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Some fear Wyoming isn't ready for the gray boom
(Wyoming Tribune-Eagle (KRT) Via Acquire Media NewsEdge) Jul. 13--CHEYENNE -- By 2020, Wyoming is predicted to replace Florida as the nation's grayest state.
More than 20 percent of the population will be age 65 and over. But geriatric experts question whether the state is prepared to care for the needs of this growing population.
A statewide shortage of health-care professionals worries Deb Fleming. The director of the Wyoming Geriatric Center at the University of Wyoming said the state does not have enough home health nurses, public nurses and physicians.
Meanwhile, 90 percent of
older patients have more than one chronic condition, including arthritis, osteoporosis, high blood pressure, high cholesterol and diabetes. About 60 percent of these patients have more than two chronic illnesses.
"You don't have people with one chronic condition," she said. "You have patients with a constellation of them."
Another problem is that some physicians have dropped their Medicare and Medicaid patients. Fleming said most physicians are already overburdened with patients, and the reimbursement rate for these services is low.
The Wyoming Geriatric Center was established last year to improve health care for older residents, providing specialized training on topics such as healthy aging, chronic disease, end-of-life issues and mental health for older adults. It is one of 47 federally funded centers across the country to train future health-care professionals.
But these efforts are small compared to the growing need, she added.
"We have to talk about mental health needs," Fleming said. "We don't have the resources to care for this population."
And as health-care costs continue to rise, the problem is only going to get worse. She has already heard stories from frustrated patients about accessing care and getting the care they need in a timely fashion. Meanwhile the 77 million individuals known as the baby boomers will begin turning 65 in 2011.
Fleming said the irony is that medical schools are teaching less about geriatrics now than a decade ago. It's also harder to encourage students to specialize in geriatrics.
"It's not just our problem, it's a national problem," she added.
Older residents often remain in the workforce past the age of retirement to hold onto their health-care benefits. But this is an expensive group to insure. Fleming said many employers are dropping coverage or forcing older employees out of their jobs.
Communities also must adapt to the needs of their changing demographics. Sidewalks need to be safe for walking and accessible for people in wheelchairs, said Rita Inoway, state director for AARP. A good example can be found along the streets of downtown Cheyenne.
She added that amenities such as the Greater Cheyenne Greenway encourage physical activity, which is essential for healthy aging.
"Physical exercise is good for the brain as well as the body," Inoway said.
Older adults also want more options for long-term care. AARP provides information on home modifications, since more people want to age in place. Some of the suggestions include adding lever door handles, grab bars and non-slip surfaces.
"I think it's also a reflection of the fact that people are living a healthy life longer," said Joanne Bowlby, associate state director for communications for AARP Wyoming. "They don't necessarily need the full spectrum of care that's provided in a nursing home. They might have a chronic condition or a disability that requires some assistance but doesn't necessarily require them to be in an institutionalized setting."
But there are still barriers to health care, especially in rural communities, such as distance to providers, a lack of providers and a lack of affordable insurance options.
"The number of uninsured among the elderly is very low," Inoway said. "That's a good thing. But the co-pays are going up, and that's a bad thing. Some of the co-pays are getting unaffordable."
She added that many older residents also struggle to cover the costs of prescription medications. Bowlby said new models of Medicare service require more patient responsibility to pick, compare and monitor plans. And the choices can be difficult to make. But programs such as the Wyoming Senior Health Insurance Information Program aim to help patients navigate the system.
She said Wyoming's senior centers are taking a more active role by encouraging visitors to eat better and exercise.
"That's certainly going to help ease the aging process," Bowlby added.
Community leaders also are re-evaluating the lack of services and long-term care options. She said it can be a strain for residents in Pine Bluffs or Burns to travel to Cheyenne to visit a relative when there aren't alternatives closer to home.
Fleming said other groups are exploring nursing home alternatives. The Sheridan Senior Center built Green Houses, which cluster small groups of residents into a single home instead of a larger building. Residents live together as a family, eating, cooking and completing chores together. They also get to have pets and plants to make the setting as homelike as possible.
"(Residents) get the same level of nursing care as they would in a nursing home, but it doesn't look like a nursing home," she said.
Older residents in Cheyenne also have more resources than in many other parts of the state, said Laurie Wright, service line director for continuum of care at Cheyenne Regional Medical Center. But it's still possible to fall through the cracks in the Capital City. Patients may discover that they are not eligible for Medicare or that they need services Medicare does not cover. Other residents may need specialized transportation to get around or more daytime care options.
She said CRMC is exploring service additions, including an adult day care where visitors could participate in activities and get medical care. The alternative would provide a place for seniors to go if they live with relatives who work during the day. And these are the patients who often are overlooked, since they are not in a nursing home, in-patient care or home health care.
CRMC staff also is considering the feasibility of the federally-funded Program of All-Inclusive Care for the Elderly, or PACE. This option allows seniors to remain at home while still collecting medical assistance, as well as transportation and adult day care services.
"I don't think we are well enough prepared (to care for the state's aging population)," Wright said. "But we are trying."
To see more of Wyoming Tribune-Eagle, or to subscribe to the newspaper, go to http://www.wyomingnews.com/.
Copyright (c) 2008, Wyoming Tribune-Eagle
Distributed by McClatchy-Tribune Information Services.
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