Massachusetts Faces Urgent Crisis in Elder Care Services

The state of Massachusetts is confronting a significant challenge in elder care, as highlighted by a recent report from Dignity Alliance Massachusetts. This report, titled “Massachusetts at a Crossroads: Facing a Predictable Crisis,” reveals that the commonwealth is ill-prepared for a demographic shift that will see the number of residents aged 85 and older increase by 40% over the next decade. As the United Nations marks the International Day of Older Persons, it is essential for communities, particularly in Greater Lowell, to acknowledge and address this impending crisis.

The quality of life in Massachusetts is often praised, with institutions like Lowell General Hospital providing high-quality acute care. However, the long-term care sector is nearing a breaking point. The Dignity Alliance report warns that the current system is not equipped to meet the needs of today’s older adults, many of whom wish to remain in their homes and communities. Over 90% of older adults and people with disabilities express this desire, yet state funding continues to prioritize outdated institutional models that fail to provide adequate privacy and effective protection against infectious diseases.

Systemic Failures and Call for Action

The challenges are particularly pronounced in communities outside of Greater Boston, where rising housing costs, underfunded programs, and a shortage of care workers exacerbate the situation. When nursing homes close, residents are often relocated far from their families, which can be especially detrimental for low-income individuals relying on MassHealth for support. The message is clear: the existing system is not designed for the realities of today’s aging population, and care quality is declining.

Advocates and caregivers have long sounded the alarm about these issues, yet coordinated, transparent action remains lacking. The Dignity Alliance report outlines a potential path forward, suggesting that Massachusetts should launch a public process to assess long-term care needs over the next five to ten years. Prioritizing investments in home care, adult day programs, accessible transportation, and workforce support is essential for enabling individuals to age in place with dignity.

To improve the remaining facilities, the report emphasizes the need to move away from large, shared-room nursing homes, which are increasingly seen as relics of the past. Instead, smaller, homelike settings that provide privacy and respect individual needs should be developed. However, achieving this vision hinges on addressing the ongoing workforce crisis.

Direct care workers, many of whom are women and immigrants, often face challenging working conditions, including low pay and high demands. They deserve fair wages, benefits, and clear career pathways. Dignity in care provision must extend to those delivering that care, ensuring a respectful environment for both caregivers and care recipients.

Significant Initiatives and Future Steps

There are hopeful developments on the horizon. The Marsters v. Healey settlement requires the state to facilitate the return of thousands of nursing home residents to community living. Additionally, the newly established Office of Aging and Independence could play a pivotal role in coordinating efforts across various agencies, provided it is granted full Cabinet-level authority.

In May, Governor Maura Healey issued Executive Order No. 642, directing every Cabinet department to focus on “age-friendly” programs. Reports detailing progress are expected next month. Yet, without genuine funding and actionable steps, these initiatives may fail to address the urgent needs for affordable housing, transportation, healthcare, and staffing.

The decisions made in the next two years will impact every family in the region. Massachusetts has the opportunity to prepare through thoughtful planning and investment in elder care, or it risks facing a crisis as the aging population continues to grow. This is not solely a financial decision; it is a moral imperative.

Community members, local leaders, and elected officials must advocate for immediate action: investing in home- and community-based services, supporting fair wages for care workers, and holding state leaders accountable for implementing the Dignity Alliance plan. The dignity of Massachusetts’s residents and the future of elder care depend on it.