Rep. Richardson's Newsletter
May 16, 2013
Honoring Oregon's Seniors...In Their Homes
Our most elderly citizens deserve our respect and attention. They deserve, whenever possible, the opportunity to live and die in familiar surroundings, in their own homes. This newsletter’s focus is on long-term care and the information shared below has been updated. [For a brief YouTube video introduction to this topic, Click here.] In the stories below you will see why this topic is important to me.
My father, Ralph Lee Richardson, was 81 years old when he died in 1991. He was a self-sufficient man who worked hard his entire life. A few months before his death, Dad took me aside and gave me his final instructions. He told me he and Mom had no debt; they had a few thousand dollars in the bank and he felt Mom should have enough to live on her meager social security payments and his small pension from the Carpenter’s Union. He told me he had made arrangements to be cremated and under no circumstances did he want to be taken to the hospital. He had heard the horror stories about the high costs of dying in a hospital, and he clearly did not want to leave Mom strapped with huge bills for heroic measures that could only delay the inevitable. Dad knew his body was shutting down and he had decided not to fight it anymore. In short, he had had enough. I was with him at the end. He passed away in peace, in the old Gold Hill doublewide mobile home, where Dad and Mother had lived since 1983.
Nine years later, in July 2000, my sister and I, along with family and friends, had the bitter-sweet honor of sharing the final months, weeks, days and hours with my mother, Eva McGuire Richardson. She was a wonderful woman. She had no interest in politics or world affairs, but she had a great interest in helping those around her. She looked for the good in everyone and never said an unkind word about anyone. She was 91 years old when she passed away in the Gold Hill doublewide.
One month later, in August 2000, a family friend spent countless hours along with our family, attending Cathy’s 98 year old grandfather during his final phase of earthly life. Rulon Sirls Winsor passed away at a home we own in Central Point. Grandpa Winsor was mentally quick to the end. He had a great sense of humor. I remember one day he said, “I have lived a good life and I do not have an enemy in the world…I outlived them all.” Grandpa’s goal was to perform church service on his 100th birthday. He almost made it.
The final story ended in August 2001. One year following Grandpa Winsor’s death, Cathy, our children and I had the honor and the burden of providing long-term care for my sister, Donna Sue Richardson, during her third and final battle with breast cancer. Donna also died in our home in Central Point. It was late August 2001. She was only 53 years old. In her final hours, I was sitting at her bedside, late at night. As the end approached, the medications could no longer veil her exquisite pain. We expressed our love for each other; she tightly squeezed my hand, and then closed her eyes for the last time. After months of heroic suffering, Donna was at peace.
These were good, humble people. They cared for me when I was young, and I helped care for them when they could no longer do so themselves. I will never forget them. Each of them was born, lived and died, and, like it or not, all of us are following the same path.
I have shared these personal stories with you to make a point. When family or friends are there to care for senior or diseased family members—which is the case about 80% of the time—the final years can truly be golden. I remember my Mother saying at age 88 that these were the happiest years she could remember. At that time in her life, my two sisters and I were always close by. She once laughed and remarked that all she had to do was snap her fingers and we would “come a-runnin.” Not all senior citizens have such a close and loving support system.
When an elderly person outlives family and friends, the community has the opportunity and the responsibility to provide more than just food, shelter, and Medicare. We, as caring human beings, can open our eyes and our hearts. We can search out and visit an elderly neighbor who lives alone and is easily forgotten. Once I had the opportunity to deliver lunches for the Meals-On-Wheels program that is administered by the Area Agency on Aging. It was truly humbling to take a hot meal to the home of a shut-in widow, and realize my five minute conversation at her door would be the only contact she would have with another human being that day. Volunteers who can give as little as 1½ hours, one day each week, can be angels of mercy to such folks who have no one to watch after them. (If you would like to learn more about being a Meals-on-Wheels volunteer, call your local Meals-on-Wheels provider. In Jackson County, please call: 541-734-9505 x4. In Josephine County, call 541-955-8839.)
What about those who need more than just a hot meal if they are to avoid moving to a long-term care facility? How can we help older Oregonians retain the dignity, the honor and the opportunity to live out their final chapter of life in the comfort and familiar surroundings of their own homes?
Oregon has blazed the trail for in-home, long-term care with different programs for differing levels of personal needs and resources.
Oregon Project Independence, is a nationally acclaimed program that makes it possible for senior and disabled Oregon citizens to remain in their homes for as long as they are able. In fiscal year 2011, OPI served 1,583 seniors, which due to budget constraints was down from a high of nearly 3,200 in FY 2008. Data reported in 2009 indicated that 64 percent of OPI clients had income below the Federal Poverty Level (FPL). Think about it. For an average cost of only $400 per month, these poverty-level older Oregonians receive enough help to enable them to stay independent and at home. The services given under OPI include heavy housework like laundry and vacuuming, help with personal hygiene (like bathing), transportation, grocery shopping, etc. The Co-Chairs Proposed budget does not recommend any specific funding levels for Human Services, so we do not yet have a clear sense of what the recommendation is for Oregon Project Independence. The Governor’s Budget recommended funding OPI at its current level of $9.78 million. Advocates for seniors are favoring an investment in this program to restore it to the previous level of $12.6 million in order to enroll those on waiting lists.
Oregon Project Independence is financially prudent even though it does not receive the “federal match” that other programs receive. Similar services provided by the state’s Medicaid-funded in-home care program cost Oregon $950 per month with the regular federal match rate. When you add to those monthly rates the costs for case management, administration, and in many cases, coverage under the Oregon Health Plan (which is available to Medicaid-eligible seniors), the actual costs to Oregon taxpayers can nearly triple the $480 monthly cost of OPI. In short, gaining the federal match is not always the best deal for Oregon. The same 2009 data mentioned above also revealed that less than 10 percent of OPI clients transitioned to more expensive Medicaid-funded services, despite the high rate of OPI clients whose income was at or below the FPL. Finally, OPI requires a $5 annual fee, and additional monthly charges may be required, on a sliding-scale based on the client’s income. These charges, although small, enable OPI clients to pay something toward the benefits they receive. Most older Oregonians do not mind paying something toward their OPI services. Many are children of the Great Depression. They appreciate a helping hand; they do not want a hand-out.
Medicaid-Funded Long-Term Care. As alluded to above, there are alternatives to Oregon Project Independence for both self-funded and Medicaid-qualified, state-funded long-term care for older or disabled Oregonians. These services generally provide a higher level of care at a much higher cost to Oregon taxpayers. Adult foster care is live-in 24/7 care that takes place in private homes and costs, depending on the level of care, from $2,400 to $5,000 per patient, per month. Higher levels of care are given in nursing homes at an average monthly cost of about $7,500.
Conclusion. My parents were adults during the Great Depression. The example they set for us kids was one of, “Use it up, wear it out, make it do, or do without,” (Still good advice today).
We helped our older generation transition from life through death. It was not convenient. It was not always pleasant, but it was our duty. Such service was good for them and it was good for us. Our family is not much different from other Oregon families and friends who care for 80% of Oregonian’s elderly population without state subsidization. The remaining 20% do not fare so well. Oregon has an aging population and the cost of their long-term care is not cheap. The fastest growing age component of Oregon’s population is in the 85+ years category, and nationally, the fastest growing segment will be 80+ for the next 40 years!
In sum, for "end-stage" living, the greatest costs are incurred by those receiving long-term care in nursing homes, residential care facilities and assisted living facilities. Since most elderly Oregonians would prefer to live in their own homes if possible, we as family, as friends, and as neighbors, have the honor and duty to be engaged. We can reach out and ask what we can do to help care for elderly family and community members. The needs of Oregon’s elderly citizens are real and must be addressed. Programs such as Oregon Project Independence and Oregon’s state-funded in-home care programs are setting a standard for the rest of America. Tax increases will never be enough to keep up with institutional costs of caring for our aging population. Family, friends and community-based programs ultimately must assume responsibility to ensure adequate care for our seniors. They, who so generously gave us the care we needed when we were young, now deserve the best we can give to them.
P.S. The House has just passed Senate Bill 832A. [Click HERE] When SB 832A becomes law it will designate the second Sunday of August as “Spirit of ’45 Day” and “commemorate the service and sacrifice of the World War II generation.” Oregon is determined to ensure America’s “Greatest Generation” is never forgotten.