Len Kaye, University of Maine
Originally published in The Bangor Daily News on May 27, 2014.
The tone of the discussion in Maine on aging-related issues in recent months has been unusually upbeat. That is as it should be. A large majority of older Mainers live independently, are engaged in their communities and rate their health and quality of life quite high.
But nearly 250 professionals who serve older adults across the state were vividly reminded May 12, at the University of Maine’s Annual Clinical Geriatrics Colloquium held at Bangor’s Cross Insurance Center, too many exceptions to the rule remain.
The theme of the event, “Older Adults in Crisis,” reminded those in attendance approximately one in four adults 65 years and older experience frequent mental distress. Additionally, older adults continue to face unexpected emergencies in their homes, communities and even institutional settings.
Yes, we do have specialized resources available in the state for elders confronted with sudden threats to their well-being, including crisis counseling services, hot and “warm” lines to call for immediate support, hospital emergency room care, adult protective services, disaster and emergency management services, crisis support groups and more. These critical programs can help stave off an impending mental or physical health crisis.
But what about older adults living in a home where they are subjected to neglect, abuse and exploitation by relatives? They need to get out fast and go somewhere safe.
Amanda Cost, community response program manager at Spruce Run-Womancare Alliance, believes more people need to be aware abuse occurs at all ages, and she confirms there are no emergency shelters specifically for older adults in crisis. Cost believes more safe and supportive short- and long-term housing solutions for older adults are needed.
And what happens to the aging adult who on the street who requires emergency shelter to survive a cold night? Is Maine prepared to respond quickly and effectively? And how will Maine deal with increasing numbers of older adults seeking aid and shelter as they near the end of life?
Dennis Marble, executive director of the Bangor Area Homeless Shelter, recognizes that there are special challenges in serving older people who are homeless. If they have chronic back pain, dysfunctional knees and hips, and limited mobility, should these individuals follow house policy and leave the shelter beds during the day?
Marble believes it is exceedingly demoralizing for an older adult to have to stay in today’s emergency shelter. He hopes the Affordable Care Act will incentivize hospitals and other medical providers to more clearly see the link between health and housing, and realize that investing in housing for those in need could actually reduce health care system costs through the reduced use of emergency services and acute care beds.
In the meantime, safe temporary and transitional housing options for older Mainers in crisis remain extremely scarce. All too often, nursing home placement may be the only alternative — certainly an extreme response in many cases.
Martha’s Cottage is the first transitional home for elder abuse victims in Maine and one of a precious few housing options of its kind anywhere in the country. This Elder Abuse Institute of Maine home is located in the Portland area but is only able to accommodate three older adults at a time. I am not aware of an option like this being available anywhere else in the state.
Add to that the fact there is only one federally funded program, Health Care for the Homeless, designed specifically to provide primary health care to homeless persons — a service of particular significance for older adults on the streets.
The Affordable Care Act’s expansion of Medicaid to most people earning at or below 138 percent of the federal poverty level directly benefits very low income people — including the homeless — but it will only be available in states that have expanded their Medicaid program. Twenty four states have yet to do so, including Maine.
Amid our well-intentioned efforts to focus on the opportunities and promises that emerge from an aging Maine, we must not lose sight of the growing numbers of vulnerable elders who will need a variety of specialized services, including emergency and transitional services designed to meet the unique needs of an aging populace.
Lenard W. Kaye is a professor at the University of Maine School of Social Work and director of the University of Maine Center on Aging. He is a member of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.