New Jersey’s population of senior citizens is growing, but many of them are choosing to stay in their homes as they age, rather than go to nursing homes.

Those changing attitudes have led New Jersey officials to adapt. Last fall, the state received federal government approval to overhaul its Medicaid program.

The Comprehensive Medicaid Waiver allows the state more flexibility to provide community-based and in-home services rather than institutionalization, which is more expensive. That flexibility will help the state deal with the increasing senior population.

“The baby boom generation is just now retiring, so it’s really the younger part of the seniors who are going to need services, not the older old,” said Lowell Arye, deputy commissioner of the state Department of Human Services.

In the 2010 Census, New Jersey’s population was 8.7 million, with 1.18 million people 65 or older. The projection by the state Department of Labor is that the state’s population will grow to 9.6 million by 2030, 1.9 million of which will be 65 or older. Now, 38,000 people live in nursing homes in New Jersey, Arye said.

Currently, 69 percent of all Medicaid long-term health care funding is given to nursing homes, and 31 percent is for home- and community-based services, Arye said. The waiver was put forward by the state to rebalance the way in which services are provided, he said.

“All the baby boomers are saying, ‘It’s hard enough putting my parents into a nursing home. I would rather have them age in place,’” Arye said.

Most elderly people who cannot live on their own rely on their families to provide some kind of care, said Don Redfoot, senior strategic policy adviser for the AARP.

But as the baby boom generation ages, many — particularly those who did not have children — are left wondering how they will be cared for when they become incapacitated or reach extreme old age. If a relative doesn’t step in, these folks may require some kind of paid in-home care.

Nick Regine, 63, lives with his wife, Kathleen Arleth, 70, in Somers Point. He does not have children and never discussed with anyone who would take care of him if he needs care and his wife dies before he does.

“I haven’t given it a whole lot of thought. Even though I have some ailments, I still feel like I’m pretty vibrant. I still have a lot to offer. I don’t see that as something in the near future,” Regine said. “I don’t want other people to be burdened with my old age and my existence as I get older.”

The key, Redfoot said, is to get people thinking about it while they are able to make plans for the future.

“If you do not have family ... some people purchase long-term care insurance,” Redfoot said. “What it does is, in the event that you need services, you have some way of paying for it. If you don’t have family caregivers who are providing a lot of those services, then you may need to purchase more services.”

Former postman Dennis Bartley, of Brigantine, has been retired for five years. The 62-year-old, who lives alone and has no children, said his nieces have talked to him about what would happen to him if he reached old age as a single man living alone.

“I have two nieces who said if it ever gets to the point, they would take me in. I don’t know if I’m looking forward to that or not, because then that brings up all kinds of issues. Am I competent enough to be with them that I know where I’m at, or I’m gone with something like Alzheimer’s? That’s a concern, because I don’t want to be a burden,” Bartley said.

Bartley said he has seen the perspective from both sides. His father didn’t get the chance to grow old. His mother did.

“My father died when he was 59. He was there one day, and the next day, wham, not sick a day in his life, and he was dead,” said Bartley, who is a five-year prostate cancer survivor. “Yet, I saw my mom live until she was 91, and in fact, she moved in here with me. I became my mother’s mother.”

To prepare for cases of illness or injury in which he might no longer be capable of making decisions for himself or his death, Bartley has a living will.

But Bartley is a rare case. Most Americans do not have a living will — a written document that allows a person to state in advance his or her wishes regarding the use or removal of life-sustaining procedures in the event of illness or injury.

And one study found 37 percent of older adults living in the community rather than in an institution had completed an advanced directive, compared with between 5 percent and 15 percent of all community-dwelling adults, said the federal Centers for Disease Control and Prevention. An advance directive allows a patient to communicate health care preferences in the event he or she is no longer able to make those decisions.

Discussing what to do with aging baby boomers who have no children to look after them is not new to those who have been working in the field, said Dr. Lawrence Weiss, founder and CEO of the Center for Healthy Aging in Nevada.

Boomers will change a great deal about how seniors who cannot live on their own are dealt with, Weiss said. The status quo will change as young, active boomers will not want to live in senior communities with those in their 80s and 90s, Weiss said.

A new wrinkle is the outsourcing of aging, as shown in last year’s movie “The Best Exotic Marigold Hotel,” Weiss said.

The film tells the story of a group of seniors traveling to India to make their retirement incomes stretch further.

“I have several friends that have gone to South America or Mexico or some other place because, basically, they can live on some of the retirement income they have,” Weiss said.

Contact Vincent Jackson:


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