Helping Older Hoosiers Age in Place

In 2017, when Tammy Nazario’s severe neuropathy stole her ability to walk more than a few steps, she lost her job as a housekeeper and became homebound.  Two years later, after twice breaking bones and falling repeatedly, Nazario, 64, of Charlestown, feared she’d need to move.

LifeSpan Resources, her local Area Agency on Aging,  averted that by connecting her with improvements and  services, including a walk-in shower, wheelchair lift and home care aide.

“When they showed me that with help and the right equipment, I didn’t have to go into assisted living or a nursing home, I was so glad,” Nazario says. “I’m doing great now.”

The state legislature begins its session next month, and AARP Indiana plans to advocate for more support to help people like Nazario live independently.

A large majority of Hoosiers want to age in place, says Ambre Marr, state legislative director for AARP Indiana. Lawmakers can help by bolstering the home care workforce and maintaining—or increasing—funding for programs that support that option.

“Right now, the balance of care choices leans heavily toward nursing homes and other facilities,” Marr says. “Indiana needs to build up alternatives and shift toward more home-based care.”

A 2020 AARP scorecard on long-term services and supports ranked Indiana 48th among the states in residents’ choice of options and care providers.

Only about 18 percent of the state’s Medicaid costs for such spending went to home- and community-based care for older people and adults with physical disabilities, according to the scorecard. That compares with a national average of 45 percent.

Better support for both Medicaid and non-Medicaid efforts, such as the state program known as CHOICE, could make a difference, Marr says.

CHOICE provides cooking, cleaning and other services for those 60 and older at risk of losing their independence. Nearly 1,100 people are on statewide waiting lists for the program.

Legislators have until April to pass a two-year state budget. Other areas AARP is monitoring include more housing options for older Hoosiers, and funding for public transportation, adult protective services and high-speed internet. Such resources make aging at home easier and communities more livable, Marr points out.

Filling jobs a challenge

To boost home- and community- based services, Indiana will need to find workers for those new jobs, says state Sen. Ed Charbonneau (R-Valparaiso).

The General Assembly increased pay for some of those caring for Medicaid recipients during its last budget cycle. Charbonneau, chairman of the Senate’s Health and Provider Services committee, expects next session to revisit issues such as burnout and competition from other industries, especially as the population ages and demand for long-term services increases.

He notes that aside from being what people want, home- and community-based care can save the state money on Medicaid- funded institutional care.

“When we drill down and look at the numbers, we should be able to make the case for a huge return in investment,” lawmaker Charbonneau says.

For more updates on AARP Indiana’s advocacy efforts, check out our podcast and video series the Legislative Director Talking About Legislative Things at aarp.org/legislativethings and everywhere podcasts are found.

Sarah Hollander is a writer living in Cleveland.

More on Home Care

• The AARP Guide for Caregiving at Home
• Identifying the Best In-Home Care Options