Meeting the Growing Needs of Long-Term Care for the Elderly
Hawaii has an opportunity to continue its innovative national leadership on aging in place and with dignity by creating a state solution to pay for long-term care.
My father was recently diagnosed with Alzheimer’s. As a result, my entire family has been grappling with questions of how to care for him as he gets older and the Alzheimer’s becomes more severe, as it inevitably will.
My parents can’t live on their own any longer, so they moved in with me this past winter. While I am grateful that I can help my parents, as a newly minted member of the sandwich generation, I worry about my ability to meet their needs while working full-time and raising a four-year-old daughter. And at the top of our family’s list of concerns is how we’ll be able to afford my father’s long-term care.
My family is hardly alone in grappling with this — every day 10,000 Americans turn 65, and by 2030 20 percent of our population will be past retirement age. Already, more than 40 million Americans are caregivers for family members, many for loved ones with Alzheimer’s. As our country and state ages, this number will only continue to grow.
Nursing homes — still the primary form of long-term care in our country and the option that is most often supported by public funding — are prohibitively expensive, with a private room costing upwards of $80,000 per year. Home care, the option that would best support people who want to age in place, is also financially out of reach for many families.  Our underfunded and patchy long-term care system is especially tough on middle class families, who are increasingly spending down a lifetime’s worth of savings to meet their long-term care needs.
This is a hidden crisis in our country that is only beginning to get the attention it deserves.
Much like Social Security and Medicare were the bold solutions we created to address the economic and health needs of older Americans, it’s time we come up with the solutions we need today to address our long-term care needs.
Hawaii has long been a leader in this field. From Ohana zoning, specialized local loan products, and the strong infrastructure of small private care homes to the state and county support of aging services to the immensely strong volunteer efforts of groups like Project Dana, Hawaii leads the nation in aging in place and with dignity. That leadership extends to Hawaii’s federal delegation. Sen. Mazie Hirono, for instance, is currently involved in a bipartisan effort to establish a state innovation fund to help states come up with creative solutions for the booming population of elderly Americans.
Luckily, Hawaii government has been exploring just such innovations. Recently Hawaii’s Long-Term Care Commission ordered a report on the feasibility of several different kinds of state efforts to help aging adults live meaningful and dignified lives at home. That report authored by local Professor Larry Nitz urges, among other things, the creation of a social insurance fund to be used to help families struggling with care. The fund essentially draws down from either GET or payroll taxes to create a fund that each Hawaii resident can draw from — a little like a state-based Social Security fund — in order to pay for long-term care needs of our long-term residents. Others suggest encouraging growth of the private sector — a tax break for people who purchase long term care insurance, for instance.
To delay action to future generations is to consign millions of families like mine to a collective future of uncertainty. My father is like so many people in America who are aging and need (or will eventually need) support as they get older, whether from home care workers or a quality care facility. No matter the solution, I know our goal will be to maintain his dignity to the fullest extent possible.
A program like the one recommended by the Hawaii Long-Term Care Commission would go a long way toward providing families the economic security and peace of mind we all need when we are caring for our aging loved ones. America needs ideas and policies like this that make it possible for all families to afford quality care, and we need our elected officials and local governments to take the initiative to come up with 21st-century solutions.
Our history as a nation shows that it’s often individual states that lead the way in coming up with the bold and necessary policy solutions we need for our new realities.
Hawaii can be one such leader today, when it comes to meeting the needs of our aging residents.
Sarita Gupta’s co-leader of the Caring Across Generations Campaign, AiJen Poo, is leading a follow-up conversation Thursday at Davies Hall at St. Andrew’s Cathedral from 6 to 9 p.m. The event is free and open to the public. It is sponsored by FACE, the Hawaii state partner for Caring Across Generations.
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