Senior Citizens, Elder Care – Ageing Iowans
We all know senior citizens. They are our parents, our grandparents, our friends, our neighbors, our aunts and uncles. These are people about whom we care, people whose health may be starting to fail, or may be becoming increasingly fragile. I’m betting we also know someone who is not as sharp as they used to be; someone on Social Security barely making ends meet and worried that they may not be able to afford their medication if the price goes up again. We know them and we worry about them, especially if they are living alone; especially if they have recently lost their life partner. What if they fall? How often does someone check on them? Can they shovel their walk or get to the store or to the doctor in inclement weather?
This is not a partisan issue – it’s about people who matter to us, who have lived their lives and raised their children and worked their jobs. And they deserve dignity and peace of mind. They deserve for their senior citizen years to be their Golden Years – not their years of worrying if they will be able to make ends meet and if someone will care for them if they get sick.
I know from living it with my parents and with all my grandparents that for many, it is very humbling to have once held a job, to have raised a family – and to have something happen – a financial event, a health event – that causes them to realize they may no longer be completely in control. It is difficult for them to watch contemporaries die and start to feel more and more alone. It is frustrating to lose one’s hearing, for example, and if you can’t afford hearing aids, to lose out on conversation and become more isolated.
So how do we ensure that our senior citizens – the ever increasing ranks of ageing Iowans – can enjoy their Golden Years? I propose that we examine six areas:
Housing: This includes ageing in place (is it accessible or can it be made accessible?); different housing opportunities, including assisted living, independent living in senior citizen homes; co-housing; living or near relative; and accessible/affordable housing – to list just a few. There is no “one size fits all” solution. It is often better for the person to remain in familiar surroundings if that can be done safely, with any services required (and less expensive).
Services: Meals on wheels, which can be the only contact an elderly person may have in a given day; visiting nurses; senior citizen centers; contacts with other human beings; basic home assistance – cleaning, laundry, changing lightbulbs, fixing a faucet, organizing medications and making sure they are being taken). This may not be the same in rural settings as it is in some rural settings, where distances are greater and services may not be as readily available.
Mobility: Transportation outside the home, including to social events and doctor’s appointments; and the ability to be mobile inside the home are both keys to independent living and being able to age in place. Transportation also matters for caregivers.
Health care: This is the time of life when people have more serious health events, but not everything is covered, either by Medicare or Medicaid. Medicare still has the donut hole for prescription drugs. Privatized Medicaid in Iowa is a disaster for so many – and many nursing homes have a preponderance of Medicaid patients. If they can’t pay the bills with what the MCOs pay them, then what? And how do we ensure that those who have health events, and are ready to go back home will have the support they need? For that, the CARE Act is a start.
Database and help accessing that database: Many programs are available to senior citizens; many qualify for services under the ADA as well. Yet at a time in life when both technology and change can be overwhelming for some, it can be difficult to get a comprehensive overview of what is available. One stop shopping and someone to help would be ideal. Johnson County is trying hard with their Livable Communities website and a new position designed to help people navigate it. It is a good model to watch.
Caregivers: We already have a shortage. Caregiving must become a respected profession, with a reasonable wage, or people will constantly move on. The shortage will only increase as the baby boomer generation retires and ages. We need new models, we need to work with community colleges, and we need to find ways to support and offer support and continuing education to existing caregivers.