Researchers have described aging baby boomers as the “pig in the python”—a large swell in an otherwise skinny distribution. At a recent Bipartisan Policy Center forum in Portland, Maine, Senator Angus King (I-ME) explained, “If you have ever seen a picture of a python eating a pig, there is this big lump in the middle. We [boomers] are the lump.” In fact, over 10,000 baby boomers turn 65 each day. In the coming years, this abrupt swell of older adults threatens to overwhelm our delivery systems and support networks. Millions of older adults will be at risk of financial insecurity and may lack access to adequate health services and safe, affordable housing.
BPC’s Senior Health and Housing Task Force hosted the forum with Sen. King, Portland Mayor Ethan Strimling, and two panels of local and regional experts following National Falls Prevention Day. The forum provided an opportunity to recognize the many local and state leaders and practitioners in Maine working to promote healthy aging, and to dive into policy opportunities detailed in BPC’s recent report, Healthy Aging Begins at Home.
Work on the ground
As the nation’s second “grayest” state with over 18 percent of its population age 65 or older, Maine is keenly aware of the issues resulting from shifting demographics. Though as Sen. King remarked, Maine’s aging challenges are exacerbated by a deteriorating housing stock, a substantial rural population, and a lack of accessible broadband in many communities.
Millions of older adults may lack access to adequate health services and safe, affordable housing.
Despite these impediments, Maine is one of the nation’s leaders in connecting health and housing services for older adults. Organizations like Avesta Housing and Bath Housing, which own or manage a combined 2,300 apartments in and around Maine, are providing seniors with affordable and suitable housing often integrated with health and supportive services. By creating partnerships with hospitals and incorporating needed services, these organizations are changing the landscape of aging for Maine’s seniors. Larger groups such as AARP Maine, LeadingAge Maine, and the Maine Affordable Housing Coalition bring stakeholders together from every sector to champion aging issues, share best practices, and improve the livelihood of Maine’s seniors.
Experts agree preventing and lowering the risk of falls is a tremendously important issue. Falls are the leading cause of injury among older adults, and accounted for a staggering $31 billion every year in medical costs. Every second of every day an older adult falls, and every 11 seconds an older adult receives treatment in an emergency room for falls-related injuries. Falls can be debilitating and even deadly. Responding to falls also places an immense burden on local budgets; the singular cost of sending a first responder to assist a fallen older adult averages $900.
Thanks to the work of the organizations we hosted at our forum and their partners, Maine is making progress. Dorothy Baker from the Yale School of Medicine noted that, in the city of Portland last year, 30 percent of the older adult population fell. This year that number is down by 5 percent. The falls prevention programs that are being implemented in Maine were essential in achieving that improvement and their expansion is needed for future progress.
Progress is also being made around the region. As Chris Herbert from Harvard’s Joint Center for Housing Studies noted, Vermont is the only state to mandate universal design features for all newly constructed homes. Universal design features are structural and minor features that can make homes more accessible and enable seniors to age more safely in their home. Vermont’s Support and Services at Home (SASH) model is making strides to align health and housing services by providing individualized, on-site support by a Wellness Nurse and a trained SASH Care Coordinator.
More to be done
Despite the inspiring work being done in and around Maine, more still needs to done. For example, demand for affordable housing is outpacing supply. Across the state, 9,000 seniors are waiting for affordable homes. As Deborah Keller, executive director of Bath Housing, noted, her organization has 300 people on a waitlist for 166 apartments in a town of 8,500 people. Avesta Housing, which operates across southern Maine and southern New Hampshire has a waitlist of 2,000 people for 1,081 homes, and only expects to have 130 openings next year.
Along with the need for more affordable housing supply, practitioners and aging advocates across the state have emphasized the burdens that fall on an older adult’s family members. In Maine, families are providing $2.2 billion in unpaid care each year. Without additional resources for low-income Mainers, much of the cost burden of care will continue to fall on family caregivers.
Demand for affordable housing in Maine is outpacing supply. Across the state, 9,000 seniors are waiting for affordable homes.
One specific recommendation in the Healthy Aging Begins at Home report is for states and municipalities to establish and expand programs to assist low-income seniors with home modifications in order to facilitate healthy aging. In Maine, there is concern that existing state and federal programs are not working and are too complex for citizens to navigate. Sen. King is looking to address these issues at the federal level with the introduction of the Senior Home Modification Assistance Initiative Act, which would establish a process to better coordinate the existing federal home modification programs and provide consumer-friendly information on how those programs can benefit older Americans.
At the local level, Bath Housing took it upon themselves to address this issue in their town by applying the CAPABLE model to create a network of partnerships that sends a team to participating homes to assess them for use and safety. For less than $3,000 per home Bath Housing is making modifications that, based on preliminary data, are associated with a reduction in falls, a reduction in close-calls for fires, a reduction in 911 calls, and a reduction in hospitalizations.
In order to address the demographic “pig in the python” problem, Maine must continue to improve the connection between housing and health services for older adults. The rest of the nation should follow Maine’s lead.