Opinion: Aging at home

By MARC LACROIX

Published: 04-30-2023 7:00 AM

Marc Lacroix lives in Concord.

A stitch in time saves nine. That adage is apt when discussing the services and supports that people need as they age and need assistance. Providing services to keep people in their homes will save the state money in the long run.

Members of the New Hampshire Legislature have a chance to make it easier for us to keep our loved ones in their homes as they age. They can include money in the budget that will increase the ability of the system to make relatively small investments in home care that can yield big savings from delayed or avoided institutional care.

Care in the community costs far less than care in nursing homes or assisted living when health needs are not acute. I would like to share my story as a caregiver for my father.

When he was 91, he was living independently in Berlin in a second-floor condo that had no elevator. My father was socially active. He attended church three days a week and visited his local senior center for lunch and fellowship. He loved making 2,000-piece puzzles with others, dined out with friends, and ended his days watching a movie or playing cribbage in tournaments at friends’ homes. He was active and climbed the set of stairs up to his condo several times a day.

Over time, my father developed shortness of breath. Eventually, he began to isolate himself at home. He was diagnosed with asbestos exposure, a result of a 46-year career at the paper mill. There was no cure or relief from symptoms available. His pulmonologist expected him to get worse and suggested a stair lift to help him go up and down his stairs.

We reached out to ServiceLink about financial assistance for the lift and received a call back two months later that resources were not available. By this time, my sister and I had privately paid for the lift, which allowed our father to continue living independently in his condo for two more years until his death.

My father did not want to live with me in Concord because all his friends were in Berlin. If he couldn’t live in his condo, he would prefer living in a nursing home in his area so his friends could visit him. Long-term nursing home stays are paid privately or by state Medicaid programs. In my father’s example, the $5,000 chair lift saved the state of New Hampshire two years of nursing home payment which easily can be $10,000 a month.

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This is not just a financial issue. The dignity and quality of life my father enjoyed living independently should be available to everyone. It is shameful that New Hampshire ranks 50th in terms of the percentage of government spending for long-term care services going to home- and community-based services rather than nursing homes.

In New Hampshire, only 14% of public spending goes to services in the community (home), compared with an average of 36% in New England and 45% nationally. We must do better, and given New Hampshire’s rapidly aging population, we need to figure this out.

As our parents, spouses, and grandparents age and develop physical limitations, New Hampshire family caregivers are faced with a system that is heavily biased toward providing care in nursing homes. This is not what the majority of us want. With appropriate medical services, physical home alterations and support with daily living activities such as shopping and bathing, Granite Staters should be able to choose to age at home where they have connections to their friends, family, and community.

The Senate passed SB 36, a bill that would require the development of a plan for establishing a comprehensive and coordinated system of care that promotes healthy aging and enables older adults and adults with disabilities to receive the care they need in their homes and communities if that is what they want, and their health status allows it.

Such a system would include features such as better access to information regarding resources for people who need it, similar to what my sister and I sought through ServiceLink. Additionally, it would provide funding for needed services and low-cost home renovations, such as my dad’s stair lift, that would allow someone to age in their home instead of a nursing home.

Speaking as a former licensed nursing home administrator and a licensed physical therapist, as well as an AARP NH volunteer, nursing homes are great when you need that level of care, but most of us want to age at home. We need better access to long-term services and support in the community. I encourage legislators to ensure that there is money in the budget to do so.

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