Wednesday, August 21, 2019

Guess I won’t be retiring to Maine after all

I’ve always enjoyed visiting the state of Maine.

My husband and I used to head Down East a couple of times a year. A few days in Perkins Cover (Ogunquit), where we’d walk the Marginal Way and then sit out on the porch at Barnacle Billy’s eating way overpriced lobster rolls and drinking way too strong G&T’s. We’d hit Portland for a long weekend or two and try out some of the always great new restaurants there.

For a number of years, I spent a wonderful week with my friend Shelly and the in-and-out company my husband and some overlap with my sister Trish and her family in a rundown lobsterman’s house on Christmas Cove near Damariscotta. The spot couldn’t have been more glorious; the house couldn’t have been dumpier.

It had been in the same family since the 1920’s and, other than a modest update to the tiny kitchen redone in the 1960’s, nothing had been touched. The tennis trophies won by the long-gone kids, the colored pencil drawings that had been tacked to the bedroom walls since 1932 were one thing. The pillows and mattresses from the 1920’s, leaden with dust mites, were quite another.

After our first adventure there, my sister Kath (who overlapped with Trish and family on the other end of our two week joint rental) figured out that bringing our own air mattresses, pillows and reading lights would greatly improve the experience. So that’s what we did.

I love Maine.

Maine is beautiful. Maine is nearby. Maine has lotsa lobstas. And lotsa outlets. Plus the whoopie pie is the state treat. What is not to like?

Sure, they tend to elect some terrible and/or useless politicos (their recent governor, Paul LePage; their current senior senator, Susan Collins) but it has always seemed to me that it would be a reasonable place to retire to. And their second senator, Angus King, almost but not quite makes up for Collins.

Of course, when I think “reasonable place to retire to”, I’m thinking Portland, a charming small city with decent medical care. Not up in the sticks in abandoned papermill country. Which is a good thing, given that in the poorer, more remote quarters of Maine – which means most of Maine – there is a colossal shortfall when it comes to people to care for the olds. And Maine, which may not have much by way of natural resources when you get beyond pine trees, lobsters, and water, definitely does not lack for old folks.

In fact, Maine is the oldiest state in the US.

Last year, Maine crossed a crucial aging milestone: A fifth of its population is older than 65, which meets the definition of “super-aged,” according to the World Bank. (Source: WaPo)

Other states will be joining Maine soon – including New Hampshire and Vermont – and, given demographic trends, most will pretty much end up there as well – but for now Maine is one of the worst places for elder care.

People aren’t able to get home health care aides to help keep aging parents in their homes. Skilled care facilities have long waiting lists. Openings (i.e., deaths) don’t come fast enough, and there are too many waiting to occupy a freed up bed before it’s gone cold.

Families in Maine:

….are being hammered by two slow-moving demographic forces — the growth of the retirement population and a simultaneous decline in young workers — that have been exacerbated by a national worker shortage pushing up the cost of labor. The unemployment rate in Maine is 3.2 percent, below the national average of 3.7 percent.

Maine’s problem is exacerbated by its lack of immigrants. They do have some pockets where immigrants have found their way – most notably from Africa, for some reason – but immigrants have clustered in the state’s larger cities and towns, not necessarily where the need is greatest.

As I mentioned, Maine’s by no means alone:

Across the country, the number of seniors will grow by more than 40 million, approximately doubling between 2015 and 2050, while the population older than 85 will come close to tripling.

Experts say the nation will have to refashion its workforce, overhaul its old-age programs and learn how to care for tens of millions of elderly people without ruining their families’ financial lives.

The workforce refashioning isn’t happening fast enough for Maine.

One fellow interviewed for the WaPo article is only 63, but has muscular dystrophy. For over a year, he’s been trying to find a nursing home that can provide the 24/7 care he needs. But nursing homes are not just overtaxed, they’re closing “at an unprecedented rate.” While Mark Honey waits for a spot to open up, he gets by on home healthcare. But the service he works with can’t provide him with the 70 hours a week he’s entitled to.

Honey said he lives in fear of one of the caretakers getting sick and quitting or finding another job. “When you’re confined to a bed, there’s not much you can work with,” Honey said. “It only takes one or two of the girls being sick, or one of the two of them quitting, for me to not be covered. And then you’re up the creek without a paddle.”

It’s not just home healthcare workers.

About one-third of Maine’s physicians are older than 60. In several rural counties in the state, close to half of the registered nurses are 55 or older and expected to retire or cut back their hours within a decade.

Add to this problem the fact that by 2026, the 65 and up population of the state is forecast to increase by 55%. (For the country overall, growth in the old-olds - 85 on up - population is expected to exceed 200%, while “those ages 75 to 84 will rise by more than 100 percent…By contrast, the number of Americans younger than 65 will increase by about 12 percent.”

And you can only raise wages so fast and so furious if there are just not enough people to earn those wages.

“The U.S. is just starting this journey, and Maine is at the leading edge,” said Jess Maurer, executive director of the Maine Council on Aging. “As we are living longer, all the systems that have always worked for us may have to be changed.”

Sounds like a reasonably good argument for immigration. Or robots. In the current political climate, it will probably be the robots rather than any of the huddled masses types who might be willing to work as home healthcare workers.

“Left unaddressed, this will be catastrophic. We as a country have not wrapped our heads around what it’s going to take to pay for long-term care,” [Bruce] Chernof [CEO of the SCAN Foundation, which advocates on long-term-care issues] said.

Wrapping our heads around any problem doesn’t seem to be America’s strong suit, especially in these times. In order to wrap our heads around something, we’d need to unwedge them first, no?

Meanwhile, Maine’s off the old retirement list.

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