The aging Baby Boomer generation will bring unprecedented financial burdens to state and federal budgets – possibly breaking the bank – unless  the current levels of institutionalization are significantly reduced.

Nursing home reimbursements are costing the country hundreds of billions annually. The costs are so high that most people who are institutionalized, especially if they live for several years after confinement, eventually are forced to go on welfare.

Home care is the best option for large percentages of the elderly to stay off the welfare roles – Title IX – by which their institution’s bills are paid by the government. Currently, in Connecticut, that amounts to about $12,000 each month, per person, and that is virtually the tip of the iceberg.

Not everyone is capable of caring for an elderly relative at home home and not everyone should. But to make it easier for those who are considering such a move, the LA Times today ran an article that hits some of the highlights of preparing yourself, your home and your relative for what is certain to be a life-altering decision for everyone involved.

From the Los Angeles Times:

Stuff happens, so be prepared. If they have a personal emergency response system, your parents can call for help, 24/7, with only a push of a button. Newer systems can detect when a person has fallen down, so even if they’re too injured to push the button, the system will automatically alert an operator.

Being prepared can prevent stuff from happening. In the long run it’s important to create an environment where such a system is needed as rarely as possible, says Linda Ercoli, director of geriatric psychology at UCLA. “If you fall and break your hip, you might be able to push a button and get help, but the fact remains that you’ll have broken your hip.”

Your parents’ home may be booby-trapped with all sorts of falls waiting to happen — including slippery showers or tubs (add grab bars), slide-prone throw rugs (get rid of them or tape them down) and fate-tempting steps and stairs (consider installing ramps or even chairlifts). Poor lighting is another open invitation for your parents to take a tumble or bang their heads or stub their toes. With brighter, better-positioned lights, they can see what they’re doing and where they’re going.

Be an alarmist. Smoke and carbon monoxide alarms should be standard in every home. But your parents might also benefit from other, more specialized alarms, for example, an alarm that goes off if a pot has been left unattended on the stove for too long, or one that reminds them to take their medications (and alerts someone else if they don’t).

Life-simplifying devices. Clothing that fastens with Velcro — instead of buttons or zippers — can make a welcome difference for fingers stiff from arthritis. And for backs no longer terribly keen on bending, an extra-long shoehorn can be a real blessing.

Staying connected. Isolation can be a problem for seniors, especially as they become less mobile. If their hearing has also gone downhill, talking on the phone may be difficult. But a phone with amplified speakers can help, and if their eyes aren’t so sharp anymore, big buttons can help too. So can email with big fonts.

Senior centers and adult day care are other good options for those who can get to them — as are pets, at least in the right circumstances.

Food. Nutrition can be problematic for seniors. “Will they eat right — or even at all?” Perhaps your parents are eligible for Meals on Wheels services. Also, senior centers often offer no- or low-cost lunches. You might even hire someone to shop for groceries and prepare meals.

Professional services. Staying in their own home can be a lot easier for your parents if they don’t need to worry about keeping it clean or keeping the yard looking good. You can hire professionals to do those and almost any other chores your parents might no longer feel up to.

Taking care of business. Maybe it’s time for you to take charge of your parents’ finances — pay their bills, balance their checkbook. And it’s important for them to consult an elder law specialist. How they handle their assets can have big-bucks repercussions down the road, affecting their eligibility for programs like Medicaid, to name just one example.

Take care of yourself too. Worrying about and caring for your parents can wear you down. You can become isolated yourself and find yourself thinking, ‘I want my life back.’ Part of the challenge is the guilt you feel. That’s where caregiver support groups come in.

Resources. Countless agencies and organizations are dedicated to providing invaluable — but often free or low-cost — senior services. Information about many of these is available from your local Area Agency on Aging.

The Times did a good job of highlighting some of the ways to prepare for elder care. There are many more of course, and the emphasis will change drastically if elderly parents move into their children’s homes. But the basics are still essentially the same … prepare your home and yourself for a new set of priorities, and above all retain your sense of humor.

She returned to the state Capitol  in late January,  went right back to work and says  she’ll be running for another term!

“Too many important things are happening, I’ve got to be here,” she told the Hartford Courant.

Prague, 86,  attended a press conference on the issue of home health care options for the elderly and disabled.

State Sen. Edith Prague, New London Day photo

“It is no secret that anybody who needs care wants to be at home to get that care,” Prague said, adding that she’s “living proof” that home care works.

Prague said she suffered a minor stroke on Christmas. “My daughter came over and noticed that the left side of my face didn’t look right,” she said. “There was nothing else. When I got to the hospital, they told me it was a very minor stroke, lucky for me, because strokes can be devastating.”

OK, maybe it’s not politically correct, but it does reflect a reality in human demographics – the study of humans and charting us by categories such as age, race, religion, and education.

I received an update on the status of Connecticut’s elderly from the state Commission on Aging over the holidays that is quite revealing in many ways, starting with the fact that statewide the population is getting older quickly. More to the point we are older on average than the population of most other states, and women do indeed outlive men.

As of the 2010 census Connecticut had 506,559 people aged 65 and older out of a population of 3,574,097, which amounts to 14.2 percent of the population, compared to 13 percent nationally.

Connecticut ranks 7th for median age – 40, compared to a national median age of 37.2. Additionally,  2.4 percent of the state’s population is aged 85 and older, one of the highest rates in the nation which has an average of  1.8 percent

Connecticut had 930 centenarians – people aged 100 and over according to the 2010 census, and one super-centenarian, aged over 110!

If the current statistics don’t succeed in showing where we’re going, it also is noteworthy that 26.9 percent of  Connecticut’s population – 960,000 people – are Baby Boomers, people born between 1946-1964 and they will turn 65 in the next 18 years.

Ron Winter

Now here’s where we get into the gender issues.  Connecticut’s population of people aged 65 and older is 58 percent female, which means 42 percent are male.

As we continue up the age ladder to those aged 85 years and over, nearly  70 percent of the population is female, meaning the male segment drops down to 30 percent.

By the time we get to the centenarians in Connecticut 85 percent are female and the guys are hopelessly outnumbered, although if they value female companionship they don’t have to look very far for friendship.

Demographics also chart where people live and in the eight Connecticut counties, Litchfield has the highest percentage of people aged 65 and over – 16 percent of that county’s population, and Tolland has the lowest at 11.9 percent.

In Connecticut’s five largest cities, Stamford at 13.1 percent has the highest percentage of people aged 65 and over and Hartford at 8.9 percent has the lowest.

While CT’s total population grew by 4.9% from 2000 to 2010, its population of older adults grew more quickly: Residents aged 65 and over grew by 7.7 percent; and, remarkably the fastest growing segment of the population was those aged 85 and over, which grew by 32 percent!

There is much to make of these trends, primarily that the older the population, the more care it will need and the more expenses for that care will grow. Even with ongoing efforts to keep as many elderly as possible out of institutionalized care, which now costs about $12,000 per month and up, the number of people who will reside in some form of assisted living will increase sharply in the coming  years.

The impact on state and federal budgets will be enormous, and it is plain to see that community and home based care will be the saviors not only of our financial security, but of the quality of life for many elderly residents too.

I was relating the story of a woman I had written about last year and how she died in an institution with her body pumped full of drugs. My friend said that while drugs are administered at times to alleviate pain there are many times when the elderly are approaching death but neither need nor want pain-killing medication.

She said that loss of appetite is an early sign that the body is beginning to shut down but where a younger and healthier person would soon feel hunger pangs and literally be forced to eat, an elderly person who is nearing death might not feel pain at all.

In fact, she said, first-time care givers often attempt to convince their relative to eat more and drink more as a first response to decreased appetite, which is not only unnecessary, but could be counterproductive.

Ron Winter

Since the body is shutting down its needs are far less than normal and food requirements are far lower, she said. But the body produces natural endorphins she said, that block the pain that otherwise might be felt from hunger.

In the case of a person who is nearing death the body produces higher doses of endorphins so pain such as hunger may not be felt at all.

Before I go any further endorphins are defined by Webster’s dictionary as “any of a group of endogenous peptides (as enkephalin and dynorphin) found especially in the brain that bind chiefly to opiate receptors and produce some of the same pharmacological effects (as pain relief) as those of opiates …”

Endorphins are further defined as consisting of two root words: endo- and –orphin which stem from endogenous and morphine, meaning a morphine-like substance originating inside the body.

In other words, endorphis are natural pain killers.

I wasn’t unfamiliar with endorphins as I spent much of my life as a weight lifter and personal trainer. Endorphins are often referred to in the fitness world as natural blocks between the discomfort of exercise and the desire to attain fitness goals.

Long distance runners are familiar with endorphins which many believe kick in usually after a few miles. Speculation is that the human species survived because endorphins allowed them to run at high speeds over great distances presumably to avoid being captured and eaten by Saber Toothed Tigers or other predators or that time.

There are some researchers who disagree with that hypothesis and say that runner’s high comes from completing the challenge not from being involved in it.

I tend to disagree with that concept though because in year’s past when I ran long distances as part of my fitness regimen, the runner’s high kicked in somewhere around the fourth mile. I was never a marathon runner and topped out at 7-mile runs, so I could hardly say that the challenge was over when the good feelings began.

There also is considerable research on endorphins and the role they play in relaxation, mental disorders, acupuncture and even pregnancy.

It is interesting to say the least that much of the debate on endorphins centers on whether specific activities release endorphins and to what degree, yet with the elderly it isn’t activity that can release them but inactivity.

Obviously as our population ages many people who now concern themselves with exercise induced endorphin levels will begin to take an interest in endorphin levels that occur when they aren’t exercising. Who knows what secrets may be unlocked in the functioning of the human body by an aging generation that many have criticized for being too self-absorbed.