As housing prices soar and wages for health care providers lag, advocates for Iowa's aging population are calling for a major change in caring for the state's aging population.

Economic conditions have conspired to close several nursing homes in Iowa in recent years. The average wage for workers who provide long-term health care in Iowa is about $16 an hour.

Brad Anderson, Iowa state director for AARP, said it is far too low to attract and retain dedicated workers. But beyond boosting wages, Anderson argued providers need to improve working conditions for prospective workers and make providing long-term health care an attractive career option to younger people.

Anderson pointed out aging Iowans are also demanding a different type of care now.

"We believe it's time for a new model," Anderson asserted. "A vast majority of Iowans want to get long-term care in their own homes rather than a nursing home. So, we as a state need to find a more effective way to get them what they want."

Anderson emphasized in addition to attracting more workers with better wages and working conditions, providers need to be more transparent about how taxpayer dollars are spent, and adopt a mindset that focuses on home-based care.

Results of a recent AARP survey showed 78% of Iowans who need care prefer to receive it at home with caregiver assistance, reflecting the national trend.

Anderson acknowledged policymakers have been talking about changing the long-term health-care model for more than 20 years. Iowa nursing homes closing due to lack of funding and qualified workers has put the issue front and center.

Anderson stressed communities can lead the culture shift by developing a home-care network investing in technology and working with local schools, becoming destinations for older Iowans who want to age at home. But he added the demographics are not going to get any more favorable than they are right now.

"For example, by 2035, for the first time in history, we're going to have more Americans over the age of 65 than under the age of 18," Anderson noted. "We need to ask ourselves who is going to take care of the next generation of older Iowans?"

Anderson is optimistic about progress given state agencies and the Department of Health and Human Services understand the need and are working with advocates such as Iowa AARP on solutions.

Drawing attention to a housing option that could make it easier for older Nebraskans to "age in place" is one of the goals of an AARP Community Challenge grant-funded contest.

Omaha by Design was awarded a nearly $24,000 AARP "Demonstration Grant" for its "Duplex by Design" contest. The contest is for duplex designs which "promote health and greater autonomy" with their accessibility and affordability.

Abe Lueders, director of urban design and affordable design fellow at Omaha by Design, explained duplexes are one type of badly needed "missing middle housing."

"When we say 'missing middle,' we're talking about basically small multifamily buildings," Lueders noted. "That includes duplexes but also up to quadplexes, townhomes; things that are bigger than a house but smaller than an apartment."

AARP maintains one reason small, affordable housing is missing in many communities is too little of it has been built since the 1940s. This causes some seniors to remain in larger homes than they need.

Empty-nest Baby Boomers in the United States currently own twice the number of large single-family homes as Millennials raising children.

Todd Stubbendieck, state director for AARP Nebraska, said not only is there a need for more "accessible" senior housing but also for more housing options that allow seniors to live independently for as long as they can.

"Duplexes provide that opportunity for a little smaller space, downsized, maybe less stairs and just more of an age-friendly design option for folks," Stubbendieck outlined. "This project is going to highlight and raise awareness of duplexes and create some buildable designs that folks in Omaha can work with."

Lueders stressed in addition to being more affordable and accessible, "missing middle housing" creates more housing on a single lot. He pointed out duplexes are "the next rung up" on the housing ladder, since they are built on the same scale, use the same construction methods and are subject to the same residential building codes as single-family homes.

"It seemed like a really fruitful housing type to explore because of how low the bar for entry is," Lueders emphasized. "Because part of the goal is that you want to create a design that smaller developers can build. Maybe people that are newer to development that have a small piece of land and want to create some housing."

Contest designs must all fit a specific lot, which Lueders added ensures every designer is working with the same real-world constraints.

Registration for "Duplex by Design" closes Sept. 16, after which designs will be accepted until Oct. 18. The first, second and third place winners will receive cash awards of $2,500, $1,500 and $1,000.

A new report found Connecticut residents will benefit from Medicare's new out-of-pocket cap.

An estimated 49,000 people in the state would see prescription costs reduced because out-of-pocket costs will be limited to $2,000 per person each year. The report estimated the number of residents using the cap will hit more than 62,000 by 2029.

John Erlingheuser, senior director of advocacy and outreach for AARP Connecticut, said unaffordable prescriptions are forcing people to take matters into their own hands.

"We continually hear from folks that cut back on the number of pills they're supposed to take," Erlingheuser reported. "Maybe they're taking them every other day as opposed to every day, or they're cutting pills in half and taking a partial dose every day as opposed to taking the dose that they're required to take."

This cap stems from the health care reforms in the Inflation Reduction Act. Other reports showed more than 11,000 Connecticut Medicare enrollees using insulin can save about $590 per year. The out-of-pocket cap goes into effect on Jan. 1.

However, state lawmakers are reviewing other options to reduce prescription prices such as establishing a prescription drug affordability board, an independent body tasked with evaluating drug prices to determine if a price increase is valid.

Erlingheuser explained it can help keep prescription drug costs from getting too high.

"What it'll do is really allow the state of Connecticut to monitor the cost of prescription drugs, compare it with other states, and really put a downward pressure on those manufacturers to bring down those costs," Erlingheuser outlined.

Connecticut's most recent bill to establish a prescription drug affordability board failed to pass due to last-minute hurdles during the shortened legislative session. Public hearing testimony was mixed with many praising the idea of saving people money. However, some opposed Connecticut's bill creating a board because its members would not be representative of people who need lower drug costs.

A new online resource guide is available to help Mainers prepare for the upcoming presidential election.

It includes key dates for voter registration, information on absentee ballots, and recent changes in Maine election law.

Jane Margesson, communications director with AARP Maine, said the guide is strictly nonpartisan and useful to both first-time and lifelong voters.

"No matter what your question might be, or how you intend to vote," said Margesson, "all of the resources are right here for you and of course it's all absolutely free."

Margesson said Maine voters age fifty-plus made up nearly 60% of the electorate in the 2020 presidential election, and she said she expects high turnout among that age group again.

The election guide is available on the AARP Maine website.

Polls show strengthening the economy and making sure Social Security is fiscally sound are top issues for older voters this election.

The fund's reserves could become insolvent in 2035, and preventing any shortfalls will require Congressional action.

Margesson said caregiving is another top-of-mind concern. She said roughly 160,000 Mainers provide unpaid care for a parent, spouse or loved one - often while juggling a full or part-time job.

"We really are looking to candidates once again to come together in a bipartisan voice," said Margesson, "to take a look at the caregiver situation and find ways to help caregivers through better support."

Margesson said while Social Security and the challenges of caregiving may be top issues for older voters, they impact everyone and the state's economy.

She said every voice matters in this election and that Mainers should know help is widely available to ensure they can take part.