Retirement redefined: Preparing for long-term care needs

An average of 10,000 people a day are turning 65 years old, according to the Minnesota Department of Health.

The Minnesota State Demographer’s Office expects that people age 65 and older will outnumber the five to 19-year-olds statewide by 2020 and in Anoka County by 2035.

These statistics may not be shocking because there has been a lot of press about aging baby boomers. What also concerns those in the long-term care industry is they feel Minnesotans and its government are unprepared to handle the vast health care needs that comes with this aging population.

Everyone needs to shoulder the burden, says Gayle Kvenvold, chief executive officer of Aging Services of Minnesota, and Wayne Olson, senior vice president of operations for Volunteers of America. Governments must invest more and become innovative in the programs they assist. Individuals must save more. Companies need to offer long-term care programs similar to 401(k) programs because the government will not be able to handle serving such a large number of senior citizens. Senior services providers need to be more efficient to reduce costs.

“We tend as individuals not to think about what we will need in terms of long-term care when we get older until it’s absolutely staring us in the face,” Kvenvold said.

Unfortunately, the country is in the middle of a perfect storm of issues, Kvenvold said. Besides the fact that the population is rapidly aging and living longer, the recession has hit individuals and governments hard. There is a lot of demand placed on the shrinking dollar.

Nevertheless, Olson said the problem cannot continue to be pushed down the road and it will likely take many different options to meet people’s needs.

Some may not be able to save as much because of long-term unemployment or they work for a company that offers little or no retirement package. They may want to have an opportunity to cash out life insurance plans, for example.

A survey conducted by The Long-Term Care Imperative showed that 75 percent of those surveyed support this idea. This group is a legislative collaboration between Aging Services of Minnesota and Care Providers of Minnesota, which are the state’s two long-term care trade associations.

Higher taxes, especially in today’s economic climate, are not ideal for a lot of people, but the survey showed 64 percent stated they would be willing to pay more taxes, although the amount was not specified.

Gov. Mark Dayton April 28 signed the omnibus health and human services budget bill.

According to Jessica Sorenson, vice president of public relations for Aging Services of Minnesota, the budget includes several key components that impact long-term care.

For example, the state biennial budget approved at the end of the special session last year called for a 1.67 percent cut in the care provider waiver program, which helps individuals that lose Medicaid eligibility as a result of level of care changes. Most of the waiver program cuts would have affected individuals with disabilities of any age, but an approximately $3 million slice would have directly impacted seniors, Sorenson said.

Rep. Jim Abeler, R-Anoka, was one of the authors for the new health and human services bill, which delays the payment rate cut another year. He said members from both political parties agreed that it was important to keep those with the lowest service needs out of nursing homes and receiving waiver payments.

This waiver program cut may not even be necessary a year from now if the federal government approves eligibility requirement changes the state Legislature requested at the end of the last session, according to Abeler and Sorenson.

More efficiencies

Kvenvold said improved technology to enable a person to stay at home as long as possible or allow a caregiver to be more efficient are important for the future of long-term care.

There are electronic monitoring devices called WellAWARE that enable caregivers to monitor their client’s activities through sensors, not cameras. For example, these devices could sense how often someone enters the bathroom. If the number of bathroom visits spike, the caregiver could ask their patient what problems they have been experiencing. There could also be a sensor under a bed mattress to find out if a person is sleeping longer or shorter periods of time.

Kvenvold said the hospital and rehab nursing facilities need to work closer together to make sure people do not bounce back and forth between facilities and thus increase health care costs.

A portion of the new state health and human services budget legislation enables caregivers to share client assessments with a county’s health and human services department as long as the client allows this.

Sorenson said a nurse serving a client in an assisted living facility can add valuable information to the assessment process since he or she has direct knowledge of the client’s needs and abilities.

Aging caregivers

According to The Long-Term Imperative, 57 percent of those surveyed reported that they are or have been caregivers to aging loved ones.

Olson said with people living longer, there may be situations where a 100-year-old person needs care, but their 70-year-old son or daughter may need care as well. The problem is compounded when families have fewer children and live far apart.

What this would lead to is less informal caregivers and the need for more professional caregivers, Olson said.

Unfortunately for this profession, the growth in the caregiver labor force is limited.

According to information from the state demographer’s office and conveyed by The Long-Term Care Imperative, the labor force in this industry increased by an average of 1.12 percent between 2005 and 2010. The state demographer’s office is expecting this percentage to drop to 0.10 percent between 2020-2025.

The average age of caregivers is about 47 years old for registered nurses and 46 years old for licensed practical nurses, according to Sorenson, so many caregivers will be retiring and there may not be enough replacements to handle the increased demand of the aging population.

The Long-Term Care Imperative pointed out a sizable gap in wages between those who work in nursing facilities and home care and those who work in hospitals.

At the time that salary survey was conducted in 2009, a registered nurse (RN) in a hospital made about $40.15 per hour compared with an RN in home care that made $26.21 per hour and an RN in a nursing facility that made $23.83 per hour.

The gap is less between licensed practical nurses and certified nursing assistants. For example, a CNA in a hospital in 2009 made an average of $16.72 an hour. A CNA in home care and a nursing facility made a little over $12 an hour.

To read about the growing number of seniors in Anoka County, click here.

Senior resources available in Anoka County

• Senior Information Line: 763-783-4707 or www.accap.org/senior_information_line.asp
• Anoka County Senior Social Work Services, 763-422-7070
• Anoka County Family Caregiver Connection (formerly known as the Senior Caregiver Network), 763-422-6960
• Anoka County Retired Senior Volunteer Program (RSVP), 763-422-7090
• Anoka County Community Health and Environmental Services, 763-422-6970
• Anoka County Economic Assistance, 763-422-7246
More information on additional services for seniors, including a downloadable resource guide, is available at www.anokacounty.us/v4_seniors/default.aspx.

Eric Hagen is at eric.hagen@ecm-inc.com

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