Recently I have been visiting centenarians in long-term care facilities around the state.
Had my last surviving grandparent lived, she would be 103 today. It is amazing to meet people who have, in some cases, great-great grandchildren; sadly, in many cases they have children who preceded them in death.
New Hampshire has an exceptionally old long-term care population. That makes it a bit hard to compare our state to others and suggest, say, we should divert money from nursing home care to home-and-community-based services (HCBS), although some will make that facile argument.
As women live longer than men, an indication of the age of our nursing home population is that fact that we had, as of the last federal data (2014), the nation’s second-highest proportion of women among nursing home residents – at 71.4 percent we narrowly trailed Rhode Island (71.6 percent). New Hampshire was one of only eight states where at least half of nursing home residents were 85 or older. Amazingly, we were also one of only 10 states where between 10.2 percent and 13.3 percent of residents were 95 or older.
Like my grandmother, who courted with my grandfather by horseback, centenarians that I have spoken with talk about the horse-and-buggy days. For many, memories of work, including in mills, are vivid. One gentleman, who was an aviator, recounted flying as if he is still engaged in it – as he had dementia, it was clear this had been his happiest activity in life.
All but one of those I spoke with could no longer walk unassisted, including a woman who, remarkably, had been able to do so up until the age of 99 (she is 107 now) – when she helped older neighbors younger than herself. Yet I found an absence of self-pity. My grandmother had been similarly stoic when a hip injury confined her to a wheelchair for the remainder of her days. Two centenarians even participated in the recent Senior Olympics at a Winchester nursing home – it drew facility residents from three states.
These residents cannot rally on the State House steps in Concord, but, if they could, they would do so for their dedicated caregivers, whose love for them is palpable.
We are falling behind our neighbor states in Medicaid funding for caregiving. Maine legislators overrode a gubernatorial veto, and afforded direct care workers a 10 percent wage increase, while Massachusetts continues an effort to boost funding for all low-wage nursing home workers. While funding here is arbitrarily set, even Vermont lawrequires payments be increased “annually by inflation factors which are reasonable and which adequately reflect economic conditions.”
New Hampshire’s nursing home providers are fine with taking care of those with the greatest medical need, while others are served in HCBS. But for that to be the case, HCBS needs higher Medicaid funding, too. AARP reports that 2017 data showed that personal care aides made an average of $12.07 an hour. The liquor store by my office is offering more than that ($12.34) to starting clerks. Where are our moral priorities as a state?
Any discussion of health care in New Hampshire seems to begin and end with the opiate crisis. In this election year, it is remarkable to look at candidates’ websites and see no mention whatsoever of the long-term care needs of an aging state that already has the nation’s second-oldest population. As citizens, we must do all we can to speak up for those who cannot themselves be as civically engaged.
(Brendan Williams is the president/CEO of the New Hampshire Health Care Association.)