Charleston Southern University

Denise Rivers, Deputy Director
Lt. Governor’s Office on Aging

*Data from American Community Survey and 2010 Census
The facts are staggering.
The needs are astounding.

• South Carolina, like the rest of the nation, is getting older.
• Every day, 10,000 Baby Boomers turn 65.
• SC ranks 17th in the nation for the highest percentage of age 60+ residents (917,000)
• Approximately 12% of SC’s senior population lives in the Trident area (over 113,000)
  Charleston – 65,208 (18.5%) Berkeley – 27,219 (15.3%) Dorchester – 21,153 (15.4%)
• Charleston as well as Greenville was selected by AARP as one of the top 20 places to retire. Charleston was selected as one of the “Dream Towns” and one of the “best places to reinvent your life,” and Greenville for its “simple life”.
• As older citizens realize the advantages of moving to our state, our senior population will continue to increase. From 2007 to 2030, the population of adults age 65 and older is projected to increase by 89%, more than four times as fast as the U.S. population as a whole.
• The 85 – 94 age group is experiencing the fastest growth – 30% while the 95+ age group increased 26%.

Why the disproportional increase in the “graying” of SC? Like the rest of the country:

• aging “Baby Boom Generation”
• advances in medical science, people are living longer with chronic illnesses and disabling conditions

But for SC specifically:

• immigration of retirees from other states
• low tax burdens for seniors (4th in the nation)
• homestead exemption (allows state residents 65 and over to not pay taxes on up to the first $50,000 of assessed property value)
• the state allows for the full exemption of Social Security income and the partial exemption of pension income

• Of the more than 917,000 South Carolinians over the age of 60, at least 42% have at least one disability which makes them more likely to live below the poverty level.
• 10.4% of seniors live below 100% poverty level ($11,170/$15,130) – true for all 3 counties in the Trident area
• One in every 5 of those individuals age 65 and older survives on an average of $7,500 a year.
• Only 3 out of 10 eligible seniors get SNAP ($908 net = $200 month)
• 10.5% of the children in this state live with grandparents who are heads of households. 33% of the grandparents are over 60 and 23% live in poverty.
• In Charleston and North Charleston alone, there are 1,947 grandparents responsible for their grandchildren
• Roughly 70 % of you turning age 65 will have long‐term care needs, generally 3 years worth; 20% of you will need LTC for five years or more; and 5% of you will spend more than five years in a nursing facility.
• The number of elder abuse and neglect cases is soaring.
• There have been instances where a senior can no longer pay and the nursing home drops the older adult off at an ER or a homeless shelter.
• Deaths

Mr. James, a Washington Employee who had worked in the White House for 50 years for 10 presidents from John F. Kennedy to Barack Obama was found dead, days after his death, inside his home during a brutal heat wave. A couple of years ago, he started to struggle and retired from the White House. He was hospitalized twice for dehydration and malnutrition. He had stopped bathing. He wore the same tattered and fetid clothing. He smelled. He went to the bathroom in buckets on the front porch of his home. The city sent a hazmat crew to remove 10 buckets of human feces and urine from his porch. He had no electricity or running water. His property fell into disrepair. Rats rummaged through the weeds and mounds of trash in his yard. All were clear signs he desperately needed help. He died of heat exhaustion in August after the heat index reached 112. The Inspector General is looking into whether city agencies could have done more to prevent his death. He served 10 presidents, but died alone in squalor.

A little closer to home. U.S. District Judge Mathew Perry: died on a Fri. and was found on Sunday by a family member who each Sunday went to the judge’s home to prepare a meal for Perry and his wife. His wife was home but in poor health.

These are the types of haunting stories we will hear more of. People dying, unnecessary deaths, some lonely, because of overburdened, underfunded and hamstrung government. There’s less and less funding and more and more elderly.

Older adults prefer to remain in their homes and communities, but it becomes more difficult as we age.

So what Do We Have to Offer? We fund, through the Older Americans Act and with a little bit of state funding:

• Congregate Meals
• Home Delivered Meals
• Some In-Home Services
• Limited Transportation
• Caregiver Support
• Limited Legal Services

However, we currently have over 4,000 on the Wait List for Aging services. But this is not an accurate number because providers stopped adding people to the lists.

Health and Human Services has over 400 on their CLTC Wait list for Home and Community Based Services and they removed 600 Medicaid Nursing Home beds. No longer do loved ones have to be placed within 50 miles of a spouse or family member.

These are all Government Services.

We said SC places a lower per capita tax burden on its residents. However, if citizens move to South Carolina primarily because of its low taxes, do they also expect the same amount of services that were present in their home state? And, if these services are not available, are they willing to accept higher taxes to pay for them?
What do we do?
What is the role of government?
Last election, message was less government.

So, are we getting what we asked for?
• What happens to our senior population with no caregiver?
Caregivers – “Out-migration”
No access to resources
No access to medications
No access to Nursing Home beds

What does it cost us? The range of aging services – home-delivered meals, personal care, adult day services, etc. – that help seniors remain in their home costs less than $1,000 dollars per individual per year. In contrast, persons in Medicaid-paid nursing home beds cost taxpayers anywhere from $25,000 to $37,000 per year. Private pay is about $65,000 per year. About a third of nursing home residents pay all of their nursing home costs from their own funds.

In Alaska Nursing home bed is $202,000.
2008 Nursing Home Bed Occupancy

• 90% Charleston (12 beds)
• 91% Berkeley (9 beds)
• 95% Dorchester (3.6 beds)

What can you do?
Many of our state officials are new to their jobs and many state agencies have new Directors. They also have less staff due to budget cuts. Educate as many legislators as possible so they can make informed decisions with the dollars they appropriate. Ask them if our seniors are a priority?

Put pressure on state policymakers to redefine the way LTSS are financed and delivered.

Redirect funds towards Home and Community Based Services instead of institutional services.

We, the LGOA, have asked the Legislature for an additional $5 million for HCBS. This investment can potentially save the state expenditures of more than $30 million in delayed or prevented nursing home admissions over the next few years.

Should government care for seniors not able to care for their own needs?

Are we comfortable with seniors going to bed at night hungry? Are we willing to say this is OK?

Are we comfortable knowing some seniors are isolated with no caregiver, no access to basic food needs, no access to medications?

If you say no this, then we need to fund these basic services.

If you think this is acceptable, then say, “I don’t want to fund senior services. Let everyone take care of their own needs” but don’t be surprised or outraged or look to blame an agency or group when there are bad outcomes. Without proper funding, bad outcomes are expected.

Federal and State government cannot be the sole funding sources for these services.

Click here to view, Definition, Vision, and Initiatives.

• Assessments by our nurse or social worker
• Trained and monitored caregivers for personal assistance, med reminders & transportation

Call 843-852-9090.

Singing the blues? It could be depression. Memory loss can be a sign of major depression. Patients with major depression can be forgetful, lose interest in friends, have attention deficits or belabor making decisions. Are you having crying spells or excessive anxiety for a few weeks or more? Time to call your doctor.

Chemical Warfare? Forgetfulness could be the side effects of medications. A recent report stated that there are over 120 prescription medications that could affect your memory. Most frequently, they include anti-depressants, cold and flu medications, and sleeping pills. Changes in mood or behavior, suffering from memory loss or having confusion. call your doctor for a time to review every medication!

Flustered by Food? Nutritional deficiencies such as Vitamin D or B-12 can wreak havoc on the body. “Follow a balanced diet that includes protein. People with higher blood levels of vitamin B12 were six times less likely to experience brain shrinkage and dementia. Ask your doctor to check your blood to see if you have a vitamin or mineral deficiency.

Measure what you drink everyday…dehydration can cause confusion and urinary tract infections…call your doctor immediately with sudden onset confusion and forgetfulness.

One last word: Remember to get up and get moving: Exercise for 1/2 hour daily like walking or jogging helps improve mem-ory.

The first story is that a very patient receptionist in a memory care unit was being interrupted and antagonized by a gentleman resident throughout the workday.  He came and stood in front of her and mumbled a phrase for long periods, and would not be dissuaded by her appeals.  With a little detective work, she learned that he had worked as a delivery person for his entire adult life.  She gave him a clipboard filled with paper with numbered lines and a few empty, sealed packages.  Each time he came to the desk, she signed his clipboard, and he went on his way seemingly satisfied that he’d accomplished his task.  The mumbling? The receptionist decided that he had been asking for her signature all along.

The other poignant story that touched me is one about an elderly woman and her doll.  She had five adult children and she had always loved infants, so her daughter kindly purchased a life-like doll for her.  She also purchased inexpensive bundles of wash clothes to double as “diapers for the baby”.  The lady’s caregiver brought her a laundry basket filled with the cloths every morning. The lady neatly folded each one and placed them back in the basket.  This exercise was repeated throughout the day.  The lady was content because her hands were doing productive work.  She and her baby doll were inseparable and the staff commented sweetly about her baby consistently.  It is a minor thing to those of us with our faculties, but it was her LIFE that was enriched by a simple ritual of feeling purposeful.

When a family member with dementia has no alternative except to live in a facility with a memory unit, it is important to ask about and insist upon activities everyday to engage them.  One very concerned daughter asked, “Where is the LIFE in the memory care unit?”  She reported, “I visited a memory care unit today in an affluent facility in my hometown. The setting and physical environment was wonderful, but the schedule posted for the day only included 3 meals and a piano listening time. Nothing else. Another resident’s family member confirmed that there were no other activities ever offered for the unit. No puzzles, no handcrafting, no dancing, no staff socially interacting with small groups.  The assisted living area offered any number of activities each day, but residents of the memory care unit could not attend their activities unless a family member accompanied them.”

So, when you are visiting possible memory units for your loved one (or choosing in-home caregivers), be sure to ask “Where’s the LIFE? What will you do to care for my mom and dad?”

Sherly 843-852-9090

Physical Activity and Older Americans

Middle aged adults might experience a decline in brain function if they are sleeping less than 6 hours a day or more than 8 hours. The mental decline is apt to be equivalent to being 4 to 7 years OLDER.

Trying to always do more in a given 24 hour day is causing people to sacrifice sleep to ensure they complete everything that is expected of them.

The study  by the University  College London Medical School cites that women who slept 7 hours a night have the highest score for every cognitive measure followed by those who had six hours.

However, less than 6 hours or more than 8 were associated with lower cognitive scores.

Sleep provides the body with its daily need for restitution and recovery.  It is not yet clear in studies why 7 hours appears to be optimal for the majority of people.