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Aging in the Inland Empire: African-American Elders in Peril

Part One - The Unraveling of the Safety Net

New America Media, Special News Report, Linnie Frank Bailey Posted: Sep 10, 2009

This is the first in a two-part series examining the plight of African-American elders and people with disabilities in Southern California's Inland Empire. New America Media political journalism fellow Linnie Frank Bailey examines the effects of recent budget cuts that have reduced services in the states adult day health care centers from five to three days a week.

An Aging World
Throughout history, the cultures of the world, from Judeo Christian, to Islamic, Hindu and Buddhist societies, have defined the success of a people by their treatment of their elderly. African countries, likewise, have a tradition of celebrating elders for their longevity and wisdom. However, even in cultures that value the elders of their society, global aging is becoming a concern as the older populations of the world compete with younger generations for limited resources.

Experts ponder, What will be the fate of the worlds elders as they increase in number and require more of the worlds food, energy, housing, and medicines?

According to a recently released National Institute on Aging report, An Aging World, the worldwide population of adults aged 65 and over is projected to grow from an estimated 506 million in 2008 to 1.3 billion in 2040. The report shows that elders will grow from 7 percent of the worlds population, to 14 percent in just under 30 years.

The growth among African Americans over 65 will follow these global patterns. According to the U.S. Census, the African-American population of adults aged 65 and over was 3.1 million in 2007 and is expected to grow to nearly 10 million by 2050.

Aging is affecting every part of the country. Nowhere is this more apparent than in California. According to the most recent census data, the countrys most populous state also ranks first in the number of adults aged 65 and over. And while Los Angeles County has the largest senior population of all of the counties in the country as reported in the 2000 census, current projections suggest that Riverside and San Bernardino counties combined will soon have the largest number of seniors of any geographic area in the country.

August 31, 2009 is D-Day for Barbara Porter, director of the Inland Empire Adult Day Health Care Center (ADHC) in Corona, Calif. That is when, due to recent state budget cuts, MediCal (the Medicaid program in California), will slash its funding level for users of ADHCs from five to three days a week.

Our families are scrambling, said Porter. I know of at least 10 elderly participants who will be put into nursing homes immediately because there is no one to care for them those two days they cant come here.

The Inland Empire ADHC is one of 340 adult day programs in California. An ADHC is a licensed MediCal-certified health facility that treats the health and other needs of older adults with multiple chronic conditions, such as Alzheimers or Parkinsons disease The centers provide an organized day program of therapeutic, social and health services, and offer a respite for families caring for loved ones who cant be left alone.

Because two days of the work week have been cut, the options left for families are not easy. For most family caregivers, reducing their hours or quitting their jobs to provide care is not an option during these tough economic times. Many will either pay the ADHC out-of-pocket rate, hire a sitter, put relatives in a nursing home, or risk leaving them home alone.

Some of our participants require 24-hour care, said Porter. Leaving them alone would be considered abuse.

AgingThe elders who come to the Inland Empire ADHC fall into two groups -- those who have been developmentally disabled for most of their lives, and others struggling with the ravages of aging, such as dementia and other chronic illnesses.

People come to us when Grandpa forgets and leaves the stove on, or when Grandma has a stroke and needs daytime care, said Porter. About 100 participants come to her center regularly.

Years ago, developmentally disabled adults seldom reached old age. However, because of advances in treatments over the years, life expectancy is growing longer.

Some of these people are over 60 and being cared for by aging siblings because the parents have passed on, Porter observed. Because people are living longer, it is not uncommon for us to see frail elderly children caring for sick elderly parents, or vice-versa.

'Our Son is Helpless'

Family caregivers, such as 63-year-old Corona resident Sandy Davis, depend on ADHCs to give them a break from the constant demands of caring for a severely disabled loved one.

Sandys son Desmond, 36, suffers from a complex mental illness called schizoaffective disorder, which includes paranoid bipolar disorder and major depression. To control the condition, Desmond takes a host of medications. However, prolonged use has caused medically induced Parkinsons disease.

There have been times when Desmond has been hospitalized over 20 times in a single year, said Davis. My husband and I assist him in taking his medication, eating, dressing and bathing. Our son is helpless.

Davis feels blessed to have a daughter and grandchildren who can help with Desmonds future care. For now, though, Inland Empire ADHC has given the family a respite from 24-hour caregiving and provided Desmond a chance to exercise and interact with others in a safe, medically-controlled environment.

Davis is still employed, so her retired husband will have to pick up the slack during the additional two days. I know Desmond will be disappointed, she says. He loves the time he spends with friends at the day center.

Family caregivers and advocates for elders are searching for alternative ways to counter the missing two days of service. While some residents of more affluent coastal cities can afford to pay as much as $200 daily in out-of-pocket costs for adult day health care, many family caregivers in the Inland area cannot afford the $80-a-day rate the Inland Empire ADHC charges.

MediCal covers $76.50 per day for ADHC services, and $170 to $200 per day for nursing home careso it will cost the state more if caregivers resort to putting their loved ones in nursing homes.

In addition, not all nursing homes accept MediCal. Some only allot a small number of beds to the low-income MediCal patients. Recently, in an impromptu survey of nursing homes within a 50-mile radius of the Inland Empire ADHC, Porter found only one MediCal bed available.

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