The elder boom: the industry that cares for old people has made great strides, but there are still problems to be dealt with

New Mexico Business Journal, Jan-Feb, 1999 by Nancy Harbert

Stanley and Ruth Fish moved into their first apartment in November of 1987. They love their third-floor view of the neighborhood, the outdoor pool, on-site library and the option either to cook meals or eat in a downstairs dining room with their neighbors at Manzano del Sol Good Samaritan Village in Albuquerque.

Like many older Americans, the Fishes are planning for their future. Stanley is 88 and Ruth is 87. They have compressed a lifetime of accumulations into a two-bedroom apartment, and while they hope they will never need to check into the nursing home unit at Manzano del Sol, if that day comes, the Fishes have prepared for it.

As America's life expectancy continues to grow, so will the challenge of caring for our older population, with the greater burden falling on the long-term care industry, which addresses the various needs of seniors, along with a small segment of developmentally disabled citizens. In 1994, about one in eight Americans was 65 or older and by 2030 it's expected one in five Americans will be a senior citizen.

In New Mexico, more than 10,000 older people live in long-term care facilities, which consist of residential care communities and nursing homes. A residential care facility, also known as assisted living, is an intermediate step between independent living and round-the-clock nursing care. Typical services provided include three meals a day in a group dining room, personal care services, such as help with bathing and dressing, help with taking medications and transportation.

"These would be the types of things we might do for an old parent who comes to live with us," says Linda Sechovec, executive director of the New Mexico Health Care Association, a trade association of licensed long-term care providers. In New Mexico, residential-care facilities vary greatly - from small group homes to premium retirement communities. Costs reflect this diversity, ranging from $1,000 to $2,500 a month, paid primarily by the individual resident, through Social Security payments, retirement funds and personal savings, Sechovec says.

Most nursing home residents, on the other hand, pay only a small amount of their living costs. Medicaid pays approximately 75 percent of the costs, Medicare picks up about 6 percent and the resident pays the rest, Sechovec says. In New Mexico, costa average about $95 a day for basic nursing-home care, she says. The more skilled services required, the more the cost increases. At Ruidoso Care Center, for example, residents in its Alzheimer's unit pay $112 a day.

Typically, the state's approximately 7,000 nursing-home residents receive around-the-clock nursing care, assistance with daily personal chores, which can range from getting into and out of bed, bathing, dressing and eating, rehabilitative services as needed and supervised activities. At Ruidoso Care Center residents often go out for lunch at restaurants, participate in regular bingo games and take field trips, says Tammy Torres-Cox, social service director and admission coordinator.

In addition to nursing home residents, Ruidoso Care Center, secluded among the pines of the Sacramento Mountains, is home to 12 developmentally disabled residents. The average age in the center's intermediate care facility for the mentally retarded (ICF/MR) is between 50 and 70, and they mix well with the older crowd, says Torres-Cox.

"A lot of time the younger developmentally disabled clients help the older residents, like getting them a cup of coffee or just visiting with them," she says. "It gives them a sense of purpose."

Nearly 300 people live in 37 ICF/MR facilities across the state, usually with each other. Once ostracized in large, impersonal state-run institutions, these people are now living in small, privately run group homes, such as those operated by Santa Maria el Mirador in Santa Fe, which oversees about 30 homes in north-central New Mexico. Integrating them into a community, where in many cases they find jobs and enjoy a social life, is part of a national trend that began 20 years ago. Not only has their quality of life improved, but the average $64,000 per person annual cost to house them in privately run homes is much less than the $300,000 per-person fee the state paid 20 years ago, says Mark John. son, executive director of Santa Mafia el Mirador. Costs are covered by the New Mexico Medicaid program.

About 120 men and women, ranging in age from 18-70, live together in groups of 34 in homes operated by Santa Maria. They are supervised by trained personnel who work in three shifts around-the-clock. Residents are taught how to take care of their needs such as personal hygiene, dressing, grocery shopping and utilizing community resources. "The range of disability is broad - we serve profoundly disabled people and others who live independently," Johnson says. "We provide job coaches for some, others go to day rehabilitation programs, others need speech and occupational therapy."

Csshanges also have improved the nursing home industry, as well.