Increase of seniors brings need for strong caregiver community

Hawaii is going to need more caregivers.

The state’s seniors, those 65 and older, made up 17.1 percent of Hawaii’s 1.4 million residents in 2016 — a jump from 14.3 percent in 2010, according to recently released data from the U.S. Census Bureau.

Experts stress the importance of supporting the caregiver community, as the state has seen a dramatic increase in its aging population over the last six years. The portion of the population made up by those 65 and older grew 25 percent from April 1, 2010, to July 1, 2016, while Hawaii’s total population grew 5 percent over that same period.

The increase is largely attributed to the baby boomers, those born from 1946 to 1964, and the trend is only expected to continue.

State Chief Economist Eugene Tian said the portion of the population made up by those 65 and older will continue to increase over “many years” as the state’s 333,546 baby boomers age. The first baby boomers will hit 80 in the next 10 years.

Tian said one of the implications for the state is a need for more nursing homes and medical serv­ices.

“We need more nursing homes. … In the future — we’re talking 10 years to 20 years — the industry in the state will be developed,” Tian said. “We’ll need a lot of those facilities.”

But seniors tend to prefer caregivers to nursing homes.

“Generally, people want to age at home,” said Craig Gima, spokesman for AARP Hawaii. “They don’t want to go into nursing homes. And it’s a more cost-effective way to age, as well.”

The annual cost of a semiprivate room in a Hawaii nursing home is approximately $129,575, according to AARP. The cost of about 44 hours a week of home health care is about $54,912 for homemaker services and $57,772 for a home health aide.

Gima said some initiatives AARP is focusing on are supporting the caregivers as well as building communities that allow seniors to be independent longer.

“We have to make sure people are cared for, caregivers are cared for and communities are age-friendly,” he said.

As the aging population represents a larger portion of people statewide, the number of potential caregivers available to help them is declining. By 2056 the population 65 years and over in the U.S. is projected to become larger than the population under 18 years, according to the U.S. Census bureau.

Gima said the ratio between caregivers — generally between ages 45 and 64 — and the people they need to care for — 80 or older — is expected to decline in Hawaii. It is projected to go from 3-to-1 in 2030 to 2-to-1 in 2050.

“Hawaii needs to do more to promote home care and communities where people can age at home,” he said. “This could include things like directing more Medicaid long-term care dollars to home care (and) providing state funding for programs like Kupuna Care.”

Lawmakers passed House Bill 607 to establish the Kupuna Caregivers program. The program helps community members obtain care for seniors while remaining in the workforce by offering different caregiving and support services, such as adult day care, personal care and transportation assistance. The program would give some working caregivers up to $70 a day.

“This program is really meant to help reduce the negative effects of caregiving on working families,” said Pedro Haro, Hawaii advocacy director for Caring Across Generations.

There are 154,000 family caregivers in Hawaii, and, if they were paid, the value of their services is $2.1 billion, according to AARP.

Another reason for the increase in the senior population is that people are living longer.

Gima said AARP is also focusing on helping the aging population with financial security, as well as planning cities to be “age-friendly” as those 65 and older tend to live longer. Gima said cities that allow seniors to live independently have better public transit as well as safe and walkable communities where drugstores, grocery stores and parks are easier to access.

“Honolulu is doing some of that now in Chinatown and Kakaako,” Gima said.

A major issue facing the growing population of seniors is a lack of retirement savings, causing some to stay in the workforce longer.

“It’s difficult and expensive for many small businesses to offer IRAs through payroll because you have to hire a financial planner, perhaps a lawyer,” Gima said. “There’s also a question about fiduciary responsibility.”

AARP said there are about 216,000 workers in the state who work mostly for small businesses where the employer does not provide an opportunity for them to save money for retirement.

Gima said eight states, including California, Oregon, Illinois and Washington, have passed what are called work-and-save laws. These laws are set up to make it easy for states to offer private savings plans at low cost to businesses and workers.

“If low-income workers start saving $1,000 a year, Hawaii would save $32.7 million on public-assistance programs like Medicaid, food stamps and housing assistance over the first 15 years, and the savings would grow exponentially as more people saved,” he said. “The combined state and federal savings would be more than $160 million.”

When it comes to Hawaii’s aging population, the state fits in with the national trend, as those 65 and older accounted for 15.2 percent of the nation’s total population.

“This trend is happening nationwide, not only in Hawaii,” Tian said.

The first of the baby boomer cohort turned 65 in 2011. Since then the group has been driving the growth in the aging population nationally. By 2029 more than 20 percent of the total U.S. population will be over the age of 65, according to the U.S. Census Bureau.

Hawaii’s median age, 38.6 years, is slightly higher than the national median of 37.9 years. Maine has the highest median age in the nation at 44.6 years, and Utah has the lowest at 30.8 years.

While Hawaii’s stats track the national average, Haro said Hawaii is ahead of the curve when it comes to caring for its seniors.

“With the longest life span in the nation, Hawaii has really stepped up and tried to figure out innovative ways to care for our elderly,” he said. “The Kupuna Caregivers program is the first in the nation, and honestly, the eyes of the nation are on Hawaii to lead the way in regards to care for the elderly.”