It Takes a State | Health + Fitness | Seven Days | Vermont's Independent Voice
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It Takes a State 

Assessing the cost of Vermont's aging population

Vermont is showing its age. Each year, the number of "old folks" in our ranks gets larger, both in real numbers and as a percentage of the state's total population. Like the rest of the nation, Vermont is on a collision course with the Baby Boomers -- the generation born between 1946 and 1964 -- who are approaching retirement age. Within 20 years, this demographic bubble will strain every facet of our economy, from housing and health care to transportation, labor and industry.

In many respects, the graying of the Green Mountain State is part of a larger trend in New England. For years, Vermont's population growth has been slowing. Meanwhile, the state has also been experiencing an exodus of its young people to Sun Belt and western states, where jobs and housing are generally more plentiful, and the quality of life is considered better -- or at least the climate is more temperate. This outflow is already creating a tighter labor market that will continue to put pressures on Vermont businesses.

How will Vermont balance the inevitable shifts in priorities? In some cases, the state's small population and unique rural character will create daunting challenges; in others, size may work to our advantage. But two things should be kept in mind: First, this demographic shift won't happen overnight. According to Julie Wasserman at the Department of Disabilities, Aging and Independent Living, demand for elder-care services won't peak until after 2030, when the oldest "boomers" turn 85. Second, unlike the impacts of wars, pandemics and terrorist attacks, the graying of Vermont is both predictable and inevitable.

There is a silver lining to the impending bout of senioritis: Just as the Baby Boomers reshaped societal attitudes about career, home life and childrearing, so, too, will they redefine the way we think about, and provide for, our elders. Many Vermonters have already begun laying the groundwork for this shift in attitudes.

THE BIG PICTURE

37.7 -- Vermont's median age in 2000

40.4 -- Vermont's median age in 2004 (estimate)

5 -- Vermont's rank among the states with the oldest median age

55% -- Projected growth rate of Vermonters aged 65 to 74 from 2004 to 2014

26% -- Projected growth rate of Vermonters aged 85 or older from 2004 to 2014

THE GOOD NEWS: Generally, Vermont's seniors are healthier than they were 20 years ago. They smoke less, are more physically active and have access to better medications and health care. The incidence of disabilities among elders is declining, albeit gradually. As John Barbour, executive director of the Champlain Valley Agency on Aging, points out, Vermont elders are more likely today than 20 years ago to be college educated, use the Internet, drive a car, travel and live independent lives. As a result, their own quality-of-life expectations are high.

THE BAD NEWS: More independence has also brought more isolation. Participation in senior meal programs has been declining, as has membership in community groups such as churches, granges and social clubs. "People used to be more tied into their community and knew their neighbors better," Barbour notes. A senior "can live in a building with 100 other people and still be isolated," he says.

HOME INSTINCT

22 -- Percentage of Vermonters 85 or older living in nursing homes in 1992

14 -- Percentage of Vermonters 85 or older living in nursing homes in 2003

The current buzz phrase in the senior housing community is "aging in place," which means helping seniors remain in homes and communities that are familiar to them. It's often assumed that most elderly people 85 or older live in hospitals or nursing homes. In fact, 80 percent of long-term elder care is provided in the home by informal caregivers -- spouses, children and other family members.

THE GOOD NEWS: Home ownership among seniors is very high in Vermont. Moreover, the state's excellent nonprofit housing organizations are exploring new residential options for the elderly that are more desirable, and cheaper, than institutional living. Among them is Burlington's Cathedral Square, which provides housing to about 1000 people. CEO Nancy Eldridge says Cathedral Square is looking into an innovative model of clustered senior housing called "green houses," which combine the independence and privacy of separate apartments with the supports and cost efficiency of assisted living. "The challenge is that seniors want to stay in their own community," Eldridge says. "The trick is to make the numbers work."

THE BAD NEWS: Currently, there are only two affordable, assisted-living facilities in the entire state. And experts predict a shortage of both formal and informal caregivers in the next 20 years.

GETTING AROUND

1 -- Rank of Grand Isle among Vermont counties with the fastest growing elderly population

0 -- Number of locations in Grand Isle County that provide kidney dialysis

200-- Number of seniors and others served by CIDER, a transit agency in Grand Isle

150,000 -- Estimated miles put on CIDER's four vehicles this year

THE BAD NEWS: Grand Isle is representative of most Vermont counties: small, remote towns that are far from medical services with no real public transportation. Nonprofit transportation agencies such as CIDER -- Champlain Islanders Developing Essential Services -- are already strapped for cash and can't predict how they'll cope with the increased demand in the next decade. "In terms of absolute numbers of people, [we might not] grow by the thousands," says CIDER Executive Director Robin Way, "but even another 100 or 200 people of that age is going to put a real strain on what we're able to do."

THE GOOD NEWS: A recently acquired grant will enable CIDER to do some strategic planning. Way says, "We need to know the answer to the question of how we're going to serve those people."

WORKING IT

+55% -- Projected change in the number of Vermonters aged 65 to 74 from 2004 to 2014

-10% -- Projected change in the number of Vermonters ages 18 and younger from 2004 to 2014

5 -- Number of Vermont's five fastest growing occupations related to health care

17 -- Number of Vermont's 25 fastest growing occupations related to health care

THE BAD NEWS: By 2020, Vermont will have more Medicare beneficiaries than students in its public schools. This shift is already causing a serious shortage of skilled workers, according to Vermont Labor Commissioner Patricia McDonald. "We are facing a slowing population-growth rate, an exodus of young people and an aging population, all of which are converging to create a tight labor market," she says.

THE GOOD NEWS: Everywhere she goes in Vermont, McDonald says employers are discussing demographic shifts and the need for skilled workers. The Department of Labor has been actively encouraging Vermont employers to include "non-traditional workers" as viable parts of their workforce: seniors, refugees, disabled people and those transitioning between jobs. They tend to be motivated. "To me, that's something that we can offer as a competitive edge in Vermont," McDonald says. "We can rely on our traditional solid work ethic."

TO YOUR HEALTH

46.7 -- Average age of a Vermont pharmacist, as of May 2005:

76 -- Percentage of Vermont's medical laboratory workforce over 40

79 -- Percentage of Vermont's nurses over 40

The graying of Vermont will take a double hit on the state's health-care industry: First, an older population will mean increased demand for both acute and long-term medical services. Second, the people who provide those services are aging, themselves. Currently, more working nurses in Vermont are over 60 than under 30.

THE BAD NEWS: Vermont's physician population isn't keeping pace with the projected growth in need over the next decade. Paul Harrington, executive vice president of the Vermont Medical Society, says it's a struggle to attract new doctors to Vermont. The culprits: lower Medicare reimbursement rates compared to other states, and liability premiums that have increased 50 to 100 percent in the last four years, Harrington says.

Vermont may have a low cost of living and a high quality of life, but doctors are finding they don't have enough time to enjoy the amenities that attract people to Vermont. "Particularly in rural parts of the state, you may be the only physician, so you don't have other physicians on call," Harrington notes. "You're basically working seven days a week, potentially 24 hours a day. So it's a pretty hard lifestyle."

THE GOOD NEWS: After 10 years of declining nursing school enrollment in the 1990s, Vermont's student-nurse population is on the rise again. Mary Val Palumbo is director of the Office of Nursing Workforce, Research, Planning and Development, a program created in 2001 to address the state's acute nursing shortage. Although Vermont anticipates a wave of retirements in the next five to 10 years, Palumbo says they're continuing to "feed the pipeline."

Next up on the agenda: retaining older nurses or retraining them for faculty positions to teach the next generation of professionals. "Right now in the legislature, there's so much talk about health care, and it worries me sometimes that there isn't the simultaneous discussion about the people who provide health care," Palumbo says. "Health care is not just buildings and insurance reimbursement. It's people taking care of people."

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About The Author

Ken Picard

Ken Picard

Bio:
Ken Picard has been a Seven Days staff writer since 2002. He has won numerous awards for his work, including the Vermont Press Association's 2005 Mavis Doyle award, a general excellence prize for reporters.

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