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Seniors Get Wired to Stay Home

With the oldest of the baby boomers turning 66 this year, there’s been some talk–and a lot of handwringing–about how to provide the services they will need as they age without bankrupting themselves, their families, or state and federal governments.

Paul Maguire /

Allen “Chip” Teel, a doctor with a family practice in Maine, thinks he has a solution.

“Everybody recognizes the aging of the population is an issue,” says the Nobleboro resident. “But the default options are still assisted living facilities, nursing homes, and one-on-one hourly care at home,” which can be “prohibitively expensive.”

Dr. Teel calls his solution “the Maine Approach.” His goal: To allow older people to remain at home, while providing them with cost-effective services using technology and a combination of volunteer and paid labor.

So far, Dr. Teel’s network is pretty small. It currently serves 60 people living in or near Damariscotta, a coastal town of 2,000.

Each pays his company, Full Circle America,  a monthly fee that typically ranges from $400 to $1000, depending on how much care the person needs. (By comparison, the average cost of a full-time home-health aide in Maine is about $4,200 a month, according to a survey by insurer Genworth Financial) Full Circle is an L3C or “low-profit limited liability” company, a legal designation that allows it to receive tax benefits in return for facilitating investments in socially beneficial ventures.

In return for their fee, members receive services that mix the high-tech with the personal. Many wear devices that enable them to call for help with the push of a button.

But the network also distributes other, less conventional devices, including screens that let seniors hold video conferences with friends and relatives without having to navigate the internet. “You simply press an icon of the person you wish to talk to,” says Dr. Teel. The devices, he adds, have proven popular with residents, many of whom have difficulty getting out, especially in winter.

The Maine Approach also uses video cameras to perform spot-checks on members, typically four time a day. If a resident wanders away from home, Dr. Teel says, sensors alert the network’s call center, which can also relay a message to an adult child.

Dr. Teel acknowledges that some of these measures can compromise privacy, but he describes them as preferable to many of the alternatives. “The biggest invasion of your privacy is to have to move into a residential care facility and share a bedroom with someone you don’t know or have strangers in your house,” he says.

Dr. Teel says volunteerism is a critical part of his approach, in part because it helps keep costs down. Some volunteers, from Damariscotta and other surrounding communities, visit members or take them out to lunch. Just as significantly , the care recipients themselves also volunteer, helping each other and the broader community. For example, Dr. Teel says, “we have 85 and 90-year-old shut-ins who make daily phone calls to a couple of other members for us.” Another member, “an elderly woman who lives by herself and suffers from dementia,” volunteers her piano so local children whose families don’t own a keyboard can have lessons.

“Elders have been brainwashed to believe there isn’t any meaningful contribution they can make,” Dr. Teel says. “But that’s where we’re missing the boat. They have enormous hidden resources of talent we are not using,” he adds.

Dr. Teel, who also runs a network of seven small assisted living facilities in Maine, says he also locates paid services for members.

Can the concept be adapted to communities outside of small-town America? Recently, Dr. Teel wrote a book, “Alone and Invisible No More,” to promote the Maine Approach and solicit start-up capital to seed similar ventures. Dr. Teel says he has received some funding from a private foundation and is working with officials in Vermont to devise a plan to help nursing home residents move back into their communities.




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    • Laffer & Moore, WSJ:”And the evidence that we disoevcred in our new study for the American Legislative Exchange Council…”A deeply shocking result. Can you imagine the look on the faces of the free market advocacy group that promotes conservative public policy, when they saw what their data “revealed”?”…moved from the nine highest income-tax states such as California, New Jersey, New York and Ohio and relocated mostly to the nine tax-haven states with no income tax, including Florida, Nevada, New Hampshire and Texas. We also found that over these same years the no-income tax states created 89% more jobs and had 32% faster personal income growth than their high-tax counterparts.”Yay, fun with statistics. It’s also true that the average per capita income in top ten states like New York, New Jersey or Massachusetts is a third higher than Texas or Tennessee. It’s easier to achieve “32% personal income growth” when you start from an income base below the national average than one well above it. And it’s very hard for “anti-growth” states to tax that massive income advantage into oblivion.”New Hampshire is our favorite illustration. The Live Free or Die State has no income or sales tax, yet it has high-quality schools and excellent public services. Students in New Hampshire public schools achieve the fourth-highest test scores in the nation — even though the state spends about $1,000 a year less per resident on state and local government than the average state and, incredibly, $5,000 less per person than New York.”That IS incredible. Even though New Hampshire has fewer than 300,000 residents under the age of 18, while New York has 4 and a half million. There’s certainly no difference in infrastructure or complexity to account for there.

    • @Bill: Some people simply don’t have any family. Services like this can serve a great need or could supplement care people are already receiving. I think there are a great number of people who could benefit from this sort of thing. Making it easier for older people to socialize also has a lot of benefits, too. May with mobility issues can’t go out to visit with family and friends, so having video equipment can help keep them engaged and connected to others.

    • Anything that can be done by agency (or by social worker for that matter) can always be done better and cheaper by family and friends. This is why there is no need for nursing homes – oops maybe we do need agencies and social workers after all. 100 plus years ago family was always the support network for our elderly. It is terribly sad that this is no longer true. In today’s society there is an overwhelming need for the types of services that Dr. Teel’s Full Circle America provides. Simply look around you and face reality and you will see that this is true. Families work and have their own lives and are simply unable to provide the care that aging parents need. This leaves nursing home or very expensive at home care. It seems that Full Circle America is trying to find the middle ground that will allow people to stay in their home and still be cared for in an affordable manner. It is sad that taking care of older people has to have a cost but I challenge Mike to volunteer at his local elder care agency since he apparently doesn’t have a family to support and bills to pay. The idea is to provide needed care at an affordable price. People live longer at home and are happier and healthier. If Full Circle America makes this possible for the many who don’t have a family support group then more power to them.

    • How much did this Company pay to have this article published.. What a waste of money.. There are better ways of enjoing live then this.. Taking care of older people is all about the money.. I know for a fact when a person enters a rest home they live for about 3 years… During this time period the operators of these businesses suck every penney they can out of each individual..

    • Well, as a social worker who finds community resources for older folks to help them stay at home, I have to say that the services that this company offers are already mostly available to seniors all over America. Many seniors I visit already have or are getting medical alerts, to call for help if they need it, at around $25 a month. The “I’ve fallen and can’t get up” button has been around a long time. Spot checks are available by phone by local agencies by volunteers for free, as as medicine reminders. What can’t be done by agency can be done by friends and family. Video calls can be done easily on a computer, and once set up, can be turned on and left on, if desired. If a senior wanders away from home, they shouldn’t be living independently anyway, as that indicates a dementia that needs closer supervision. The price of over $4,000 a month for on-site personal care indicates a person also needs help with food preparation, housekeeping, bathing, and assistance with walking, etc. No electronic device can provide that. In-home care, a few hours a day or week is usually enough to keep a senior at home safely. Overpaying for surveillance of a senior or anyone is not necessary if it can be done for less, and it can.

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  • Encore examines the changing nature of retirement, from new rules and guidelines for financial security to the shifting identities and priorities of today’s retirees. The blog also explores news that affects retirement, from the Wall Street Journal Digital Network and around the web. Lead bloggers are reporter Catey Hill and senior editor Jeremy Olshan. Other contributors include The Wall Street Journal’s retirement columnists Glenn Ruffenach and Anne Tergesen; the Director for the Center for Retirement Research at Boston College, Alicia Munnell; and the Director of Research for Pinnacle Advisory Group, Michael Kitces, CFP.