Age Wave - How Minnesota Gubernatorial Candidates Would Approach it
Aging - where do Minnesota's Gubernatorial candidates stand on it? The Minneapolis Star Tribune did a Q&A series called "It's About Our Future" with the major candidates and asked each of them the following question:
What must Minnesota do now to prepare for the dramatic aging of its population expected in the years and decades ahead -- which could, among other things, increase long-term care costs and cut tax revenues?
Following are each candidate's response: [NOTE: Ecumen also sent questions to each candidate. Tom Horner was the one candidate who responded with answers. You can read them here.]
Tom Emmer, Republican
Minnesota is the best place in the world to live and raise a family. It is also the best place to retire, and more Minnesotans will be doing so in the coming years. That will mean fewer Minnesotans in the workforce and more demand for government services.
Raising taxes isn't the answer to these demographic changes -- growing our economy and creating new job opportunities is. Minnesota has to become more competitive, more productive and more attractive to new and established businesses. Economic growth will result in population growth to fill the economy's need for a skilled workforce. Higher taxes are a short-term fix that will create greater problems in the future. Workforce quality will become more important than ever. Reforming our education system to ensure more accountability and better results will help. The better educated our workforce, the higher our productivity will be. And more productive workers are better paid, which in turn will generate the revenue to fund what we expect from government.
A robust economy will provide the foundation for a better future. Higher taxes and more government are a recipe for a slower economy and fewer jobs for Minnesotans.
Mark Dayton, Democrat
Between 2010 and 2020, the number of Minnesotans who are 65 or older will increase by 40 percent. This means we need to change the same old way we have been doing things. For example, there are common sense -- and cost-effective -- solutions to help our elders live at home longer. Minnesota has made significant advances in its utilization of "Elderly Waivers," which fund home- and community-based services for people age 65 and older who need the level of care provided in nursing homes but who want to continue Advances in technology can help people keep track of their elder parents who are living independently with the confidence that their parents will receive immediate help in emergencies. This approach is a win-win; it expands options for people and saves money.
If I'm governor, my lieutenant governor, Yvonne Prettner Solon, will establish a "Seniors Service Center" in her office, which will provide one toll-free number that seniors can call for immediate help with state or federal programs or other needs. Our center, too, will help our seniors live their retirement years with peace of mind and security.
We also need to think more broadly about the tremendous assets that our seniors bring to their communities. People past the traditional retirement age of 65 still have major contributions to make -- as business leaders, advocates, classroom volunteers, mentors to small businesses, and contributors in the arts and civic endeavors. Most retirees have many years of energy and experience still to offer their communities. We all stand to benefit enormously from their contributions.
Tom Horner, Independent
The next governor should be a leader in creating a national reform model, changing how older adult services are delivered and how they are funded. Among my priorities are the following:
- Create more home-based, community and institutional care settings to provide a range of options to meet the needs of older Minnesotans, with a priority on helping people stay in their own homes -- to "age in place" -- for as long as possible.
- Streamline oversight of long-term care, assuring that high standards are being met but eliminating some of the costly overlap in regulatory agencies. With this, however, has to come strong consumer protection for older Minnesotans.
- Create new incentives for individual savings. One option is to adapt the popular college savings program (the so-called 529 plans) for older adult care. These plans give tax incentives for savings but allow flexibility in how the funds are used.
Beyond care reform, though, Minnesota will need to be a leader in other areas:
- Assure lifelong learning opportunities for those Minnesotans who want to stay in the workforce.
- Promote the expansion of access to high-speed broadband, allowing more Minnesotans -- including older adults -- to work from home.
- Continue to provide transportation alternatives to the car. More seniors will need more transit options.
- Reform the tax system. With more Minnesotans no longer earning wages, a consumption-based tax system will be fairer for all.
What's the Secret to Living Past 100?
Helen "Happy" Reichert, photo by Jurgen Frank
Do you think living beyond 100 is up to your genes or your lifestyle?
Helen "Happy" Reichert is 108 years old. She hates salads, veggies, and getting up early. She enjoys rare hamburgers, chocolate, cocktails, nightlife and smoking. And . . . she smokes . . . a lot. In an interview with Spiegel International, she says:
"I've been smoking for 80 years, all day long, every day. That's a whole lot of cigarettes."
We know smoking isn't good for our health, but why is Helen alive at 108 and living fully? Apparently, she and other "supercentenarians" are in a class by themselves, especially when it comes to genetics. But despite Helen's smoking habit, one study - Boston University's New England Centenarian Study - says centenarians it has studied does share some characteristics: The study is the world's largest sample of centenarians.
Characteristics in Common According to The New England Centenarian Study:
- Few centenarians are obese. In the case of men, they are nearly always lean.
- Substantial smoking history is rare.
- A preliminary study suggests that centenarians are better able to handle stress than the majority of people.
- The study's finding that some centenarians (~15%) had no significant changes in their thinking abilities disproved the expectation by many that all centenarians would be demented. Alzheimer’s Disease was not inevitable. Some centenarians had very healthy appearing brains with neuropathological study (we call these gold standards of disease-free aging).5
- Many centenarian women have a history of bearing children after the age of 35 years and even 40 years. From the New England Centenarian Study, a woman who naturally has a child after the age of 40 has a 4 times greater chance of living to 100 compared to women who do not.6 It is probably not the act of bearing a child in one’s forties that promotes long life, but rather, doing so may be an indicator that the woman’s reproductive system is aging slowly and that the rest of her body is as well. Such slow aging and the avoidance or delay of diseases that adversely impact reproduction would bode well for the woman’s subsequent ability to achieve very old age.
- At least 50% of centenarians have first-degree relatives and/or grandparents who also achieve very old age, and many have exceptionally old siblings. Male siblings of centenarians have an 17 times greater chance than other men born around the same time of reaching age 100 years and female siblings have an 8½ greater chance than other females also born around the same time of achieving age 100.7
- Many of the children of centenarians (age range of 65 to 82 years) appear to be following in their parents’ footsteps with marked delays in cardiovascular disease, diabetes and overall mortality.
- Some families demonstrate incredible clustering for exceptional longevity that cannot be due to chance and must be due to familial factors that members of these families have in common.
- Based upon standardized personality testing, the offspring of centenarians, compared to population norms, score low in neuroticism and high in extraversion.
- Genetic variation plays a very strong role in exceptional longevity.
Ecumen Opens New Senior Housing in Maplewood, Minnesota
Ecumen Seasons at Maplewood, a newly opened senior housing in Maplewod, Minnesota, is a good example of well-thought community design planning. The 150 apartments, which include independent living, assisted living, and memory care are located in a multi-age residential area, adjacent to a community walking trails and nature preserve and near Maplewood Mall and Healtheast Saint John's Hospital. Amenties include a spa with beauty salon, wellness center, movie theater, art studio and underground parking. Below is an inside look filmed by Ecumen colleague Helen Rickman ahead of last weekend's grand opening.
Don't Be Mean to Old People (Or Any People) - Check out the Video
Lesson learned here: Don't be mean to old people - or any people.
Jim Klobuchar -- A Man Confides His Pain
A Man Confides His Pain to His Best Friends
by Jim Klobuchar
For as long as they had known him he met all of the markers of the gregarious man. Despite his more than 70 years he was robust and strong physically, a man who had achieved professionally. He was also a marvelous story teller with a gift for self-deflation and good will. These seemed instinctive and made him popular alike with long time friends or just about anyone who happened to walk into his life.
He acknowledged that there was another part to his personality in an earlier life, when he could be charitably described as arrogant and recklessly self-involved.
But that was years ago. His life now, apart from the usual trials of getting old, had brought him contentment, the love and counsel of his wife, an acceptance of himself and what his friends saw as the gifts that flowed from his decision years ago to give up drinking.
These people, relatively older, meet regularly to renew their commitment to sobriety and to share the events of their week or month. The talk can be thoughtful and sometimes intimate but it’s usually nothing too ponderous and can get hilarious. But it’s generally a lot of expressed gratitude for the relative peace that has entered their lives.
Fundamentally, this comes down to the truth, hard and undeniable, about their earlier lives. Facing that truth and acting on it has not necessarily brought them to some gleaming grail of bliss. But it has restored them to the part of humanity they lost through their self-indulgence. Gathering each week is their recognition of a shared resolve to keep that commitment in the forefront of their lives because doing it alone—for them—is an invitation to losing it and all of the horror that follows.
Not long ago the man who had re-discovered himself and acquired these friends, and is usually at the center of the free-wheeling banter, asked permission to speak on a personal matter. He said he would have to leave early to be at his wife’s side. She had been diagnosed with inoperable cancer. He couldn’t know how much time she had left, but he needed to be with her this morning. He had a request. This was a strong and self-sufficient man unapologetically expressing a desperate need, a man who had been an amateur boxer and who had dealt with contention and crisis all of his professional life. He was now in tears of grief. His anguish was profound. “I’d like your support,” he said, “I need you.”
They gathered around him and embraced him, each in turn. There was almost no talk. And when it was over, one in the group drove him to the hospital.
What happened in the next hour of their gathering expressed the unbreakable bond that had grown among these imperfect men and women, recognizing once more that it was in the admission of their weakness that they had gained strength. They saw it simply and truthfully in the tears of a strong man asking for their help and embrace.
People who have grappled successfully with the ogre of addiction, and have lived beyond it to renew their gratitude for this freedom, often express the lessons of the struggle in axioms that seem to make sense. None more than this: “We’re only as sick as the secrets we keep.”
There are no more secrets for this man. There was an outpouring of love and kinship, a willingness to walk together with him and shelter him when the road is at its most difficult, but the mind and heart are clear.
It is the human condition at its best.
Governor Candidates and Elder Care
Gov candidates all support elder care program
by Dan Olson, Minnesota Public Radio
October 6, 2010
Maplewood, Minn. — In the midst of a contentious debate over how to fix the state's $5.8 billion budget deficit, Minnesota's candidates for governor appear to agree on one piece of the budget.
Republican gubernatorial nominee Tom Emmer, Democratic nominee Mark Dayton and Independence Party candidate Tom Horner all say it's a good idea to preserve a little-known program that helps keep older people who are poor and disabled out of expensive nursing homes.
The Elderly Wavier program is a growing part of the state budget that helps pay for their care. That's a big concern for many Minnesotans, as nursing homes are expensive. Monthly rates can easily exceed $7,000.
Federal and state taxpayers pay nursing home costs for old people who are poor. Yet nearly all surveys show older people, including those with health problems, would prefer to stay at home, and of course, it's much cheaper.
The Elderly Waiver program, created 30 years ago after a federal rule change allowed Minnesota and other states to do so, allows old people in poor health who have run out of money to stay at home, or in some cases at an assisted-living apartment. They receive care there instead of going to a nursing home.
It helps people like Jackie Mavis, 84, who lives in a tidy but small efficiency in Lakeview Commons, an assisted-living community in Maplewood.
Mavis, who arrived at Lakeview Commons several years ago, never expected to live there.
"I had back surgery and I got what they call a club foot from that, and that's the reason I came here," she said. "I did say I'd come for two or three months, but I guess six years is a little longer, isn't it?"
After working 42 years for an insurance company, Mavis had some savings, a pension, a bit of insurance coverage and Social Security. But that wasn't enough to afford the $3,000 to $4,000 a month cost of living at Lakeview Commons.
"I was on my own for awhile here, but the money goes fast," she said.
When nearly all of Mavis' money was gone, she qualified for the Elderly Waiver. Now she pays just over $800 a month. Taxpayers pick up the rest, which is on average, about $1,300 a month for Minnesotans getting the help.
The alternative is a nursing home that costs as much as five times that amount.
The cost savings are one reason the candidates for governor agree Elderly Waiver is worth keeping -- even in the face of a projected $5.8 billion state budget deficit.
During a recent debate in Brainerd, the candidates were asked whether Elderly Waiver should be saved.
Dayton praised the program.
"Many elderly who'd like to stay in their homes should be supported in doing so," Dayton said. "That benefits them, it benefits the larger community."
Emmer has said the state's health and human services spending should focus on children and the elderly. He has called for cutting some government programs to balance the budget, but not Elderly Waiver.
"That should be one of our priorities," Emmer said. "But again, you got to go back to this argument that somehow, government should be allowed to expand, no matter what our economic situation is. It isn't the right approach."
Horner also supports the Elderly Waiver program. But he said government needs to get better value for the money it spends.
"It is exactly the kind of investment we ought to be making for the future," Horner said.
Given the consensus among the candidates, the program likely will survive regardless of who is elected governor.
Spending on Elderly Waiver takes a relatively small portion of Minnesota's overall state budget. This year, it will cost about $303 million for nearly 21,000 recipients, according to Minnesota Department of Human Service projections. Of that, 60 percent will be paid with federal dollars and 40 percent by the state.
Next year, Minnesota's contribution rises, as it will have to pick up half of the costs.
In recent years, the state has tightened requirements and reduced Elderly Waiver payments to care providers. Because of those changes, some care providers are turning away folks who qualified for the program.
That's happened as Minnesota's elderly have become one of the fastest-growing components of the state population.
Tom Horner Talks Aging
1. In 2020, Minnesota will have more seniors than children for the first time in our history. What are opportunities for innovation that you see as it relates to this unprecedented demographic shift often called “The Age Wage”?
We need to integrate technology into care delivery to achieve the highest quality, most cost-effective services and outcomes:
- Use technology to manage the chronic illnesses of older Minnesotans on a daily basis to help them live healthier, more active lives and avoid expensive hospitalizations. New online services are now connecting older Minnesotans with care providers for daily interaction through special internet connections. This is another reason why a statewide broadband system is so important.
- Use specifically designed computers that can perform daily monitoring of blood pressure and other vital signs and face-to-face conversations that give care providers a chance to spot warning signs and make adjustments in medication or diet before a crisis occurs. Where these systems have been implemented, they are proving to be enormously successful in improving the quality of life while reducing costs.
- Implement technologies to allow seniors to stay in their own homes longer, saving them money and, potentially, saving tax dollars in the event the senior spends down to Medicaid. In addition it gives family caregivers, especially those who live far away, a measure of comfort when they are unable to be with their loved one.
In addition, we need stages of care, so that seniors who don’t need highest-cost nursing care can remain as independent as possible. We need to find more ways to encourage local communities to provide the relatively small but crucial services (like snow shoveling, garbage carry-out, meal delivery) that can allow people to stay in their own homes.
2. According to the Minnesota Board of Aging, only half of working adults have access to an employer-sponsored retirement plan; the other half do not and are struggling to save for retirement. The current economic recession further hampers people’s abilities to save. Experts predict that approximately one-third of Minnesotan Baby Boomers cannot afford long-term care costs.
What is your vision for financing long-term care for the coming age wave?
As more options for care become available, payment must become less dependent on rigid and poorly designed public programs. Reforms should encourage individuals to take greater responsibility for funding the cost of care and also make it possible to take advantage of the care setting that best suits their needs. We need to expand the incentives available to help seniors and their families contribute toward their long term care expenses:
- Create incentives for private savings with plans like the 529 program for funding student education
- Develop more affordable catastrophic insurance options as well as focus additional savings incentives for those with lower/moderate income
- Encourage home equity programs with lower administrative fees
- Reduce the incentive to use Medicaid as the sole long-term care insurance program by creating a system where users become responsible for co-payment of long-term care costs.
3. How do you foresee aging policy changing in your administration?
As the population over the age of 65 increases the pressure only grows to solve the problem of affordable and sustainable long term care. I believe my proposal goes a long way toward addressing the immediate and mid-range concerns, while building the base that Minnesota will need to address the long term issues around aging. My administration will consider what some might think of extraneous issues, such as the need for transportation to receive the care that people need as well as other community services that will allow people to age in place. I expect that my push to make broadband internet service available statewide will provide new opportunities for monitoring and treating the ailments of old age, which will benefit families caring for their elders as well as the patients themselves.
4. What is your vision for the way you, personally, will age?
This would be a good question to get the conversation started around Minnesota! I think I share the vision of all Minnesotans who want to age near loved ones with as many freedoms intact as possible. None of us want to be told where we have to go as we get older and need care. However, individually we need to think about what that means, and prepare for older old age. My wife, Libby, and I try to do what the experts advise--watch our diets, get plenty of exercise, and stay involved. My choice is community involvement on issues that matter to me--the environment, helping those less fortunate, and good public policy. One of my heroes in terms of contribution to society and aging well is the late former governor Elmer L. Andersen. Well into his 90s, he was an advisor, a philosopher, and friend to many younger people and cared deeply about our state.
5. Where do you want to live when you are old? Your current home, assisted living or a nursing home?
Like most Minnesotans I would choose to remain in my home as I age. The statements above and the details in my FAIR proposal lay out a plan to keep Minnesotans in their homes as long as it makes sense to them. We would all prefer the kind of assistance that makes continued living at home possible, noting that companionship of people we love, and who care about us, is crucial. I hope not to require full nursing care, but want to make sure the excellent nursing home care available in Minnesota is still there, should that need arise. My plan, if I am elected, is to change the way nursing home care is financed, so that care will be available for anyone who needs it.
Jim Klobuchar on Retirement: Favre, Bliss & Blitzes
Several years ago, a man I knew professionally was on the brink of retirement and found himself anguishing in the throes of indecision. This was at a time when retirement from work was still a sensible proposition. It was before Wall Street permanently retired a sizeable army of the American labor force by paralyzing the economy, passing out executive bonuses while 10 million people lost their jobs.
I asked my friend to describe his dilemmas. “I’m ready,” he said. “I’ve done the work. We’ve saved money. I want to fish. I want to play slow-pitch softball. I want to write poetry. I want to watch the swallows come back to Capistrano. I’m a Grandpa and I want to run in Grandma’s Marathon.”
I thought all of these were reasonable grails for his later years, and he deserved them. He said he was secure in his job but he was ready for freedom. “The trouble is trying to stay relevant,” he said. “Basically, I’m worried about disappearing if I retire. I know that sounds awfully self-absorbed.”
I said I thought self-absorption in small doses was not a capital crime. “Test the waters,” I said. “Tell your boss you want to feel the joys of retirement. You can work out your own agendas, goof off, read Ovid’s Art of Love if you’re out of practice. Tell your boss you’d like to consider this an extended leave, and if it didn’t work out you’d like to come back and burn up the pavement with your old zeal.”
He laughed hysterically. “Name me one guy who could do that,” he said. I couldn’t then. Today I can and he has become avatar of retirement in the 21st century, Brett Favre.
Let me re-introduce Brett Favre. He is here. He is there. He is in the commercials selling Wrangler Pants. He is in the Minnesota Viking huddle not only calling plays but happily ignoring signals from the bench. He is No. 4 in your program and No. 1 in the hearts of students of abnormal psychology.
This is Brett Favre, the retiree of the year. He is also the retiree of last year; and the year before that; and the year before that. There is every probability that he will be the retiree of next year. He has already announced that this will be it, his final season, and the makers of Wrangler Pants are delirious about the possibilities of next year’s promotion campaign when Brett shows up two days after training camp ends. For your records it’s Aug. 23, a Tuesday.
So let’s say you are 65 years old and want to know what all of this portends on the broader scale. Let’s say you are 35 and just as baffled as your venerable elders. What it means basically is that Brett Favre has succeeded where Ponce de Leon failed miserably. There IS a Fountain of Youth. For Brett Favre the Fountain of Youth is football. Never mind that some of his contemporaries—Joe Montana, Dan Marino, John Elway—and a few thousand others made their pile and decided it was time to grow up. Favre recognizes no such generational protocols. A hundred yards of green grass is to Favre what the big bend in the Mississippi River was to Huckleberry Finn. It is an instant invitation and a jolt of adrenalin. It is his renewal. It is the same reason why some aging globe-trotters keep going back to the Himalayas to trek. It is not to prove they can still do it. No, not that. It is reconnecting with a part of life that has fueled their glands and created for them a kind of rough-hewn but special community. For Favre that isn’t necessarily defined by throwing a touchdown pass to the tight end with two Neanderthals draped around his collar bone. Horsing around in the locker room is a big part if it, slapping butts, hollering in the pure primitive joy of winning with a bunching of guys who share both the pain and the euphoria.
That is basically what motivates him. Year after year ... So why not say so? So why doesn’t he drop all of the goofy mimes about not being sure, the ones that turn this extraordinary athlete in to a caricature? Is it a crude negotiation for more money? Fundamentally, not. Somewhere he has choreographed the right time and right way for Brett Favre to retire. The worst way is to be throwing interceptions in the final moments of big games. “I don’t want to fail,” he says. And when he has, in January the last three years, it depresses him and he wants out. Until three months later.
Most people understand a sensible time to retire. Favre agonizes and puts conditions on it. The best way to figure this fellow out is to sit back and to enjoy watching him play. Never mind what he says. Watch what he does. Which is right about now. It will be a show—again.
Jim Klobuchar -- A Small Hallelujah on the Highway
I can explain what I was doing standing on the edge of a heavily-trafficked suburban highway, an oversized red Bible in hand while I peered across the roofs of the onrushing motorcade.
I can explain it without any serious hope of extracting much sympathy. Two friends who recognized me called later to find out whether I had staked out the corner of County Road 6 and Interstate 494 to deliver a prophecy. They said they were surprised because they never heard of a prophet wearing a T shirt illustrated in front with a cartoon of five shaggy Himalayan animals going “Yakety Yakety Yak.”
I am not going to burden you with the fringe embarrassments. The truth is that I was about to run out of gas and was looking for my wife, who I believed at that very moment was charging to my rescue in her handy Prius. I didn’t intend it to become a saga. I considered explaining my vigil to a few motorists who slowed down to inquire. I was going to tell them that I was searching for my wife. But warning buzzers soon sounded in the backwaters of my brain. Talk like that could have subjected my wife to suspicion of desertion, for which I admit ample grounds existed.
What happened was the price I paid for my ignorance of some of the thrilling advances in the dashboard services now available in today’s automobiles. It left me approaching empty on the gas gauge en route to a meeting. The only rescue service available to me was my wife, which is where the melodrama began.
I attend a Tuesday morning men’s meeting where a small group of us gather to explore the repair work needed in the spiritual condition of our lives. We take turns as the weekly presenter. A last minute announcement from the scheduled discussion leader, who was unavoidably extended at a conference out of town, stirred my juices of volunteerism. The morning of the meeting I quickly prepared some talking points and for support hauled with me a Bible I received 25 years ago as birthday gift. I backed my new two-weeks-old car out of the garage 15 minutes away from the scheduled start of the meeting, just enough time to be the first to arrive with an explanation of the curriculum change.
Ten minutes into the ride I checked the instrument panel for the fuel gauge. My eyes settled on the familiar circle and arrow to the left of the stirring wheel. The arrow was set halfway up the gauge. A minute later I reviewed the rest of the metrics and was stunned to confront one on the right side of the wheel, identified at the top with an F for Full and at the bottom with an E for Empty. The arrow pointed indisputably at E. The other thing I noticed was that it was blinking violently. It didn’t matter that I quickly figured out the confusion of dials. The prior week I had been driving six or seven hours a day in a rented van, with the gas gauge left of the wheel.
I stared again at the dial of my new car. At the top it read H for Hot and at the bottom C of Cool. In my misery I imagined a quick change in the alphabet and added a D for Dummy. I turned the car into a service lane just off the highway and phoned my wife at home two miles away. No answer. I tried her cell. Nothing. I tried the land line three times. Voice mail. It was brutal. I could hardly call 911. She answered the fourth call. “I was watering the flowers,” she said sweetly. Apologizing to my wife and the flowers, I gave her an estimate of the situation, the way we learned it in the Army. I might run out of gas before I reached a station plus it would throw the meeting out of whack. I then walked back to the rush hour traffic to spot her, hauling the Bible because we were going to make a quick change—I’d drive her car to the meeting, she drives mine to the gas station. For all of it’s reverence, this was a BIG, DEEP, RED Bible, maybe maroon red, maybe vermilion red, immediately announcing me to part of the curious traffic as a potentially defrocked preacher or a traveling peddler.
My wife saved the day with all flags flying. I made it to the meeting. She filled the tank and the flowers survived. Later, at home, I took my first tour of that little old automobile manual. My wife strode through the house the rest of the day like the commander of the evacuation armada at Dunkirk. Naturally, I saluted.
People - The Pulse of Senior Housing and Services
When you talk with people about why they enjoy working in senior housing and services, they will tell you it's the people they work with. People such as our customer Frances Beck, who just makes you feel good. She lives at Ecumen's Bethany Community in Alexandria, Minnesota, and was named our Volunteer of the Year in 2010. Her joy is infectious. Meet Frances in this news story from the ABC TV station in Alexandria: