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Jeffrey S. Barkin is a past president of the Maine Medical Association, a practicing psychiatrist, and co-host of “A Healthy Conversation” on WGAN.
Who will care for us?
The question is deceptively simple: Who will care for us when we can no longer care for ourselves?
Maine is the oldest state in the nation. That is not just a demographic curiosity — it is a looming crisis. We are living longer, but we are not necessarily living healthier. Dementia, frailty, and chronic illness are advancing on families already stretched thin. For many, the promise of “aging in place” is colliding with the reality of too few hands to help.
Drive through rural towns and you see closed general stores, shuttered mills, schools with fewer children. What you don’t see, until you look closely, are the older Mainers inside their homes — proud, independent, and increasingly alone. The daughters and sons who might once have cared for them often live hours away, pulled by jobs that disappeared here a generation ago.
Nursing homes are closing. Home health agencies can’t find workers. Hospitals, already strained, are boarding patients who are too sick to go home but have nowhere else to go. Families find themselves improvising — an adult child sleeping on a couch, a spouse lifting a partner far heavier than she can safely manage, a neighbor checking in twice a day. These are acts of love, but also of desperation.
The cost of care is staggering. A nursing home bed in Maine now averages more than $150,000 a year. Home health aides, when they can be found, charge rates that quickly drain savings. Medicaid can cover some costs, but only after families spend down nearly everything they have worked for. Too many are discovering, too late, that the safety net has holes wide enough to fall through.
We need to face this with honesty and urgency. It is not enough to tinker around the edges — to create one more task force, to write one more report. We need a comprehensive plan to build a care infrastructure as robust as our roads and bridges.
That means investing in the workforce: training, paying, and respecting caregivers so that young people see this as a career worth choosing. It means rethinking how we use technology, from telehealth to home sensors, without losing the human connection we all crave. It means supporting families, not punishing them, when they step up to care for loved ones.
And it means asking ourselves, as citizens, how we want to be cared for — and how we are willing to contribute to make that possible for others.
Because this is not a question for “someone else.” It is not just about the very old, or the very sick. It is about all of us. Unless we die suddenly, we will all face the long decline. We will all need help.
The truth is stark: If we do nothing, we will be left to fend for ourselves in a system that is already buckling. But if we act — with compassion, foresight, and resolve — we can build a future where aging with dignity is not a privilege, but a shared promise.
Who will care for us? We will. If we choose to.
