By Brian Goslow
Thanks to her sister, Redwing Cleveland, 68, of Agawam, doesn’t have to worry about having an ample supply of tickets for the Pioneer Valley of Massachusetts Transit Authority PVTA Senior Van Service to take her shopping or to medical appointments.
She said that isn’t the case for many of her fellow seniors.
In recent years, she said, the cost of a PVTA ticket has gone from 50 cents per ride to $2.50. “Five dollars a day (round trip) for people on a fixed income is just way too much and so many of these people now stay home,” Cleveland said. “Most of these seniors would take the van everyday to the senior center (if they could afford it) to have lunch and spend the afternoon taking classes offered there, or just spend the time chatting with other people.”
Four years of diminishing revenues have the state’s senior advocates fighting to maintain programs at level funding at a time when many of those programs have yet to receive their promised funding and when more residents are reaching retirement age, calling for increases in services.
In some instances, this has resulted in raising the cost of services currently used by seniors for whom even an extra dollar is one too much when they’re already making decisions on whether to pay their heating bill or buy food.
While the impending influx of baby boomers into the retirement system comes as no surprise, for all the hoopla of a “senior tsunami,” wide scale reevaluation and establishment of new programs directed at a generation whose life expectancy has grown substantially since their birth haven’t been put into place.
According to the Massachusetts Department of Public Health, the life expectancy of state residents at birth, as of 2008, is 80.4 years, a huge leap from the 65.4-year expectancy when the first boomer was born in the mid-1940s. Eleven percent of the state population is 65 or older.
Many who are retired or had soon hoped to be, have been hugely affected by the economic depression that hit in 2008. The loss in property values, for example, has forced many older homeowners to delay downsizing plans. Instead, many are looking to remain in their homes as long as possible.
With 3,000 people a day nationwide becoming eligible for Social Security, Massachusetts Secretary of Elder Affairs Ann L. Hartstein said many of the people she speaks with are shocked when they actually begin to consider the implications of the services retired baby boomers will require.
“We’ll have to change how we do business — everything will be impacted,” Hartstein said, “from convincing construction companies of the need to start thinking about the kind of housing seniors will require, to educating area businesses why they need to put programs in place to hire older residents looking to re-enter or stay in the workplace in light of the expected decrease in the number of available workers in the coming years, to how people who no longer drive can get to those jobs as well as their normal everyday living schedule of shopping, doctor’s visits and socializing with friends.”
AARP Massachusetts has called for Gov. Patrick’s administration to make aging policy a priority. While its director, Deborah Banda, acknowledges the difficulty of putting programs in place in light of the state’s financial difficulties, she said it’s important it looks past the current situation.
“The changes we need to make for our older population aren’t going to change overnight,” Banda said. “When the services are needed by more and more people, we’ll need to have had a plan in motion towards achieving what’s needed.”
Hartstein said her office has been working with local councils on aging on how to educate their communities-at-large on what the aging population will look like in the future. “Right now, one out of five state residents is of retirement age; in 2030, it’ll be one in four,” she said. “Communities need to address this. These people are going to need access to shopping, transportation and housing.”
The Massachusetts Association of Councils on Aging and Senior Center Directors (MCOA) recently sent an open letter to the state legislature on its fears of the effect 2010 Federal Census numbers will have on the way payments are made to councils on aging in the state.
While the state has continued to maintain a $7 per elder payment in recent years, the onset of the boomers into the system will make that per-elder allocation impossible to maintain. It’s estimated that when the new census numbers are used to recalculate that figure, the payment will be decreased to $5.75 to $6 per elder.
This comes at a time when the services provided at senior centers are expected to be at greater demand. This includes programs aimed at keeping seniors healthier both physically and mentally by keeping them socially engaged
Along with fighting to maintain already existing programs, senior advocates hope to bring new programs online.
Hartstein said her office is committed to developing a plan for residents affected with Alzheimer’s and other cognitive diseases and assisting those caregivers who look after them. Details are expected this summer.
Home care advocates are still waiting for many elements of the state’s Community First Olmstead Plan, announced in 2008 as the initial effects of the financial downturn first hit, to be fully put into place.
“ ‘Community First’ has turned into cut community programs first,” said Massachusetts Home Care Executive Director Al Norman. “This fall, we had 3,000 people waiting to get into home care programs. It took an act of the general court to make that (getting them home care assistance) happen.”
Mass Home Care expects the state to see up to 600,000 people over the age of 60 added to its population over the next 20 years while those between the ages of 50 to 59 will decline by approximately 260,000. Their health and home care demands will call for a large increase in the number of professionals to provide needed services.
“We’re going to have to increase the formal caregiving network through better training and better pay for these people (personal care attendants, certified nurse assistants, homemakers and home health aides) — they’re all in great demand,” Norman said.
Norman said an informal caregivers network is also needed and a system put in place that would allow spouses to be paid caregivers. “For a long time, no family member could be paid for caregiving for a relative. Now you can hire a son or a daughter to provide adult foster care or as a personal care assistant.”
The state would benefit from the savings compared with assisted living or nursing home placement. W. Scott Plumb, senior vice president of the Massachusetts Senior Care Association (MSCA), also raised concerns. He said his organization is in the process of compiling a study looking at expected demand for long term care facilities 20 years from now. His group represents 500 nursing and rehabilitation facilities, assisted living residences, residential care facilities and continuing care retirement communities.
While final results won’t be released until spring, Plumb said the study has seen an explosion in the demand for adult day care centers. “Now the state has called for wiping it out (state funding for adult day care programs) entirely,” he said. “You’re tied to those whims.”
Initial results from the MSCA study found an expected increase in those seeking home- and community-based care and a moderate increase in numbers of people seeking facility-based care.
“The influx in numbers of baby boomers alone will create an increased demand for nursing home beds as well as short stay beds and Medicare funded rehabilitation and post acute care,” Plumb said. “The population (in this age range) is going to double so the numbers will go up. There are always going to be some people that can’t live in the community.”
Plumb said MSCA’s affiliates are able to meet current demand for services, with occupancy rates in the low 90s. While that number is lower than it had been in the past, he said, that’s due to the change in some of the services MSCA’s facilities provide.
“There’s been a substantial increase in post-acute care,” Plumb said. “Most are three-day stays — a rule of Medicare.” Stays in a MSCA facility, he said, can cost $500 a day as opposed to $3,000 a day in a hospital.
Chet Jakubiak, executive director of the Massachusetts Association of Older Americans, said that all the years of talk on the incoming “Silver Tsunami” helped fuel anti-senior bias within the younger population. The was fear that the majority of the country’s resources would go toward keeping Social Security and Medicare at the younger generation’s expense.
“It makes it hard to get people to deal with their (seniors’) needs,” Jakubiak said. Similarly, he said, elders seemed to have dropped out of sight when it comes to public policy agenda planning. He noted that instead of being a drain on resources, seniors play an important part in the local economy “They spend most of their Social Security check and retirement funds in their local communities, be it at the barber shop, getting their food in a local market or paying for services.”