It was three days before Thanksgiving when my mom got the call.
“We can’t take care of her anymore.”
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:
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.
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.