Florida Leads States in Effort To Provide More Elder Care

In a light-filled room, elderly men and women seated in a circle giggle in delight as a golden-haired toddler throws a ball to them. At a table several feet away, other seniors help a little girl make butter.

The site is All Saints Episcopal Center - a day care for both children and elderly.

The children like having the adults around, but it's the elderly here who reap the most benefits, says Penny Borgia, director of this day care in a residential section of Jacksonville, Fla. "If we didn't have the center, most would have to be institutionalized or put in nursing homes."

This intergenerational program and others like it are garnering more attention in Florida, as citizens grapple with with the effects of an aging society. While Florida has long had the largest population of senior citizens in the country, in coming years the proportion of state residents age 65 and older will rise dramatically, with important implications for Florida and other states.

The projected increase is attributed to the aging of the large baby-boom population, continued retiree migration, and more people who are living longer. By 2010, Florida will have 3.3 million people over age 65, up from 2.3 million in 1990. The numbers of seniors age 85 and older are expected to triple during the same period - from 210,000 to 631,000.

At issue is the cost of providing care to greater numbers of elderly at a time when Social Security and Medicare are in need of reform. The phenomenon is also putting a squeeze on more families, who find they are unprepared to handle the financial and emotional challenges of aging parents, growing children, and their own retirement.

"In demography, we refer to this [aging of baby boomers and more people living past 85] as a revolution," says Ray Coward, director of the Institute of Gerontology at the University of Florida in Gainesville. "We just have not gone through this before, and it's something we can't ignore.... People see the state of Florida as going through what the rest of the country will go through."

With the tidal wave on the horizon, some here are urging both the state and the public to get more involved. This fall a new group, the Florida Commission on Aging With Dignity, started a public education campaign to alert people to the current and future demands for health care and long-term care in Florida.

"This debate is going to catch fire all over the country, but if Florida doesn't grab it it's going to be a wildfire," says the organization's director, Jim Towey. "We have the opportunity to lead the way in offering practical solutions to help all generations cope with the challenges of aging."

Aging With Dignity is holding forums across the state that bring together government, business, and religious leaders, along with ordinary citizens. The goal, says Mr. Towey, is to formulate solutions in a way that can avoid intergenerational conflict. The forums are focusing on planning for retirement; care and funding issues; protecting Medicaid from fraud; and removing barriers that hinder families from caring for their own elderly.

Last month, for example, Towey convened a forum in Jacksonville, one of the state's youngest cities where there are more moms pushing strollers than seniors walking laps in malls. But by 2010 the city will see its elder population swell, leaving more residents in the so-called sandwich generation.

Colleen Galligan has first-hand knowledge of the challenges that can confront the sandwich generation. Last year her mother became physically unable to care for herself. Ms. Galligan and her three siblings shared the responsibility of caring for her, preparing meals, scheduling doctor appointments, and finding someone to help during the day. Money was also tight.

"The most stressful thing to me was having small children and caring for mom at the same time because it put so much extra work on my husband," says Galligan, who also had a full-time job. Her mother passed on recently, but Galligan says in retrospect she wishes the family would have been better prepared financially.

Indeed, a huge challenge for Florida will be how to care for those age 85 and older, almost half of whom require nursing care or need to live with family, says Mr. Coward.

"That population has unique needs, not just medical," Towey says, and programs such as the day care at All Saints Episcopal Center is a model for what can be done. "When you bring the old and young together, you deal with loneliness and isolation, the need to love and be loved.

"Government won't be able to do it," he adds. It's "trying to fix problems, but it can't develop relationships with people. We need to deal with the whole person."