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Florida's tide of seniors rising even faster than predicted

By Laura Green, The Palm Beach Post, Fla. on

Published in Senior Living Features

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. Taking care of Gloria has been an almost full-time job 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 -- the highest ranking on a state frailty assessment -- she sat nearly six months on a waitlist before learning in October that her number came up. The couple qualified for personal care, such as help bathing Gloria, hot meals to their home and several hours of respite for John each week.

Litton is lucky. An aging wave in Florida has pushed waitlists for senior services to historic highs.

In a state where 1 in 20 residents are 80 or older, 55,000 seniors have qualified for assistance but must wait for home-delivered meals, transportation or help with personal care.

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 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 resident 18 to 64 costs the state about $818. But people 65 and older 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 Florida is facing a demographic reality for which the state is not ready, advocates say.

Florida is now the nation's oldest state. More than 1 million residents are 80 or older. And in the next 16 years, the state's elderly population will double to nearly 10 million residents.

Palm Beach County is one of fewer than 50 counties nationwide that have both high numbers and a high concentration 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 seniors as 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.

Analysts say that trend will continue.

"It's really exciting, and it's also challenging," said Jaime Estremera-Fitzgerald, chief executive officer at 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."

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.

Growing population exceeds increased funding

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

Funding for seniors 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 because older people who have needs are typically invisible," 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 advocates such as Duggar and Beck have been successful in recent years in lobbying lawmakers to increase funding.

State-funded programs for the aging received an additional $20 million in funds 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, help with laundry, and personal care, including bathing.

The $60 million program got a funding increase of about $5 million this year -- and $10 million during Gov. Rick Scott's tenure. Five million in one year may seem like a lot, but it allowed local organizations that offer in-home care to pull just 800 seniors 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 qualified for that program but can't get off the waitlist Among them are more than 2,000 who ranked as the most frail -- the most likely to find themselves in 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 four 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."

Marshall said that funding has made a significant dent in waitlists serving Florida's frailest seniors, those most at risk for placement in a nursing home.

"We've not seen increases like this in over 15 years," Beck 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."

The costs of placing a senior who could remain home with a little help in a nursing home instead are both personal and financial.

"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 $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 3,0000 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 up stream as can be."

Local advocates worry about influx of seniors

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 congregate meals, which allows seniors to gather for cafeteria-style hot meals.

The organization serves about 12,000 seniors.

Private donors are helping to keep afloat programs serving seniors. The organization has also started to look at money-making programs 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 full cost, the organization can't add seniors to the program, said Danielle N. Hartman, its 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 funding to pay for the program. But in 2011, numbers grew so high that federal funding could no longer cover all the seniors who wanted meals. The program began running a waitlist. But Lugo, the executive director, said in good conscience 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.

She couldn't do it. So she reached out to donors to help bail out the program.

Lugo said she's 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 the bread cart," Lugo said. But seniors were literally racing to the free bread, knocking down each other.

"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 actually buy dog or cat food because it's cheaper than groceries, Lugo said.

Despite those seniors at risk of falling through the cracks, local organizations are pulling others from the waiting list and helping them remain home with the help they need. Just not as many seniors as need to help.

"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.

Family hoping home-based 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 their mortgage plus Gloria's medications and supplies, such as diapers, wipes and creams. 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.

(c)2014 The Palm Beach Post (West Palm Beach, Fla.)

Visit The Palm Beach Post (West Palm Beach, Fla.) at www.palmbeachpost.com

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(c) The Palm Beach Post, Fla.

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