What demographers call the "silver tsunami" began in 2011, when 10,000 members a day of the huge baby boom generation began to retire. That will continue until 2030, and will shape our state, since nearly one-third of Connecticut's population is made up of baby boomers.
So it's promising that Gov. Dannel Malloy's efforts to emphasize in-home services are beginning to pay off for the elderly and disabled who need long-term care.
One sign? Nursing home vacancies in the state have increased. Only 11 of the 230 licensed nursing homes in the state were at capacity this spring, according to an article in the Connecticut Post, and the nursing home occupancy rate has dropped over the last 10 years.
Currently, the state pays $2.7 billion on patients who need long-term care through the Medicaid program, the government health care for the indigent and disabled. Of that amount, $1.2 billion a year goes for nursing home care alone.
There will always be a need for nursing home beds, particularly with the elderly population on the upswing. But home or community care is far less expensive, and generally preferred by most patients.
The state's challenge is to create a system that gives people equal access to any institution when they need it and home care whenever feasible. We aren't there yet; there's a waiting list of several months for the state-funded Home Care Program for Elders. "People call in a time of crisis, and they need the services, but they end up going to a nursing facility," said Julia Evans Starr. That winds up costing state taxpayers even more. That waiting list needs to be winnowed down.
The state needs to keep striving toward its goal of serving, in the community, 75 percent of Medicaid patients needing long-term care. Other states, such as Oregon and New Mexico, are nearly there. Currently, in Connecticut, a little over half the Medicaid patients requiring long-term care get services in the community. That's good. We need to keep improving.
Connecticut should also think in broad terms about the demographic trends ahead, aside from the laudable goal of saving money. It's undeniable that the state's population is going to gray in the not-too-distant future. Towns and cities should be included in a dialogue about what it will mean to have an increasingly aged population, with more people getting home care. The trend will have an impact on issues as varied as transportation and disaster preparedness.
Most of all, there should be ways for people receiving home care to be part of the life of their communities. Inclusion, rather than isolation, will be key.