I was at a statewide conference on aging recently and heard a statistic that knocked my socks off: 50 percent of children born today in wealthy nations will likely live to be 100 years old. Dubious, I looked for a source of that statistic, and it was the Lancet, one of the most respected medical journals in the world.
This jibes with our experience in Maine, the oldest state in the nation (by median age). When you look at the statistics for those over age 65 in Maine, one of the fastest growing groups is the very elderly — 85 years and older. I mused recently to a few friends that it is becoming routine that friends and family are living to 90 years old and beyond. This was not true in my youth.
I went digging further in the Lancet article and they noted reassuringly that, in future decades, these “super elderly” will be living with less disability and fewer limitations. Still, the sheer numbers of people living to their 90s or 100s will mean that more people will live long enough to be diagnosed with cancer, arthritis, diabetes, or cardiovascular disease.
Think of the implications of this large increase in the extremely elderly. Let’s start with medical care, a science-based discipline that bases treatment decisions on proven research. There are few, if any, studies today that point to the treatment strategies that are best for those at the extremes of age. Even tried and true treatments, like hypertensive medications, give clinicians pause because there is no proof that they work well with the extremely elderly.
Financial implications loom large for those living very long lives. Personal finance planning will be critical because an individual will need retirement funds to last far longer. This comes at a time when employers are trending away from guaranteed matching contributions to retirement plans. Moreover, the viability of Social Security and Medicare becomes even more salient to people living 25 or more years beyond the required retirement age of 66.
Fortunately, the millennial generation has been saving for retirement at a much higher rate than their boomer parents. According to a 2016 Wells Fargo study, 59 percent of millennials have started saving money for retirement, mostly because they do not believe Social Security will be there for them when they reach retirement age. Nearly 60 percent believe most of their retirement income will come from self-funded 401(k) plans or IRAs, according to the Transamerica Retirement Survey of Workers).
Then there are financial implications for Maine — let’s start with Medicaid, or Mainecare. Today, elder adults and people with disabilities are only about 40 percent of those covered by Mainecare but they account for nearly 70 percent of the expenses. They rely on Mainecare to pay for nursing homes and other expensive services not covered by their Medicare plan.
As the Lancet article pointed out, while the “super elderly” cohort will be generally healthier, the sheer numbers of them will bump up the need for long-term care services like nursing homes, pressuring the Mainecare budget even further. This is a compelling argument for more state investment in health and well-being programs for our elder citizens — a certain cost-containment measure.
Communities around the state are already working to promote health and well-being in seniors. Much of the effort revolves around “aging in place,” where seniors remain in their own homes as long as possible. This is a huge issue in Maine, as 79 percent of Maine seniors own their own home, enabling 97 percent of Maine seniors to live independently. Healthy 90-year-olds can remain in their homes with the right supports.
Those supports include basic home maintenance services, wood stacking, snow shoveling, rides or transportation, check-in phone calls, among others. Maine communities are mounting largely volunteer efforts to assist their elder neighbors with these types of supports.
But there are local and state policies and resources that need to be re-examined as Maine’s population matures even further. We need more attached or detached dwelling units or “mother-in-law” apartments to accommodate family care-giving in our communities, requiring new local ordinances. We need state and local cooperation to develop more senior housing. We need to develop more supports for family caregivers in the face of worker shortages in the long-term care industry. We need to elevate salaries and benefits for that workforce to retain them, since we will need more of them in the years ahead. And home-based nurses, from public health to care management, will be in greater demand. These supports will require accurate forecasting and creative decision-making by such state agencies as Maine State Housing Authority, Mainecare, the Office of Aging and Disability Services, Maine CDC, and other government bureaus.
Let’s embrace our title of oldest state and work at the state and local level to make our independently-minded seniors the healthiest in the country.
Lisa Miller, of Somerville, is a former legislator who served on the Health and Human Services and Appropriations and Financial Affairs committees.
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