Where You Live May Decide the Kind of Care You Get When You are Older or Have Disabilities
New Scorecard Gives Maine High Marks for Serving Older, Disabled Residents, but More Must Be Done to Improve Long-Term Services and Supports, Especially for Family Caregivers
PORTLAND – Maine ranks 10 th overall when it comes to meeting the long-term care needs of older residents, but AARP warns that more must be done, at an accelerated pace, to improve how Maine effectively serves and supports older residents and people with disabilities. This, according to a new, comprehensive state-by-state Scorecard from AARP with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation.
Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers – an update of the inaugural 2011 Scorecard – ranks each state overall and within 26 performance indicators along five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and, effective transitions. New indicators this year include length of stay in nursing homes and use of anti-psychotic drugs by nursing homes, raising serious concerns about the quality of institutional care.
“The vast majority of older Mainers want to live independently, at home, as they age – and most will do this with the help of unpaid family caregivers,” says Lori Parham, state director of AARP, which serves more than 231,000 members age 50 and older in Maine. “Maine is making some progress to help our older residents, but this Scorecard shows we have more to do – and we don’t have time to stand idle.”
Today, unpaid family caregivers provide the bulk of care for older Mainers, in part because the cost of long-term care remains unaffordable for most middle income families. In Maine, more than 191,000 residents help their aging parents, spouses and other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The annual value of this unpaid care totals approximately 2.3 billion dollars.*
“When it comes to helping older Mainers live in the setting of their choice, this silent army of family caregivers assumes the lion’s share of responsibility,” explains Parham. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for by Medicaid. They deserve some basic support.”
According to the state Scorecard, Maine ranks in the bottom quartile regarding elements of caregiver well-being. For example, according to the Scorecard, almost two out of five family caregivers face a high degree of stress and worry. Maine needs to take action to improve legal and systems supports for this group and allow nurses to delegate basic health maintenance tasks, such as checking blood sugar or temperatures, to home aides. However, more must be done.
The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net. That’s why AARP is fighting to expand services provided at home and in the community and better balance these funds with respect to more expensive nursing home care costs. The Scorecard highlights serious concerns about institutional care in Maine such as reports of residents with pressure sores and the use of antipsychotic medication.
While Maine ranks 23 in increasing the percentage of Medicaid long-term care dollars that support care provided at home and in the community – the care setting that most Mainers prefer – the Scorecard spotlights significant areas that call for improvement. It is important to note that Maine’s scores, compared to the last Scorecard issued in 2011, worsened for all three of these indicators:
- Percent of adults age 18+ with disabilities in the community are satisfied or very satisfied with life (ranked 37 in 2014 vs. 16 in 2011)
- Rate of employment for adults with ADL disability ages 18-64 relative to the rate of employment for adults without ADL disability ages 18-64 (ranked 39 in 2014 vs. 27 in 2011)
- Percent of high-risk nursing home residents with pressure sores (ranked 13 in 2014 vs. 6 in 2011)
“This Scorecard gives us a snapshot of how well Maine serves our older residents, those with disabilities, and family caregivers – and shows us where we must sharpen our focus to better assist hardworking Mainers,” concludes Parham. “Now is the time for policymakers to act.”
Long-term care (also called long-term services and supports) is a diverse set of services designed to help older people and those with disabilities; services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility like a nursing home.
The full state Scorecard, along with an interactive map of state rankings and information, is available at www.longtermscorecard.org.
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About AARP: AARP is a nonprofit, nonpartisan organization, with a membership of nearly 38 million, that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families such as healthcare, employment and income security, retirement planning, affordable utilities and protection from financial abuse. We advocate for individuals in the marketplace by selecting products and services of high quality and value to carry the AARP name as well as help our members obtain discounts on a wide range of products, travel, and services. Learn more at www.aarp.org.