Rhode Island’s population is aging rapidly. By 2030, more than one in 10 Rhode Islanders is projected to be 75 or older, compared with roughly one in 11 Americans nationwide. And the state’s 75-to-84 population is growing particularly quickly, projected to increase by nearly 60 percent between 2020 and 2030. Whether the infrastructure needed to support that population will keep pace is less certain, prompting many Rhode Islanders to take healthy aging into their own hands.
Financial advisors often say that the first step toward a healthy lifestyle is having options. And careful financial planning allows for choice. “Money alone doesn’t create happiness, but being more confident in your financial situation can create options that allow you to do the things you enjoy,” says Ashley Macksoud, wealth management advisor at Merrill Rhode Island.
Macksoud’s approach to financial planning is much like the old proverb about planting fruit trees: the best time to plant one was 20 years ago. The second best time is today. “It’s never too early or too late to work with an advisor,” she says. “An advisor can evaluate where you are today and make course corrections as your life circumstances change.” Whether those goals are traveling, buying a dream home, or spending time with loved ones, all of them are better enjoyed by people who feel good. That’s why many seniors are choosing to invest in their healthcare.
A new model of healthcare growing in Rhode Island is direct primary care, a membership-based model where patients pay a practice a monthly fee for primary care services, in many cases cutting insurance out of the equation. These practices tend to be small, with ample time for individualized care. “I charge a monthly fee that covers all of your primary care services, such as appointments, in-office procedures, texts, prescriptions, video calls,” says Wendy Regan, MD, a board-certified family medicine physician who runs Harbour Direct Primary Care in Jamestown. She worked under the insurance model until 2020, when she realized its demands didn’t allow her to practice medicine the way she wanted to. “Insurance demands healthcare providers maintain a full schedule of 12-to-15-minute appointments. That doesn’t let me connect with patients in the way that best serves them.”
Sarah McGinley, APRN, a board-certified family nurse practitioner and founder of Weatherly Direct Primary Care in Wakefield, sees the relationship as the model’s chief advantage. “I left the insurance model because I felt it was wrong to rush a human being through a visit if they were having a hard time,” she says. “People are not robots.” Regan and McGinley say that direct primary care is designed to work with insurance, however, not replace it. Insurance remains necessary for specialist appointments, labs, and ER visits.
Regan says that her primary goal is to help her patients feel like they’re in control of their health. “When you hire me to be your physician, I need to know what’s important to you,” she says. “Is it independence? Function? Cognitive status? Quality of life? Once we know your goals, I can help you meet them and feel like you have agency over your life.” Although both practitioners work with people with a variety of lifestyles, they tend to attract a certain type of patient. “My practice draws the type of person who’s an active participant in their health,” says McGinley. “They’re proactive and want to make changes that positively impact their health.”
That’s where a place like Roots Physical Therapy and Yoga, in Providence, comes in. Twice a week, they hold a class called Yoga for Healthy Aging, which uses movement to safely build strength, maximize mobility, and improve balance. Jaclyn Plante, PT, DPT, OCS, RYT, a doctor of physical therapy and the yoga and movement studio manager at the facility, teaches one of the classes and blends her yoga experience with her medical knowledge in her approach. The average age of the Yoga for Healthy Aging class is 55-plus, but the class and studio are open to and inclusive of queer, aging, abled, or disabled folks. “Our studio motto is we’re psyched you’re here,” Plante says.
“I apply the tenets of yoga through the lens of physical therapy,” she says. “For example, when we’re doing chair pose, I encourage them to think about squatting into a chair or reaching into the dryer. Those visuals really resonate with the older population.” She’s also aware that transitions from standing to sitting are when a lot of falls happen. Falls aren’t necessarily the greatest threat to an older adult’s life, but they may be one of the biggest preventable threats to an older adult’s independence. “During class, we work our way from a seated position to a single-leg balance and then work back down to the mat, but we do it in a flow sequence that you’d expect in a yoga practice.”
Almost as important as the physical aspects of a class like this are the social aspects. “We always encourage people to come to class a few minutes early, but I find people come even earlier than
recommended to catch up and make plans with each other,” Plante says. “And our classes are intentionally kept small, so students get that one-on-one attention in a community. But the result is that when someone is missing, others notice and check on them.”
Despite the best medical care and prevention techniques, however, the way people age and the physical and cognitive issues they face are sometimes out of their control. And long-term care is expensive. To address care costs and empower people to embrace long-term planning, a membership program was recently launched through Warwick-based St. Elizabeth Community called atHome Together, to help people age at home for as long as possible. Jessica Smith, director of atHome Together, says the program is ideal for people who have assets to protect and want to have a plan in place.
Smith explains how the program works. “You pay a large one-time fee when you’re healthy – the sweet spot is when people are in their 60s to 70s – and then you pay a monthly fee. That monthly fee gets you a care coordinator whose job is to understand your family and your wishes. They walk along with you as you age.”
But that fee also unlocks priority access to care. “Let’s say you’re aging at home and your care coordinator thinks you’d benefit from help bathing. We’d coordinate and pay for that care,” Smith explains. As members decide with their care coordinator that they need to transition into assisted living or a long-term care facility, atHome Together also would arrange and pay for that care. “It’s a way to access care with today’s dollars,” Smith explains.
She says the program is ideal for solo agers or for aging couples who don’t want to become a burden on their adult children. “We tend to only think of senior living facilities in a crisis, so this is a whole different mindset for seniors,” Plante says. “I think this is an amazing program and I’m shouting it to the rooftops for healthy seniors in a position to afford it. It all comes down to peace of mind.”
No amount of planning can dictate exactly how a person will age. But financial preparation, strong relationships with healthcare providers, physical strength, community connections, and a plan for the future can preserve something almost as valuable: choice.
atHome Together at St. Elizabeth Community:
StElizabethCommunity.org
Harbour Direct Primary Care Inc.:
WendyReganMD.com
Merrill:
Advisor.ML.com
Roots Physical Therapy and Yoga:
RootsSpecialtyServices.com
Weatherly Direct Primary Care:
WeatherlyDirectCare.com
A sampling of programs around the state that offer practical help for staying healthy, engaged, informed, and independent. Many of these organizations offer free or affordable services to seniors and family members.
By Ken Abrams
Age-Friendly Rhode Island.
A statewide coalition that promotes healthier, more inclusive communities for older residents and publishes the Rhode Island Healthy Aging Pocket Guide. AgeFriendlyRI.org
Legal Aid.
Rhode Island Legal Services provides free assistance to qualifying adults 60 and older with public benefits, housing, consumer matters, and elder abuse. The Rhode Island Bar Association also offers people 60 and older a free half-hour consultation and reduced-fee referrals. RI Legal Services: 401-274-2652, Bar Association, 401-521-5040
Meals on Wheels of Rhode Island.
The organization delivers nutritious meals to eligible homebound residents and provides regular social contact and wellness checks. RIMeals.org, 401-351-6700
Pride in Aging Rhode Island.
The organization supports LGBTQ+ older adults through advocacy, education, monthly cafés, social dinners, and community events, as well as by working with health-care and senior-service providers to create more welcoming programs. PrideInAgingRI.org
Rhode Island Aging and Disability Resource Center.
Specialists provide free, confidential guidance for questions about home care, transportation, nutrition, Medicare, Medicaid, heating assistance, and caregiver support. OHA.RI.gov, 401-462-4444
RI Elder Info.
A nonprofit website that offers an extensive, town-by-town directory covering housing, transportation, health care, legal and financial planning, veterans’ services, caregiver support and activities for older adults.RIElderInfo.com, 401-585-0509
RIPTA Senior Transportation.
Adults 65+ can receive reduced off-peak fares, while qualifying low-income seniors may ride free through RIPTA’s Reduced Fare Bus Pass Program. RIPTA.com, Reduced Fare Program, 401-784-9500, RIde Paratransit, 401-461-9760
Village Common of Rhode Island.
A volunteer network that helps older adults remain in their homes and communities; seniors can receive transportation, household assistance, technology help, and home visits and participate in social and educational programs. VillageCommonRI.org, 401-228-8683
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