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January 9, 2013

The silver tsunami

A month ago, Dr. Zettie Parker-Turner resigned as administrator of the Rivers Edge nursing home in Prospect. Her love — and need to care — for her mother in Memphis trumped her passion for the position. Likewise last year, Dr. Ken Winters, R-1, chairman of the state Senate Education Committee, opted not to seek re-election. At 78, he ended his eight-year term to care for his beloved wife, Shirley, in Murray.

On Christmas Eve, a friend in California wrote of her distantly hospitalized matriarch: “My mother is not a fan of roommates. She has requested I correct this ‘mistake’ immediately. Merry Christmas, Mama, my lovely mother in the midst of an ungraceful departure from this realm … I really ought to be there for her right now. My guilt consumes me, head first.”

For years, I’ve been reading about the imminent “silver tsunami,” a perfect storm created by an aged population living longer with more chronic conditions amid skyrocketing costs and a shortage of caregivers. The evidence that it’s here is prevalent, and if we weren’t so obsessed with slaying immediate sharks, then we might have to tend to the dying sea.

The U.S. Census Bureau projects that more than 1 million Kentuckians, or 23 percent of the commonwealth, will be 60 or older by 2020. By 2030, nearly 20 percent of Americans will be 65 or older. Ninety-one percent of them have at least one chronic condition (such as diabetes, asthma, hypertension and depression) and 73 percent have at least two, according to the National Partnership for Families and Women, which affirms that “workers need access to paid sick days to care for their own health and the health of family members.”

Baby boomers are stepping up to the plate. According to caring.com, boomer caregivers’ active role in ensuring that seniors take medications as prescribed could save Medicare as much as $100 billion annually.

Many of these caregivers themselves have at least one chronic illness. Depending on the intensity and duration of their assistance, related stress may compromise their physical and financial health.

Last Friday night’s lineup of public-affairs programs on KET resonated among those who believe that no public policy should be made without respect to our elders.

“Comment on Kentucky” panelist John Cheves of the Lexington Herald-Leader said, “Sen. Rand Paul wants entitlement spending cut rather than taxes raised. Social Security, Medicare, Medicaid — he points out correctly that these are the largest part of the federal budget. However, Kentucky, more than most states, depends on the federal entitlement programs to survive … So it’s not clear if we actually cut entitlements what’ll happen to Kentucky.”

PBS’s “Need to Know” told the story of a 94-year-old Alzheimer’s patient whose loved ones have been taking care of her for nearly a decade. “The government estimates that someone over 65 will need an average of three years of long-term care,” said the narrator. “To get that care in a nursing home costs an average of $72,000 a year.”

A companion report highlighted an expanding Rhode Island program that pays loved ones to assist afflicted elderly persons at home, “an innovative way to save money while providing better care with better results.”

“Washington Week” aired a clip of U.S. House Speaker John Boehner, R-Ohio, saying, “Public service was never meant to be an easy living. Extraordinary challenges demand extraordinary leadership.”

Our seniors deserve extraordinary protection as they teeter the on the edge of this cliff. Their demographic landscape can’t be changed. But “their ability to remain in their homes and communities is dependent in part on the availability of resources to support their well-being and opportunities to remain connected,” according to healthtrust.org. Access to in-home care and public transit, therefore, advances their interests and contains costs.

It’s difficult to overstate the gravity of this crisis. Whether such a privileged nation can afford to manage it is a question that vexes Dr. Jeffrey Halter, a professor of internal medicine at the University of Michigan. “Thoughtful people ought to be able to figure out how to provide good quality health care for everyone in America,” he told Medicine at Michigan magazine. “So we don’t have to send our older people packing off to the wilderness when they hit 75, and say goodbye and good luck.”

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