Advocates for the elderly praised the debate for its spirit and scope. The candidates, Democrats Lt. Governor Buddy McKay, Rick Dantzler, and Keith Arnold, and Republican Jeb Bush, agreed on issues such as home health care for the elderly and opposed physician-assisted suicide, suggesting instead a need to focus on better care and pain management.
The campaign's focus on the aging is a much-needed response to Florida's growing elderly population. The Tampa Tribune reports that Florida has 3.4 million people over the age of 60, almost a quarter of its population. Those aged 85 and over have increased by 139 percent since 1980. One-third to one-half of the "oldest old" are likely to develop dementing illnesses.
The candidates want to see more state-supported care that would allow elders to stay in their homes longer. In addition to improving access to home-based care, Bush vowed to end the wait lists for community-based programs. In Florida, programs such as Meals on Wheels and Community Care for the Elderly, provide 12 million meals a year to elders and adult day care, as well as homemaker services, transportation, and physical therapy to 51,391 elders a year. However, access to these programs is limited for the 20,000 elders who are placed on wait lists yearly.
All candidates opposed physician-assisted suicide, but supported programs that promote death with dignity. Danzler stressed the importance of pain control, "With advancements in medical care, there is no pain that cannot be managed."
"We need to focus on the things that cause people to despair and to even consider this ultimately tragic course," stated McKay. McKay's suggestions include ensuring that home care and health benefits are readily available and that health decisions are made only by the patients' family and physician.
According to Jim Towey, president of the Commission on Aging with Dignity, the candidates built a consensus "to better educate the public on end of life care." McKay suggested a larger state role in assuring patients of their federal and state rights in health decision-making.
Bush advocated the use of Five Wishes (see Exchange, January 1998), a legal document in checklist format, which allows its authors to indicate their preferences for breathing and feeding tubes, pain management, healthcare surrogate, and even non-medical issues such as "What I want my loved ones to know."
The candidates also plan to create a stronger Department of Elder Affairs with more control over nursing homes, other programs serving elders, and Medicaid. At present, Florida's senior programs remain fragmented and inefficient because they are not consolidated in this department. The department has gained more funding to aid family caregivers for Alzheimer's patients and created two pilot projects for managed long-term care systems.
The forum was an unprecedented and promising first step in raising issues about aging and possible solutions. Although the candidates tried not to place aging issues in competition with child advocacy issues, a challenge in the next few years will be to find ways to improve care for the elderly while maintaining programs that serve children and other vulnerable populations.
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