We Grow Old, We Grow Old
Monday, March 23rd, 2009As if anyone needed it, last week came another reminder that Vermont is becoming downright geriatric.
Meaning maybe we do need it. Memory is one of the first things to go, they say.
(Who says? I forget).
Last week’s contribution was a new report showing that for the second year in a row, Vermont had the lowest birth rate in the country, 10.5 for every thousand residents. Add in the information dating back to 2004 that Vermont has the second-highest (after Maine) median age in the country, and this looks increasingly like a state where the average guy will wear the bottom of his trousers rolled).
(Those wishing an explanation of the literary reference in that last sentence and in the title of this post may click here).
The new numbers from the National Center for Health Statistics seem to have been ignored by most of the state’s media with the noted exception of WCAX-TV, Channel 3, which gave the story big play last Thursday.
To their credit, the station and correspondent Brian Joyce did not yield to the temptation to moan that the results proved that Vermont must be doing something wrong. Instead, it acknowledged that the state’s relative geriatricity stems less from what Vermonters do than from what they are.
They are white people. Worse, they are white Anglos. Meaning they are bland, boring, and possibly under-sexed. Ergo, they have fewer babies.
Channel 3 stayed away from the boring, under-sexed angle and focused on demographics and economics. Vermont’s potential mothers, it turns out, are not merely white and Anglo, but affluent and educated, precisely the people who have fewer babies.
The station cited University of Vermont economist Art Woolf explaining that these women want fewer babies because they want to earn more money.
It’s hard to argue with that, but one of the problems with economists, including smart ones like Woolf, is that they tend to think economics explains everything. Those women no doubt also want more leisure, and some of them may not want to bring many (or any) babies into what they consider an already over-crowded world.
As Channel 3 noted, aging is not without its difficulties, for a state as well as for a person. All those educated, childless (or one-child) women might get richer, but at the expense of threatening Vermont’s economy if there aren’t enough workers in the future. Employers, Woolf said, will ” go to North Carolina, or Boston, or Arizona, or Texas, or someplace where they can find workers to do the job that they want .”
Maybe. But that doesn’t mean the state will not prosper. First of all, lots of older people still work, often well into their seventies. (Seventy is the new fifty-five, or something like that.). With rare exceptions, older people do not have children living with them; they pay the taxes that support the schools without adding to the pupil population . They also tend to have guaranteed incomes from pensions or investments. When they spend that money, they create jobs.
True, as Woolf said, a living, working-age, person has to exist to fill that job. But if workers are more productive, there need not be as many of them, and Vermont’s educated population (presumably the men those educated women team up with are comparable learned) would seem to be more productive than most. In the inter-connected age, outsourcing some work to places with denser populations could prove a profitable arrangement for a rural state with relatively few people.
Besides, it isn’t as though the rest of the country is going to be awash with working-age folks. According to some projections, one in three Americans will be over 60 in 2030.
In a report issued last fall by the Carsey Institute of the University of New Hampshire called “Grey Gold: Do Older In-Migrants Benefit Rural Communities,” researchers Nina Glasgow and David L. Brown concluded that an influx of older residents into rural areas, including in New England, was certain to increase, and presented both opportunities and challenges to the towns where they settle.
Some of the challenges of having lots of old folks around are obvious. A state would need more health care and emergency medical facilities, more senior centers and meals-on-wheels providers.
Then there’s the drug problem.
What? Grandma’s one toke over the line?
Well, there’s a little of that, and likely to be more of it. After all, all those kids who were, say, 16, in 1967 (roughly when pot-puffing became downright respectable in some circles) will be senor citizens within a decade. Some of the haven’t given up the habit.
But that’s a small part of the senor citizen drug problem. First of all, unless Grandma gets behind the wheel of a car after smoking her joint, she’s not much danger to herself or others. And according to Patricia Facey, the director of the Coalition on Substance Abuse and Older Vermonters, “the real problem is polypharmacy.”
“Polypharmacy means ‘many drugs’ and refers to problems that can occur when a patient is taking more medications than are actually needed,” according to a medical web site associated with the University of Chicago. ” It is a particular concern for older adults, who make up 13 percent of the population but account for almost 30 percent of all prescribed drugs.
Facey acknowledged that there are few reliable statistics as to the extent of the problem, either nationally or in Vermont. But according to the Coalition’s latest newsletter, substance abuse among the elderly is “a growing and often hidden problem,” a problem likely to be more serious in a state with a high proportion of elderly residents.
The typical polypharmacy abuser, Facey said, is someone who takes several drugs – prescription and over-the-counter – often without telling one prescribing physician about the prescriptions written by others.
Sometimes, she said, polypharmacy results from forgetfulness. “But sometimes it’s intentional, because people are trying to kill pain, or they suffer from depression or loneliness, grief, or isolation. They’re trying to numb those feelings.”
In a few cases, she said, elderly patients deliberately go from doctor to doctor getting pain medicine prescriptions, then go from pharmacy to pharmacy getting them filled.
Then there are the senior citizen tipplers. According to the Coalition’s newsletter, 3 million Americans over the age of 60 are alcoholics, and widowed men “75 and older have the highest alcoholism rate of any age group.”
“Problems with substance abuse are frequently overlooked in older people, for a variety of reasons, Facey said. “These include the stigma. It is hard to accept the fact that an older person is inappropriately using drugs or alcohol. Our society associates this behavior with immorality and lack of control.”
Furthermore, she said, it’s easy for others to misinterpret the symptoms of drug abuse by the elderly.
“Caregivers may assume that age related conditions (are) causing the behavior, such as frequent falls, slurring of words, forgetfulness and confusion. They can be incorrectly attributed to Alzheimer’s disease or related disorders. ”
The Coalition, a relatively new (and low-budget; it survives on a $4,500 grant from the Vermont Department of Health ) organization dedicated to controlling the problem of elderly substance abuse, “meets via VTT interactive television every other month, and then the other months by teleconference,” Facey said. “The interactive TV meetings are presentations where we educate a lot of people.”
So far, its approach is “low tech,” she said. Older people are encouraged to “put all their medications in a bag, and bring it to the doctor with them.” Middle-aged children of older parents are urged to “watch for sings, things like (bank) accounts disappearing, or money getting stolen from you and you don’t know where it goes.”
Grandma, in other words, might be filching it to pay the pharmacy, or to buy lottery tickets in quantity. Gambling is not a substance, but it can be an addiction, and older people – often lonely and depressed – can be especially susceptible to it.







