Help pack a million meals for struggling seniors on 9-11. Volunteer today


Military and Veterans Discount


Free AARP E-Books

Protecting Yourself Online for Dummies

Here's the mini guide you need to steer through the hazards with confidence.

Learn More


AARP Games - Play Now!


AARP Staying Sharp: Keep Your Brain Healthy

News & Politics Forums

Share your opinions on news and current events that matter most to you.

Join the discussion »

AARP Auto Buying Program



In-Home Care Crisis

Nursing Home Don’t Put Me

Severe State Budget Cuts Force Families to Make Hard Choices

“Home care, meals, help for Alzheimer’s caregivers­—all help the state save money by keeping people out of nursing homes, and that’s a message we want to take to legislators,” says Randy Hunt, CEO of the Senior Resource Alliance, an area office on aging in Orlando. Hunt knows that lawmakers now working on Florida’s 2010 budget are staring at an estimated shortfall of $5 billion.

In the coming months, states will be looking for sources of new revenue—higher taxes on cigarettes, sales taxes on the Internet, increased traffic fines—and trying to find the least harmful cuts they can make. Reluctant to chop a whole program or service, lawmakers may freeze or cut fees to those who provide the services, including not only nursing homes and hospitals, but also agencies that supply home care workers and health aides. Such cuts, though, eventually tend to translate into problems of access and quality of care, says Nick Johnson, director of the state fiscal project for the CBPP.

Unfortunately, even the economic stimulus package assembled by Congress and President Obama—with its billions of dollars of state aid, including more than $87 billion for state aging and Medicaid programs—does not fully protect these home and community long-term care services. “The stimulus money will give states a baseline, so cuts may not have to be so drastic,” says Donna Folkemer, group director for health at the NCSL. “But it probably won’t allow new programs or even help them to hold on to all the current programs.”

And standing still can be moving backward. Consider Florida. While its Community Care for the Elderly escaped cuts this year, for nine years it has gone without a budget increase while its target population of older residents has grown by 700,000, according to Jack McRay, advocacy manager at the AARP Florida state office in Tallahassee. Today, 50,000 older Floridians are on waiting lists for these kinds of home services, state experts say, and 2,272 people died last year while on lists.

Those numbers worry Shirley Miller, who, up until she was 80, earned extra money by working the night shift at the reception desk of her apartment building. “When you’ve been independent all your life, you don’t want to ask for help,” Miller says. “But I just can’t keep up anymore. I need help.”

Barbara Basler is a senior editor at the AARP Bulletin.

Illustration by Gerald Dubois

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts


Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.


Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

member benefit aarp financial service auto insurance

AARP® Auto Insurance Program from The Hartford offers members no-cost quotes.

membership benefit financial college aarp

Advice on saving for education from AARP® College Savings Solutions from TIAA-CREF.

AARP Credit card from Chase

Members can earn 3% cash back on purchases with the AARP® Credit Card from Chase.

Member Benefits

Join or renew today! Members receive exclusive member benefits & affect social change.

Rewards for Good

Your Points Balance:

Learn More

Earn points for completing free online activities designed to enrich your life.

Find more ways to earn points

Redeem your points to save on merchandise, travel, and more.

Find more ways to redeem points