Transportation, housing and nutrition were all mentioned as top concerns when it comes to seniors on Orcas. The prevailing theme for a large part of a recent meeting was the subject of home care.

“We need a bigger pool of care givers to screw in a light bulb or heat up a cup of soup,” said one attendee. “As well as certified health care givers who can do things like a bandage dressing change.”

The town hall meeting on Oct. 24 was held at the senior center to discuss how islanders look toward retirement and beyond and what can be done to help them stay on Orcas as they age. San Juan County Councilman Rick Hughes planned to co-host the meeting, but his ferry was delayed due to fog and he could attend until later in the night.

“As we begin our strategic planning to include the next 10 years, we want to serve you better,” said Marla Johns, senior center director.

Johns took notes throughout the meeting on posters taped to the wall. On the first poster, Johns wrote some illuminating figures.  The median age on Orcas is 60 years, 40 percent of the population is 65 years or older and ages 80 and over are the fastest growing population.

These numbers are part of a trend happening not only on the island, but on a national and international level. This trend is cause for concern for seniors because a less younger populations means a less able work force, which will affect many occupations, including the number of certified and non-certified home care givers.

In the U.S., the population that is currently at least 65 years old –13 percent – is expected to reach about 20 percent by 2050, according to the U.S. Census Bureau. Other areas in the world will also experience an aging population.

“… because of falling fertility rates, the number of young and working-age people is expected to decline elsewhere: by 10 percent in China, 25 percent in Europe, 30 percent in South Korea and more than 40 percent in Japan,” wrote Joel Kotkin in Smithsonian magazine.

Japan is looking at employing robots that can do the work of caregivers.

“Panasonic last year launched a robotic bed that can transform into a wheelchair, so the elderly can get up without assistance,”  according to Patrick Collinson of the Guardian newspaper.

Robotic stuffed animals to raise the spirits of the elderly are also being used in senior facilities.

But in many cases in Japan, the U.S. and other countries, home care falls to the responsibility of family members.

Those who have family members are lucky, but Johns asked those at the meeting what to do about seniors who don’t have children or grandchildren up to the task.

That’s when home care workers are crucial.

Community member Barbara Trunkey raised the idea that institutional care may be less expensive than staying at home and paying for a caregiver.

“Medicaid limits home health to three hours a day, so what about the other 21 hours of the day?” she asked at the meeting. “It costs about $27 an hour for a formal caregiver.”

Informal caregivers who come to do chores for elderly may be cheaper, but can come with pitfalls.

“Nearly every week I have someone coming to me saying, ‘I have been taken advantage of.’ More often than not it is people who have been hired to come in the home and there is no oversight,” said Johns. “The older population of 70 to 80 are a very vulnerable demographic. Exploitation to seniors is a huge problem.”

In response to Johns, several people echoed her concern and one person said that it is the senior’s responsibility to check references.

Johns said another problem with home care is that Medicaid, Medicare and insurance policies require the patient to go to a licensed agency. But the agency needs a minimum number of people to be financially viable before working with a location like Orcas Island. But Medicaid won’t insure if the agency is not willing to serve them.

“We wind up in a circle,” Johns said.

One solution called out at the meeting was using volunteers because San Juan County has a large pool of retired professionals.

“Volunteers have a role, but will not solve the problem,” said Stephen Bentley, Orcas Senior Advisory Committee chairman.

Other ideas tossed around about how to create better services included redefining nonprofits already working to expand aid opportunities, create more billable services, have senior services on a levy, improve community education and communication, and increase county funding and business opportunities. Johns said that she envisions this being step one in finding a solution, but she felt the meeting was successful in getting an important conversation started.

“It keeps people talking and thinking about senior services,” Johns said.