Governors brace for baby boomers

By Marsha King
Seattle Times staff reporter

BRIAN CASSELLA / THE SEATTLE TIMES Wyoming Gov. Dave Freudenthal, far left; Washington Gov. Gary Locke, second from left; and other governors listen to John Fregonese, an urban planner, at the annual National Governors' Association meeting in Seattle yesterday.

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Imagine neighborhoods so well-designed with sidewalks and shops that older residents who don't drive can still get out easily on their own to pick up a loaf of bread, check out a library book or bump into friends.

Such high-tech gadgets and urban-planning ideas dominated yesterday's opening session of the National Governors' Association (NGA) annual meeting at the Westin Hotel in Seattle. The meeting ends today.

Besides playing politics, the governors were here to learn what best practices can help their states get "elder-ready" — that is, prepare for an onslaught of 77 million aging baby boomers, the oldest of whom turn 58 this year.

The challenge is to find ways to keep today's older generation and boomers independent, theoretically delaying or even eliminating their need for expensive long-term care.

To that end, the governors received from a NGA task force a "Top 20 List" of actions to improve long-term care in their states.

The list includes:

• Establishing "fast-track" eligibility for home and community-based services. Medicaid-eligibility rules have made it routine to refer people discharged from hospitals to nursing homes.

• Improving tax treatment of caregiver expenses to provide financial relief. Some states offer a deduction for expenses; most offer a credit.

• Expand family- and medical-leave benefits to caregivers. Some states have broadened the federal law by applying it to workplaces with fewer than 50 employees. Huge numbers of baby boomers are living longer thanks to medical advances, but they still may not be able to care for themselves.

"It's estimated that half may go broke trying to cover the cost of their own long-term care," said the NGA chairman, Idaho Gov. Dirk Kempthorne.
 
States now spend about $76.5 billion in Medicaid dollars on long-term care. In Washington, the tab is $1.1 billion in state and federal dollars for all kinds of long-term care.

"Every state is dealing with these issues," said John Fregonese, a principal at Fregonese Calthorpe Associates, a Portland-based regional and urban-planning firm. Fregonese spoke at the opening session yesterday.

He urged governors to champion flexible zoning that allows a variety of housing choices and needs.

Aging boomers may want to move from single-family homes to apartments and eventually assisted living. As people age, their mobility, including their ability to drive, decreases, while keeping active and independent is one of the essential parts of healthy living.

So it's a good idea to build walkable cities, where it's not too far from one place to another and the trip in between is pleasant and interesting.

Prototype home-health technologies were demonstrated by Eric Dishman, a social scientist who works for chip maker Intel.

He's director of Intel's Proactive Health Research Lab in Portland and chairman of a new grassroots group called CAST, or Center for Aging Services Technologies. CAST comprises technology companies, long-term-care providers and university researchers who want to accelerate the development of technologies to help the aging.

Intel's Health Lab aims to make the home "a node of diagnosis and care."

Take the walking cane, developed in collaboration with Oregon Health & Science University. A tiny computer and radio are attached to the cane. Sensors that measure force are in the tip.

When a person walks with the cane, the sensors send real-time data to a tiny computer called a mote, which can transmit to a personal computer in the home.

Analyzing the pattern of walking can reveal if the person is growing unsteady and needs help, Dishman said.

Intel is testing other technologies to help people who have dementia. Included are gadgets that remind a person how to make tea — the Intel research is being done at the University of Washington — and telephones that not only display a photo of who's calling but also what their last conversation was about.

Among the challenges that come with the new technology: privacy, funding and liability. In a question-and-answer period after the opening session, some governors wondered how privacy issues around the new home technology can be resolved.

Dishman acknowledged privacy is a huge issue.

But the technologies can be made "symmetric" between the older adult and the caregiver, he said. That way "it's not about surveillance, but communication."

Kempthorne predicted consumers will see financial incentives for getting long-term care insurance and more public-private partnerships to promote technology in the home. "We have eight years to get ready for the baby boomers," he said.