The story comes from KCLU’s podcast The One Oh One. You can listen to the full episode here. Here is a link to Senior Concerns’ 60+ nonprofits list – they can help and share resources on aging.
The first thing to do when compiling resources and trying to understand the silver or gray tsunami a bit better, is to look into the data behind it.
“Some people call it gray tsunami, which means that it's coming fast without you knowing it, that's a good metaphor for it,” said Professor Jamshid Damooei.
He is the director of the economics program at California Lutheran University, where he also directs their Center for Economics and Social Issues.
Damooei is quite familiar with the Ventura County community having taught at the university for 35 years. He likes to describe his work and teachings as economics with a human face.
In 2020, he wrote a massive 134-page report about Ventura County called ‘The Future of Caregiving for an Aging Population’.
In the report one key thing we learn is that in the decades to come, the amount of young people is going to decrease while the amount of elderly people is going to balloon.
People are living longer, the Baby Boomer generation is reaching retirement en masse and the days of the big families of six, seven or eight plus kids – they are a thing of the past.
“We’re going to really see amazing changes. 38 years from now, the growth in the children aged 0 to 15 is going to go down by 13%. The number of people who are 85 and plus is going to go up by 300%,” said Damooei.
That’s a quadrupling of older seniors by 2060.
To really paint the picture of this situation, Damooei says for every two children there will be one person over the age of 85.
“That's a really a sea change from now through then,” said Damooei.
Doubling of cases of Alzheimer’s disease
And with old age the occurrence of Alzheimer's increases.
“So if you look at the number of Alzheimer's people in the United States in 2020, we had about 5.8 million [people] of them. If you really look at 2050, mid century, we have 13.8 million of Alzheimer’s,” said Damooei.
That’s more than doubling in 30 years.
And because the share of elderly people in Ventura County is larger than the national average – that change is even quicker here. The number of seniors living with Alzheimer’s disease in Ventura County is projected to more than double over the next 17 years.
What the data says about caregiving
And as you age, and especially if you have dementia or Alzheimer's, you’re going to need some kind of caregiving.
Some seniors are able to hire healthcare workers to care for them in their own homes – something known as aging in place. Some will go to assisted living facilities or nursing homes. But as I laid out in the previous episode, that can be very expensive or unavailable and so many family members – often spouses and children – are forced to become caregivers.
And in the future the number of those available caregivers is going to decrease.
Damooei’s research says right now, for every person aged 80 plus, there are about 6.5 caregivers available. By 2060 that number drops to just 2.
“What that means, it means that we have to think about how we're going to take care of ourselves,” said Damooei. “Getting old is a privilege. But living with dignity is a right.”
Looking at age – the biggest share of caregivers, a third, are in the 50 to 64-year-old category – in many cases, the spouses. The next biggest share at a quarter of all caregivers is 18 to 34-year-olds – probably the children.
And caregiver work of this kind is unpaid. Damooei estimates all the unpaid hours caregivers worked across the U.S. last year were valued at a minimum of $264 billion.
What we learned in part 1 of this series is that free caregiving is not easy. The work and burden is so tremendous caregivers, often women, are forced to leave the workforce.
That means they stop earning and investing in their own future; and they stop contributing to the economy.
“So if you're looking at these numbers, the working people are shrinking. The savings will also fall proportionally when the savings fall, investment potential will fall. So the change of the demography is about taking care of people who need care is also about taking care of the economy and the needs of the economy,” said Damooei.
We’ve talked a lot about the financial and practical implications of the silver tsunami.
Professor Damooei also has data on the emotional impacts. In part 1 of this series we heard from caregivers who are doing a great job and for the most part are coping.
But not everyone feels that way.
His report describes the spectrum of emotions caregivers feel about looking after a loved one. Things like anxiety, tiredness, sadness, isolation, resentment but also pride, sympathy and a sense of accomplishment.
“Look at these emotions. Positive emotions. Negative emotions. If you put them together. This is the kind of psychic state of the caregivers,” said Damooei.
Changing the way you think about this care
So what does Damooei believe needs to happen to prepare for this tsunami.
First he says we need to change the way we think about this type of care.
“Nobody really questions ‘How do you take care of your children’ and ‘Do you want to take care of your children? Should we help you to take care of your children?’ Do we ask the questions about ‘How do you take care of your granddad or your parents?’ We don't,” said Damooei. “We have to change the mentality, really. You have to think about caregiving, particularly when the population is getting old as a part of the need of the society.”
A change in mindset means legislators would probably need to relook at wages paid to unionized health care workers and spending on public entitlement funds like Social Security or Medicare.
“Welfare state – that we have to relook at union labor wages. We have to get ourselves to be serving a population that will have a different set of needs,” said Damooei.
And he says it’s not just about what politicians can do.
“I would really put more emphasis on awareness, building community activism and really expecting change to happen and stand for it and bring it into elections and other things,” said Damooei. “Vote for those who really follow your ideas for better society, and I think those will really help quite a lot.”
What do our politicians say?
So.. Are our local politicians, who represent us at a federal level, thinking about this issue?
I started with Democratic Congresswoman Julia Brownley. She represents virtually all of Ventura County and many of the people and places I visited for this series, but her office said she was not available to comment on this issue.
Luckily Congressman Salud Carbajal was happy to chat over Zoom from his office in Washington D.C. Carbajal, also a Democrat, represents all of Santa Barbara County and parts of Ventura and San Luis Obispo counties.
He says he’s been aware of this issue since his days as a county supervisor.
“Over six years ago, I put together a senior symposium that we dubbed the Silver Tsunami,” said Carbajal. “What became abundantly clear back then is that we invest for various challenges and needs in our country but the one area that clearly was disadvantaged in our attention, especially when it came to resources, were the resources that go to address the needs of our seniors.”
Carbajal has served in Congress since 2017. He says he has friends who are caregivers to their elderly loved ones, plus he’s thinking about this for himself.
“I, within the next seven years, will be 65 and so I fully understand this phenomenon and what it means, even personally,” said Cabajal. “If you look at those in California over the age of 80, the population is such, of those individuals, that it would be as big as the state of Delaware.”
The wins and wishes
Ok, so we’ve talked a lot about the problem – the silver tsunami. For the rest of this piece I’m going to focus on what is being done about it.
I talked in depth with Carbajal about what he’s doing to address the silver tsunami and I put his solutions into one of three categories.
Number one – ‘the wins’.
Number two – ‘we tried to do this but it didn’t work’.
And category number three – ‘the wishlist’.
Let’s start in category number one – ‘the wins’.
Recent legislation Cabajal points to is the passing of the Inflation Reduction Act – the massive climate, health care and tax bill that President Biden signed into law last August.
Carbajal gave me a few examples of how that legislation helps seniors.
“We passed the Inflation Reduction Act that capped medical expenses for seniors – prescription drugs, no more than $2,000 a year before it could have been $5,000, $10,000,” said Carbajal.
That goes into effect in 2025.
“We also enabled Medicare to negotiate with drug companies to bring down prescription drug prices for our seniors,” said Carbajal.
That includes the price of insulin being capped at $35 a month for Medicare recipients which went into effect this year.
The Inflation Reduction Act also, as the name suggests, is aimed at lowering the deficit and help bring inflation under control – which is a big concern for seniors on a fixed income.
Let’s now move to category two – ‘we tried to do this but it didn’t work’.
And by ‘it didn’t work’ I mean Republicans (and some Democrats) on Capitol Hill weren’t on board and so compromise was required.
How? Well the Inflation Reduction Act was called something else originally – the Build Back Better Act. Through negotiations it lost its name and many of the initiatives Democrats wanted to get passed – initiatives that would have directly affected what we are talking about today.
“The Build Back Better really addressed this issue head on: it boosted the compensation for homecare workers and child care workers. It expanded access for affordable homes or community based services, and it created a National Paid Family Leave program to ensure more caregiving,” said Cabajal. “That would have helped many families who find themselves in a position where they need to take time off to care for a parent, for example.”
Republicans were opposed to the idea of the bill early on. Republican Senate Minority Leader Mitch McConnell said the proposal “may actually be a Trojan horse for massive tax hikes and other job-killing, left-wing policies.”
And even as the Build Back Better bill took shape and throughout negotiations, budget-conscious Republicans said it was just too big and expensive.
Let’s move now to category three – ‘the wishlist’.
And stick with me on this… wishlists can be long and this one no exception.
Salud Carbajal is backing a number of initiatives. Things like the Social Security 2100 bill which would enhance benefits by making people who earn more… pay more into the program.
“Some individuals are not paying their fair share into our Social Security system to make sure we shore it up,” said Cabajal.
He wants to do the same with Medicare.
“We also need to make sure that we are having individuals who make over $400,000, contribute more towards our Medicare system so that we can continue to shore up our Medicare system,” said Carbajal.
Carbajal also signed on to a bill called Housing For All which would have provisions for helping the elderly get housing.
He thinks there should be tax credits for the unpaid work of caregiving and he believes immigration could help solve the shortage of healthcare workers.
“Somebody might say, well, what does immigration have to do with seniors and the silver tsunami? Well, we know that many immigrant groups fill many of these important jobs of caregiving – nurses, assistants,” said Cabajal. “And so we need to enhance immigration reform so that we could provide a broader workforce to address caregiving.”
But all of these bills remain stalled right now on many democrat’s wishlists – in a bitterly divided Congress there’s little hope of getting them passed in the near term. Remember immigration reform has been talked about for years and risks to Social Security and Medicare get brought up every couple of years.
So when it comes to addressing the silver tsunami at a national level there have been a few wins; there were things that were tried; and there are a lot of other things that are pretty much pie in the sky right now.
Where’s the help in Ventura County?
OK, so while Salud Carbajal is in Washington, who’s working on this issue in Ventura County?
Well, now is time for some definite wins! You can take your notepad out as we’re getting into the resource-rich section of this episode… and I’m just kidding about the notepad… at the end of this episode I’ll tell you where you can find a text version of this episode with links to all the resources.
There is a local authority called the Ventura County Area Agency on Aging or VCAAA. Monique Nowlin is deputy director.
She likes to describe their work this way.
“We're a no wrong door. So that means no matter how you darken our doorstep, we're going to provide these supportive services to wrap around you,” said Nowlin.
Nowlin says they are the focal point for aging in the community, focusing on caregivers and care receivers, as she calls them.
The agency created a master plan for aging last year – something mandated by the state and is a first of its kind locally. It’s just like those master plans that cities or counties create for infrastructure, for example.
The plan’s goals, which they aim to achieve over 10-years, include things like creating more housing options; making transportation more accessible and the community more walkable; also closing the digital divide and finding opportunities for flexible work if seniors still can and want to.
“And how we did that is it was really an organic process. We had community conversations, we got feedback from the public, we got feedback from our advisory council members,” said Nowlin. “And we developed these goals so that we could make sure that we're addressing, gosh, for instance, housing for all ages and stages, health care, health reimagined, inclusion and equity.”
So if you’re a senior and you want to know how the agency can help you, what would that process look like? Well a lot of time it starts with a phone call to their hotline – (805) 477-7300.
“You make a phone call and a lot of times people are not even sure. They're like, ‘Hi, you know, I just want to see what kind of resources are available for an older adult’. And then begins a short term case management discussion or like assessment of what you need. Some people don't know what they don't know,” said Nowlin.
VCAAA offers a variety of free programs – some you have to qualify for but others are for all seniors.
They can help with things like where you can get a meal; get legal assistance or help with transport to the doctor.
“People don't realize we can provide two medi-rides per month to the doctor anywhere from Santa Barbara to Los Angeles. We wait for you and we take you back home and we provide Dial a ride and bus tickets for you to get around the county,” said Nowlin.
Counselors can talk you through your health insurance and Medicare because we all know that can be pretty confusing.
While they have you on the phone, Nowlin says they’ll often see what else they can help you with.
“You're calling for help with Medicare. And then in the course of the conversation, we find out that you need help with food so we can connect you to food resources or, we find that you need some home modifications so we can connect you there,” said Nowlin.
That program includes installing grab bars and other things that make it safer for frail seniors to age at home.
There is also a program for low-income seniors who need help cleaning their home.
There’s their fall prevention program where seniors learn how to improve mobility and balance. They have tai chi or chair based exercise classes that take place over 6 to 12 weeks.
And really sometimes it’s just about convincing seniors to take the help.
“Sometimes older adults. I will get the push back. ‘Well, I don't need a handout. I've never taken anything from the government. I don't want to start now.’ But I tell them these are benefits that you're entitled to. We have older American and we have older American funds to pay for these services. That's what we're here [for]. We're the advocates for older adults,” said Nowlin.
Most of the time how these seniors end up getting the help they need is through their caregiver – the many spouses, children and family members doing this work. VCAAA has resources there as well.
“The most impactful program that we have for caregivers is really the Caregiver Resource Center. I can't speak highly enough about all of those services. It's like one stop shop.
There are three brick and mortar caregiver resource centers in the county – at Senior Concerns in Thousand Oaks (where we visited in the previous episode); at the Camarillo Health Care District and at La Buena Vida in the Santa Clara Valley which focuses on monolingual Spanish speakers.
Caregivers today have been called the sandwich generation – you know because they are often caring for children and their parents. Nolan adds to that metaphor and calls them the panini generation because of how pressed the caregivers feel.
“If you're the primary caregiver and the only caregiver. It may be challenging for you to leave that loved one who may maybe have dementia,” said Nowlin. “You don't want to leave them at home alone, but you still have to do the grocery shopping. You still have to pay bills so we can provide respite care so that that individual can go out and run their errands or maybe just have a little time to themselves.”
What does success look like?
There are some really amazing success stories.
Monique Nowlin shares a story about a 100-year-old resident from Santa Paula being cared for by her 64-year-old daughter, who reached out for help.
“She enrolled in our Family Caregiver Resource Center in early 2021. She began her journey with this by using the respite offered and allowed in the program to install grab bars,” said Nowlin. “And later in 2021, our program measured her for risks of being a caregiver burn caregiver burnout and it was through the Family Caregiver Resource Center we were also able to connect with our Depression program.”
She was able to attend the fall prevention program classes and shared what she learned with her mother, which is the care receiver,” said Nowlin. “I mean, 100 years old and the mom’s going strong.”
I’m sure this episode, part of this two-part series on aging, could leave many people thinking about their own aging future or who will be their caregiver.
Remember Professor Jamshid Damooei from the beginning of the piece – I asked him if he’s thinking about it.
“Quite honestly, when it comes to family I have as much a dilemma or questions as anybody can have because you don't want to be a burden for children. Obviously your spouse is very important.” said Damooei. “But financially, I think [I will] probably be more focused. Emotional – other parts are things that depends, you know how you lived your life, how you build your relationship, how people you know are attached or like you or don't like you. Those are very individual things. But I try to really have a family or a group of supporting friends. But, but who knows?”
If you haven’t already I encourage you to read part 1 in this series where you’ll learn about the experiences of seniors and caregivers in our community.
California Lutheran University is the licensee of KCLU.
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