Senior Centers key provider in RI’s Long-Term Care Continuum 

Published in RINewsToday on September 19, 2022

Over nine years ago, this columnist penned a commentary, “Senior Centers, Not Just a Place to Play Bingo,” that appeared in the Pawtucket Times and Woonsocket Call.  As we celebrate National Senior Centers Month in September, today’s Senior Centers continue to take a wholistic view of providing programs and services to their older participants. They are providing programming and services that truly takes into account the body, mind and social needs of their members, aged 55 and up. As I stated years ago, “senior centers are not a place that our parents once visited years ago to just knit or play bingo.” That continues to be true, and even more so, today. 

“Every day, senior centers bring our grandparents, parents, older neighbors, and friends together to build community and share trusted services and information to help all age well,” said Dianne Stone, NCOA’s Associate Director of Network Development and Engagement in a statement announcing the September celebration of the nation’s Senior Centers. “Research shows that compared with their peers, people who attend senior centers have higher levels of health, social interaction, and life satisfaction,” she says.

“There’s never been a better time to come home to your senior center,” Stone said. “Come see everything your local center has to offer,” adds Stone.

Senior Centers continue to be a catalyst for mobilizing the creativity, energy, vitality, and commitment of the older participants, says Mayor Donald R. Grebien in a proclamation he released on September 1, recognizing September as Senior Citizens Month. The City’s Leon Mathieu Senior Center, like the 35 senior centers around the state, empower their older participants to take control of their own health and well-being and the health of their fellow participants, says the mayor. 

Established in the 1980s by the U.S. Administration on Aging, the centers programming has slowly evolved to encompass activities that encourage healthy aging and wellness. Senior Centers across the Ocean State offer activities and programs, case management and social services and public benefits counseling, also social and cultural programming, social and recreational opportunities, even offering a place to eat a nutritional meal.

Many of the Senior Centers have their own vans and drivers who transport seniors to and from their homes for shopping, social cultural activities, to medical appointments and into each Senior Center’s meal sites.

Even during the early days of the COVID-19 pandemic, Senior Centers responded by connecting with their members by making health checks thru telephone calls, offering programs and services via internet and social media sites, and delivering meals to the homebound seniors. During the ongoing pandemic, Senior Centers continue to provide countless hours of support to older adults, and have become integral to health care delivery throughout Rhode Island by providing COVID-19 guidance home testing kits and vaccine education to their participants.

At Pawtucket’s Leon Mathieu Senior Center, health screenings, specifically taking blood pressure readings, are performed by nursing students from Rhode Island College and URI Pharmacy students discuss the importance of being compliant with taking prescribed medications, too. Proper nutritional counseling is also offered. 

Starting in church basements, many as small social clubs, the passage of the Older Americans Act in 1965, propelled Senior Centers into a key provider role in the nation’s long term care continuum of care.

Today, more than 10,000 Senior Centers serve one million older adults every day. In Rhode Island, 35 agencies, serving over 200,000 persons, are geographically spread out from Westerly to Woonsocket and from Foster to Tiverton. Some are managed by municipalities, others by nonprofit groups. While catering to serving the state’s burgeoning elderly population, some have expanded their mission to offer programs for young and middle-aged adults.

According to the state’s Office of Healthy Aging, Rhode Island’s older adult population is growing rapidly. Over 31 percent of Rhode Islanders are 55 or older versus 28 percent nationally, and our state has the highest proportion in the United States of those 85 or older. 

With the graying of Rhode Island, the state’s Senior Centers are offering programming and services to attract the state’s aging baby boomers by focusing on health and wellness, recreation, and lifelong learning.  Yes, Senior Centers are a key provider in the state’s long-term care continuum to keep aging boomers, healthy, independent and allow them to age in place in the community.

Providing resources for local senior programs should be a shared responsibility of federal, state, and local governments, says Maureen Maigret,  chair of the Long-Term Care Coordinating Council’s Aging in Community Subcommittee and a Board Member of Senior Agenda Coalition of Rhode Island (SACRI).  “It was frustrating to see drastic state cuts to these programs in the mid 1990’s and we were pleased funding was restored. Governor McKee put $200,000 in the current budget, with the idea this was a step toward to providing funding equal to ten dollars per person aged 65-plus in each community,” she notes. 

“Aging advocates such as the SACRI will be pushing to get to the ten dollar level,” says Maigret. As state funding increases, Maigret calls on local communities to continue to provide funding and resources to their local senior centers to meet projected population growth of their older adult residents.  

According to Maigret, research has shown their importance in slowing or preventing functional decline and promoting a good quality of life.

Today’s Senior Centers are not your parent’s bingo hall, as some still mistakenly believe. Why not visit the Leon Mathieu Senior Center or your local Senior Center during National Senior Center Month and you may even be surprised with what you find? Call the Leon Mathieu Senior Center for more details about its offered programs and services at 401/728-7582. Or go to https://pawtucketri.com/senior-center.

To find a Senior Center in your community go to https://agefriendlyri.org/tools-resources/senior-centers-rhode-island/./Herb Weiss

 

Courtesy of AARP: Long-Term Care Data at Your Finger Tips

Published in the Woonsocket Call on September 2, 2018

Across the States 2018: Profiles of Long-Term Services and Supports, by Ari Houser, Wendy Fox-Grage, Kathleen Ujvari, of AARP’s Public Policy Institute, was released days ago. The jampacked 84-page AARP reference report gives state and federal policy makers comparable state-level and national data culled from a large number of research studies and data sources, some of the data gleaned from original sources.

AARP considers the 10th edition of Across the States, published for the past 24 years, “the flagship publication” to assist policy makers make informed decisions as they create programs, and policies for long-term services and supports (LTSS). State-specific data “is easily found, “at your fingertips,” claims AARP.

Across the States, released August 27, 2018, includes a myriad of aging topics include: age demographics and projections; living arrangements, income, and poverty; disability rates; costs of care; private long-term care insurance; Medicaid long-term services and supports; family caregivers; home- and community-based services (HCBS); and nursing facilities. Each state profile is a four-page, user-friendly, print-ready document that provides each state’s data and rankings.

Looking at Trends

AARP Public Policy Institute researchers have identified four trends in reviewing state data. Of most importance to Congress and state legislatures, Across the States gives a warning that America’s population is aging. The nation’s age 85 and over population, those most in need of aging programs and services, is projected to triple between 2015 and 2050, a whopping 208 percent increase.

But, by comparison, the population younger than age 65 is expected to increase by only 12 percent. The under age 65 population, currently, 85 percent of the total population, is projected to be 78 percent in 2050. Bad news for propping up the Social Security system with the worker-to – beneficiary ratio declining.

Across the States researchers say that the demographic shift of an increasing older population will have an impact on family caregiving. “The caregiver support ratio compares the number of people ages 45–64 (peak caregiver age) to the number ages 80+ (peak care need),” notes the report. Today, there are about 7 people ages 45–64 for every person age 80. By 2050, that ratio will drop to 3 to 1.

America’s older population is also becoming more diverse, reflecting overall trends in the general population. Across the States researchers note that the Hispanic population age 65 and over is projected to quadruple between 2015 and 2050.

Finally, Across the States report notes that State Medicaid LTSS systems are becoming more balanced due to the increase of state dollars going to fund home and community-based services (specifically to care for older people and adults with disabilities). But, this trend varies in level of balance, say the researchers, noting that: “The percentage of LTSS spending for older people and adults with disabilities going to HCBS ranged from 13 percent to 73 percent in 2016. While 40 states became more balanced, 11 states became less balanced for older adults and people with physical disabilities in 2016 compared with 2011.”

Taking a Closer Look

Across the States notes that the age 85 and over population is projected to significantly outpace all other age groups when the aging baby boomers begin turning age 85 in 2031. In 2015, people ages 85 and older made up 2 percent of the US population. By 2050, they are projected to represent 5 percent. By contrast, in the Ocean State the age 85 and over population was 2.7 percent of the state’s population. By 2050, look for the oldest-old population to inch up to 5.4 percent.

Throughout the nation the cost for private pay nursing facility care is well out of reach of most middle-income families. Across the States notes that in 2017 the annual median cost for nursing facilities is $97,455 for a private room and $87,600 for a shared room. But, in Rhode Island the annual cost is higher, with a private room costing $ 104,025 and $ 101,835 for a shared room. The researchers say that for the cost of residing in a nursing facility for one year, a person could pay for three years of home care or five years of adult day services.

Because of the high costs, most people go through their life savings paying for costly care and ultimately have to rely on the state’s Medicaid program. Nationally, the percent of Medicaid as primary payer in 2016 was 62 percent (61 percent in Rhode Island).

According to Across the States, family caregivers provided $470 billion worth of unpaid care in 2013, more than six times the Medicaid spending on home and community-based services. In Rhode Island, 134,000 provided 124 million hours of care annually with an economic value $ 1.78 billion. But, AARP’s report warns federal and state policy makers about the stark demographics in America’s future that will for the nation’s “Oldest Old” to scramble to find a caregiver, due to a shortage. Will state’s have the financial resources to fund programs and services to make up for this demographic reality.

For a copy of Across the States report and Rhode Island specifics, go to: http://www.aarp.org/content/dam/aarp/ppi/2018/08/across-the-states-profiles-of-long-term-services-and-supports-full-report.pdf.

Survey: Older Americans Puzzled About LTC Programs and Services

Published in Woonsocket Call on July 19, 2015

Planning for your golden years is key to aging gracefully.  But, according to a new national survey looking at experiences and attitudes, most Aging Boomers and seniors do not feel prepared for planning or financing their long-term care for themselves or even their loved ones.

This Associated Press (AP)-NORC (NORC) Center for Public Affairs Research study, funded by The SCAN Foundation, explores a myriad of aging issues, including person-centered care experiences and the special challenges faced by the sandwich generation.  These middle-aged adults juggle their time and stretching their dollars by providing care to their parents, even grandparents while also financially assisting their adult children and grandchildren.

Older American’s Understanding of LTC

This 21 page survey report, released on July 9th, is the third in an annual series of studies of Americans age 40 and older, examines older Americans understanding of long-term care, their perceptions and misperceptions regarding the cost and likelihood of requiring long-term care services, and their attitudes and behaviors regarding planning for possible future care needs.

The survey’s findings say that 12 percent of Americans age 40 to 54 provide both financial support for their children and ongoing living assistance to other loved ones.   Federal programs are often times confusing to these individuals, too.   More than 25 percent are unsure whether Medicare pays for ongoing living assistance services like nursing homes and home health aides. About 1 in 4 older Americans also overestimate private health insurance coverage of nursing home care.

Researchers noted that about half of the respondents believe that a family member or close friend will need ongoing living assistance within the next five years. Of those who anticipate this need, 7 out of 10 reports they do not feel very prepared to provide care, they note.

More than three-quarters of those surveyed age 40 or older who are either receiving or providing ongoing living assistance indicate that their care includes at least one component of “person-centered care.”  This approach allows individuals to take control of their own care by specifying preferences and outlining goals that will approve their quality of life.

The survey also finds that most of those reporting believe that features of “person-centered care” have improved the quality of care

Paying for Costly LTC Services

The 2015 survey findings are consistent with AP-NORC survey findings from previous years, that is older Americans continue to lack confidence in their ability to pay the costs of ongoing living assistance.  Medium annual costs for nursing homes are $91,260; the cost for at-home health is about half that amount, $45,760, says the report.

Finally, only a third of the survey respondents say that they have set aside money for their care. More than half report doing little or no planning at all for their own ongoing living assistance needs in their later years.

“The three surveys on long-term care [by AP-NORC] are helping us create a comprehensive picture of what Americans 40 and older understand about the potential need for these critically important services,” said Director Trevor Tompson, at the AP-NORC Center in a statement. “Experts estimate that 7 in 10 Americans who reach the age of 65 will need some form of long-term care, and our findings show that many Americans are unprepared for this reality,” he says.

Dr. Bruce Chernof, President and CEO of The SCAN Foundation, says that the 2015 study takes a look at public perception regarding long-term care and most importantly, how people can plan for future long-term care needs.  “The insight provided by this research is critical because it will help us promote affordable health care and support for daily living, which are essential to aging with dignity and independence.” he says.

AP-NORC’s 2015 study results are validated by other national research studies, says AARP Rhode Island State Director Kathleen Connell.    “AARP’s research, both nationally and state by state, reveals that people in the 50+ population are concerned about the cost of retirement and especially long-term care,” she says, observing that “very few people seem worry free on this question and rightfully so.”

 Beginning the Planning Process

Connell adds, “I would say our response to this survey is that it adds to the awareness that people need to start thinking about this at an earlier age. And that means not only focusing on saving but also getting serious about health and fitness.”

What can a person do to better prepare for paying for costly long-term care and community based services?   “AARP.org has an abundance of information on long-term care. There’s advice on long-term care insurance, a long-term care cost calculator and many other resources. We also need to remain strong as advocates for programs that support seniors. Social Security, Medicare and Medicaid need to remain strong in order to support Americans entering the most vulnerable chapters of their lives,” she says.

Amy Mendoza, spokesperson for the American Health Care Association (AHCA), a Washington, DC-based trade association that represents over 12,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities, calls for increased conversations to help planning for potential future need.  “Given that the need for long-term or post-acute care is a life changing event, it demands some considerable thought, discussion and research,” says Mendoza.

“AHCA’s “Care Conversations” program helps individuals have the honest and productive discussions needed to plan and prepare for the future long-term care needs,” adds Mendoza.  Care Conversations has a Planning Tools page on its website which provides information on advance directives. Learn more at: http://careconversations.org/planning-tools.

Todd Whatley, a certified elder law attorney, notes that some of his best clients are middle age adults who after taking care of their parents want to avoid costly nursing home or community based care services.  “They are then suddenly very interested in some type of [insurance] coverage for the extraordinary expense of long term care when a year earlier, they had no interest whatsoever,” he says.

Whatley, President-Elect of the Tuscan, Arizona-based National Elder Law Foundation, suggests contacting a financial planner or Certified Elder Law Attorney when purchasing long term care insurance, “Get early advice from someone with their best interest at heart.  There are many times that a person simply doesn’t need this product financially, but most people do.

To locate a Certified Elder Law Attorney, contact Lori Barbee, Executive Director, National Elder Law Foundation.  She can be reached at 520-881-1076 or by email: Lori@nelf.org.

For a copy of the study, go to http://www.longtermcarepoll.org/Pages/Polls/long-term-care-2015.aspx.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.