A stateline.org sampling indicates that none of the 50 states has a comprehensive plan for dealing with elderly issues, despite projections that the ranks of older Americans will swell in coming years as Baby Boomers reach retirement age.
New Jersey, Washington, Oregon, New York, Ohio and Florida each shines in dealing with certain areas, but no state ties it all together.
"My guess is that no state has really mapped out a strategy, I mean a big strategy, that makes a difference in elderly care," says Robert N. Butler, author of the book, "Why Survive Being Old In America? "While there has been some improvement, given the huge numbers of Baby Boomers coming down the pike, we have not been proactive enough.
"The only state I know of that has significant training in geriatrics is Ohio," says Butler, a professor of geriatrics at Mt. Sinai Medical Center, in Manhattan. "Every state should have (geriatric training) funds for their medical schools. We don't have enough well-trained doctors to care for older people in the United States."
Buutler says New York state is ahead of the curve when it comes to helping seniors secure community-based home care, which some find preferable to nursing homes.
In 1997, 34.1 million U.S. citizens were 65 and older, according to the U.S. Census Bureau. The total will grow to an estimated 34.7 million by the 2000 millennium, 39.4 million in 2010, 53.2 million seniors in 2020 and 69.4 million in 2030. The tremendous projected rate of increase from 2010 to 2030 will be driven in large part by the "Baby Boomers" hitting 65.
Contrast that with 1940, when only 9 million citizens were 65 and older, according to the Census Bureau. In 1960, that number had grown to 16.7 million, then rose to 25.7 million in 1980.
Senior citizens tend to utilize more health care than their more youthful counterparts, as South Carolina recently discovered. It reported a 17.6 percent increase in the cost of health-care claims for state workers, in part because of "an aging population," according to Office of Insurance Services director Jim Bennett.
At least one state -- Connecticut -- has taken a stab at a major component of the health-care puzzle confronting seniors.
"One of the things that Connecticut has been pretty good about has been taking on some responsibility for medical costs for poor older persons. That is not, as you probably know, widespread nationally."" says Dr. Richard W. Besdine, director of the University of Connecticut's Center on Aging.
In general, says Besdine, no state "is especially well prepared" to provide for its elderly residents. From education, to health care, to job creation, he says that states have coped with Baby Boomers needs on a catch-as-catch-can basis, and senior care is no different.
"We have a brilliant record in this country of waiting until the horse is out of the barn," Besdine notes.
States also must deal with access for silver-haired Americans. Specifically, helping senior citizens unable to drive secure transportation.
From 1990 to 1997, the state with the biggest increase in its 65 and over population was Nevada, where the ranks of seniors grew 49.2 percent. Alaska came in second at 42.7 percent, followed by a big drop to Hawaii and Arizona, which both had 25.3 percent rises.
Next came Utah at 19.4 percent, Colorado, 18.9, New Mexico, 18.2, Delaware, 16.7, North Carolina, 15.1, Wyoming, 14.8 and South Carolina, which rounded out the top ten at 14.4.
New Jersey, Oregon, Washington and Florida are mentioned by aging experts as being more attuned to the elderly than most states. And Minnesota is praised for its programs dealing with assisted living, special care units and dementia.
Nationwide, 57 state agencies have been established to deal with issues affecting the elderly, as required by the Older Americans Act and the federal Administration on Aging.
A typical one is the Virginia Department for the Aging, which is responsible for coordinating, funding, planning and evaluating programs for older Virginians. It has a biennial budget of more than $50 million.
Virginia began allocating money toward senior issues began in 1973, when the General Assembly created a state Commission on Aging.