AGING AMERICANS: TOUGH CHOICES

Editor's Note: This is the first of a five-part series examining issues facing Missouri's growing elderly population.

Caring for elderly family members is never easy, but selecting a nursing home is by far the most difficult decision.

Cecil Kemp of Jackson recently moved her mother into a nursing home in Advance.

"She got to the point where she could no longer be left alone," Kemp said. "She had so many things happen."

Her mother was often confused and required medication for diabetes.

Family members tried in-home care for a while, but it wasn't successful. That's when the family chose a nursing home.

"When we made the decision, we tried to make it as best as we could for her," Kemp said. "She's never really accepted the fact and wants to go home.

"Until someone lives through that, you don't know what it's like. I would get up and pray, 'Lord just get me through these days.'"

With a growing elderly population, many families struggle with choosing nursing care for aging parents and relatives. "I don't know what the answer is," Kemp said.

With 591,000 residents receiving Medicare benefits during an average month, Missouri is struggling to support its elderly population.

And as the nation's population grows, more people are expected to live longer lives. But living longer also means facing new problems like poor health, financial struggles and other age-related readjustments.

In the United States, nearly one-eighth of the population -- 33.2 million people -- are elderly. Missouri ranks ninth in percentage of elderly residents.

There are just under 1 million residents over the age of 60, said Ryan Burson, state demographer. And those numbers are climbing.

The growing elderly population "presents a challenge to any agency that provides health care or services to the elderly," said Jerry Simon, acting director of the Missouri Division of Aging. "We are planning for this and taking a look at our needs now and in the future."

The agency is in the midst of developing a strategic plan for handling Missouri's elderly population boom.

While the offerings of assistance remain the same, more and more people are benefiting, said Ruth Dockins of the Southeast Missouri Area Agency on Aging.

"We don't have any more money necessarily, but we have a larger number to serve," she said. "As more and more seniors live longer, we hope the money grows with it. Otherwise the services will be affected in some way."

The Agency on Aging acts as a clearinghouse for services to senior citizens. It provides information about everything from transportation assistance to nursing home ombudsman. For information, call 335-3331 or (800) 392-8771.

Because the aging population has grown, the number of services available has increased as well, Simon said. The Division of Aging has created programs designed to improve the quality of life of Missouri's elderly.

"Our goal is to have care options that help keep them independent and in their homes," said Debbie Hendricks of the Missouri Division of Aging.

Helen Sander, a communication liaison for the Visiting Nurses Association of Southeast Missouri, agreed. Her agency offers medical and housekeeping assistance to elderly people.

"Most people want to be at home where their things are and where family members can come to see them," she said. "Older people get more confused when they are away from what's habit."

The trend is to offer services that help people maintain their independence, not to force them into a nursing home.

While many elderly remain independent, about 5 percent of the nation's elderly live in nursing homes, according to 1990 statistics from the U.S. Census Bureau.

Many people leave the hospital and stay at a skilled nursing center until they have recuperated enough to go home again. Nursing centers now offer rehabilitation services like speech therapy, physical and occupational therapy for stroke victims. "It's more like a step down from a hospital," Sander said.

Like many other facilities in the area, The Lutheran Home offers everything from home health care to assisted living services.

"We run the gamut of what services are available," said Susan Essner, director of social services and activities. "It says a lot to the community because people who are interested know we can provide the service needed."

However, not everyone is happy with a loss of independence or a move into a nursing center that often comes with old age.

"You see it a lot more in the people who come directly into skilled nursing," Essner said. "They haven't had the luxury of planning ahead or assisted living. They are generally unhappier."

"There's still the general belief that a nursing center is the place to go at the end of your life. But we do a good job of providing quality. Many people find contentment here."

-- The Associated Press contributed to this story.