Editor's Note: This is the first of two parts of a story by New America Media addressing the effects of California's budget crisis on the care of seniors.
Linnie Frank Bailey
New America Media
Aging is affecting every part of the country. Nowhere is this more apparent than in California.
According to the most recent census data, the country’s most populous state also ranks first in the number of adults aged 65 and over. And while Los Angeles County has the largest senior population of all of the counties in the country as reported in the 2000 census, current projections suggest that nearby Riverside and San Bernardino counties combined will soon have the largest number of seniors of any geographic area in the country.
August 31, 2009 was D-Day for Barbara Porter, director of the Inland Empire Adult
Day Health Care Center (ADHC) in Corona, Calif. That is when, due to recent
state budget cuts, MediCal (the Medicaid program in California), slashed its
funding level for users of ADHCs from five to three days a week.
“Our families are scrambling,” said Porter. “I know of at least 10 elderly participants who will be put into nursing homes immediately because there is no one to care for them those two days they can’t come here.”
The Inland Empire ADHC is one of 340 adult day programs in California. An ADHC is a licensed MediCal-certified health facility that treats the health and other needs of older adults with multiple chronic conditions, such as Alzheimer’s or Parkinson’s disease The centers provide an organized day program of therapeutic, social and health services, and offer a respite for families caring for loved ones who can’t be left alone.
Because two days of the work week have been cut, the options left for families are not easy. For most family caregivers, reducing their hours or quitting their jobs to provide care is not an option during these tough economic times. Many will either pay the ADHC out-of-pocket rate, hire a “sitter,” put relatives in a nursing home, or risk leaving them home alone.
“Some of our participants require 24-hour care,” said Porter. “Leaving them alone would be considered abuse.”
to a recently released National Institute on Aging report, “An Aging
World,” the worldwide population of adults aged 65 and over is
projected to grow from an estimated 506 million in 2008 to 1.3 billion
in 2040. The report shows that elders will grow from 7 percent of the
world’s population, to 14 percent in just under 30 years.
The growth among African Americans over 65 will follow these global patterns. According to the U.S. Census, the African-American population of adults aged 65 and over was 3.1 million in 2007 and is expected to grow to nearly 10 million by 2050.
The elders who come to
the Inland Empire ADHC fall into two groups - those who have been
developmentally disabled for most of their lives, and others struggling with the
ravages of aging, such as dementia and other chronic illnesses.
“People come to us when Grandpa forgets and leaves the stove on, or when Grandma has a stroke and needs daytime care,” said Porter. About 100 participants come to her center regularly.
Years ago, developmentally disabled adults seldom reached old age. However, because of advances in treatments over the years, life expectancy is growing longer.
“Some of these people are over 60 and being cared for by aging siblings because the parents have passed on,” Porter observed. “Because people are living longer, it is not uncommon for us to see frail elderly children caring for sick elderly parents, or vice-versa.”
Family caregivers, such as 63-year-old Corona resident Sandy Davis, depend on ADHCs to give them a break from the constant demands of caring for a severely disabled loved one.
Sandy’s son Desmond, 36, suffers from a complex mental illness called schizoaffective disorder, which includes paranoid bipolar disorder and major depression. To control the condition, Desmond takes a host of medications. However, prolonged use has caused medically induced Parkinson’s disease.
“There have been times when Desmond has been hospitalized over 20 times in a single year,” said Davis. “My husband and I assist him in taking his medication, eating, dressing and bathing. Our son is helpless.”
Davis feels “blessed” to have a daughter and grandchildren who can help with Desmond’s future care. For now, though, Inland Empire ADHC has given the family a respite from 24-hour caregiving and provided Desmond a chance to exercise and interact with others in a safe, medically-controlled environment.
Davis is still employed, so her retired husband will have to pick up the slack during the additional two days. “I know Desmond will be disappointed,” she says. “He loves the time he spends with friends at the day center.”
Family caregivers and advocates for elders are searching for alternative ways to counter the missing two days of service. While some residents of more affluent coastal cities can afford to pay as much as $200 daily in out-of-pocket costs for adult day health care, many family caregivers in the Inland area cannot afford the $80-a-day rate the Inland Empire ADHC charges.
MediCal covers $76.50 per day for ADHC services, and $170 to $200 per day for nursing home care—so it will cost the state more if caregivers resort to putting their loved ones in nursing homes.
In addition, not all nursing homes accept MediCal. Some only allot a small number of beds to the low-income MediCal patients. Recently, in an impromptu survey of nursing homes within a 50-mile radius of the Inland Empire ADHC, Porter found only one MediCal bed available.
Copyright 2009 New America Media. Reprinted with permission.