WASHINGTON – It’s no coincidence that at the same time the Maryland Board of Pharmacy says there is a “tremendous shortage” of pharmacists in the state that advertisements for erectile dysfunction pills litter the airwaves.
The volume of prescriptions is increasing in large part because of a state population that is already aging at a slightly faster rate than the rest of the country. That, coupled with the aging of the baby boom generation, has state officials projecting the senior population will double in the next decade.
“We are planning today to meet the challenges of the tsunami that is approaching as baby boomers become seniors,” said Jean W. Roesser, secretary for the state Department of Aging.
But there is still much to be done, said Donna DeLeno, advocacy representative for AARP Maryland.
“If Maryland doesn’t start planning an array of long-term care options, the state could go bankrupt,” she said.
The numbers bear both of them out: The Census estimated that there were 625,000 people age 65 or older in Maryland as of July 1, or 11.3 percent of the total state population.
That was still lower than the national average senior population of 12.4 percent and one of the lowest rates in the country. But the number of senior Marylanders grew by nearly 4.3 percent from April 1, 2000, compared to national growth of 2.6 percent during the same period, and the number of those 85 and older grew 16 percent in the state compared to 12 percent nationally.
At the same time, Maryland’s 18-and-under population grew just 0.73 percent — from 1.37 million to 1.38 million — compared to national growth of 1.04 percent in that age group.
The result is an aging population that requires more services — especially health-related ones — and a smaller workforce available to help them, said Hal Sommers, a research statistician with the state Department of Health and Mental Hygiene.
The state already has a shortage of nurses, Sommers said, and it will also have to answer questions about housing needs, as many of the elderly will begin to rely on family caregivers, assisted living or nursing homes.
DeLeno said the state needs to increase funding for “infrastructure for seniors,” such as transportation routes, staffing at healthcare facilities and the quality of care there.
She said most home- and community-based services for seniors — such as respite care, adult daycare and nursing home visits by nurses — have long waiting lists. As seniors wait, they tend to get sicker and then “their only resource is to spend down” in order to become eligible for Medicaid, she said.
But Medicaid spending in Maryland next year will reach $4 billion — half of which is state money. That is 8.1 percent higher than the current year and 28 percent higher than in 2002, according to state budget projections. Enrollment in the standard Medicaid program is also expected to grow by 4.5 percent next year, part of the reason Maryland will have a $25 million Medicaid shortfall, according to the state Department of Legislative Services.
The solution, in addition to continuing cutting costs, is to increase funding for home- and community-based services, which saves Medicaid money by avoiding institutionalization, DeLeno said.
The state also faces increased demand for prescription drug assistance for its aging population.
“There is this expectation that there will be drugs to fix everything and a tremendous pressure on drug companies to come out of research and development with new drugs,” said Robin Vahle.
Vahle, a registered nurse, is also the senior project manager overseeing the senior prescription drug program at CareFirst. Members of the program, who must be Maryland residents on Medicare with no other form of health insurance, receive pharmacy benefits for a nominal fee.
The program has 33,200 members and continues looking for new members, even though the Maryland Health Insurance Plan, which oversees funding for it, would like to limit plan membership to no more than 37,000, Vahle said.
“I’d love to see us reach the 37,000 mark, but I doubt if there will be more funding available” after that, she said.
But not all seniors are a burden on the state.
AARP reported that more Americans work past retirement age, some because they need the money or health benefits, but most do it to remain physically or mentally active. The organization also devotes a page on its Web site to grandparenting and developing relationships between young and old.
The state Department of Aging is promoting healthy lifestyles among “younger” seniors, including a newsletter that offers fitness tips and healthy recipes.
“Even as Maryland protects the frail elderly with vital programs, we are trying to help the younger aging population in Maryland stay as healthy and active as possible,” Roesser said.
Vahle said it is encouraging that so many groups are concerned about the future of the aging population.
“This is a huge bubble of people, but it seems to be a value of healthcare providers and people that the elderly have something to give,” she said. “Warehousing is not an option.”
The goal, Roesser said, is to allow seniors to “live with choice, independence and dignity and to remain connected to their communities for as long as possible.”
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