Healthy Aging looks to tackle ‘silver tsunami’

Updated August 1

Healthy Aging Martha’s Vineyard (HAMV), an Island senior advocate group, is working with Windemere Nursing & Rehabilitation Center, the Martha’s Vineyard Hospital, the Martha’s Vineyard Commission (MVC), and Navigator Elder Homes of New England to provide solutions to expand elder housing options on-Island.

HAMV chair Paddy Moore and Martha’s Vineyard Donors Collaborative executive director Peter Temple presented statistical data to the commission to highlight the need for elderly care services for the rapidly growing 65-or-older population on-Island, dubbed the “silver tsunami.”

MVC executive director Adam Turner prefaced Moore and Temple with a presentation on Island elderly population projections provided by the University of Massachusetts Donahue Institute. The data projections show the Island elderly population growing exponentially, while most other age-group populations are decreasing. By 2020, the elderly population (age 65 and above) is expected to make up 24 percent of the Island’s population — climbing steadily to 29 percent in 2035, according to the projections.

“No matter how you slice it, the elderly population is getting bigger,” Turner said.

An increase in elderly populations is a trend that can be seen across the state, but is elevated on the constrained Island, Turner said.

Hospital CEO Denise Schepici was in attendance at the meeting to explain how the hospital was tackling the elder population growth. “In order to serve this growing population, we need more primary-care physicians … I’m trying to focus on hiring the doctors as we all together try to solve the elder long-term-care issues.”

The comments echo statements Schepici made at an open forum in June in which she described Windemere as the “past” and “not the future of elder care.”

Turner also surveyed over 2,000 Island residents over the age of 65. In his data, he found that while 78 percent of respondents said “it was very important” to stay on the Vineyard while they age, they found it was becoming difficult to do so. Elders are also living longer with advances in medicine, but as they live longer, elders face disabilities, illnesses, isolation, increases in costs of services such as meals, nursing care, and life care, and limited access to primary-care doctors, forcing elders to look for these services off-Island, which requires transportation which can be difficult for elders.

Senior center usage is increasing, which Turner accredited to education and outreach of programs offered on the Island.

In his presentation, Temple highlighted aging in community issues. As people get older they make less money — $25,000 is the annual average income for elders age 85 and above, according to a survey conducted by the Heller School at Brandeis and paid for by HAMV — which can be problematic because long-term care is expensive. A certified nursing assistant (CNA) makes $30 an hour, which when working for eight hours a day, five days a week, can cost $62,000 a year. This, Temple said, was a conservative estimate, and would only work if an elder had a family member to take care of them nights and weekends.

“This becomes an issue for the community,” Temple said.  “How do we as a community see that [elders] get the affordable help they need?”

One of Moore and Temple’s potential solutions to care for the Island’s elderly population is Green House Homes, nursing homes that improve elderly satisfaction through individualized care, innovative design, and workforce housing for employees.

Green House Homes are different from traditional nursing homes such as Windemere which Temple said was “full,” “operates at a loss,” “isn’t sustainable,” and is “old.”

A Green House Home tends to house 10 to 12 elders. Their design is made to look and feel like a home, complete with private rooms, bathrooms, home-cooked meals, and no drug carts.

“Green House is like a brand,” Turner said.

“Two hundred fifty-six Green House Homes in 31 states, and it’s got a 15-year history. It’s not a theory,” president and CEO of Navigator Renee Lohman, who attended the meeting, said.

The homes also utilize a form of elderly care called Shahbazim. A Shahbaz — a term derived from a Persian legend of a falcon who hovers over the country, protecting it — is a versatile worker who provides personal care, meal planning, laundry service, and does activities with seniors living in the home.

Green House homes can be configured into assisted living (AL) homes or nursing homes. In assisted living homes, elders have less care, but more independence. In nursing homes, elders have more round the clock care and less independence.

HAMV has determined the Island needs two 12-bed Assisted Living and Memory Care (AL) homes. Temple estimated the development costs of the homes to be $8.5 million with net operating incomes to be $62,620 a year.

To build the homes would require finding free land.

“How is that possible on this Island?” commissioner Josh Goldstein said.

“Someone might give land, someone might have land,” Temple replied, but added, “It’s not doable without it.”

Commissioner Trip Barnes called the $8.5 million price tag “pie in the sky,” and a “very conservative” estimate.

Between 2015 and 2017, Windemere was having trouble finding CNAs who could afford to live on the Island, Temple said, so they hired “travelers,” or off-Island CNAs. “They are paid a significant premium in the rate, and the hospital pays for their housing costs,” Temple said.

MVC Chairman Jim Vercruysse called the travelers an “anti-solution” to the CNA deficit.

Temple said HAMV is working with the hospital and Navigator to update studies and figure out how workforce housing could be implemented on the Island.

The commission will meet with Schepici on August 2 to discuss a development of regional impact (DRI) plan to convert two units at Windemere into clinical and business service buildings.

Updated to correct net operating incomes. — Ed