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Delivering
independence
Businesses cater to seniors who want
assistance without leaving home
By
Barbara Yost
The
Arizona Republic, August 21, 2003
 Keiko
Conn (left) of Home Instead Senior Care works in Garnette Widdifield's
home for three hours every morning.
Garnette
Widdifield, 89, was reluctant to leave her north Phoenix home even when
mobility became difficult and she gave up driving.
An artist by trade, she had designed this house 40 years ago. She sweeps
her arm around a living room filled with books, knickknacks and her many
watercolors. How to pack all those belongings? The thought of living in a
retirement facility was unsettling.
"I
don't think I would have the freedom," says Widdifield, who likes to
invite friends for lunch.
Two and a half years ago, her nephew found a solution. Home Instead Senior
Care, a Nebraska-based company with several Arizona franchises, sends
Keiko Conn to the home for three hours every morning. Conn brings
groceries, makes the bed, washes dishes, fixes breakfast, sets out food
for lunch and dinner, and treats the home as if it were her own.
"She does everything for me," Widdifield says, grateful that the
service has allowed her to remain independent. "She is a
friend."
Businesses that help seniors live a fuller life are "a growth
industry, without question," says Debbie Seplow, owner of two Home
Instead franchises in the Valley.
Although nursing assistance has been available for years, the boom has
been in non-medical care, says Jim McCabe, a professor of social work at
Arizona State University West and owner of Eldercare Resources.
"In the field of social sciences and health, it's the fastest growing
health care specialty," he says.
McCabe, whose business offers services similar to Home Instead, cites the
fact that Americans are living longer, living better and want to stay out
of nursing facilities. Every day, he says, 5,000 people in the United
States turn 65. Those who make it to that milestone are likely to live an
additional 17 to 19 years.
Many of those people are relatively healthy but need some assistance to
maintain independence.
Out of that need has come a new profession called geriatric care
management. Because it's an emerging industry, there are few statistics on
its size. Jihane Rohrbacker, public relations director for the
Tucson-based National Association of Professional Geriatric Care Managers,
notes that the organization had just 30 members when it was formed in
1984. That number grew to about 600 by 1990 and 1,700 today.
"It's becoming more and more recognized," Rohrbacker says of the
association, whose members hold advanced degrees in such professions as
nursing and social work.
Demographic surge
Several
factors are driving this industry:
• An expanding market. A 2002 report by St. Luke's Health
Initiatives says that between 1990 and 2000, Arizona's population
increased by 40 percent, with residents 85 and older the fastest growing
segment. The report estimates the state's senior community will triple in
size and make up 26 percent of the state's population by 2050. The number
of people older than 75 is projected to grow to 12 percent of the
population in 2050, up from 7 percent in 2000.
• Children unable to step in. In the past, aging Mom and Pop were
taken in by their children. Today's baby boomer children are often two-job
couples with no one at home during the day. In the United States, there
are 22 million households where someone - usually a woman - is caring for
a senior outside that home while holding a full- or part-time job,
according to Steve Cohen of New York-based Living Independently, a home
health-aid business. "They're exhausted," he says.
• America's mobility. Children move away from home, leaving parents
behind. Seplow says many of her customers are adult children living out of
town who hire her to care for their parents in the Valley.
These factors have sparked innovation in products and services that put
children's minds at ease.
Home Instead is one of several companies that perform non-medical
services, such as bathing, meal preparation, laundry and housekeeping.
Caregivers take elderly clients to doctor appointments or the hairdresser,
engage in conversation, or make small home repairs. One client likes to
listen to the piano at the Nordstrom department store in Scottsdale, so
his caregiver takes him there to hear the music.
Services are available occasionally or round the clock. Fees range from
$9.50 to $18.25 an hour.
Seniors in need of assistance with finances, such as paying bills and
making investments, once turned to the family lawyer. Now they are
increasingly consulting fiduciaries, who specialize in those functions,
says Pamela Johnston, secretary of the Arizona Fiduciary Association.
Fiduciaries can also manage medical decisions, such as assuming power of
attorney for those deemed incompetent.
In 1999, Arizona became the first state to certify fiduciaries.
"There's more awareness of the need for this kind of service,"
Johnston says.
High-tech help
A
boom within a boom is occurring in technology that monitors seniors'
health and safety in their homes, says Cohen of Living Independently. His
company, with clients all over the country, develops and installs sensors
that detect activity and alert caregivers to possible health problems.
Sensors are placed in such locations as the bedroom, to detect when the
resident rises; the kitchen, to record whether the senior is eating; and
near the spot where medications are stored, to make sure medicine is being
taken. Another sensor in the bathroom detects how long is spent there (too
long, and a fall is suspected) and how many nighttime trips are made
(which could indicate an illness).
Children are buying these services for their parents, but the senior is
not coerced, Cohen says: "It's all voluntary."
This is just the beginning of "smart" technology, says Russ
Bodoff, executive director of the Center for Aging Services Technology in
Washington, D.C., a not-for-profit organization.
Many high-tech devices already exist, and "tremendous improvements
are coming," Bodoff says.
In the field of "telehealth" are instruments that read blood
pressure, blood sugar levels, body temperature and weight, often at a
touch, and send readings to doctors by computer or telephone. New devices
will be wireless.
Emergency response systems, made famous in 1990 with the Lifecall ads
("I've fallen and I can't get up"), have evolved. Such devices
now can be worn on the wrist or the belt.
There are medication-dispensing devices that alert patients when to take
pills and when they've missed a dose.
Some children are interested in having video cameras similar to
"nanny cams" installed in their parents' homes to detect
problems. Understandably, such cameras are controversial, Bodoff says,
with seniors balking at the invasion of privacy.
Caveat emptor
Another concern in the industry is the potential
for fraud. As the geriatric care field is "starting to blossom,"
scams are also blooming, says Barry Gold, executive director of the
Governor's Advisory Council on Aging.
For example, beware those "seminars" that offer assistance in
financial planning or long-term care. They could be simply pitches for
buying annuities, Gold says.
Free advice on long-term care is available at the Arizona Department of
Economic Security's State Health Insurance Program at 1-800-432-4040. The
agency also provides free counseling for Medicare recipients on such
matters as Medicare benefits, bill disputes, supplemental insurance plans
and the governor's prescription drug program.
Some companies, though honest, simply charge exorbitant rates. Often the
same services are available free by calling the Area Agency on Aging
hotline at (602) 264-HELP (4357). Cohen says one of the greatest concerns
for seniors is bathroom safety, making them receptive to companies that
will, for instance, convert bathtubs into walk-in shower stalls.
Unscrupulous contractors might overcharge or fail to do the work properly,
he says.
One mistake people make is failing to plan ahead, says Guy Mikkelsen,
president and CEO of the Foundation for Senior Living, an agency that
serves the elderly under the auspices of the Roman Catholic Diocese of
Phoenix.
"People typically wait too long to request services," Mikkelsen
says, then they grab the first offer or take the most expensive one out of
convenience.
Despite such obstacles, the industry can only continue to grow. The next
wave of innovation will serve the needs of today's baby boomers, who are
for the most part healthy and hoping to maintain an active lifestyle,
McCabe says. He has dubbed them the "wellderly."
He predicts a boom in demand for leisure activities of high quality and
low cost, perhaps with some assistance.
But resources for an increasingly aged population are still scarce, he
says. Many boomers are just a decade from retirement. Unless this booming
industry explodes, there won't be enough services to go around.
"We have less than 10 years," McCabe says, "to anticipate
the future and plan for it."
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