Aging in Appalachia: State Programs Stretch to Care for the Elderly as Young People Leave the State

Feb 26, 2019

This story is part of an ongoing series examining aging in Appalachia. You can read more here.

As we grow old, many of us will find we need help with everyday tasks, like cooking, cleaning and bathing.


In West Virginia, there are few programs that can help, and those that do serve the state’s aging population are overburdened -- with waitlists that can stretch months or years -- or require applicants to qualify for Medicaid.

This leaves the older population dependent on younger family members to fill caregiving roles. Meanwhile, to find work, the state’s young people are leaving the state and thus moving away from their elders, causing those over age 65 to be  the fastest-growing segment of West Virginia’s population.

A recent report by the West Virginia Department of Health and Human Resources found this dynamic is creating a critical gap in services needed by the elderly.

“The infrastructure of services provided to the elderly will be a critical need far into the future as the population of West Virginia continues to age, resulting in increasing costs of state and federal programs for the elderly,” wrote the authors.

 

In West Virginia today, about 16 percent of the population is 65 and older, according to the DHHR report. It’s projected to grow to about a quarter of the total population by 2030.

So who is going to pay for the services needed by aging West Virginians and who will help care for them if the bulk of the young people leave?  

“At the end of the day, I think the aging population of West Virginia is something West Virginia as a whole has to really think about -- how we’re going to retain our young people and our young workforce here to help with our aging population and our aging parents?” said Cindy Beane, commissioner for the West Virginia Bureau for Medical Services.

The challenge is acutely felt for state-run programs. These organizations can only serve a fraction of the aging population.

Medicaid has a program to help low-income West Virginians stay independent as long as possible. Additionally, it administers the Aged and Disabled Waiver program.

“It’s a program to help keep our seniors and people with disabilities in their homes versus in a nursing home,” said Beane.

The waiver program provides personal care and in-home help for more than 5,800 low-income West Virginians who would otherwise be eligible for nursing home care. In January, the DHHR cleared its waitlist -- so everyone who has applied and qualified for the services now receives them.

Seniors who don’t qualify for Medicaid -- but would like to stay in their homes and independent as long as possible -- can also get help from a program called Lighthouse, administered by the Bureau of Senior Services.

“We go into the homes and provide personal care -- we provide bathing, grooming, dressing, toileting,” said Kim Thompson, director of Lighthouse. “We do provide meals. We also do their laundry. We can also provide some light housekeeping.”

In 2018, Lighthouse served almost 2,500 people, but that barely scratches the surface of need across the state, Thompson said. There are more than 320,000 adults aged 65 and older in West Virginia.

Thompson said they make no effort to advertise their services, given that people already spend years on their waitlist. Occasionally a brochure for the program will get out and then she’ll get a lot of calls. She said she keeps track of how long the waitlist is in each county. Statewide, there are almost as many people on the waitlist as there are being served.

“Once they get on the Lighthouse program, they don’t usually come off the Lighthouse program,” said Thompson. “The only way they come off the Lighthouse program is if they go to a nursing home, they pass away, or they move out of the state.”

 

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.