Bill Nemitz’s article last week in the Portland Press Herald (see the link at the end of this blog post) on the proposed MaineCare cuts and the fallout for Maine seniors should terrify the state of Maine. As a senior care advisor, helping seniors and their families transition into care communities (like assisted living and nursing homes), I have worked with more than 75 MaineCare families over the last 3 years. I also work closely with many of the senior living communities that will close if these cuts pass. I know the staff members, who depend on their jobs which are now being threatened. I am worried about all of these people so close to us here at my company.
About 92% of our clients have dementia. They are making the move into residential care (assisted living) because they have no other safe alternative; they don’t move just because they want to, or because their children don’t want to care for them. This transition is most often precipitated by a crisis where it becomes clear that the senior’s environment at home with the care of friends and family is no longer safe. Maybe it’s a bad fall, or a medication overdose. Maybe they aren’t taking their medication at all, or they’re not eating. Perhaps they wandered out of their home late at night and got lost in the cold.
These clients need senior living options. More often than not, they need assisted living as opposed to nursing care. This is because most people with dementia require little medical support unless they have additional medical complications. Instead they need safe monitoring and social support such as “cueing” – meaning constant reminders to do daily activities of living that we often take for granted, like getting dressed, performing general hygiene activities, feeding oneself, etc. The great thing about this is that assisted living costs significantly less than nursing homes. According to a Genworth cost survey, the average cost in Maine in 2011 for assisted living communities is $4,625 per month. The average cost in Maine for nursing homes is $7,908 – nearly double the assisted living costs. So why is this relevant to the MaineCare discourse? Because if these cuts pass, those 75 MaineCare clients that we have confidently placed into assisted living and the many other thousands of families on MaineCare currently living in assisted living will have to go home, go homeless, or go to nursing homes. In all three cases they will be in real trouble.
It might sound to some like a reasonable expectation that the adult children of the seniors should be taking care of them in the home out of pocket, until you consider what Bill Nimitz pointed out, which is how many of these caregivers will have to quit their jobs, therefore loosing their income, selling their homes or tapping into their own retirement accounts. And what will that mean for them in 15 years when they need to pay for their own care needs?
Then there are those who have no retirement accounts or homes to sell; they will not have the option to make it work. Their only options will be to go homeless and suck more resources out of the state or to get their seniors into nursing homes that will continue to be supported by MaineCare. And they will get into the nursing homes because while seniors with dementia often don’t need the medical care nursing homes provide, they require so much assistance with daily living that they qualify anyway.
With nursing homes averaging nearly double the cost of assisted living facilities in Maine, it seems MaineCare will end up paying out more in nursing home costs than it does already. Not to mention, nursing homes are not the best places for seniors with dementia. In nursing homes they don’t get the social stimulation they need to thrive. The quality of life goes down significantly. So not only will the nursing home solution be no solution at all for seniors, it will open up a new economic drain on MaineCare.
Ultimately, it’s going to put thousands of Maine families into economic ruin. It’s going to cut jobs to hundreds, if not thousands of Mainers working at the MaineCare supported communities. And it’s going to jack up the demand on nursing home MaineCare payouts. Try as I might I can’t see how this proposal is the economic relief LePage is describing it to be.
To read Bill Nimitz’ article in the Portland Press Herald, click here:
