A reader poll that accompanied the Oct. 13 article “Governor candidates on the issues: Health care” reveals less interest in elder housing compared with other state health issues. But there are three very good reasons why you should care about the future of elderly housing in Maine.

• Reason No. 1: It costs you a lot of money.

The largest portion of long-term care (nursing home) costs in Maine and in many other states is paid by taxpayers through Medicaid.

For some time, it has been noted by health care experts that the current model used for housing our elderly is in need of an overhaul.

• Reason No. 2: It’s going to cost you a lot more money if something isn’t done about it.

Maine cannot afford more of the status quo. The number of Mainers over 65 requiring long-term care services is projected to grow by 103,000 people between 2010 and 2020, according to a study by the University of Southern Maine’s Muskie School of Public Service.

Gov. Paul LePage, for all his rhetoric about streamlining and reducing Maine’s burgeoning health care costs, wants to dump more taxpayer money into nursing homes without seeking additional options for dealing with the problem.

LePage’s opponents in Augusta support “Aging in Place” initiatives, which keep more of Maine’s elderly out of nursing homes and in their own homes. Aging in place has been recognized as a far cheaper option for Maine.

The U.S. Department of Housing and Urban Development website cites case studies showing the potential of $9 billion in Medicaid savings if only 10 percent of Americans needing long-term care enrolled in an “Aging in Place”-type program instead. Several other New England states have already or are making steps to adopt such policies.

• Reason No. 3: You and Grandma are going to feel a lot better about your options.

Most of the older folks in Maine whom I have known are fiercely independent and want to remain in their homes.

As a nurse, I have had the chance to work with older adults in hospitals and in nursing homes. After providing care to these individuals, I would ask if there was anything else they needed before I left.

Time and time again, their eyes would gaze toward the window (if there was one) and they would say, “I just want to go home,” or they might joke about me sneaking them out.

The biggest fear I would encounter was not of a procedure or that they might die, but that they would not be allowed to return home. Their fears were not unfounded, as many seniors begin their residence at a nursing home after a health event that lands them in the hospital.

People’s lives and identities are tied to their homes. I remember clearly the home of one hospice patient. This patient had large, bright and dramatic artwork adorning the walls. I learned through conversation that the works held tremendous emotional value to this patient.

This person was able to live out the last days at home surrounded by an environment that held identity and meaning with the support of visits from a hospice nurse. Preserving this person’s environment as it was would have been impossible with institutionalized care.

The decision to place a family member in long-term care is feared by many people and in many cases can have damaging effects on the health and emotional well-being of both the individual needing care and his or her family members. It’s not that all situations are this way; quite a few Maine nursing homes receive high marks as far as standards go, and newer, more humane models of long-term care facilities are being introduced.

But even the best nursing home poses challenges. Good care is expensive and may be beyond the means of many Maine families. Also, the best facility may be many miles from a patient’s family members and the community in which the person has lived and known for most, if not all, of his or her life.

In many cases the decision to move to a nursing home is made for financial or practical reasons, not because it is necessary for the care of the older family member.

With the proper support, many of those now living in nursing homes could be taken care of in their own homes with a better quality of life – and, as research is revealing, they may enjoy longer lives as well.

Keeping older Mainers at home saves money and provides an option that many families want. We will always need nursing homes, but our current reliance on them for housing our elderly is costly for us now and unsustainable for our future.

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