The news of nursing home closures in Deer Isle, Whitefield and Bingham has reinforced the seriousness of the long-term care workforce shortage in Maine. The Press Herald’s recent editorial “Our View: Maine cannot continue to underfund nursing homes” (Sept. 7) is right that increasing state funding for our nursing homes is part of the solution to this problem. However, in order to comprehensively address the needs of older Mainers who require assistance with daily life, we must address the crisis across the continuum of care.

Direct care workers in nursing homes are providing an essential service for older adults who are in need of that level of care. Their work is physically and emotionally challenging and, without a doubt, they should be paid more and any increase in rates should go to them. Increasing the compensation for direct care workers will help with retention and recruitment. That’s why the Legislature included language in the biennial budget this year to increase the MaineCare reimbursement for the labor portion of the rate to at least 125 percent of minimum wage.

Additionally, many MaineCare rates for those serving older adults and people with disabilities will get a boost by having an automatic cost-of-living increase included in their rates. This means that MaineCare won’t be constantly trying to play catch-up when reimbursement falls below the cost of providing services. These are important developments, but money alone won’t solve the problem.

It is important to also recognize that care for older adults often happens outside of nursing homes. Home care, livable communities, programs like Meals on Wheels and family support networks are all critical to older Mainers’ long-term care. Home care is generally less expensive than institutional care, and three out of four adults over 50 want to stay in their homes and communities as they age. To help Mainers age in place, we must also recognize the valuable work of family caregivers who are often providing unpaid, around-the-clock care for their loved ones.

We need a system that supports each part of the continuum of care: those who are served by it and those who need it to live their best lives. The Commission to Study Long-Term Care Workforce Issues released a report last year that lays out a blueprint for how to solve the problem. One issue the report touches on but doesn’t specifically address is how the underlying attitude toward older people and people with disabilities affects how we treat the workers who care for them.

Ageism and ableism must be tackled as a serious problem. According to the Maine Council on Aging, “Ageism is discrimination based on prejudices about age … it often involves assumptions that older people are less competent than younger people. Ageism has a huge negative impact on older people throughout all areas of life.” Until we better understand the lived experience of older Mainers and their contributions to our economy and our communities, it will be a challenge to make spending on their care a priority.

Gov. Mills has an excellent opportunity to lead on these issues by supporting Maine’s “Age-Friendly State Plan,” implementing the commission’s recommendations, and creating a Cabinet on Aging similar to the one she reinstated for children’s issues. By addressing systemic problems in a holistic way and including the people affected in those conversations, we will make progress together.

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