A Senior Concern: Healthcare in the 21st Century
Last year, I walked into a nursing home looking for my aunt (one of the last surviving members of my extended family) and could not find her. I had not seen her for about three years, but I expected to see her much as I had left her some years earlier. When she was finally pointed out to me, I did not recognize her. She was a shell of the woman I once knew and now was confined to a wheelchair. As I entered the room, the smell of urine and baby powder almost overpowered me, but I noticed that smiles came across the zombie-like faces of many of the residents of that facility when my son (5) and daughter (3) came into view. Some wanted to touch them. Others wanted to hear them talk and watch them laugh.
As I was ushered to my aunt’s wheelchair, she recognized me and reached out for me. She was in the early stages of Alzheimer’s disease and knew my name, but did not remember that my mother (her sister) had died almost 20 years ago. She spoke of her as if she had talked to her yesterday. She warned me incessantly of the need to “raise my son right” and “take care of that little princess.” Aunt Margie always had a way (which she quietly enjoyed) of making sure she told you “what you needed to hear.” At bottom, I think she always saw herself as my mother–especially since mine died when I was in college.
She wanted to show me to her room, so we slowly made our way down the corridor to the place she called home. We entered to find two hospital beds (one for her roommate) with a few pictures of our family (my mother and father among them) in the midst of what looked like a hospital room. My aunt repeated herself over and over again (as those who suffer with this disease do) until finally she seemed exhausted from our 15-minute visit. She wanted to hug my children and never tired of telling me that my son looked just like my mother.
As we left the room, I could not help but realize that the number of people in this nursing home (already filled to capacity) would only grow in the coming years as America’s population ages. The loneliness and despair of many in that facility made me wonder just how bad it would become for America’s elderly population.
Aging in the 21st Century
Richard J. Hodes, former director of the National Institutes of Health (NIH) wrote in his 2005 budget request that the United States is “in the midst of a demographic shift unprecedented in history.” Of the more than 300 million U.S. citizens, more than 35 million were older than 65. “There are more elderly people today than at any other time in history,” he wrote. He predicted the number of elderly Americans would double to more than 70 million, and make up approximately 20 percent of the population—up from 13 percent in 2005.
The latest statistics reveal that the fastest-growing group are those 85 and older. These are also those who are most at risk for serious illness and extended or permanent disability. “Their ranks are expected to grow from 4.3 million in 2000 to at least 19.4 million in 2050,” Hodes said.
“These statistics reveal a shocking reality for all of us who serve these aging adults,” stated Bill Pierce, president of Baptist Village Communities (BVC) of Oklahoma. “The challenges which are before us are enormous, but we must work to provide resources and services that are cost-effective, convenient and sustainable through the end of life.”
Pierce was recently recognized for his 20 years of service to BVC and remembers his first days in the job.
“When I first looked at the numbers, it was obvious to me that we would have problems simply meeting the budget—let alone expanding and developing the ways and means of service to those who looked to us for help,” he said.
When Pierce took the helm, the organization owed almost $4 million to the Baptist General Convention of Oklahoma (BGCO), and was some $23 million in debt.
His first priority as president was to simply tell people the truth about the financial state of BVC. By doing so, he fast became known as a man who speaks his mind and works to reconcile problems quickly as a change agent in a fast-paced and very expensive area of social and medical service.
“The BGCO has been enormously helpful to us, and we could not have accomplished what we have done over these decades without their help,” he said.
As he reflects on his years of service, he candidly admits that “somewhere along the way we have missed it with those who are elderly.” Rather than see them as “real people” who still have desires and hopes and dreams, “they are often viewed as a very different person than they once were.” While the effects of aging do take their toll on the body, “the mind and heart are still active in ways that still enable people to live and serve in community with one another.”
Pierce spends much of his time in the various villages and communities (all eight of them) interacting with the “neighbors” of BVC. He speaks of those “who live with us” as friends, but he notices a distinct attitude that permeates this entire segment of the U.S. population.
“They are very concerned about the direction of the country,” he said. “It is not so much politically as it is the entire culture of our nation.”
He believes that while homosexual marriage and other social problems dominate the news, “a more fundamental concern exists about the way Americans retire and spend their last years.”
The rising costs of healthcare and the demands on families have combined to place in peril the way the elderly receive everything from healthcare to shelter to end of life issues. The amount of money required to adequately provide for the coming generational tidal wave of healthcare costs for this generation “cannot truly be comprehended,” Pierce said. “Financially, we are only seeing the tip of the iceberg, and it is going to get much worse.”
The looming crisis has developed over the course of several decades and involves millions of people, billions of transactions and (soon to be) trillions of dollars. Yet, closer to the question of how to pay for healthcare is the idea of what healthcare will be required and how best to provide the services for people who desperately need assistance. Simple ideas such as moving to electronic medical records, elimination of the duplication of medical tests, reforms in Medicaid that enable patient choice in health matters and preventative measures of wellness could salvage a system that most believe is in desperate need of reform. Pierce is quick to concede that unless radical changes come to the healthcare system in the United States, healthcare as it is known today is destined to collapse.
“While the new federal health care plan contains some elements which might be beneficial for seniors, the plan as a whole is very troubling,” he said. “Medicare and Medicaid as we know it are unsustainable. We will either have to raise taxes or reduce eligibility or a combination of both.” Pierce thinks that a combination of both actions looms on the horizon.
“The pace of change in healthcare is very fast, and the rapid changes require an ability by those of us who serve with senior adults to meet their needs in ways which provide for them a picture of the Gospel of Christ,” Pierce stated. “Change is coming whether we like it or not. How we prepare for that change is the great challenge for our time.”
Next Week – Part II – Adding Life to Years