By Becca Heller
Facing a $1 million cut, the Maryland Department of Aging is focusing on providing more at-home services to keep the elderly out of costly nursing homes.
Coming on the heels of last year’s $4 million budget cuts, the $1 million cut in the governor’s fiscal 2014 budget is 2% of the department’s overall budget. At the same time, the department is confronting the needs of the rapidly-aging Baby Boomer generation.
“The shift from a younger America to an older one will affect us all,” said Gloria Lawlah, secretary of Aging. “By 2040, the number of Americans over age 65 will more than double to 88 million. Put in another way, one in five Americans will be 65 years of age or older. One in five.”
Lawlah, speaking last week to the Health and Human Resources Subcommittee of the House Appropriations Committee, said the department needs to focus on keeping seniors living semi-independently in their own communities, as opposed to growing old in nursing homes.
Nursing home costs dwarf at-home services
The average cost to care for a person in a nursing home is about $72,000 each year, said Carol Lienhard, the co-chairwoman of Maryland Senior Citizen Action Network. Alternatively, at-home senior care programs cost the state about $1,800 on average to serve one person for a year.
“Last year 225 seniors went to nursing homes from the waiting list for senior care programs. The cost of those 225 seniors in nursing homes was $16.2 million,” said Lienhard. “We could serve the entire senior care waiting list [of 2,710 seniors] for $5 million and still save the state $11 million, just on the cost of institutionalization of those 225 people.”
Rebalancing the budget to expand these cost-efficient programs would also allow more seniors to remain in their community, which is what most of them truly want, according to Lienhard.
“If any of you have ever been to visit seniors in nursing homes, they all say: I want to go home.”
Secretary of Aging calls for a change
With thousands of seniors on senior care waiting lists, millions of dollars being exhausted in nursing home services, and, now, another budget cut for the Department of Aging, Lawlah said the state needed to change the way it is doing business.
“It is my hope that as we expand home and community based care options through new opportunities available under the Affordable Care Act, we will become less dependent on nursing home care and that the savings from reduced nursing home utilization will position the governor to invest more state dollars in expanding these important, cost-effective services,” said Lawlah.
I certainly endorse the sentiment, but a lot of the details don’t add up. Ms. Lienhard says that it only costs $1,800 to serve an elderly person in their home for a year. Where? Certainly nowhere in the US. I was very fortunate for hire some student nurses for my mother-in-law for $15 per hour, which is WELL BELOW any other source I could find. Even that would work out to about 2 1/2 hours per week, and I suspect the cost would be more likely to run close to $20 per hour. I think some zeroes went missing. Also, it is not really valid to compare in-home care to nursing homes. A senior who would benefit from in-home care is probably more of a candidate for less-expensive independent living or at most assisted living, not a nursing home. A problem they did not adequately cover is that assistance is available through Medicaid for nursing homes but not (except in a very limited way) for the other alternatives. As a result, many people go to nursing homes who really do not need to. A final element is that when we provide in-home care it is also important to remember to include socializing outlets to keep the seniors more alert.