Elder Care in the Granite State
Last week, I attended New Hampshire Theater Project’s Elephant in the Room discussion on navigating care for seniors. The film they made about the subject featured snippets from different caregivers about the challenges of navigating the system, figuring out how to pay for it and what kind of care is appropriate, and how to initiate the hard conversations that aging requires us to have with loved ones.
Afterwards, more than a dozen of us sat in a circle and discussed our experiences and the shared sense that we need to do a better job taking care of elderly people as well as supporting the people who are caregivers and the places where this care occurs. I emphasized how these personal stories intersect with public policy: as the second-oldest state in the country, New Hampshire needs leaders who will address the fractures in our system so all of us can age with dignity.
The fastest-growing age group in New Hampshire is people over 65. Yet, according to AARP’s Long Term Services and Supports (LTSS) scorecard, New Hampshire ranks 31st in the country in affordability and access when it comes to home care costs, nursing home costs, long-term care insurance, and support for caregivers. We can do better.
And we must do better, because the demand is going to keep rising. Over the next decade, the state is projected to need 6,300 more long-term care beds and 36 more facilities—roughly 780 beds a year. And that doesn’t include the additional demand for primary care, mental healthcare, and in-home support.
Meanwhile, it feels like we’re moving in the opposite direction. When the Ammonoosuc Community Health Services clinic in Franconia closed because of Medicaid cuts, 1,400 patients lost nearby access to care. Half of them were older adults with serious medical needs. Now they’re driving 10+ miles for basic appointments.
Across the state, nursing homes are dealing with their own crisis. Only 19 out of 73 say they could meet the upcoming federal staffing requirements. Rockingham County’s nursing home is only half full because they can’t find enough staff (in large part because of low pay and the high cost of living nearby).
Last year, every single nursing home in New Hampshire fell at least $26.13 per resident per day short of the full Medicaid reimbursement rate. This is unsustainable.
When Medicaid falls short, the stress gets pushed onto families, workers, and the facilities themselves. Add in the pressure from federal cuts in the “Big Beautiful Bill,” and New Hampshire is left trying to do more with less.
Fortunately, there are a number of different solutions.
We can support long-term care workers by raising wages and addressing the housing shortage that makes it impossible for many of them to live close to where they work. New Hampshire’s minimum wage is still tied to the federal minimum wage, which hasn’t budged in years. It’s $7.25 an hour! That absolutely affects staffing and turnover in these facilities.
We can help people age at home where appropriate by passing and expanding Medicare for All to include long-term care and home-support programs—things like home modifications, personal care hours, and long-term home health. And we can support bipartisan legislation like the Credit for Caring Act, which would give tax relief to the many people balancing full-time work and caregiving.
Most importantly, we can choose to take this seriously—recognizing that it’s not a niche issue, but something that will affect all of us at some point. In Congress, I will make sure these issues get the attention they deserve and push for the changes we need so our seniors can age with dignity.
In the meantime, consider sitting down and initiating a conversation with your loved ones about what it means to age with dignity, so that you’re ready when the time comes: https://states.aarp.org/new-hampshire/caregiver-resources.
Learn more and find resources at the NH Alliance for Healthy Aging: https://nhaha.info/