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Hawaii seniors struggling to survive

HONOLULU—Older Americans in Poverty is the latest fact sheet assessing the precarious financial health of many American seniors over age 65. The state-by-state comparison is the AARP’s Public Policy Institute’s snapshot conducted at least once each year. This latest offering is based on a three-year average from 2006 through 2008 and due to the timing of the sampling, excludes much of the recessionary fallout. Even so, the report shows the 2008 figure of 15.6 percent for Hawaii’s seniors age 65 and older who rely almost exclusively on their Social Security income. While Hawaii’s rate is near the bottom of the national ranking, that still leaves almost 30,000 seniors who count on only their monthly checks to survive. The good news is they are managing to survive—barely.

Ellen O’Brien, PhD is a strategic policy advisor with the Washington-based Institute. She agrees that because the government safety net ensures that seniors can have a basic—very basic—quality of life, the AARP report may have been eclipsed by the continuing general focus on the tanked economy and people with no safety net at all. This doesn’t change the reality for any senior faced with the choice to eat or buy medications or split pills and try to cover the basics on an average of $1100 per month. It is driving the national debate on Social Security, O’Brien says, adding she fully expects the 2009 data to show the situation with seniors has further slipped, in part based a technicality.

“The way the federal government comes up with poverty thresholds is to simply adjust them for inflation,” O’Brien says. “There hasn’t been much inflation, so for 2009, the threshold will go down. That alone will mean more seniors in poverty.”

Inflation calculations aside, the fact that 53 million Americans receive some sort of Social Security for retirement, disability, or because a worker they relied on became disabled or died is significant. It means the safety net is working.

“That’s what a lot of people misunderstand about Social Security. It’s not just for seniors,” says AARP Hawaii’s Barbara Kim Stanton, “though in Hawaii 1 out of every 5 people is a senior. That’s 20 percent of our population.”

Of the approximate 190,000 Hawaii seniors 65+, Shin Domen is only able to assist 120 of them—and that’s 90 percent less than those who come to him hoping for help. Domen is the executive director of CSI, Inc. which stands for Comfort, Security, and Independence. It’s a nonprofit case management firm which does monthly bill paying and other accounting services for its clients. The service isn’t free but reasonably affordable; clients or their families pay $37.00 per month.

“Most of our clients are ages 65 to 95 and the percentage of those who only receive Social Security is about 10 percent or about 10 to 15 clients. We target the asset rich but cash poor,” he says. “They have a pretty good pension, but it’s not going to last very long if they want to qualify for Medicaid.”

With family squabbles and sibling rivalry, Domen says that by the time his company counsels a family, its members want someone neutral and transparent. Stanton agrees that it can be necessary to have an outside party handle an elder’s finances, but she cautions “you have to look for someone who is solid gold.”

While that choice may be possible for some seniors and their families, Stanton is more concerned about those on the fringes of care. The fragile and elderly who depend on social services to make daily living possible, bring meals, and assist with bathing may not get any or adequate help to stay healthy. She says some seniors are only being bathed twice a week; others are left to their own devices.

“We had one 85-year-old woman who was taking care of her 90-year-old husband and because they didn’t have Kupuna Care services, she was keeping him clean by wheeling him out in the yard and hosing him down,” Stanton says. “It’s tragic.”

The neighbor islands and rural Oahu have the most acute problems, she adds, citing the AARP Hawaii survey showing 47 percent of seniors in Kona and 42 percent of seniors on Maui had to leave to get medical services. With a 95 percent occupancy rate for nursing home care at an average annual cost of $120,000.00 in Hawaii, home and community-based services in every county are vital to cost-effective and successful aging for this group. Most seniors want to live out their lives in their own homes, she says.

Stanton applauds the 2010 Legislature for its bipartisan appropriation of $3 million in “rainy day” funds for Kupuna Care and she is asking for help in calling on Governor Lingle to release the monies as called for in SB 2469. Stanton is also buoyed by the federal healthcare bill and what it will immediately provide in the form of a one-time $250.00 rebate to partially reimburse qualifying seniors for their medication. Those seniors don’t have to do anything to get their checks.

“The first checks to seniors will come out beginning June 15. This is important because Hawaii has highest percentage of seniors who fall in the ‘donut hole,’ Stanton says. “For those in the Medicare program for prescription drugs, once they pay out of pocket up to a certain amount, then they pay 100 percent (of the cost of their drugs) until they reach the catastrophic level. This has been very difficult for our 36,000 seniors who fall into that donut hole.”

Another issue for younger seniors is the long term affect for those in their late 50’s or early 60’s who find themselves out of a job and not able to replace it. Stanton admits while she hates to say it, age discrimination still exists. One way toward survival may mean taking an early Social Security retirement benefit.

“If you claim your retirement benefit early at 62, and your full retirement age is 66, your monthly benefit is reduced by 25 percent,” cautions O’Brien.  “If you can at all afford to delay claiming, that is what you should do.  Your reduced check might not seem like that small an amount, but years from now, that reduced check may not be enough, even when it’s adjusted later to account for inflation.”

With Hawaii’s long lived and aging population, how all seniors are—or aren’t—able to sustain themselves will be an issue we’ll all face in the very near future with our families, our friends, ourselves. Bette Davis let us know that aging isn’t for sissies, but it shouldn’t be complicated by poverty.

We know the Social Security box has an expiration date for the delivery of full benefits—2037 by most reckoning—and although that year seems way off in the far future, we need to shatter any complacency that all will simply be well without any action on our part.

Seniors now living on small and fixed incomes are giving those of us still working—and kids not yet even contemplating their first job—a lesson in personal responsibility. Pay attention to these people. Talk to them. Talk to your kids about retirement as soon as they have that first job.

Social Security may be there in some form down the line for them and for us, but saving regularly, spending less and not bowing to consumerist pressure to equate stuff with self worth will help everyone create far more golden years. Meanwhile, those now fully or partially dependent on Social Security deserve to live with dignity, comfort, and basic necessities.

The interview with Barbara Kim Stanton, Ellen O’Brien and Shin Domen is on the Town Square archive at www.hawaiipublicradio.org One correction: The 170,000 number given in the introduction as the number of Hawaii seniors 65+ living on Social Security alone was misquoted. My apologies. bak

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