IN THE NEWS: Palm Beach Post Features JFS’ Role in Caring for Area Seniors

Laura Green

Palm Beach Post Washington Bureau

Nov 18, 2014

Florida can’t care for all of its frailest seniors
Yet the elderly are still pouring into Florida — far outpacing other states

At 71, Gloria Litton can’t bathe herself, feed herself or get out of bed at her Delray Beach home without being carried. Her husband, John, 67, owned a land surveying company, but he had to stop working to care for Gloria since a 2006 breast cancer diagnosis and a string of accidents and illnesses from which she never recovered. “It’s like having a job where you never get any time off,” he said. “It’s 24-7. It’s all I can do.”

Although Litton scored a 5 — ranking her the most frail and most in need of care on a state assessment — she sat nearly six months on a waitlist before qualifying for in-home help, hot meals delivered to her home and several hours of respite for John each week.

The Littons are lucky. An aging wave in Florida has pushed waitlists for senior care to historic highs. Florida is one of the nation’s oldest states. One in 20 residents is 80 or older. That’s more than 1 million Floridians.

The demand for services for the oldest and frailest is expected to grow as the migration of seniors to Florida is projected to double the aging population to nearly 10 million by 2030.

There are 55,000 seniors who have qualified for taxpayer-financed assistance but must wait for home-delivered meals, transportation or help with personal care, such as bathing or feeding.

Some clients wait for years. Some die waiting.

“You’re making these calls (and you’re told), ‘Where were you six months ago? We had to place mom in a nursing home or she’s no longer with us,” said Elizabeth Lugo, president and CEO of the Volen Center, which offers a broad range of senior programs in southern Palm Beach County.

Luring seniors to sunshine

For 50 years, Florida has sold itself as a mecca for retirees. In exchange for sunshine, golf courses and pristine beaches, they bring their pensions and retirement accounts. They contribute to the state’s economy in sales and property tax.

“We’ve been inviting people to come on down to Florida — and they have by the millions,” said Robert Beck, a partner at Adam St. Advocates in Tallahassee, who lobbies on behalf of senior programs.

Seniors may just be Florida’s great import.

Over the course of a year, a typical Floridian aged 18 to 64 costs the state about $818. But people 65 and older, while they’re still healthy, each contribute about $2,850 to the state economy, according to 2010 data analyzed by the University of Florida’s Bureau of Economic and Business research.

“They’re givers. They’re not takers here,” Beck said.

But some of those same seniors who contribute so much to the economy during the early years of retirement become a strain on state resources when they grow older or ill.

Advocates and elected officials are bracing for a wave of seniors that shows no sign of stopping.

In 2013, more than 112,000 seniors moved to Florida from another state. Another 27,000 people 65 or older came from abroad. California, the state with the next most significant migration of seniors, saw half as many older residents move in from another state.

Palm Beach County is one of fewer than 50 counties nationwide that have both high numbers and a signficant percentage of seniors, according to the Census Bureau. In 2013, the county had more than 300,000 residents 65 and older. They account for nearly 23 percent of the population. Only a dozen U.S. counties have more than 250,000 senior residents.

A host of factors contribute to the challenges of a growing aging population.

Seniors are living longer than anyone expected, and many are outliving their pensions. Florida has an unusual burden in that sizable numbers of its seniors have moved to the state later in life — away from family and a safety net.

“It’s really exciting, and it’s also challenging,” said Jaime Estremera-Fitzgerald, chief executive officer at the Area Agency on Aging for Palm Beach County and the Treasure Coast. “When I tell you they’re coming, they’re coming in huge numbers.”

Financing exceeded

As Florida’s seniors age, and become more frail, they need more than the state is giving, advocates argue.

Money for senior services does not automatically follow the numbers. Unlike education spending, dollars for senior programs are not tied to the population.

Margaret Lynn Duggar, executive director of the Florida Council on Aging, spends much of her time explaining the needs of seniors to lawmakers.

“It’s a really tough educational piece,” she said. “You might see them in the grocery store or in Walgreens or somewhere. It’s not the same as children who have needs. Older people can get shut in their homes very easily and become invisible.”

But such advocates as Duggar and Beck have been successful in lobbying lawmakers to increase money in recent years.

State-financed programs for the aging received an additional $20 million during the last legislative session.

Take the Community Care for the Elderly program. It provides in-home care to seniors, such as home nursing, home-delivered meals, grocery shopping, and help with laundry and bathing.

The $60 million program got $5 million more this year — and a total of $10 million more during Gov. Rick Scott’s tenure. Five million dollars in one year may seem like a lot, but it paid for fewer than 1,000 seniors to get off the waitlist.

“About 91.1 percent of the waiting list will still be waiting,” said Jack McRay, AARP’s Florida advocacy manager.

As of September, 34,650 seniors who are qualified for that program must wait. Among them are more than 2,000 ranked the most frail – the most likely to find themselves in costly nursing home care.

“As Florida’s economy continues to grow, so does Florida’s elder population and the need to provide quality care for our state’s elders. In the four years before Governor Scott came into office, there were no or minimal funding increases. Since Governor Scott has taken office, he has increased funding by an average annual increase of approximately 4 percent,” said Ashley L. Marshall, a spokeswoman for the Florida Department of Elder Affairs. “As the population increases, we continue to evaluate the need and request more money. We’ve been very grateful for the increases that we’ve been getting.”

Beck, the lobbyist, agreed.

“We’ve not seen increases like this in over 15 years,” he said. “However, the need and the waiting list numbers are barely reduced simply again, because of our demographics. Florida has so many seniors as a percentage of our population.”

Placing a senior in a nursing home instead of caring for him in his own home presents both personal and financial costs.

“Our whole mission is to help keep people in their homes for as long as possible with dignity and independence,” Estremera-Fitzgerald said.

The economic case is simple: Nursing home care costs taxpayers four times as much as helping a senior stay at home.

Home-based services provided by the state cost about $6,656 per person compared with a state cost of $27,326 for placing a senior in a nursing home.

And that’s not the full picture. The federal government kicks in most of the nursing home cost. The true total for a single nursing-home placement is more than $60,000 per year.

During 2012, more than 3,000 clients on home care waiting lists went into a nursing home, costing the state an additional $66 million, according to the Florida Council on Aging.

“If you keep people more independent before they have another fall or they aren’t eating properly so their medications aren’t working, we’re saving money as a state,” Duggar said. “All around it’s a better plan for people to be served in their home as far as upstream as can be.”

Not enough money for hot meals

Local organizations serving seniors are struggling to meet the needs of the current population.

Ruth & Norman Rales Jewish Family Services calls on 400 volunteers to provide a broad range of senior services, including transportation, a telephone check-in program and cafeteria-style hot meals.

The organization serves about 12,000 seniors.

Private donors are helping to keep afloat senior programs. The organization has also started to look at money-making ventures to help subsidize their mission.

Despite those efforts, its meals on wheels program has hit its limit for subsidized meals. Unless clients can pay, the organization can’t add seniors to the program, said Danielle N. Hartman, president and chief executive.

The food pantry is also at its client limit. The organization caps clients for that program at 200 percent of poverty, which is $31,460 for a couple.

“We have these people who are not indigent and yet they’re seniors and they’re not wealthy,” Hartman said. “That’s one of the things as a board that we’re really going to grapple with.”

Hartman said her board has begun planning for the impending doubling of the senior population.

The organization has come up with some creative ideas. The group has started to pair able-bodied seniors who need extra income with seniors who need companionship or help at home.

For $15 an hour, a senior can get a companion who will drive her to errands or a doctor’s office, fold laundry and offer other help. The program raises money for Jewish Family Services and benefits the paid companion as well as the senior who may be lonely and in need of help.

“At the end of the day we’re all human, and we crave that human connection,” Hartman said.

The Volen Center, a Boca Raton-based community center, offers a broad range of services to seniors, including social programs, adult day care, bus service, individual transportation, in-home care and a program aimed at seniors experiencing dementia.

One important program for seniors is hot meals served at several locations in southern Palm Beach County. The organization gets federal money for the program. But in 2011, numbers grew so high that the federal money ran out. The program began running a waitlist. Lugo, the executive director, said in good conscience that she couldn’t turn away hungry seniors.

“If someone has made the effort, and they’re hungry, and they want a free lunch … To tell them, ‘I can’t serve you. We have to put you on the list. …’ ” Lugo remembers.

So she reached out to donors to help bail out the program. Lugo has gone back multiple times to the same donors as the requests for free hot meals grow. She knows that’s not a sustainable plan.

“At some point their resources are maxed out as well,” she said.

The center also picks up day-old bread and pastries donated by Publix and gives them away to clients.

“We used to just put out the bread cart,” Lugo said. But seniors were literally racing to the free bread, knocking each other down.

“These are your golden years and that’s what it’s come to? You’re desperate for a loaf of bread? It’s bad and people don’t see it,” Lugo said.

Some seniors have to choose medicine over food. Some buy dog or cat food because it’s cheaper than groceries, Lugo said.

Lugo is grateful when her organization can pull seniors from the waiting list. But she can’t serve everyone who needs help in order to stay in their homes.

“When we ask for names off the waiting list, we’re given the 5s — the most at-risk people. I will do a happy dance in the street the day we’ve served 1s and 2s,” Lugo said.

Hoping home care helps

John Litton is one of those seniors whose life will be easier, he hopes, now that his wife, Gloria, has qualified for home-based care.

The couple burn through their Social Security each month and have had to raid their 401Ks to pay for their mortgage plus Gloria’s medications and supplies. A social worker gave John a list of food banks that might help fill his cupboards. But he hasn’t made it to one because Gloria gets easily confused and panicked when he’s away.

The Littons can’t afford to hire someone to help care for Gloria. That’s why they were so grateful to learn she got off the waitlist and qualified for help from the Volen Center. For about a week, an aide visited around an hour or more a day. She gave Gloria a bath and did light housework.

“It helped immensely,” John said.

Then an infection sent Gloria to the hospital and John had to suspend the aide’s visits. He’s watched Gloria seesaw before.

“You’ve got to live through it,” he said.

THE DEMOGRAPHIC FACTS

Florida’s wait lists for programs designed to help frail seniors stay in their homes and avoid nursing home care are at historic highs.

— About 55,000 seniors are on the state’s waitlist.

— Nearly 8,000 are ranked as highest priority, and most of those considered frail are still waiting.

— Some seniors never get off the list: They move to a nursing home or die first.

— The average state cost to provide home-based services: $6,656.

— The average state cost to provide nursing home care: $27,326

— Total nursing home care costs more than $60,000 a year, with federal funding included.

— By 2030, Florida’s senior population will double to nearly 10 million.

— More than 300,000 residents 65 or older lives in Palm Beach County.

— Florida is now home to more than 1 million residents age 80 or older.

WANT HELP?

To learn more about seniors programs, opportunities to volunteer or a way to donate, go to:

— Your Aging & Disability Resource Center: a one-stop helpline to connect seniors and caregivers to services. Call 866-684-5885

— Volen Center — volencenter.com; 561-395-8920

— Ruth & Norman Rales Jewish Family Services — www.ralesjfs.org; 561-852-3333

Though the needs of the Florida’s most frail seniors are defying state budgets, the elderly contribute more to state economy than adults as a whole.

$818 - what the typical resident 18 to 64 costs the state a year

$2,850 - how much residents 65 and older contribute to the state economy

Elderly Floridians generally have no children in schools, which costs the state. They are more likely to own property, thus contributing more in property tax.

Source: University of Florida’s Bureau of Economic and Business research.

Though the needs of the Florida’s most frail seniors are defying state budgets, the elderly contribute more to state economy than adults as a whole.

$818 - what the typical resident 18 to 64 costs the state a year

$2,850 - how much residents 65 and older contribute to the state economy

Elderly Floridians generally have no children in schools, which costs the state. They are more likely to own property, thus contributing more in property tax.

Source: University of Florida’s Bureau of Economic and Business research.

MORE ONLINE

For an interactive look at the wave of aging Floridians, from numbers flocking to Florida each year to a county-by-county look at the elderly population, go to mypalmbeach.com.

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