Wednesday, July 01, 2009

Cuts Impact on Elderly in California: A Test of Conscience

I have been teaching Gerontology courses since the early seventies at California State University Dominguez HIlls. In 1977, my colleagues and I created the first Gerontology Graduate program in the State University system. Recently the college has stopped accepting new applications and the program will be soon be eliminated. One reason given is there were too few students. “Your program just isn’t big enough” in spite of the fact since the seventies, the program has been graduating well trained students who have successfully gone out into the workforce taking strategic positions serving older adults throughout Southern California. Other Gerontology programs throughout the State are also facing dim futures, if recent trends are not reversed.

For the 30 plus years that I have been teaching courses on aging, I have been told by the uninformed that Gerontology is a great field because so many of us are aging we will need Gerontologists to meet the needs of the increasing numbers of old people of the future. Well, the future is here and we seem to be going backwards. Needs and issues of older adults do not necessarily translate to a job world opening its doors to an army of experts. The ageist society we live in prefers to look the other way. The old also do this, talking about their grandchildren coming first, not taking into account their own needs. The consequence is a small workforce of underpaid and overworked caregivers and service providers.

One former student working as an ombudsman for the State of California lost her job due to previous budget cutting. Ombudsman act as the State’s designated problem solving liaison for the resident or family member who has registered a complaint as well as for the nursing home provider. Ombudsmen represent the only resonating voice there is for elderly residents in long term care facilities. More cuts proposed by the Governor will devastate that program. Additionally, inspections of nursing homes will be limited to every 5 years instead of every two years.

Under the Governor’s proposal, State Adult Home Care programs will be entirely eliminated forcing many middle aged adults to have to make the decision to either quit their jobs and stay home or to place their aged parents in a nursing home with inadequate oversight. How much will the increase in elder abuse cost the State and its citizens? Adult children of the frail elderly should not be the only “eyes” watching the system and when these family members do find their loved ones injured or ignored who will be there to handle their complaints, the same people causing the problems? These proposed (2009) State Budget cuts would be the final blow to a system already ravaged by earlier belt tightening.

Another graduate who works as a case manager for a In Home Supportive Services program will no doubt lose her job if these cuts are instituted. This is the State funded entity that helps the old person who is physically limited stay in her or his own home by providing low cost housekeeping, cooking, shopping, and bathing services. Costs to the State will only go up when monies are transferred away from home care to the larger expense of providing housing in a Long Term Care Facility ($75,000 annual average cost in Los Angeles for skilled nursing care*). Since MediCal is proposed to take the biggest hit, that would mean that significant numbers of older ailing low income and lower middle class residents of California would be forced to stay on their own without help or with families often unprepared and unequipped to take care of them.

I am not saying keeping nursing homes as they exist now are the best remedy for everything that ails older Americans. Nursing homes are only one imperfect option, however, by not inspecting them, not providing ways to keep the elderly from entering them, and not helping to make facilities that house the elderly safer forces the old and their adult children into an impossible situation where every choice is a clearly a bad choice.

It is evident that the budget choices that face the State of California is a job for King Solomon. All King Solomon could do in biblical times when two mothers claimed the same child was to scare both Mothers. One Mother had to lose. If these measures are adopted, we all lose for how we as a people treat our elderly is a test of our moral fortitude and conscience. And more to the point, those who make these decisions may not realize, it is their own futures they are also putting at risk.

*Business Wire , April 29, 2008,

Sharon Raphael, Ph.D.
Professor Emerita of Sociology
Coordinator, M.S. Health Science-Gerontology Option
California State University Dominguez Hills