Last week, Governor Maura Healey signed an executive order issuing a new Massachusetts healthy aging plan, ReiMAgine Aging 2030: The Massachusetts Plan, aimed at making Massachusetts a better place for older people to live, building on Governor Charlie Baker’s Age-Friendly Massachusetts Action Plan 2019.
The new plan focuses on increasing economic security for Massachusetts seniors, making communities and physical structures more age friendly, increasing health and wellness, and directing state agencies to consider aging in all their policies and communications. The policy recognizes that with the aging of baby boomers, the number of Massachusetts residents aged 65 and over has already grown by huge numbers and that this cohort is only going to get older and need more assistance in future years. Over the next 15 years, the fastest growing segment of population will be those 80 and above.
The plan also recognizes that a large portion of older residents can still contribute, citing the statistic that between 2007 and 2022 the number of workers in Massachusetts aged 65 and above more than doubled from 131,000 to 291,000. More than a fifth of older residents spend time volunteering, which benefits them as well as their communities.
Yet many older residents are facing financial challenges. According to the University of Massachusetts Boston’s Gerontology Institute’s Elder Economic Security Index, 57% of single older adults and 26% of older adult couples face economic insecurity, having insufficient income to meet their basic needs, in large part due to the high cost of housing in Massachusetts.
The new plan is meant to align with the Massachusetts State Plan on Alzheimer’s Disease and Related Dementias, whose aim is coordinate governmental efforts to optimize available resources for dementia care.
As part of the communication efforts of the plan, the Massachusetts Executive Office of Elder Affairs has launched a podcast in partnership with the Massachusetts Health Aging Collaborative which is available here.
Specific Action Steps
The Plan includes a long list of strategies and action steps to enhance the lives of its older residents. They are too many to list or even summarize, but here are a few examples:
- “Work toward policies that prioritize the development and availability of affordable housing options including supportive housing, single-story housing, 55+ communities, multigenerational housing, more Accessory Dwelling Units (ADUs), and address long waitlists for subsidized housing.”
- “Develop an array of programs, services, and opportunities that support a range of needs (e.g., racial, ethnic, languages spoken, veterans, new immigrants, LGBTQIA+, people with mobility impairment, hearing impairment, visual impairment, etc.).”
- “Convene a multigenerational summit on ageism to explore opportunities to create intergenerational activity and mutual support among students, caregivers, and older adults that produces a white paper with guidance on how to combat ageism across generations.”
- “Increase availability of accessible and affordable transportation for older adults, particularly for medical appointments and essential errands, but also wellbeing activities (e.g., fitness programs, social connection).
- “Implement a simple, clear, easily accessible mechanism to apply for multiple public benefits through a single application.”
- “Encourage innovation in discharge planning and care transitions (e.g., create a platform that bridges hospitals, caregiving organizations and others in the community to increase sharing of information and coordination).”
Success Stories
The Plan also includes descriptions of many success stories of towns and organizations already taking steps to improve the aging experience in Massachusetts, such as Reunir, a program based in Lawrence and Lowell to “to improve older adults’ access to healthy meals, reduce food insecurity, and increase social engagement for older adults in immigrant and refugee communities,” and the Lower Cape Housing & ADU Resource Center, which is working “to help ensure residents have access to the resources and support needed to maintain their housing.”
The Plan aims to build on these success stories to improve the lives of older Massachusetts residents and, by doing so, to improve that of everyone in the state. Caregiving burdens family members of all ages. The lack of alternative housing options for seniors contributes to the statewide housing shortage. The unavailability of high quality care alternatives makes it difficult for individuals to transition out of hospitals, creating a bottleneck that keeps patients in hospitals longer than necessary, increasing costs and reducing the availability of hospital beds for others. Ameliorating all these situations will help everyone in Massachusetts.
Lack of Focus?
But I have some misgivings. By my count, the Plan includes more than 100 action steps. That seems too unfocused and too difficult to monitor and act on.
Perhaps it’s just my perspective as an elder law attorney, but it seems to me that the biggest challenge for an aging society is caregiving and, as I keep repeating, the need for caregiving will explode starting in about a decade as the baby boomers begin reaching their late 80s. Admittedly, this plan is only for the years 2025 to 2030, but we can’t wait until 2030 to get ready for the coming elder care crisis. This might be an argument for a 10-year, as opposed to a five-year plan.
Former Secretary of Health and Human Services Marylou Sudders explained to me in an interview on my Risking Old Age in America podcast, that part of the motivation for making Massachusetts more age friendly is to reduce the need for elder care, especially for care in nursing homes. If the new ReiMAgine Aging Plan achieves its goals it will help reduce the need for care and caregiving, but it will only be able to do so to some extent. We need a plan that focuses on elder care.
In addition to the lack of focus on elder care and caregiving, the huge number of action steps will make it difficult to measure the progress and success of the plan. The California Master Plan for Aging includes a Dashboard that provides extensive demographic data about older California residents both statewide and by county. A similar dashboard in Massachusetts would help us measure the success of the Massachusetts Plan.