Long-term care for seniors is often more expensive and harder to get in Maine than in many other states, according to a new state-by-state scorecard released Thursday by the AARP.
Despite significant deficiencies, Maine ranks 10th best overall in “Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers.”
AARP officials qualified Maine’s overall ranking – down from No. 8 in 2011 – saying it’s far from a ringing endorsement in a nation that’s largely unprepared to meet the needs of a rapidly growing senior population.
“It doesn’t mean we’re doing well,” Lori Parham, state director of AARP Maine, said Wednesday. “It just means we’re not doing as badly as other states. We shouldn’t be patting ourselves on the back. We still have a lot of work to do.”
A rapidly aging population poses a variety of challenges across the nation, but the situation is particularly acute here.
Maine has the highest median age in the United States – 43.5 years – in part because Maine also has a dwindling younger population, according to the U.S. Census. The state’s proportion of people age 65 and older – 17 percent – is second only to Florida’s 18.2 percent.
Maine also has the nation’s highest proportion of baby boomers – 29 percent of its 1.3 million residents were born between 1946 and 1964 – and they’re turning 65 at a rate of 18,250 a year, according to AARP Maine. By 2030, more than 25 percent of Mainers will be 65 or older, and 52,273 of them will be at least 85 – more than double the number of people in the oldest category in 2000.
Susan Reinhard, senior vice president for public policy at AARP, said the scorecard shows that even top-ranked states like Maine have room to improve on the threshold of exponential growth in the senior population.
“We need to step up the pace,” Reinhard said.
“We don’t have a lot of time to get ready.”
The scorecard reflects findings of the Portland Press Herald/Maine Sunday Telegram’s ongoing special investigative series, “The Challenge of Our Age,” which examines the various impacts of Maine’s aging population.
According to the scorecard, Maine ranks at No. 44 in affordability of private-pay nursing home care – the annual $104,025 cost of a private room runs three times higher than the $33,358 median household income of Mainers age 65 and older.
Maine ranks No. 46 in affordability of private-pay home care, which costs about $34,320 a year for 30 hours of care per week.
When private-pay costs are so high, seniors can burn through their personal resources within months and wind up dependent on Medicaid-funded long-term care programs, Reinhard said. Maine has underfunded related Medicaid or MaineCare programs for years, resulting in aging long-term care facilities and waiting lists for home care.
While Maine ranks at No. 10 for availability of home care aides, it falls far short of the number in Minnesota, which ranks at No. 1 overall. Maine has 48 aides per 1,000 people age 65 or older, while Minnesota has 76 aides per 1,000 seniors.
Maine also ranks No. 10 for availability of assisted living, with 41 units per 1,000 seniors, but far behind Minnesota’s 125 units per 1,000 seniors.
Parham said Maine must provide economic incentives to encourage development of various assisted-living options, including smaller residential care homes that allow seniors to remain part of their communities.
Maine also fails to address the growing needs of family caregivers, who number more than 190,000 in Maine and provide $2.3 billion worth of care annually, according to the AARP.
Maine ranks No. 38 for family caregivers who report having little worry or stress, having enough time and getting enough rest.
“We continue to show a lack of support for family caregivers,” Parham said. “This really is a big issue for us.”
More than 90 percent of older people receiving care in the community rely on unpaid family care, either alone or in combination with paid help, according to the scorecard.
Two-thirds of them rely solely on family caregivers, generally wives and adult daughters.
To avoid jeopardizing the health and economic security of family caregivers – and their contribution in the overall workforce – the AARP recommends expanding caregiver respite and training programs, family leave incentives and anti-workplace discrimination laws.
In other areas, Maine’s ranks dropped from 16 to 37 for disabled adults age 18 and over who are satisfied or very satisfied with life (85.7 percent); from 27 to 39 for employment of disabled adults (21.5 percent); and from 6 to 13 for high-risk nursing home residents with pressure sores (4.9 percent).
“This scorecard gives us a snapshot of how well Maine serves our older residents,” Parham said. “Now is the time for policymakers to act.”