ThisWeek Community Newspapers

Thursday, March 29, 2007

By JIM LARRICK
ThisWeek Staff Writer

Baby boomers are going to have a vastly different old age than their grandparents, according to Dr. William H. Thomas.

"This is the best time in history to grow old," he said.

Dr. Thomas, a professor at the Erickson School at the University of Maryland, is a medical doctor whose specialty is aging. He's also an internationally recognized reformer in the field of long-term care.

In town last week to speak at a gathering of healthcare providers, community leaders and the general public at Westminster-Thurber Community on Neil Avenue, Dr. Thomas said the big difference between growing old today and growing old a hundred years ago is that today "old age is a mass phenomenon."

A huge percentage of the population is living to age 70, 80, 90 and even 100, he said. This will have an enormous impact on everything from pharmaceutical development to politics to social programs to the housing market.

"This is the final act for the baby boomers," Dr. Thomas said. "Their final act will be to rewrite old age."

An obvious effect the aging population has been having on states like Ohio is the national demographic shift to the South. Ohioans are retiring in droves to the Sunbelt to get away from ice, snow, sub-zero temperatures, high heating bills and high taxes. Florida, Tennessee and other Southern states encourage the migration by offering tax breaks and by developing special housing communities and other amenities for the elderly.

A recent speech by Gov. Jeb Bush "made it quite clear that this is big business for Florida," Dr. Thomas said But there have been few efforts at counter-programming in the North.

In turn, the migration has raised the populations of the Sunbelt states and lowered populations in the North. Because seats in the U. S. House of Representatives are apportioned by population, Sunbelt states have gained seats -- and political clout -- in Congress while Northern states like Ohio have lost seats and clout.

The clout, or lack of it, extends to other issues, too, such as the apportionment of road construction money and federal healthcare programs.

Dr. Thomas says not all retirees who move to a Southern state stay there. There are also the "halfbacks" and "fullbacks." Fullbacks move south in early retirement but return in late retirement to be near family and friends and to die in their home state. Halfbacks move in early retirement to, say, Florida, but later move halfway back -- to Tennessee, perhaps, or Georgia. They want the warmth and convenience of the Sunbelt but still want to be near their loved ones.

The trouble with halfbacks and fullbacks, Dr. Thomas says, is we lose them when they're still young, make few demands on the state's social and economic systems and have relatively good income. The halfbacks never return; the fullbacks return when they're sick, old and put a strain on the system.

States like Ohio need to make a bigger effort to keep their aging populations during early retirement, Dr. Thomas said, for social as well as economic reasons.

"You're losing older people when they're still engaged and contributing to the community," he said. "The question we should be asking is how many people are we holding in the state?"

Dr. Thomas said he thinks more people would stay in Ohio if the right infrastructure were in place.

In the old days, families were centered around "the home place," which was usually the parents' or grandparents' house. "When the kids got married, they moved into a house two doors up the block," Dr. Thomas said.

Now the kids move away, and so do the parents.

What Dr. Thomas would like to see for the future is "intentional communities," small groups of people "living together for some reason." They might be a household of four or five older single people who move in together for companionship and to keep an eye on each other.

"We need to help people in Ohio make this kind of connection," Dr. Thomas said.

Instead, some communities have laws that say no more than three unrelated people may share a house.

"You couldn't have a set-up like 'The Golden Girls'" most places, he said.

The North also needs more elderly-friendly housing, like that found throughout the South: affordable one-story patio homes and condominiums with two or more bedroom/bathroom suites and easy wheelchair access. And it could use more well-designed retirement communities and nursing homes.

"One thing Americans agree on, it's that they don't like nursing homes," Dr. Thomas said.

Most people think of them as sterile, cold and institutional. They need to be "less like hospitals and more like gardens," he said.

To that purpose, he is president of The Eden Alternative, a "research, consulting and advocacy group committed to improving the care received by people who live in institutions everywhere."

Westminster-Thurber Community is an Eden Alternative site, meaning that it tries to follow the tenets of Dr. Thomas' group. Westminster-Thurber spokesmen say it is the only such site in central Ohio. Obviously, the aging of the population has had a dramatic impact on medicine. Not all of it has been positive, however, according to Dr. Thomas.

"Many of the (new) drug treatments are for things that annoy boomers," he said, pointing to products for prostate enlargement, sleep disorders and restless leg syndrome.

And, contrary to what one might think, the laws of supply and demand have not brought on a surge of physicians for the elderly. According to Dr. Thomas, the number of doctors specializing in geriatrics has declined over the past seven years. The specialty requires years of extra training but pays less than other specialties because a doctor can't see as many patients in a day if he is to give the elderly proper care.

And then there's the issue of national healthcare. Dr. Thomas thinks this one is fixable.

"If I had a magic wand, I'd expand Medicare to include everyone from age zero to 120," he said. "The system works, it's already in place and we've had loads of experience with it."

Actually, Dr. Thomas says, the problems of aging aren't new, but new and better solutions must be found for them solutions that fit with new times.

The elderly have always been with us. A stroll past the gravestones in a 200-year-old cemetery will show that. Lots of people lived to be old, even when the "average" lifespan was 50 years or less. Among our forefathers, Thomas Jefferson and Benjamin Franklin lived into their eighties; John Adams died at 90. Today, what makes the question of how to take care of the elderly important is the sheer size of the baby boom juggernaut.

Old age is "a mass phenomenon," Dr. Thompson says. Still, "This is the best time in history to grow old."