as the person needs more.
	And it may be short-term, it may be long-term, but we’re bringing that care in and in addition to that, the long-term care insurance component is underwriting the cost of that care.
Radon Stancil:	So real quick on that then, does that mean then that there is true underwriting medical underwriting to begin or is this an assessment that you guys do to be able to say whether the person qualifies to be a part of the program?
Lynne Moore:	There is actual medical. We do in order to participate, they have to do an actual membership and they have to do both financial and medical. We will review five years of medical records to ensure that the applicant meets what we call as healthy and healthy means that they do not have a diagnosed progressive declining disorder such as Alzheimer’s, Dementia, ALS, Parkinson’s, Lupus, things of that nature. Because those type of disorders we know tend to lead to extensive periods in long-term care facilities that we’re not going to be able to avoid.
	So I like to help explain that component of the program as if you live in the state of North Carolina and there’s a named storm off the coast, you can’t buy wind and hail insurance similar to this program, if you have a named storm and a health issue such as Alzheimer’s or such as ALS or Parkinson’s, we know that there’s going to be a long-running care need for that person and they won’t qualify for this program. There is an opportunity for spouses of participants to come in what we call care coordination.
	If your spouse can qualify for the program, then you and a person doesn’t medically qualified, they can come in under that care coordination only where we’ll advocate and navigate and make sure that care is being provided at a quality level, but just not have that financial underwriting of that care.
Radon Stancil:	Okay. And I know that what I’m about to say here Lynne, you know already, but I want to remind our listeners, because what I’m about to ask about how the comparative nature here of what we’re doing. So we know that, and we’ve done episodes on this, we’ve helped clients this year move into two different facilities here in the Raleigh, Cary area in North Carolina, one of which just depended upon what they wanted in their deal, but it was an upfront of around 500,000 and they’re going to be spending right now around $8,500 a month to be there. We got another client who they went in for around 350,000 separate facility. They’re going to be spending somewhere around that same mark right around 8,500?
Murs Tariq:	Somewhere around that. Maybe closer to seven.
Radon Stancil:	Yeah. Okay. And then we know there’s another facility here in the Raleigh area that is, you don’t have to do the upfront, but your monthly is going to be a little bit more somewhere around the, I think that we had there that’s paying around 9,500, something like that. And they are at this point that person is needing assisted living meaning to a degree, meaning they get a little bit of help. So I’m just trying to set that tone so the listener has context and we know there’s other areas you can go that might have that cost a little bit lower, but give context there. Now, could you lay out the look of what it looks like under this program just so we’ve got a little bit of a comparison of what the person might be thinking about?
Lynne Moore:	Right. So the way the program is modeled is the portion of it is an insurance plan in that there are levels of coverage, part of the component of the amount of the cost to compare it to a brick and mortar CCRC that’s based on an entrance fee, which is very much like a type A or type B CCRC as opposed to the rental model that you referenced where more of a buy-in program with a monthly fee associated with it that buy-in fee is determined by their age at application because of course, just as in a CCRC a type A or type B, people are prepaid for future care needs. That’s why that monthly fee can be lower because they’re paying an upfront cost.
	And our program, same thing, members pay a prepaid membership fee and it’s based on their age because the actuarial tables are looking at how far out that care start is going to be. And then they have a monthly fee, again, similar to A and B type community. However, due to the fact that the communities you’re referencing and of course we’re aware of all the communities in the area due to the fact that they have these huge, beautiful, as Murs said, very resort-like properties, you’re paying for that brick and mortar. So that’s a big component of both your entrance fee and your membership fees is paying for the brick and mortar.
	Well, in our program you already own the brick and mortar or you’re making mortgage payments on the brick and mortar. So we like to have people understand, okay, you need to take the cost of your housing when you’re doing a comparison because you’re continuing to pay for your housing, we’re bringing the services into you. And so for an average idea, a 75 year old in one of our programs, we have a hundred percent program pays, $385 a day in healthcare coverage, and it drops down as far as 50%, which is usually somebody who has long-term care insurance already existing that covers $192 on a half a day.
	So let’s say somebody already had long-term care insurance and they wanted our gold plan, which is $192 and a half of coverage today, and they were 75 years old, round about $50,000 membership fee. That’s going to be and around $500 a month in a monthly fee. So that’s very different from a $500,000 buy-in fee at a community and a $5,000 to $8,000 a month monthly fee because they are maintaining their home. We try not to even encourage people and say, “Wow, this is a tremendous cost savings,” and whatnot because we want to be realistic. They are still maintaining the cost of their home, but they are able to therefore stay in that home.
Radon Stancil:	Yeah, I mean that sounds very, I don’t mean to hog here, I just got to follow up with this. Okay, so suppose you gave that example. Would you mind giving the example of a person who doesn’t have long-term care? Just so we got the comparison there, because you just did one with-
Lynne Moore:	Yeah, and again, we’ll look at it, but really whenever we do a home visit with someone who’s interested in the program, we actually have them bring their coverage from their long-term care insurance and do a review of the amount of coverage they have thus far and then we’ll see how much gap there is and then also people are different. There are some people that are very risk-averse, and then there are some people that are willing to take a risk. And there are also people in different financial states such as if there’s a gap between the amount of insurance coverage they have and what we anticipate would be a worst-case scenario, how much of that could they absorb themselves?
	So that guides us through helping them determine their level of coverage, but even at the highest level of coverage, a 75 year old, we’re talking somewhere around $70,000 for a buy-in and about $700 a month for that top-end $385 a day coverage. So still a really good pricing and you couldn’t compare it to others.
Radon Stancil:	All right, last one and then I’m going to let Murs ask the question. On this same [inaudible 00:16:20] so does it make sense then under your program, because in long-term care, true long-term care, “Hey, if I did this at 55, yeah, I’m paying in longer, but I know I’m healthy, right?” Is there a scenario there where that makes sense under your program?
Lynne Moore:	Yeah. Well, you have to be 62 to be in the program.
Radon Stancil:	Okay, good.
Lynne Moore:	You can’t do 55, but once you’re 62, obviously for us we see a couple of things. Number one, it is less expensive. You’re talking $30,000 when you’re in your 60s and then because again, you’re prepaying, you have more anticipated years of prepaying, but a couple of things can happen. You can have a health crisis that actually occurs early and plenty of people have things occur in their 60s and 70s and when that occurs, then you’re no longer eligible to participate in the program if you’re not in it already.
	Obviously if you’re one of our members and you have a stroke or you develop Alzheimer’s or you develop Parkinson’s, that’s fine because you’re already our member. You’re not going to be kicked out of the program when you develop one of those diagnoses. So that’s the biggest thing is that if you wait past it is less expensive and you’re paying ahead by month, which that’s one benefit. But the other benefits of coming into the program earlier as let’s say in your 60s is that we know that people develop medical illnesses in their 60s and 70s that they were not anticipating.
	People have strokes, people develop Alzheimer’s or Parkinson’s or whatnot. At that point, they wouldn’t be eligible to participate in the program. By becoming a member in their 60s or 70s, they’re paying a much lower fee upfront and also while they are eligible for the program. And so to us it makes sense, the earlier the better to get in. And then we’re also already planning, we’re engaged with our members even that they’re not needing care because we’re helping them plan. We’re helping them design their homes to age in place. We are their resource. They can call us at any point for questions about aging or health or those type of issues.
	And so we’re very engaged from the beginning, but being earlier and getting in actually saves you money and also helps you be ready in case something unanticipated happens with your health.
Murs Tariq:	Yeah. One last little money question there on, so say someone does get in, you said 62 is the earliest you can get in. So say they get in at 62 they pay their buy-in, then they’re paying monthly and that monthly is associated with a daily dollar amount of care. Is that number traditional long-term care insurance? Is that being inflated as well as they reach 70s and 80s?
Lynne Moore:	Yeah, it’s inflation protected in that each year we will do a survey of area skilled nursing facilities and our a hundred percent coverage is always based on the average skilled nursing facility for the year. That’s 385 for this year. And we know that there are skilled nursing facilities that are higher and lower, but that average number is our a hundred percent coverage.
	And it’ll go up each year and then to make sure that we’re tracking along with skilled nursing. So essentially we’re saying we’re giving you enough coverage that we’re spending the same amount if you were in skilled nursing facility, but we’re going to bring that, we’re going to use that to bring that into your home. And we haven’t covered it yet, but if at some point somebody wanted to go into an assisted living or skilled nursing facility, we could take that money and apply it. Not only will we help them pay for that facility, but we will also help them choose the facility and help them transition into the facility.
Murs Tariq:	Okay. So one of the attractive things about going into a CCRC, although you give up your house, you’ve got this larger buy-in, one of the more attractive things is that there’s so many studies out there about staying busy, staying interactive, keeping your brain moving, CCRCs have all types of social interactions and clubs and all types of things there. Obviously it’s not like you could bring a whole club to the person’s house, right, but what do you say to that question of what type of social engagement are they going to get when it comes time of care?
Lynne Moore:	Yeah. I can tell you based on our experiences meeting people interested in the program and people that are now participating in the program is seniors are very busy, seniors are healthy, and they do have those clubs coming into their homes. I have to call and make sure that I’m not conflicting a Mahjong group that is meeting at somebody’s house or the bridge club or everybody’s got… Our older adults today are very different than older adults when I started a couple of decades ago, very actively engaged.
	Our program does opportunities to get together, for our members to get together and then also opportunities within the community of things that were going on that we can let them know that are available. There are also quite a few programs in the community and in through Raleigh Senior Services that we’re connected with that if somebody just wants somebody to come sit and visit and read a book or chat about something, that we can bring those folks into their homes.
	Again, as from the outset, I always say this is a program for people that want to stay home. And we know there are all kinds of people. There are introverts and extroverts, and when we talk about the 3.6% of people in these programs that will end up going and living in a community instead of staying in the program and staying at home. A lot of times that is the married person in a couple, and it is the number of introvert, extrovert, marriages are pretty impressive.
	And that introvert says, “I do not want move into a facility, period. You will not ever get me to move in there.” The extrovert is just excited about the thought of being in the community. They will choose to be in this program, and then if that introvert passes away, then that extrovert, we’re going to help them transition into a community and get them moved in so that they can be a social butterfly as they are.
Radon Stancil:	You have any more… I hogged so much earlier, I’m trying to give you opportunity.
Murs Tariq:	Nope. I mean, this has been great so far.
Radon Stancil:	So let me ask this. When it comes to, I’m going to go with the stereotype, the stereotype is that if I had people come to my house, a lot of times we don’t know to what degree this person’s qualified, what type of person they’re going to be. So am I assuming that through Thrive More, are they typically folks that you’re contracting or that work for Thrive More, or what’s the vetting process there on your side so that from the person who’s at home knows that they’re getting a good quality, a person that whatever category they need?
Lynne Moore:	And I’d say good doesn’t come close. We want excellent quality, but we do have partners that we have fully vetted. We have met with the ownership of the providers, the home health providers in the area, and we’ve talked about their philosophy compared to our philosophy, which is excellent care. I think that’s a big opportunity where both I and Jean Klein that works with me, we’re both from the CCRC background and long-term care, so we know what good care looks like.
	That’s why I tell people all the time, if you’re having good care, I know what that looks like. If that care is not good, I also know what that looks like. We are there to advocate on a daily basis to ensure that the people that we have partnered with and we have already vetted that we’re making sure they’re still providing services of an excellent nature. And if they’re not or if there’s sometimes just a personality difference between the provider and the person who’s being cared for, and we’re going to come in and work through that relationship. And it may be that, hey, we just need to get another care provider in. But that’s the other benefit of having us.
	We’re there advocating, making sure you’ve got the level of care we expect, the level of care you expect, and making sure that’s happening on a daily basis.
Murs Tariq:	Well, Lynne, I think this is great. Thanks again for hopping in with us, really to introduce this concept. I think we could go for hours on this concept, on level of care, how do you fix up the house, what recommendations do you guys make? But for someone that’s listening right now and they say, “Hey, I’ve been thinking about this. I just don’t know how to do it,” what is the best way for them to learn more about it, learn more about Thrive More, or maybe even start the process of exploring it with you?
Lynne Moore:	Yeah. We have a website, which is ThriveMoreNC.org and also keep an eye out we do presentations in the Raleigh and surrounding areas. We have a presentation coming up May 15th in Cary at the Courtyard, Marriott Parkside. And so usually we’ll send out mailers to older adults to let them know we’re doing presentations, but we’re happy to meet with people one-on-one at any time. And you set that up by going on that website, www.ThriveMoreNC.org and then as soon as you send contact information, we reach out to you and start having a conversation to see if it really does sound like a program you might be interested in participating in.
Radon Stancil:	Excellent. Well, thank you so much again. We’ll make sure that everybody has that contact information, and this has been very, very insightful to us, and we certainly do appreciate it. So thank you for coming on and chatting with us.
Lynne Moore:	Certainly. I appreciate the opportunity. It’s been something that I have been excited to learn about and really passionate about the program because I see it meets a need that I honestly wasn’t aware of a couple of years ago that these programs existed. And to find out that there is such a program for people that just want to stay in their homes and that we can both do it and do a really good job at it is really exciting for me.