The Graying of Massachusetts

Some are calling it "the graying of Massachusetts."

We're about to have the largest elderly population in history, according to the Massachusetts Extended Care Federation, which represents 580 nursing and extended care facilities.

In the past 10 years, the number of people 65 and older has increased by 13 percent; those 85 and older have grown by 25 percent. Today, one in every seven people in our state is 65 or older. That's 800,000 people.

And, the numbers will continue to increase, with estimates showing that by the middle of the next century, one in five will be over 65.

And, as more and more of our citizens become elderly, we have to find ways to care for them. Emphasis lately has been on day care, assisted living and home care, allowing our parents and grandparents to stay at home and have their health needs and some homemaking chores taken care of by professionals.

But, for many, that's not an alternative. And 54,000 of our neighbors are in long term care facilities in Massachusetts. It's estimated that 40 percent of people 65 and older will need nursing facility care sooner or later.

And, as alternative programs, like home health care, become more available, nursing homes are finding that their customers are more disabled than ever before. But nursing homes are also caring for increasing numbers of Alzheimer's patients, the head-injured and those who depend on ventilators.

Nursing homes are the second largest health care employer in the state. Three fourths of them are operated for profit. The rest are non-profit.

Nursing homes have been underfunded for many years through Medicaid, which is administered by the state. This year, we made progress--and provided additional funding to help them meet their financial obligations and guarantee better care of our elders.

Let me explain that. Many of our elderly, the majority in fact, are unable to pay their own nursing home bills. So, Medicaid pays for about 75 percent of them with federal and state dollars to the tune of about $1.4 billion a year in Massachusetts.

Cost has to be one of the considerations, obviously. With the cost of a homemaker or home health aide at about $23 an hour, and $72 per visit for a nurse, the cost of caring for someone at home could exceed the cost of 24 hour nursing care, housing, meals and services provided in a nursing home. But, all who would have Medicaid pay their nursing home bills are carefully screened to be sure that they cannot be cared for in the community in another way.

How much does a nursing home cost? About $150 a day.

Back to Medicaid. To be eligible, under the current system, and admittedly there are abuses, individuals must pay for their own care out of their savings, until they spend down to $2,000 in assets, excluding house, car, burial expenses and personal possessions. A spouse still at home is allowed to keep up to $80,760 in assets and $2,019 a month income, according to the Federation.

It's a complex issue, with costs increasing, and the elderly population increasing. And you'll be hearing more and more news on Medicaid, extended care and its alternatives, and new ways to deal with "the graying of Massachusetts" in the months and years to come.

If you want more information on Medicaid, nursing facilities, or answers to other questions concerning the elderly, you can go to www.mecf.org on the internet for a compendium of information, including lists of nursing and rest homes, assisted living residences, retirement communities, and links to other eldercare resources, including the state's web page and the Massachusetts Department of Public Health's Nursing Facility Survey Performance web page.

You can also call the federation at 800-CARE-FOR and get copies of booklets like Choosing the Best Long Term Care Option: A Guide for Elders and their Families, Guide to Extended Care Facilities, Guide to Assisted Living and Continuing Care Retirement Housing, and Facts on Long Term Care.

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