Elder Advocates Struggle To Anticipate Shifting Needs

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By: Diana T. Barth
Published: 07/09/10

Throughout all of history, and taking into account the entire world, two-thirds of the people who have survived to reach the age of 65 are alive today.

This is the first time in history that such a large elderly population has existed. That means, said Ann L. Hartstein, the state’s secretary for Elder Affairs, that the problems created by the needs of a huge aging population are unprecedented.

Ms. Hartstein, who spoke yesterday at the Bourne Council on Aging, said that everyone is learning, together, what those problems are and what can be done to correct them.

As one who gained her state position after 35 years of working with the elderly, Ms. Hartstein said that she took over her new post thinking she understood the problems of seniors. She has held her new post a little over a year now, and in that time, she has hosted about 60 listening sessions, hearing about issues from those who are directly affected by them.

She said seniors, first and foremost, need to make sure their elected officials know both who they are and what they want.

What happens in politics, she said, is that issues come up quickly. When that happens, she said, decision are sometimes made “in the middle of nowhere.”

If you have already told your elected officials what you need, and what you’d like them to do, they will remember, “and then they’ll do it,” Ms. Hartstein said.

Bourne, she said, is lucky. Not only does it have what she called a “superb” council on aging, but it has an interested and involved set of state and local officials.

Senate President Therese Murray was at this week’s session, as was Representative Matthew Patrick (D-Falmouth), and a representative from the office of Representative Jeffrey Perry (R-Sandwich).

The Cape’s seniors have the ear, and the attention, of their officials. However, what those officials had to say this week, at least about financial solutions to issues facing elders, did not paint a very bright picture.
These are difficult economic times, Senate President Murray said, and as far as the state budget is concerned, 2012 is going to be tougher than 2011.

Ms. Murray said legislators are very aware of how hard tough times are on those with fixed incomes, and are doing the best they can to keep services to the elderly intact.

Mr. Patrick noted that the state budget had been slashed by some $4 billion over the last five years, and that it was anticipated that the state’s revenue would be down by some 18 percent next year, something that will translate into a loss of approximately 1,500 state employees.

He pointed out that the economic crisis is international in scope and added, however, that, “we’ve been through these things before.”

Ms. Hartstein asked the audience members at the listening session what message they would like her to take back to Governor Deval L. Patrick.

She said her office was working on an “aging agenda,” based on nine principles, including the necessity for affordable and adequate housing, transportation, access to the work force, health insurance, and retirement income.

Sometimes, she said, the only way to support older people was to support younger people, as well. The better health care people get when they are younger, the healthier they will be when they are older.

People need to understand they have a role to play in their own future, she said.

“We’ve discovered the fountain of youth,” she said. “It’s the drink you take from the drinking fountain after you’ve finished exercising.”

When people say they do not want to grow old, they do not mean it literally; they mean they want to stay healthy, and part of remaining healthy and active is attitude.

She encouraged people to combat ageism, especially in their own thinking. “I’m too old for that,” or “Old dogs can’t learn new tricks,” are ageist statements to be rooted out of people’s thinking.

Statistically, she said, people with a negative view of old age lived shorter lives.

Once the floor was open to questions, the first focused on an initiative, publicized in the most recent COA newsletter, that would pay a stipend to family members who have to act as caregivers in certain circumstances. Information on that program, called Caregiver Homes, is available by calling Maureen Spengler at 866-797-2333.

Ms. Murray said that, along with similar initiatives, the state is looking at the “North Shore model,” housing that provides seniors with one room and a bathroom, but gives them access to a communal kitchen, dining, and living room, with meals prepared by staff.

That, and other models, keep seniors in their own homes, and out of nursing homes. Ms. Murray and Ms. Hartstein said a lot of work is being done to prevent seniors from having to go into a nursing facility when all they needed was a small amount of support.

Another question, which came from SHINE counselor Sandra A. Cortese, focused on Medicare, Part D.
SHINE stands for Serving the Health Information Needs of the Elderly, and those counselors help older citizens navigate, among other issues, the complicated Medicare prescription drug coverage program.

Ms. Cortese asked if the state could opt to narrow the number of coverage programs down to a favored few, making the system easier to navigate, but still helpful to seniors. She was told, however, that the Medicare program was specifically written to ensure that all of the program options remained open, and the state did not have the power to limit them.

Meeting attendees also heard that the gap in Medicare prescription drug coverage would be eliminated by 2014. One participant then rose to ask whether the money that was now used to fund the state program that helps fill that hole could, after the gap was closed, be used to restore assistance with the cost of premiums.

That assistance had been cut from the state budget.

Ms. Harstein told the speaker that he should make that suggestion to the legislators.

Bourne Town Administrator Thomas M. Guerino rose to identify the need for more fixed route bus service on the Upper Cape, as well as for outreach for those elders who, whether from lack of transportation or other issues, were not receiving proper nutrition.

Ms. Hartstein said that the newly reorganized state Department of Transportation was working to use modern technology to combine all of the various transportation routes, making the best use of the “pieces of the transportation puzzle” now in existence, and then moving to fill in the gaps in the system.

“It’s a work in progress,” she said.

Another speaker, from Mashpee, said councils on aging were being asked to help seniors facing serious financial problems, including foreclosure. She asked if the state could help provide financial planning to elders.

Ms. Hartstein said SHINE counselors received about two weeks of training per year; to certify a financial
planner would take years of training and would be more problematic.

Councils on aging, she said, had to be referral agencies in those situations.

Asked about long-term care insurance, she said she has been a member of a committee that is trying to ensure that people know what they are paying for when they sign up for such insurance.

People need to know if home health care—or nursing home care for those with Alzheimer’s or other cognitive disorders—will be covered under the policy.

Secondarily, such coverage might eventually be mandated as part of any long-term care insurance policy, she said.

Elder Services of Cape Cod and the Islands has a planning booklet called Embrace Your Future that helps people determine what coverage they need. Two-thirds of those people over 65 will need some kind of long-term care, Ms. Hartstein said.

Another attendee asked about the possibility of raising the retirement age under Social Security to 67 or 68, noting that it is difficult for anyone over 55 to find a good paying new job.

That, Ms. Hartstein said, is another reason why the state is working to combat ageism. As for changing the retirement age, that, she said, is another conversation to have with legislators.

A Bourne resident in the back of the room had almost the last word at yesterday’s meeting.

Commenting on a suggestion that taxpayers be allowed to donate funding for elder services as a tick-off on their state income tax forms, she suggested that those with money to give away donate it to the Friends of the Bourne Council on Aging.

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