WGBH Radio; The Callie Crossley Show

I'm Cally Crossley This is the Cali Crossley Show. Today we're looking at increasing poverty and homelessness among the elderly. Within the next 10 years the population of the elderly homeless is expected to go up by more than 30 percent. The reason behind this the nation is getting older. We're living over a longer and the elderly are facing poverty at rates we haven't seen in decades. In Massachusetts our Elder's income covers only 60 percent of all living expenses and a setback like the death of a spouse or unexpected medical expenses could force an elder onto the street. With projections of poverty and homelessness among the elderly will only go up. Does the state have the resources it needs to handle this with talk of cutting entitlement programs like Medicare and Social Security. What could the fate of the elderly be. Up next No Country for Old Men and women. First the news. From NPR News in Washington I'm Lakshmi saying outrageous and

unacceptable President Obama's reaction to news that a member of the U.S. military allegedly slaughtered Afghan men women and children over the weekend as outcry spread across Afghanistan against the U.S. military presence there. Mr. Obama is again pledging a full investigation and punishment under the U.S. justice system. The Afghan people are demanding an open trial. Mr. Obama delivered remarks at the start of a separate event at the White House. No more hording that is essentially what the Obama administration is telling China which is accused of restricting exports of key materials known as Rare Earth. President Obama says China is not letting the market work on its own. Being able to manufacture advanced batteries and hybrid cars in America is too important for us to stand by and do nothing. We got to take control of our energy future and we can't let that energy industry take root in some other country because they were allowed to break the rules. The president speaking at the White House where he said the U.S. backed by the EU UN Japan is asking the World Trade Organization to facilitate talks with China over its

export restrictions. Mitt Romney is hoping for a breakthrough in the Deep South. Voters are having their say in the GOP presidential race today in Alabama and Mississippi and NPR's Debbie Elliott reports. It is a tight race. Mitt Romney Newt Gingrich and Rick Santorum have been fighting hard for the state's rich with conservative Republican voters. But polls show no one candidate is emerging as a favorite. Can Shortz of Mo Beals says he's still undecided. I think Romney has a great business background is what attracts me to him the most. I think Newt has a lot of good ideas about national security. And I like his. It is about that. Santorum has a good social and social conservative type of focus on family and values that I like wending either Mississippi or Alabama could be a boost for the Gingrich and Santorum campaigns. While Romney is looking to increase his delegate lead Debbie Elliott NPR News Biloxi Mississippi. U.S. stocks are rising partly on upbeat retail news Andy Baxter from member station

KNAU O.W. reports sales rose in February. One reason for that is a stronger job market. The Commerce Department says retail sales rose by about a percent last month. There were improvements across a wide range of categories auto sales gave the numbers a big boost. They rose one point six percent from the previous month. Consumers also bought more clothes and appliances and they paid higher prices for gas. Sales of gas stations rose by the biggest amount in nearly a year. The retail sales increases come on the heels of last week's jobs report which showed a robust pattern of employment gains over the past three months. Those improvements could be prompting consumers to open their wallets wider. Annie Baxter NPR News. At last check the Dow is up 116 points at thirteen thousand seventy six. This is NPR from the GBH radio newsroom in Boston. I'm Judy Yule with the local stories we're following. Prosecutors and defense attorneys are presenting their closing arguments to jurors this afternoon in the murder trial of two men accused of

shooting three adults and a toddler following a robbery at a mad upin home in 2010. The defense attorney for accused killer Duane Moore told jurors his client is totally innocent and he tried to pin the murders on the state's star witness. Prosecutors say more an Edward Washington forced the victims into the street where they were gunned down. A fifth shooting victim survived but was last left paralyzed from the neck down. The case could go to the jury later today. Prosecutors say they have uncovered two documents that may be autobio autobiographical and written by reputed Boston mobster Whitey Bulger and a status report filed in court today federal prosecutors say they found one document entitled My Life in the Irish Mafia Wars at a South Boston home and a second document of the apartment in Santa Monica California where Bulger was captured last year with his girlfriend Catherine Gregg. Bulger the former leader of the Winter Hill gang is awaiting trial for his alleged role in 1000 murders loan modification scams related to foreclosure proceedings were the

number one complaint received by the state attorney general's office last year. Home improvement contractors use cars insurance claims and foreclosure scams were among the top consumer complaints that residents lodged with state insurance agencies. Officials noted that the destruction caused by tornadoes that tore through western Massachusetts on June 1st caused a spike in consumer concerns about home insurance policies. Support for NPR comes from Jane and Gerald catcher supporting the early childhood Initiative Foundation dedicated to helping children enter school with the skills needed to succeed will have clouds and sun this afternoon highs in the 60s. A chance of showers overnight lows in the 40s. Clouds tomorrow possibly some showers highs in the 50s right now it's 65 in Boston. Good afternoon I'm Cally Crossley. Today we're looking at the State of the elderly in Massachusetts. A joint study by UMass Boston and Wider Opportunities for Women finds that millions of older Americans don't have enough money for their basic needs.

And this economic vulnerability indicates that the rate of homelessness among elders will also go up. Joining me to discuss this are Ellen Bruce director of the Gerontology Institute at the McCormick graduate school at UMass Boston. Mark handily president and CEO of hearts a bustin agency committed to ending elder homelessness. And Dr. Laura Goldman director of geriatrics in the Department of Family Medicine at Boston Medical Center. And I should note that Boston Medical Center is the only hospital in the country finding permanent housing for homeless shelters through its elders living at home program. Welcome to you will. Thanks thanks. So what the study found is that there is a gap between income and expenses in all 50 states but the largest gap is in north here in the northeast where we all live. So I thought we'd start this way if I could get each of you from your every day working with the elevate to define for me who. Oh is the poor elderly person. What is the profile of a poor elderly person

in 2012. So Mark I'll start with you. I would say that the first I've my perspective of course is from the point of view of someone who's working with exclusively a homeless population and one of the interesting facts about homelessness is that people aren't always aware of is that accent. It accelerates the aging process. So if you have any kind of latent condition it would be manifest twin you if you experienced homelessness if you were a little tendency toward sadness becomes full blown depression and so on. And one of the things that about a third of the population is going to be living on their Social Security income. The average income in Boston is around 16000. And as the fabulous work done at the McCormick Institute they. Elder economic security index says that it takes 26000 to live in Boston so it's a huge gap and then if you look at at up

about a third of the population is going to live on Social Security that averages about 10000. You can see trouble on the horizon. OK over to you Dr. Laura. Well the elderly that I see often have lack of access to good food healthy lifestyles health information doctors and medicine are often quite isolated. And by the time they make it into the doctor or into the hospital they have worsening of a normal of a health condition which often makes them much sicker and much more difficult to treat. All right. And you know I did the study and one of the things that that motivated do in the study was in understanding that the economic status of any individual but elders in particular is not based just on your income and the way we've been measuring that is through the poverty line in that measures only your income. So say we Who's Whose. I'm sorry. The government the national government so what we went about is saying

let's look how much it actually cost depending on where you're living and what your situation is. And then compare that to people's income. And that's where the gap turns up. And so in Massachusetts if you look at us just by income elders have a higher average income than the national average. But the costs are so much higher and that's actually true throughout New England that there are there actual economic well-being is is much lower and there is this big gap. So the question becomes for all of both for individuals and for all of us in society. I would argue is how do we close that gap. You know what is the way that we can start to help people as they get older Be maintain some kind of economic security and we looked at through four different category before you get that letter. That's my guest Ellen Brewster rector of the Gerontology Institute at the McCormick graduate school at UMass

Boston. Because I think we want to put on the table. You know did the profile of the poor elderly but now why is the gap so big here. I mean if if all 50 states there is a gap as we've stated as your study found but why so big in the NE of the two biggest drivers. Oh I'm sorry. Well I'm sure we were about to say the same thing the two biggest drivers are the cost of housing and the cost of health care and those for elders in particular the cost of health care is twice as much as it is for the younger people because of utilization. No surprise the cost of housing is the gap that we outline there is a gap regardless of your housing. But the many many elders are living alone and the way their housing costs are the same as if they were in a couple or a family so they're not getting the economic advantage of multiple people living in the same same place and so

those are the two biggest drivers. OK so when we think about it and you know we're just chatting about it in my office we think out west California that's expensive. How can it how can we be more than it. Can it cost more to live here as an elderly person than California. They get the same health care issues they got cut Bester their budget. I mean housing issues it's hard to wrap your mind around. Well you're correct. California is a very high cost state and it is a higher income state actually it. It is one of we. We're number one but it is where I get up there in the in the top 10 as well. What we see is actually ironically is the south east is low income low cost cars but a big gap and the northeast is high. Higher income higher costs actually causing a bigger gap. OK Mark and really did you want to add something to that. She was correct I was going to say. OK. So yeah

I will say also that there is if you look at particularly the people who've fallen into homelessness they really come from just a huge range of places they could be people. We have lawyers who find themselves homeless after the loss of a spouse. I mean that's not what people think of it as being a serf a single type of person who's almost it's not. And the reality is the threat of what happens to you if you run out of resources is is very severe for everybody. And particularly I think. Ellen alluded to it. Most of us look ultimately to our families for support at the point that that we're no longer working and then really need assistance and help. And if you don't have anyone if you become a strange to know your really really great risk. So that's the fact that often many of these families are caught in the same economic downturn that you know is that they're affecting so many people so what they don't have

as many resources to offer to their elderly loved ones. Dr. Laura talk to us about what you see in your daily life of dealing with those people who are elderly and poor and trying to live somewhere and navigate this huge gap. Well eyes people. Dr. Goldman. I'm sorry. That's OK. I see people who leave the hospital and go to a nursing home let's say for temporary for a temporary stay and then when their their time is up and they're medically their medical condition has improved they discover that they have no place to go. And so I see the nursing homes dealing with the with their social workers sometimes taking quite quite an extended period of time finding them adequate housing. Often their family members can take them in or their family members have migrated to another state. And so they have lost a spouse they've they've suffered multiple losses and

really don't have a safety net. So individuals will stay in a nursing home they'll be very unhappy they don't want to be there they want to be in their own home in their own environment. But you know sometimes they just don't have a choice. Can you recall any case most recently which you know sort of just says it all about what we're talking about here in terms of the gap the vulnerability to being close to homelessness all of that. Well I have one patient in a nursing home who was a cook and a painter. He raised two children in South Boston he lost his wife about five or six years ago was hospitalized and ended up having one of his legs amputated below the knee for his diabetic condition. He has he has diabetes other medical problems takes a lot of medications he can't care for himself and so he is in long term care.

Just the other day he he admitted that he was extremely depressed. He's alone. His family doesn't come to see him anymore he is sharing a room in a nursing home and can't sleep. His roommate has the TV on at night. And this is just a man who worked his whole life raised a family and is now finding that he doesn't have the resources to live the way he'd like to live because of his medical condition is he in a danger of becoming a client of Mark's In other words becoming homeless. You know I don't think so. You know I think that there are the resources in Massachusetts we don't discharge people such as him who are so disabled from a nursing home to a shelter that that that that we don't do. OK. Fortunately that's my guest Dr. Laura Goldman director of geriatrics in the Department of Family Medicine at Boston Medical Center one of the things that is a mark if you want to say is I'm sorry. Well you know in terms of sort of telling the story I mean

one of the things that happens is that if you're homeless most of the time get your health care through an emergency room which is very expensive and it can happen. The costs that are borne by the free care system or by Medicaid and actually are very high. So ignoring this issue as it comes up actually would end up costing. It has real cost implications just one example is cost implications for for the public yes for the taxpayer. So we had a 65 year old woman who'd been homeless for a year before she went to ours. We have one assisted living facility as well as permanent supportive housing that for formerly homeless people and she was 65 the year before she'd been to the emergency room thirty four times. And she had 15 hospitalizations of multiple days in the year before. And you know the cost of an emergency room visit is in the $800 range and you just start seeing the cost of what

we're talking about the hospitalization for multiple days is what five thousand three hundred twelve thousand. So we're paying for that after we were able to take her in housing and you know if we don't have that many openings because there's such a shortage of supply of supportive housing. You know she would because she was extremely anxious and very hard to get House to agree to be house and she was very suspicious and she had lots of lots of issues. But after in the year after she moved into our assisted living facility she was seen in the E.R. five times and hospitalized four times. I mean she had a magic drop a dramatic drop which more than paid for the cost of providing her with a permanent house. And also she became able to form relationships and live a much better life and was in fact happy. So. Well something to ponder is you know why are I think

poor elderly kind of invisible to us so let's take that up in and just a bit. We're talking about the elderly many of them particularly in Massachusetts are facing poverty and homelessness. With the publication population getting older with older people living longer and the State of the economy having been weak for so long it's a reality that's hitting a lot of people. You can join the conversation at 8 7 7 3 0 1 18 970 8 7 7 3 0 1 89 70. Do you think you'll have enough money for your old age is a relative or friend facing tough times as they get older. 8 7 7 3 0 1 89 70 8 7 7 3 0 1 89 70. You're listening to any 9.7 WGBH Boston Public Radio. This program is on WGBH. Thanks to you. And seventh generation makers of

plant based for AXA laundry detergent a cold water clean in a cardboard bottle. Energy saving laundry tips are available at Seventh Generation dot com. Caring today for seven generations of tomorrows. And the New England Journal of Medicine celebrating 200 years of delivering content that inspires discovery and advances care around the world on the web at any JM dot org that's any JM dot org. And for members of the Great Blue Hill society who's a state and planned giving arrangements to WGBH create a lasting legacy and ensure public media for generations to come. What will your legacy be. On the next FRESH AIR. Why the flushing toilet took two centuries to catch on. Why strangers used to share their beds and why kitchens used to be cut off from the rest of the home. We talk with Lucy Worsley about her new book If Walls Could Talk An Intimate History of the home she hosted a BBC series on the same subject. She's chief curator of Historic Royal Palaces in England. Join us.

This afternoon at 2 here on eighty nine point seven I'm Brian O'Donovan letting you know that tickets are running for St. Patrick's Day Celtic So you're a remarkable evening of music and dance within the realm of Celtic tradition featuring performances from Susan the kill and the bee eaters germy kittle and many. Joyous. To. Secure seats at WGBH dot org stash Celtic see you there. Welcome back to the Calla Crossley Show. If you're just joining us we're talking about poverty and homelessness among the elderly. More and more elders are living with poverty and are

at risk of becoming homeless the homeless population is also ageing. Joining me to talk about how elders are doing in Massachusetts are Ellen Bruce director of the Gerontology Institute at the McCormick graduate school at UMass Boston Market underlay president and CEO of hearts a bustin agency committed to ending elder homelessness. And Dr. Laura Goldman director of geriatrics in the Department of Family Medicine at Boston Medical Center. You can join us at 8 7 7 3 0 1 8 9 seventy 8 7 7 3 0 1 89 70. Do you think that you'll have enough money in your old age. Do you have an older relative or friend who is really struggling to make ends meet. And is it time to move to a place where living expenses are lower. 8 7 7 3 0 1 89 70 8 7 7 3 0 1 89 70 and you can write to our Facebook page or send me a tweet at Kelly Crossley. So Ellen Bruce we've established that the Northeast has the biggest gap of the 50 states in

terms of navigating income and expenses for the elderly. The underpinning of your report what you were wanting to demonstrate was that in title most programs are really very very important if in fact this gap exists and it's been demonstrated that it does. Then one of the ways that some of the elderly are able to manage even if right on the brink is because of these entitlement programs. So talk to me about what you hope people take away from this study with regard to those programs. Well I think you're totally correct that is one of the things that we wanted people to understand and I think the takeaway is that a lot of people think elders are are just fine and it's because they're just looking just at income in poverty statistics. And what you really need to look at is what what are the programs that have kept our servicing elders whether

it's the health care programs that were discussed or the housing programs but also Medicare and Social Security both of which are currently being discussed for cuts and one to the things that we would like people to appreciate is both of those programs. Have helped elders one by reducing their health care costs the other by giving them income supports that enable them to live independently with some dignity in their community which I think we all think of as the goal. If we start cutting away at those we are undercutting the progress we made in the last 30 40 years I mean Social Security for Social Security had a cola. We saw poverty rates at 35 percent for elders. We don't want to go back there in sometimes worries people say oh we solve that problem. And then they forget how we solved it. It sort of reminds me of

somebody you know goes on a diet and says oh good i lost my weight and then goes and you know reverses it so we really want people not to do that. The other thing the other point that I'd like to make here ironic has to do with the health care issues. These costs do not include long term care with Dr. Goldman talking about you know elders who who when they're older and really need the kinds of supports that we're talking about they're not even included in these costs. So those costs are really astronomical and are only being paid by Medicaid at this program. At this point. So if we if we cut any of those programs. We really are in danger of seeing many more homeless people and in fact housing is one of the few areas one of the areas we don't invest in adequately. That's where we've seen a lot of you know need

but without being able to fill it. So when you say it's long term let me just be clear resume when you say long term care what are we talking about like chronic diseases like diabetes or what are you more or more like someone's been injured and handicapped What what do you mean. No long term care is usually refers to the kind of care somebody needs for a chronic illness that is so but it is usually measured in. You're functionality not the illness itself. So if you start to need help with what is called activities of daily living living you need somebody to help to cook for you to to help dress you those kinds of things as when when you start to need the kind of long term care supports that you see certainly in nursing homes. But even even you know for people who don't reach the level of nursing homes they still need help at home in order to manage. So Dr. Gomez what is the percentage of people that you see that have arced that are grappling

with long term health issues as opposed to the kinds of health concerns that were included in the study were not even as Ellen has said there is those cost of not even being considered these long term care costs. Well I think many probably. Don't know the exact numbers but maybe 60 70 percent of the elderly folks that I see do have the effects of chronic diseases their ability to function at home some way or another. So I think that there's a higher burden of illness in patients who are impacted by poverty. And this does affect the quality of their life as they get older there are higher rates of disability and higher rates of dysfunction. So that they do need either at home care or the support of a family member or even you know long term nursing home care. So and as Marcus said it's not just the fact that you've said they're sick but he said they're

sick her because of not having preventative treatment all along the way. No question. Kind of how we live our lives in middle age that determines how we're going to age. So in middle age if we have good access to good food a healthy lifestyle health information medical care medicine then we're much more likely to have an older age where we're not disabled. And where we can function at a much higher level in till you know 80s 90s Let's take a call Bruce from Marblehead. You're in the Calla Crossley Show. Go ahead please. I go you know it's always great to have them talk you want a lot. Oh I know you love to listen. My comment was sort of preempted by yeah. And Bruce I think we have the same name first and last. I didn't model at one of the most expensive communities in the Commonwealth I think everybody would agree on that. I live a very decent life on under $10000 a year my Social Security. I have no other

asset I have a 14 year old car which thanks to my good mechanic Ron I got a concert I go to plays I eat well. Health is a key. I have relatively good health. The entitlement program meaning my medicare drug. I only take two. Thank goodness. And my regular visits the doctor keep it stable. I think we have to be careful about generalization because there are plenty of programs if you know how to get them they've got a Council on Aging. We have one here in Marblehead or elderly services. You can access these things when you need extra help. I have been ninety nine and a half year old friend for 33 years she lives here in MA. Will head into your housing as a health care worker 3 days a week shift a lively and active lives on your own. Play Scrabble twice a week. I probably could have taught me. If you can believe that. So Bruce Where do you live in Marblehead you live in public housing. Ah so there are

three or four different segments. I have a small one bedroom one room apartment it is a one bedroom but it's really like one box split down the middle. It adequate you have to learn to adapt. I make certain choices in my life which did not turn out well so I had nothing to look forward to in terms of money. I have a dear sister in New York who would have taken me in if it came to that but frankly I still wanted to live on my own. I'm going to be 73. I thought I said there were three concerts. There were reports that a program library. There's plenty to do but no money. Plus you have to use coupons and look. Right well you're having it you're really enjoying and active lifestyle and we're all happy for you I think the key thing that you said that you know I'll have Dr. Goldman respond to is that you're in good health which means that you had opportunities prior to coming into being elderly to

maintain a health IT now supports you. And that's really important I think Dr. Goleman Wilts will say in just a second that a lot of people she's saying did not. So that's what we're talking about go ahead Dr. Goldman. Yeah I mean a lot. A lot of the people I see have had untreated illness such as diabetes or hypertension leading to stroke and heart disease for for many years either untreated or inadequate inadequate treatment. And so these individuals at 73 have a much tougher time enjoying life such as such as you do unfortunately. And then Mark if if I mean he's a boy he's great have great public housing in Marblehead. You're talking about a population of people who have nowhere to go right. If you look at public housing as a resource. The waiting list is years long. Eight thousand names 12000 names on lists waiting for a turnover it doesn't happen because I believe the gentleman from Marblehead isn't

going to move out any time soon because he's doing well but the people who don't have housing because we fundamentally changed our commitment as a country to providing affordable housing. It's from after World War 2 until 1980 we had an annual subsidy that was very significant for affordable housing. The last Carter budget had President Carter President Carter had 36 billion dollars the first Reagan budget cut the six for totally it. That's a huge drop in the supply and that's the point at which real estate took off. I bought a house in Cambridge in 1975. Three family for twenty five thousand dollars. It's worth more now. It's you know it it became untethered from people's normal income levels and that the result of that is that the gradual OUAT widening and it's not just income as Ellen said earlier it's its wealth. Or in the case of a home about a third of the of the

baby boom generation has negative net worth they own things but they're livin they're in debt more than than than their assets are worth. Let me ask you this question What do you have a sense of the percentage of elderly homeless in Massachusetts. Yeah there's about 7000 in Boston Greater Boston it's about 7000 men women and children of which about thirteen hundred are over 50. So the number another interesting thing is that the total number really represents something that's a problem that we could fix since hearths founding We've housed over sixteen hundred formerly homeless shelters so there's new entrants and there's some chronic people who are very tough to house whose real problem isn't homelessness it's untreated mental illness. But. And by the way from that example earlier of the excessive utilization of emergency room care there was a study in Boston done by a great

organization called mass housing and shelter alliance called home unhealthy for good. And they found that with no pre-conditions just getting people into housing saved $9000 per person per year just for Medicaid savings alone never mind the cost of shelter and the shelter system which is more expensive than you might think. And they were able to pay for the program and it works so well that at this budget time the Massachusetts budget actually increased double the funding for that program so it's it's a and I think it's fourth year it is really one affective response. So if we don't have to increase the total amount of money. It would be nice everybody would like more money in there but that's not going to happen. But if we did the right thing and did it the smart way we actually could prevent a lot of these unnecessary costs and the scale is sufficient. This is a problem that we don't have to have. We don't have to see old people on the streets or in shelters. We have the resources to do it if we just paid attention and

made it work right. That's my guest Marc Enderley. He is a president and CEO of hearts a Boston agency committed to ending elder homelessness. We're at 8 7 7 3 0 1 8 0 9 7 8 7 7 3 0 1 eighty nine seventy. Or you can write to our Facebook page or send us a tweet. So here's the scenario. We've got at least 7000 homeless people on the street. We have a lot of people that Dr. Goleman is seeing right now who are sicker because they didn't get what they needed earlier in life in middle age and now they're trying to combat all of that plus trying to just survive. And Ellen Bruce is telling us that without these safety programs including food stamps we did mention that. But I just want to put on the table that a lot of people do not understand that the increase in the number of people using food stamps at this moment were formerly middle class people. So we're talking about a lot of folks accessing those resources and that the elderly people are part of that as well. And.

I don't think I don't think we think about I think this is the point I want to talk about. It seems invisible to us. Unless you see people on the street. Mark Enderley I don't know that people recognize that they're the what we're talking about here in terms of this huge gap in the northeast with the elderly and the and poverty exists it just doesn't seem to be in anybody's consciousness. I think I mean I think there are couple reasons for that. First of all is the elderly are a very diverse group of people. And one of the things that are the calculations that we did show that depending on your circumstance you could be you know well-off that your caller he's in public housing housing is the biggest cost for single people. So that's you know that's an enormous burden off his shoulders to be able to have public housing. Many people it's a reduced number of people but. Certainly numbers of elders own their own house for a long time have paid off their mortgages paid off and they're

pretty good. Is long as their health stays well enough to maintain the house when their health goes and they can't be in the house anymore. Then you know then certain problems start depending on the value of the house. But we also are seeing more people more elders especially the baby boomers who haven't had the pattern of buying a house and staying in for the rest of their lives. They've been you know buying another house and having a mortgage so for the first time we see people re reaching retirement age with a mortgage. Those are the people that are the worst off because they have the biggest expenses. So. I think what makes it hard for people is when they look and say elderly you know look out there and you go why you know my mother is doing just fine. And it's opening our eyes to not the one or two elders that we see every day but looking to the others. And and quite frankly you know people are

still proud. They're not you know they're not traveling out saying you know I'm going into that I can't afford this or whatever. You know I've just spent my entire savings and I don't know what I'm going to do tomorrow. And I understand that you know from a public perspective as Mark has eloquently put it that this is costing the general population and there are ways to address it so that it makes it better for everybody. More when we come back I'm Kalee Crossley we're talking about poverty and homelessness among the elderly the situation is getting worse. Joining me to talk about what this means for our elders what needs to be done to reverse the situation are Ellen Bruce director of the Gerontology Institute at the McCormick graduate school at UMass Boston she was just speaking Mark Camberley president and CEO of hearts a bustin agency committed to ending elder homelessness. And Dr. Laura Goldman director of geriatrics in the Department of Family Medicine at Boston Medical Center. You can join us at 8 7 7 3 0 1 8 9 7 8 8

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Monday April 2nd here on Boston Public Radio. I'm Catholic Crossley and this is the Calla Crossley style we're talking about poverty and homelessness among the elderly and the situation is getting worse. Joining me to talk about what this means for our elders and what it means to be done what what needs to be done to reverse the situation. Ellen Bruce director of the Gerontology Institute at the McCormick graduate school at UMass Boston. Mark Enderley president and CEO of hearth a Boston agency committed to ending elder homelessness. And Dr. Laura Goldman director of geriatrics in the Department of Family Medicine at Boston Medical Center. You can join us at 8 7 7 3 0 1 8 9 seventy 8 7 7 3 0 1 89 70 or write to our Facebook page or send me a tweet. I have two Facebook comments one from Phil. He says I see a lot of elderly folks through my work who are getting cleaned out by today's economy. How can anyone survive on Social Security alone. Today let alone in the

future is a huge question. Sure I'd say most of us are planning to work until we drop. Ryan what's even scarier for my generation I'm 25 is that today's struggling elderly are from the era of pension plans. If they're having a hard time I can only imagine how horrible things will be in 40 years unless we have a single payer health care system. So that's two Facebook comments. Now we mentioned that the UMass Boston Wider Opportunities for Women Study of which Ellen Bruce was a part. Part of the reason was for doing the study was to look at the importance of these resources of the entitlement so call in title meant programs. But here's what we know. Sitting right here today everybody in Congress I don't care what side of the aisle they're sitting on has said out loud publicly they're going to cut those entitlements. I mean that's just a done deal. It's not done yet but they're working toward that now. Nobody said the guts to figure out how much when all of that but they're all committed to

doing it. That's one fact Ellen. Well I would say they they have committed to what they will call is solving it. Social security has been an insolvency problem down the road not immediately but down the road. And the solving that is both with cuts and with additional income taxes. And I think part of what we know is Social Security is probably the most popular program in this country and it's popular not only among those who are receiving it. It's popular among the people who contributed we all even you know people who aren't eligible for it have probably their parents have been. We're going to we understand it benefits the entire. You know the entire country. So I think part of the discussion is changing that that discussion to how do we save a program

that has had so many benefits to so many without cuts without cuts. Exactly. Dr. Laura Goldman there already been cuts in Governor Deval Patrick's budget to some elderly programs notable the elderly nutrition when that's right where you live in terms of looking at those seniors who come in to see you who need an extra resource just to make sure they're getting good healthy food. How how do you how is it impacting or going to impact your population. Well you know if you think about Medicare as a whole at Boston Medical Center we have we like to say that we want to deliver the right care at the right time. I think the key to health care reform is. Reducing unnecessary care. To be honest with you I think in my practice I think all physicians are well aware that there's a lot of unnecessary care sometimes it's harmful to patients.

Sometimes it's not. But if we are smart about the right care at the right time by reducing unnecessary care I think that there's plenty of money for unnecessary care and to take care of people so I again I think what Ellen said is about it's corrective when it comes to Medicare also and that is being smart about it not necessarily just cutting it across the board that would that would be a disaster. Mark we've said a couple times in the show they were anticipating an increase in numbers of elderly homeless. You are to I know that the Hart program is expanding or you're adding. Yes. Yeah we have a new. Building that's going to open. I believe the date is actually April 5th. It's 59 units of permanent supportive housing. They'll be nursing and social workers and personal care attendants on site. If

this and this is just in response to the need that we see and that we see will be continuing. There is to talk a little bit about it as part of the answer to that. What will happen with in this budget climate this issue of smart decisions about this is really critical. But there are some good ideas that are out there. For example there's the emphasis in the health care act. Global Payments really is a very powerful inducement to do that to give the right care at the right time and also to do prevention because if you can if you're looking at the actuarial data it's very easy to see. You want to keep people for example House. So that global payment strategy really has a lot of promise. I think people are attached to their doctor. And so they don't want to change their doctor and they hear about something and they want that or they get advertisements. So generic drugs as

opposed to name drugs and all of those kinds of issues are real areas for saving so I think if it isn't as draconian as they're talking about and certainly if it's not just across the board there's some real hope. There's also some new. Public revenue models that have some real promise and in fact the Commonwealth of Massachusetts just issued its first request for responses for a program called pay for success and one of its forms is these instruments called social impact bonds. And basically they're a way to forget private investment by getting people to invest if you can find a place where government's been inefficient. They're spending too much money because it's only paying for the very high end service level. And you can actually prevent those things from happening at much much much lower cost. You can save a huge amount of money and actually make a return for the investment. So it's not as bleak as the newspapers

make it seem. And my last pitch is this is. This conversation about the cuts is really the end of an extreme swing in one direction and I think once people see what happens oh my mother's going to lose her housing. Oh you know I'm not going to have you know it's happening to me now. I think that pendulum will start to swing back and people don't get how fully integrated their lives are by things have been publicly supported people take the streets for granted and they don't know that it was paid for by the public I mean they're not thinking about the thinking about that last dollar that went out went to somebody I didn't like and they say that's what they want to cut so I don't. And I think I believe ultimately that both parties have deeply rational people participating in them and they can come to an agreement. I think the fear. I think the dialogue has never been seemed as horrible to me and I'm 65. But I think there's a I think there's a pathway out. I think the pendulum swings and good ideas and good conversation and real

dialogue can make us see why not end this problem that we could fix. Not to be negative nancy but you know government typically turns very slowly that's a and b we're about to see the hugest group of people coming into their twilight years. The baby boomers and their notorious You mentioned it in passing earlier Mark for having saved nothing. So their vulnerability economically which may lead them to be then vulnerable both from a health perspective Dr. Goldman and then from to Mark to you from a housing perspective is. It's a little scary to see those numbers coming out. I don't know they have to some large degree have been voters or maybe some attention will be brought in Bruce because of that. Well but I also think their point is the actually somebody the one of the people on the Facebook mentioned that this

problem has has two ways of closing the gap but one is with the government programs. The other is providing individuals more and more help in trying to save for that. The biggest thing that we have a big change besides with the baby boomers going to face is that employer sponsored pension plans have really shifted to you say you know we'll help you say. So the the old time pension plan where you got a immensely benefit for the rest of your life has diminished greatly. And we've let that happen. I mean there you know there that can be turned around we can think more creatively about ways that people can be in a better economic stage when they're getting to retirement. Talk about working longer working longer is definitely one answer for those who can do it. A key to a lot of the problems we see is not everybody gets to 65. Hale and hearty and even

if they are they might not be working for an employer that is particularly fond of them. So we have a number of problems here that are that aren't sort of government put more money into social programs. It is what you know how can we think of making the workplace more in Thyssen for people who is older and helping employers understand how to keep older people. What is that what kind of saving mechanisms should we have out there that that help people get there. I think there are there are many facets to it and we I'm I'm pretty depending on the day you are pessimistic or optimistic about it but I think you know I think we specially in Massachusetts where we're a pretty creative group of people. And I you know I think we just need to approach understand the dynamics and the breadth of the problem that is coming upon us. So at this moment today while all of these possibly you know potentially good programs may come into being if a person is elderly

and. Vulnerable really I guess across all of the areas that we've talked about. You know what how can they take care of themselves in this moment in time in Massachusetts where the biggest gap exists. Well the first thing is it's to reach out. There are quite a few service organizations that understand elders. And it's you know it's locating the help that does exist. I don't you know we do have gaps but we have a pretty extensive network and it's trying to hook up with that that would be the first thing I would say in it. If you're not well enough to do it hopefully a family members or family members listening you know they should start with their Council on Aging or the Massachusetts elder affairs. I lost the Commission on the affairs of the elderly. It's you make of that phone call. You can get directed to services. There

are lots for example of people having food insecurity. Despite the reduction in their anger there's. Yeah right. Sorry. Club speak it. There are despite the cuts which I'm not sure are going to actually be enacted. There's been quite a bit of pushback but there are lots of feeding programs that you can find that are available I think it's you know they ask for a donation of $2. But if you don't give it you get to eat anyway and you just have to be over 60 in Boston and you're eligible for those. So there's you know if you look around and sort of like our caller from Marblehead he's figured out how to navigate right there. And you know he's not living real high on the hog on ten thousand a year but he's made a nice life for himself so I think that's and that's great and I think people can sort of what his message was. I just wanted to point out his housing is paid for which is a huge chunk of why people get in trouble. But there is there are services. If you are homeless and

hearth or you know someone who is who's older heart has an outreach program and we work with people. That they're looking and need help navigating the system getting affordable housing is a real bruising battle. There's a it's a long road to get in there there's long lists. But but you know we can help people navigate that as well. Dr. Goldman What would you say. Well I kind of agree with what what Ellen and and Marc said elder services of Boston is a an organization that I refer to all the time and use all the time and there are services that people will come into the house and and help people out so if anybody really is in need certainly a phone call away will will get them services. I should say we are in danger of going to wait lists for these home care programs. And I think that's you know the you know one of the things

in these hard times that that we have to pay attention to. We definitely have wait lists for the housing. In the past we haven't had them in the home care programs. But I think that's on the horizon if it isn't at this time. So it's I mean I would say it's a challenge for all people individually and families but all of us you know in the believe in that it not only takes a community to raise a child but also a community to help the person aged. And I say the biggest supporter of the elderly of course are their children and and most of my patients will move in with their their sons and daughters when they're when they're really in need. And sometimes it's extremely difficult. You know you talk about the invisible elderly I think. They become very visible when you know you have your mother living in your living room because she can't manage on her own and I think that's when when people really get the wakeup call

I would also say that some people are moving you know frankly just leaving this area because even though there's a gap everywhere as we've said it's just really hard here. So that's that's one way out. All right well as you say it's a challenge for a lot of policymakers and lawmakers. Thank you all very much for your conversation today. We've been talking about poverty and homelessness among the elderly. I've been joined by Ellen Bruce director of the Gerontology Institute at the McCormick graduate school at UMass Boston. Mark Enderley president and CEO of hearth a Boston agency committed to ending elder homelessness. And Dr. Laura Goldman director of geriatrics in the Department of Family Medicine at Boston Medical Center to learn more about hearts and their adopt a room program visit hearth and dash home dot org. You can keep on top of the Calla Crossley Show at WGBH dot org slash Calla Crossley follow us on Twitter and become a fan of the Calla Crossley Show on Facebook. We are a production of WGBH Boston Public Radio.