GUEST POST: The Senior Problem in Montana

[Note: This is a guest post from Greg Strandberg who is a candidate for Missoula’s House District 98 against fellow democrats Heather Cahoon and Willis Curdy. ] 

It was three days before Thanksgiving when my mom got the call.

“We can’t take care of her anymore.”

“Why not?”

There was a long pause as the nursing home supervisor tried to put their thoughts into words.

“She won’t help us anymore,” she said at last, “she takes too much care, we don’t have the staff she needs.”

After a quick conference with her three siblings and aunt living in Portland, it was decided my grandma Joyce would be life-flighted from Oregon to Montana, specifically Havre, an area where her son was a rancher but where she hadn’t lived in more than thirty years.

This was not how Grandma Joyce envisioned spending her golden years.

The Pains of Aging

My Grandma Joyce was diagnosed with a rare neurological disease in the early 90s, one that affected the use of her legs.  Well, it didn’t affect – it made them virtually useless.  She became adept at crawling about on the floor, getting by as best as she could, and stubbornly clinging to what little independence was left to her.  Most old folks in this country are pretty similar.

It got to the point a couple years ago, however, where she could no longer stay in her home.  She was developing sores from crawling on the floor and from hunching over.  It was clear she needed more help, so was sent to a home.  By Thanksgiving even that wasn’t enough for her, so she was sent back to Montana.

Old Folks in Montana

My Grandma Joyce isn’t alone, there’s hundreds or even thousands of people in the state with stories similar to hers.  Based on the 2000 Census, 14% of the state’s population is 60 years of age and older.  That same year saw 36 of our 56 counties, or 64%, had 20% or more of their populations at the age of 60 or higher.

We’ve got an aging population, one projected to be the 4th oldest in the country by 2025.  As the Montana Department of Health and Human Services State Aging Plan from 2011 says:

 

In 2000, Montana ranked 14th in the nation in percentage of our elderly population to total population. By 2025, just 14 short years away, Montana is projected to rank no less than 5th and could be as high as 3rd in the nation in the percent of those over the age of 65. This means that at least 25% or 1 in 4 people in Montana will be over the age of 65 by the year 2025.

 

Both of the following graphs do a good job showing the changes in age and where they’re going to take place the most:

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Montana’s Aging Population, 2030

The report calls this an “aging tsunami,” and they’re not far off.  Like most natural disasters, we’re unprepared and not worrying enough.  After all, this is a country where we tackle problems when they’re on our doorstep, not before they have a chance to do us harm.

As the report says, “for the next 15 to 20 years Montana will have an increase in our 65 and older population equal to or greater than the population of Havre, Montana.”

And things aren’t going to well up there in Havre.

Nursing Homes and Old Folks

In May my Grandma Joyce deteriorated further.  She stopped cooperating with care staff and generally made it about ten times harder to take care of her. She’s not that helpful anymore, and that’s one of the main problems.  She doesn’t help them bathe her, get her up, and get her clothes on. She’s giving up on life.

That’s why her elder care facility, a place called April’s, just raised her rates from $3,000 to $6,000 a month.  Don’t worry; she’s got enough money from her house sale in Oregon as well as her Medicaid to get through for a long time.  I’m just not sure every family does, or the federal government.

The main nursing home in Havre is called the Northern Montana Care Center and they have 135 beds.  They charge $12,000 a month, and one of the main reasons for this is that their non-profit 49-bed Northern Montana Hospital is too large and not filled nearly enough.  In other words, those expenses have to be made up somewhere else, and that’s with the nursing home.

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My uncle’s ex-wife has her mother in there, and it’s just terrible.  You wouldn’t believe that they won a 2009 Quality Assurance Award from Mountain-Pacific Quality Health.  They sure haven’t won any since.

This poor woman has to go up there to the nursing home each day to give her mother a sponge bath, something the staff won’t do because…well, there’s not enough of them.  I’m sure the facility isn’t paying nearly enough for young folks to clean the feces off older folks.  How much would you charge to do that?

People are living longer, I guess so they can spend their golden years in places like that.  It costs a lot, and the care ain’t worth much at times.  And boy does it cost our country a lot!

Young People Can’t Help

The problem with this nursing home model for our economy is that it requires younger workers.  Old people just aren’t the best at taking care of other old people.  You can rely on your kids, but gosh, don’t they have to clamor and claw to make every dollar they can just to get out of the mountain of debt we’ve piled atop them?  Good luck with that.

Nope, you’ll have to rely on whatever savings you’ve managed to put away or rely on that federal government to pay for you, you know, the one you hate so much?

Yeah, those federal dollars are sure flowing to Montana, aren’t they?  In fact, 60% of nursing home beds are paid for with federal dollars, according to Montana’s DPHHS’s Nursing Facilities Services report.

They take care of those old folks that would otherwise be wandering around on the curb in their hospital gowns.  Or would we rather have the feds cut back and let those folks roam?  It can be done, I’m just not sure we’d be getting another Representative in Washington anytime soon because of it.  Would you want to relocate to a state like that?

So if young people can’t take care of their parents, you will, in the form of your tax dollars.  Unfortunately there are just not enough places to put those parents, as seen in the DHHS report:

Montana currently has 193 assisted living facilities, 85 nursing homes, and 46 critical access hospitals with swing beds for a total of 324 facilities. There is the capacity to serve over 12,500 residents in these facilities.

 

Let’s not even get into the support staff that’s also needed, such as Ombudsmen, which are sorely lacking now.  And don’t think that a lot of the people caring for seniors are doing so hot themselves.  A recent Commonwealth Report states:

Three fifths of family caregivers age 19-64 surveyed reported fair or poor health, one or more chronic conditions, or a disability, compared with only one-third of non-caregivers.

So What Can Be Done?

Obviously the state will need more nursing home beds soon.  They’ll also need more young people to care for the people in those beds.  And we’ll need better jobs for spouses of those caregivers, for working that job alone probably won’t allow you to care adequately for yourself.

Here in Missoula we’ve made virtually no gains in creating meaningful jobs that will help us support these seniors in the years to come.  The city’s still down hundreds of manufacturing job from several years ago when Smurfit-Stone closed, and the only thing coming in to replace them are a Cabella’s and a new Starbucks – not exactly the jobs dreams are made of.

Resource extraction?  That oil in the Bakken Region is probably going to be running out just as our senior problem really takes off in 2030.  So that’s not a real long-term option, unless money from that is directed into some kind of fund to pay for these critical needs down the road.

Or is caring for our seniors a critical need?  Any visit to just about any nursing home in the country will tell you it’s not.  And that’s sad, because one day we’ll all be in that boat.  I just hope its still not sinking.

 

 

 

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18 Comments on "GUEST POST: The Senior Problem in Montana"

  1. Thanks for letting me post on your site today!

    • You’re welcome – thanks for writing this.

    • Greg you speak as if this is some kind of state or taxpayer problem. How outrageous. Who’s problem is it really? When you were a wee youngster and your mother became unable, who’s problem would this be? There is the State. And there is the family. And there is conscience and morality. And there are the women in the family. And there are men.

      • When I lived in China all young people took care of their parents, it was expected and it was the cultural norm. Nursing homes are few and far between, and it’s a shameful act taking an elder their.

        Grandparents care for children when parents are at work. Grandparents will live with their children in the cities, and this is quite common.

        But we don’t live in China, and parents aren’t living with their kids. But those kids will still be expected to take care of their parents when they get older. Or will they?

        There’s no shame with nursing homes here, unless you’re going to one. Problem is we don’t have enough, although most old people would say we have too many.

        They suck, that’s what I’m trying to say, our nursing homes suck. How many of you want to move into one tomorrow? I thought so.

        I guess I disagree with you, KA, because when I see the vast majority of the state’s population aging, the other half moving away, and what’s rest delegated to service-industry jobs, then yes, I’d say the state has one helluva problem on its hands.

        Whether it cares to do anything about that or not is another issue entirely.

    • Another thought Greg. Consider the possibility that Grandma Joyce can’t help herself because she is literally dying, physically and mentally, of a broken heart. What do you have to offer her?

      • And this is why the vast majority of state legislatures around the country will legalize assisted suicide within the next 10 to 15 years, and the feds will have no choice but to follow.

        How many Kevorkian’s can you put in jail? And our prisons are already overflowing, where will we fit all the suicidal seniors?

  2. Nice post Greg! This has been on my list to write about with a rebuttal to your non profit post a while back. Unfortunately I am still waiting for adaptive equipment because of…politics? People really do get hurt when we allow our discourse to take us away from problems and solutions that reflect our common reality.

  3. People do a lot of yakking about how they care about seniors, vets, and children – but they curiously don’t want any to devote any resources to those things. I don’t get it.

    • Well, the thing is we do put a lot more resources toward our old people than we do toward our young.

      Medicaid, Medicare, Social Security…these are all support structures for old people that can’t or won’t take care of themselves.

      So in America we fund our past at the expense of our future. You see this with the student loan crisis. I’m not sure funding the past at the expense of the future is such a good idea, but throwing old people to the curb won’t fly either.

      Instead I’d suggest taxing rich people more, such as we used to do under the Republican presidents of the 50s and 70s. Not waging war is another way to save money, as are treatment facilities instead of the dungeons we call prisons.

      Having companies and individuals pay taxes on what they actually make is another option that could go a long way to funding both our past and our future.

      There’s no political will for these things, however, mainly because the vast majority of elected officials are taking money from large corporations. We call this corruption, but for some reason that word’s gone out of style. Why is that? Time for a revival.

    • Yes, I didn’t focus on the pay of top CEOs and other “professionals.” I’m sure that won’t change anytime soon. Why would they want to have a more equitable system? That might mean they’d have to get down in the trenches and clean a bed pan.

      A world where a CEO has to get their hands dirty through a day of honest work is not a world I want to live in.

  4. Larry Kralj, Environmental Rangers | June 1, 2014 5:08 PM at 5:08 PM |

    “Medicaid, Medicare, Social Security…these are all support structures for old people that can’t or won’t take care of themselves.

    So in America we fund our past at the expense of our future. You see this with the student loan crisis. I’m not sure funding the past at the expense of the future is such a good idea, but throwing old people to the curb won’t fly either.”

    Jeebus, dude. You were born yesterday. Please don’t run for ANYTHING as a Dem. You have ZERO sense of history. And apparently not much smarts! Sorry to be so blunt. You simply can’t be from Butte.

    • I think it’s pretty simple – look at the federal budget and figure out which programs give money to older people and which give money to younger people, or children. Then see which one is larger.

      I know a lot of people don’t like to compare government finances to that of a household, but let’s try.

      How much money are you spending on things that benefit older people in your family, how much are you spending on those that benefit younger people in your family.

      Write those numbers down, put them in a drawer, and come back and look at them in 10 years.

      If you’ve got aging parents those numbers might change, depending on how much of the tab the government picks up based on age, health, income and other considerations. In other words, that money might not be coming from your pocket.

      But what if it was coming from your pocket? Could you afford that, and what would it do to your household? Would it put that mortgage payment in jeopardy? Then what?

      So we need the government to pay that, don’t we? Because if the government didn’t then we’d have old people on the street as well as their kids when the house is taken to pay for care and then three months later they’re all kicked to the curb when the bills aren’t paid.

      But I guess you’re rich and don’t have to take social security or Medicaid or any of the rest of it. In your world there are no worries, so I’m sorry for wasting your time.

  5. Good post, good topic, good information. Thanks!

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