Benevolent Care Funds for Assisted Living

Having been introduced to the importance of these types of non-profit organizations and funds, I thought about how one might word a letter to family members and friends….

Dear.......

If you, like so many of us, are thinking about an innovative, relevant and meaningful "end of year" tax deductible donation, or whatever form your sense of "giving" takes, I wanted to suggest something that has likely not been on the radar screen. I also wanted to provide the background for what brought me to this point. Its not just about my/our specific situation with one family member. This is a very universal and generic issue that all of us will contend with in some form.

As we age all of us worry about being a burden to our spouse, our children, other relatives, closest friends, etc. We worry we will run out of money to care for ourselves. We worry that even with enough money we will be a social, time-consuming, or emotional burden to others. We worry that we will feel a moral and emotional obligation to take on extended care for others we were not prepared for. There are many variations on the theme.

Until a few years ago when I had to confront the issue of my mom being more constrained in mobility, speech, and self care, I had not been aware of the importance of organizations and communities with a true commitment to aging with dignity without burden. I am not referring to long term care insurance or other industry vehicles. I am referring to the non-profit, mission-driven living communities who are figuring out how to ensure a consistent level of care and respect for our aging relatives that shields them and us from financial anxiety as well.

I have had the good fortune to have my mom moved to an "assisted living level of care", which will change over time, in a community near us in Rockville, MD. They have a serious commitment at a national and organizational level to "Benevolent Care" as a funding source to ensure seamless continuity of consistent and dignified service and care to those whose resources begin to deplete. i dont believe that this is just a pragmatic or charitable approach to "filling the funding gap". I see this as core to the basic mission of the care community.

I spent my career as a neurology physician affiliated with truly mission-driven organizations that also had to function or excel in the competitive universe. My residency was at the Mayo Clinic, a genuinely customer-and-service centric unique enterprise in which I was able to fully experience the vision that treating staff respectfully translates downstream to the patient/family, and vice versa. I spent many years practicing and working in collaborative practice at Kaiser Permanente in which I knew every day, with all the various issues of reality we faced, that I would never have to worry about providing a different level of care to someone based on their financial situation.

Later in my career, doing telemedicine for a privately owned enterprise, even then we had arrangements with the hospitals we served so that the patient's insurance status would have no bearing on the methods by which we interacted with them or the decisions we made, particularly related to acute care. And as telemedicine became more acceptable to more people, and essential during the pandemic, I was able to work with a few companies whose products I had helped advance, to find new ways to leverage communication tools to help ensure that patients and providers in the clinics for the "underinsured" could find ways to gain access to virtual specialty care regardless of their reimbursement status. Its all based on the same principle of realism in the real commercial world that never strays from a fundamental core mission of equity.

While all organizations or communities, whether faith-based or not, have to grapple with the basic realities of their costs, service levels, regulatory requirements and generation of operating margin, that does not imply they all approach it the same way. From what I see there are many non-profit long term care organizations that have embedded in their DNA that the care environment for anyone along the spectrum from truly independent living to highly assisted living or dependent care should retain a constant view of the dignity of that individual and a consistent vision of how their families can be efficiently engaged for communication and decision-making. Clearly my mom’s community is in this category.

The only way to ensure that can take place on large scale is to disconnect the level of service from the financial status of the resident or family but in such a manner that respects their humanity. Everyone deserves to age without being a burden or feeling as though they are. Everyone deserves to be able to attend to their aging family members in the ways they want, not in the way they are forced to.

I believe that all of us should have a vested interest in helping to bolster and support the basic concept of a large and ever-growing, not-for-profit fund that is managed for the sole purpose of supplementing any resident of any given long term care community as they live a bit longer than they might have planned for, or have needs not anticipated, or have a change in their family dynamics that lead to different resource needs

To me, such a fund provides the social and ethical lubrication to smooth the inevitable transitions that NONE of us can truly avoid.

When we moved my mom to the specific community near us, of course we went through the basic financial analysis of resources both present and expected. That is just reality. BUT it did not take long for a few things to change and the wonderful staff associated with the benevolent fund to step in and assist with a plan going forward. The importance of this approach was that it was an assumed "given" of the culture, not some special "ask".. And THAT is where the embedded sense of dignity and mission stands above all.

I decided immediately to commit an annual contibution to their benevolent fund not just related to my mom...but to apply to anyone who might have a future need. I believe that all family members, close friends and others who have a loved one lucky enough to reside in a community with such consistent care for both their residents AND their own staff (it all rolls both ways)...can feel the same sense of moral benefit that derives from such a contribution.

I also believe that the more people did this and the larger such funds became, the more people who can be covered....it means migrating to a model on a much larger scale in which "aging with dignitify" can be a far more seamless set of transitions for so many more people

Andy