Every day, 12,000 Americans turn 65. In 2022, 58,000,000 were over 65 – 17% of the population – and estimates are that by 2040, seniors will make up 22% of the population.

            While most people over 65 are healthy, as we age illnesses and frailty become increasingly common, and growing numbers need at least some care in their daily lives. How do they get that care?

            Unlike many other western countries, the United States has no organized program to help seniors who are unable to live and function independently. In many cases, particularly for those over 80, the choices come down to placement in a nursing home or a lot of help at home to allow them to avoid that dreaded option.

            Many elders and their families are surprised to learn that Medicare does not pay for anything but short-term rehabilitation, either for nursing-home stays or home healthcare. If you have a hip replaced, Medicare will cover a week or so at a rehab facility and a few weeks of home physical therapy and visiting nurses, but if you are simply too frail and sick to live independently, you are on your own.

            Long-term care insurance is available, but it is very expensive and frequently does not cover the full cost of nursing homes or extensive home care.

            To get the care needed at home, home health aides are available, but this “system” is full of problems. Such care is generally provided through agencies that hire and vet the aides. They charge the patient a lot and pay the aides very little. Most home health aides get minimum wage for very demanding work, resulting in a huge turnover. Why lift and clean an elder when you can earn the same hourly wage at McDonald’s?

            In the end, it often falls to family members to provide needed care, difficult at best when families are scattered around the country and often trying to hold down a job while assisting their parent(s.)

            Medicaid will pay for nursing home care, but to be eligible, the recipient must spend down most of their assets and become impoverished. They cannot give away assets to their family – this is carefully scrutinized. Moreover, Medicaid rates are generally so low that you will not find many “upscale” homes willing to take you.

            What can you do? Don’t get old. Seriously, one important factor is to stay as fit as you can to avoid the need for help. While exercise increases longevity, its more important benefit is to keep you independent longer.

            If you can afford it, investigate long-term care insurance. Be very careful in reading the policy and assessing the likelihood that the policy will cover your needs.

            While you are healthy, begin to make your home more “aging-friendly.” Get grab bars in the shower, railings on all stairs, better handles on doors and cabinets and put shelves lower.

            Write to your state and federal legislators and ask them to start working on a plan, either at the state or national level, to improve the care we offer our frail elders. Part of any such plan must include better pay for home health aides to encourage people to make this a career.

By Dr. Ed Hoffer

            Dr. Ed Hoffer is the chairman of the Marion Board of Health, a graduate of MIT and Harvard Medical School. He is Associate Professor of Medicine, part-time, at Harvard and a Senior Scientist at the Massachusetts General Hospital.

            I’ve been sitting here for what seems like hours trying to think of something to write about for this week’s column. I considered writing about suspenders, but that idea didn’t hold up. Then belts came to mind, but that story had too many holes.

            Looking into the refrigerator at lunchtime, I thought I might write about leftovers. Perhaps chicken soup, maybe meat loaf or Chinese food, but none of those satisfied my hunger for a proper subject. Glancing at my newsfeed on my phone, I spotted the headline… “Flaco died.”

            In case you have not been paying attention to the news from New York City (and why would you?), Flaco is an owl, a Eurasian eagle-owl to be precise. A rare bird in these parts. The majestic bird had become the talk of the town in the Big Apple recently. It seems that Flaco, a resident of the Central Park Zoo, had escaped a year ago, thanks to a vandal who cut the protective netting surrounding his home of the past 14 years.

            Flaco, wanting freedom but perhaps a bit nervous about venturing from the city he knew from birth, took up residence in and around the park. He – I presume he was a he – became the darling of the city folks and tourists as well. Flaco’s adventure took on a life of its own. TV stations did stories about him. He even made the national news. Newspapers wrote editorials about him. Some people with little else in their lives said he had become a symbol of their own desire to escape the confines of their wretched lives. (Aw, come on!)

            Anyway, upon his untimely demise (he died of severe head trauma from flying into a high-rise building), even the governor and the mayor memorialized him. I’m sure the mayor was particularly upset because of Flaco’s contribution to reducing the rat population, the bird’s primary source of food, in the city. A New Yorker article said that he was “a neighbor they could look up to.”

            I’m sure a statue of Flaco will soon be erected somewhere in Central Park.

            This would not be unprecedented. Some years ago, a cow escaped execution right here in Massachusetts. A slaughterhouse in Hopkinton had plans to turn the bovine into steaks. Emily, as she had come to be known, managed to evade capture for over a month by foraging for food in the backyards of nearby homes.

            Like the New Yorkers, the good people of Hopkinton took a liking to Emily and often helped her to evade the authorities who had been ordered to shoot her on sight. Appalled, a local family purchased Emily from the slaughterhouse and when she was captured, arranged for her to stay at the Peace Abbey in nearby Sherborn.

            Emily became famous and was visited by celebrities and visitors from around the world. Like Flaco, she became a symbol of freedom to many. She was even a bridesmaid at two weddings. Really?

            When she passed on to the great pasture in the sky, a life-size, bronze statue was erected in her memory at the Abbey. It stands between statues of Mahatma Gandi and Mother Teresa. I kid you not.

            Freedom stories about animals abound. Nigel, a parrot who lived with a British man and spoke with an English accent, escaped captivity to seek freedom. Alas, Nigel was captured far, far away and sold at a yard sale to a gentleman named Fernandes.

            After four years, a vet discovered a chip identifying the previous owner. Mr. Fernandes was kind enough to return Nigel, now Morgan, to the original owners who weren’t sure he was their bird. Nigel … er Morgan, now spoke fluent Spanish.

            If one looks hard enough, there is always something to write about. Maybe next week I’ll write about those suspenders.  

            Editor’s note: Mattapoisett resident Dick Morgado is an artist and retired newspaper columnist whose musings are, after some years, back in The Wanderer under the subtitle “Thoughts on ….” Morgado’s opinions have also appeared for many years in daily newspapers around Boston.

Thoughts on…

By Dick Morgado