“I walked in and thought, I can’t do this,” the New Haven resident said of his concerns about transmission of the virus that has killed more than 4,400 residents statewide. “I was inside, and it was making me uncomfortable.”

Like millions of employees throughout the country, particularly those working low-wage restaurant, hospitality, retail or cleaning jobs, Ortiz has no idea what the future will bring.

He was out of work for 13 weeks. Then the Cast Iron Chop House began to see enough customers to schedule four waiters a night, compared with the eight to 10 who worked nightly before the pandemic. His acting jobs also dried up since the entertainment industry has been shuttered as well.

Despite his initial trepidation, Ortiz started back the week of Aug. 3. But he doesn’t know if the independently owned restaurant will survive a second shutdown if the virus ramps up in Connecticut again.

Ortiz Contributed Photo.

Ruben Ortiz was out of work for 13 weeks before he got his restaurant job back with limited hours.

It’s a problem playing out across the state, and country, as the pandemic continues to impact jobs and lives, said U.S. Rep. Rosa DeLauro.

As of July, 16.3 million people were unemployed nationally, an increase of 10 million since February, according to the U.S. Department of Labor. “But there are only 5 million open slots,” DeLauro said. “It’s not that people don’t want to work.”

The restaurant industry has been one of the hardest hit, she said. “Restaurant employees made up 27% of all unemployment claims nationally,” DeLauro said.

Connecticut officials have pegged the state’s unemployment rate at 9.4%. “But from what I understand from the Department of Labor, it’s actually more like 16 to 17% which is pretty extraordinary,” DeLauro said.

Low-wage workers—especially Latina, Black women and adults over 50—have been hit hardest with job losses, according to union and state AARP officials. Nationally the unemployment rate is 10.2%. The figures rise to 12.9% for Hispanics and 14.6% for Blacks, the federal Labor Department said.

Over 30% of those over 50 polled by the national AARP have reported lost income or had hours reduced due to office closures, said Nora Duncan, state director for AARP Connecticut. The employment rate for those over 55 is three times higher now than it was in January, she said.

“Traditionally, without a pandemic, it takes older workers twice as long to find a job than their younger counterparts,” said Duncan, who is worried that age discrimination will impact older workers’ ability to find a job during the pandemic.

About 20% of the Service Employee International Union Local 32BJ, which represents 171,000 office-cleaning and security workers from Florida to the Northeast, have been out of work since the pandemic hit the United States, said Juan Hernandez, the union’s Connecticut district manager.

Most members provide janitorial cleaning for offices, security for businesses and universities or work as Head Start teachers, many of which have closed to avoid the spread of COVID-19.

Close to 700 union members in Connecticut have been collecting state unemployment benefits and were financially OK while also receiving the extra federal unemployment benefit of $600 a week, Hernandez said. The federal benefit ended on July 31. The average state unemployment payout as of July was $269.25 a week, said Labor Department officials.

If the federal government doesn’t act soon, Hernandez fears people will start losing their homes. “Some are looking at the possibility of being out of work for a year and a half,” he said. “They are frightened.”

Many are minority women who support families and whose jobs depend on large office buildings remaining open, Hernandez said.

“The reality is that there is no work,” he said. “Unemployment only lasts six months. We have people with families with medical conditions. Our members tend to be older with existing conditions.”

Some are afraid to return to work, he said. Others are working two jobs to cobble together the $16 an hour they made before the pandemic hit.

Cardona Contributed Photo.

Maria Cardona has been laid off from her job cleaning in Hartford since April.

Maria Cardona has been laid off from her job cleaning the Phoenix Insurance building in Hartford since April. Her husband was out of work for four weeks when he contracted COVID-19. The couple, who live in Hartford, were getting by on her unemployment, including the $600-a-week federal supplement.

It has been stressful, she said. “It was horrible,” Cardona said. “It was like your whole world is coming down.”

Office cleaning allows her to be home with her 2-year-old son during the day, said Cardona, who is 26. But the future is uncertain, she said. She has been taking classes to become a real estate agent because she doesn’t know if she will be called back to work.

“It’s really hard right now,” Cardona said. “A lot of companies aren’t hiring. I don’t even know where I’d start looking.”

The good news is that some industries have begun to recover, said Patrick J. Flaherty, assistant director of research and information for the state Department of Labor’s Office of Research. The need for non-emergency health care and dental services will return, he said.

The restaurant industry has made gains since May, with employment in June at 70% of what it was last year, compared with 44% in April, said state Labor Department officials. “While, sadly, some businesses may not be able to survive the pandemic, once it is over, there is no reason to believe the desire of the public to go out to eat will have fundamentally changed, and the restaurant industry should rebound,” Flaherty said.

But it’s too early to tell how retail and janitorial services will be impacted in the long term, he said.

Ortiz said he hadn’t received unemployment benefits since April 24 due to a glitch in the Labor Department system. He finally was sent his back payments in the past week. Prior to starting back at the Chop House, he had been working odd jobs, including live Facebook performances, to supplement his family’s income.

His wife is a teacher who has been working through the pandemic, he said. He doesn’t know what live theater performances will look like in the short term, but he has been auditioning for commercials from home.

“I’m fortunate to have a dual-income family,” he said. “I’m also an optimist. I try to look at the bright side.”

Morning radio had a field day. When it comes to sex and the senior set, those jokes write themselves.

And that’s unfortunate. Researchers say sex remains an important part of life, including for seniors. A recent study published in Archives of Sexual Behavior said that declining sexual activity among the elderly may be an indicator of poor health outcomes that include serious heart problems, and even cancer.

Yet sexual intimacy among seniors remains an under-studied part of medicine. A few researchers have been keeping up. AARP has, as well, but doctors may even ignore it.

The rest of us just may have to get over our squeamishness. As the baby boomers march into their 70s and 80s, that gap in research may become critical. By 2035, according to the U.S. Census Bureau, people older than 65 will outnumber children in the U.S. That’s 78 million seniors compared to 76.7 million children. More than a third of Connecticut residents are older than 50, and that number keeps rising. Using Census Bureau statistics, Newsweek magazine last year said Connecticut is roughly in the middle for how fast the state is aging. (Utah is aging slowest, while Vermont is aging fastest, according to the report.) According to the National Center for Assisted Living, Connecticut has 60 assisted-living communities that serve an average of 25 people. Count on that number rising, as well.

Kenny Luo Photo for Unsplash.

Sexual intimacy among seniors remains an under-studied part of medicine.

Christina Barmon, assistant professor of sociology at Central Connecticut State University and co-chair of the school’s gerontology minor, said research in the field is growing—in part because it has to. The boomers may not have it any other way—probably.

“I think the boomers are a really political active generation,” Barmon said. “They will demand better food, more privacy—but then, maybe they won’t be as demanding. We all have ageism as a big part of our culture.”

That bias toward believing in a sexless old age includes people who play the most critical role in elder health: physicians. Research shows, Barmon said, that doctors don’t tend to talk to older people about sex because their assumption is that older patients aren’t sexually active anyway. One study said that nearly 64% of doctors did not discuss sexuality in examinations of older patients with chronic pain.

In fact, doctors are ignoring glaring evidence of sexually active seniors, including skyrocketing infection rates for sexually transmitted diseases among people age 45 and older, according to the Centers for Disease Control and Prevention. That includes chlamydia, gonorrhea and syphilis.

Barmon and others say older adults tend to remain sexually active, though they may have sex less frequently than younger people. To maintain an active sex life, elders face challenges that include poor health, a lack of privacy, and a lack of available partners (particularly for women, who live, on average, five years longer than men in the U.S.).

Barmon’s research shows that adults in assisted living facilities must overcome even more barriers, including (and this is a big one) staff who may not support fraternization among residents. Those attitudes may run counter to the stated mission of assisted-living facilities that would give their residents autonomy (and privacy). Those attitudes will need to change, Barmon said.

“I think the main thing is that it can be important for health and well-being,” Barmon said. “It’s an important part of your life.”

Susan Campbell is a distinguished lecturer at the University of New Haven. She can be reached at slcampbell417@gmail.com.

This column was reported under a partnership with the Connecticut Health I-Team, a nonprofit news organization dedicated to health reporting. (c-hit.org)

In 2017 alone, the state Department of Social Services (DSS) received 11,123 reports of elder abuse and decided that 7,196 warranted an investigation. That year, self-neglect—when adults are unable to provide for their own basic care—was the most common type of elder abuse reported to DSS, at 30 percent, followed by neglect by others, financial exploitation, emotional abuse, physical abuse, sexual abuse and abandonment.

“It’s all trending up,” Dorian Long, DSS director of social work services, said.

Some of the recent cases investigated by DSS Protective Services for the Elderly are chilling. A 74-year-old man who was frail, thin and prone to falling was living alone in a home infested with cockroaches and mice. The in-home care of a woman over 90 was stopped for nonpayment because her niece had spent her aunt’s money on her own household. An 87-year-old man confused about his finances had his utilities shut off after his son had spent his money instead of paying the bills.

Long’s 68 social workers helped all the seniors find in-home care, a new conservator or better housing—whatever they needed to escape the neglect or abuse.

Sexual abuse of the elderly is also on the rise, Long said. In the past, DSS would investigate three or four cases a year, working with police, and now it typically handles 40 cases a year. Scams targeting the elderly are also increasing, she said. Seniors can avoid becoming victims by staying involved in their communities. “The more you are isolated, the more vulnerable you are,” Long said.

The Justice Department estimates that 1 in 10 American seniors are abused, and state officials say the problem is likely to grow as the population in Connecticut—already the sixth oldest state—rapidly continues to age.

Complaints about abuse in Connecticut nursing homes, residential care homes and assisted living facilities rose by nearly 15 percent between 2015 and 2017, said Mairead Painter, the state Long Term Care Ombudsman.

Experts say the numbers of elder abuse complaints may be rising due, in part, to greater awareness, but still, many cases are never reported.

“Sometimes individuals are too embarrassed to report it,” Painter said. “Sometimes people are fearful that if they report abuse, they may have to stay longer at a nursing home.”

From Physical Abuse To Romance Scams

The cases of elder abuse seem to be all over the news. In January 2018, the live-in caregiver of an 81-year-old man with dementia was arrested after going on a rampage, breaking a TV and burning papers on a stove, in the man’s apartment in the Rockville section of Vernon.

This January, a Rockville couple in their 70s had several thousand dollars in cash and jewelry stolen when they let in their home men posing as utility workers.

Sometimes the abuse is physical. When she was 69 and living in Meriden, Rita Pompano said, she endured seven months of physical abuse from her husband, Ralph Pompano.

Each day when he told his wife to grab a pillow, the pain would soon follow.

“I knew that was time for my daily beating,” said Pompano, now 76 and living in West Haven. “He’d have me put my face into the pillow so nobody would hear me screaming.”

She escaped with her son Anthony’s help in 2011, only to have her husband threaten him three months later to find out where she was hiding. Ralph Pompano, 74, pulled a gun and fired a shot at Anthony that day before fleeing to Virginia. Two years later, he died in prison.

Bonnie Brandl, director of the National Clearinghouse on Abuse in Later Life, said she has encountered cases like the Pompanos’.

“The abuser may decide their life is being cut short and will become threatening,” Brandl said. “It’s the ultimate act of power and control.”

State Sen. Tony Hwang, R-Fairfield, and four state representatives have proposed legislation to create an elder abuse registry. Similar to the state sex offender registry, it could keep people convicted of such crimes from doing it again, he said.

“We need to be sure our seniors are protected,’’ he said. The bill has been approved by the state legislature’s Committee on Aging and referred to the Senate.

The AARP Connecticut holds workshops across the state to alert seniors about scams, ranging from IRS and sweepstake scams to fake Nigerian princes, said Erica Michalowski, the organization’s associate state director for community outreach.

“We say that the scam artists have gotten the senior into their ether,” she said. “They’re keeping the senior off-balance in a heightened emotional state.”

Betty Bajek, 66, of Prospect, volunteered to educate seniors about fraud for AARP after someone stole her credit card number and charged $1,200. She said romance scams are on the rise as criminals befriend seniors, show a romantic interest in them and then ask for money.

“These con artists prey on lonely people,” she said.

Nationally, financial exploitation and neglect are the most common types of elder abuse. Some states, including Connecticut, count self-neglect as abuse. Julie Schoen, deputy director of the National Center on Elder Abuse, said that is appropriate so those seniors get help. Brandl, of the national clearinghouse, agrees that they need help, but said, “For me, it’s not elder abuse when there’s no perpetrator.”

Unlike children who are abused, seniors can decline help. Long said DSS social workers do encounter some elderly people living in squalor who refuse their services.

“We put on the charm and try to convince them, but as an adult, you have a right to make choices—even bad choices,” Long said. The caseworkers may go back a few weeks later to try again. If the person says no, they have to close the case.

Help Is Available

One of several agencies in Connecticut assisting elders is the CHERISH program in Ansonia, which counseled Rita Pompano after she left her husband. It provides a hotline, court advocacy, safe housing and counseling for victims of domestic violence who are over 60 statewide.

Its coordinator, Mary Jane Liddel, stayed close by as Pompano recounted her story of her husband’s violence. Tearing up briefly, Rita said CHERISH helped her heal. Now, she enjoys freelance writing, cooking for friends and taking road trips with friends.

“I’m just happy that I’m free,” she said.

CHERISH’S 24-hour hotline: 203-736-9944 or 203-789-8104.

To report cases of suspected elder abuse, neglect or exploitation in Connecticut, call the toll-free referral line at 1-888-385-4225; after business hours, or weekends, or state holidays, call 211.

For information about Protective Services for the Elderly, click here.

But two Connecticut doctors are studying various aspects of elderly driving and their findings could eventually make the decision-making process easier or perhaps even keep elderly drivers on the road longer.

At Yale New Haven Hospital, geriatrics researcher Dr. Richard Marottoli is studying driving longevity in women compared to men. He’s working to identify gender differences, determine whether women are more likely to stop driving sooner than men, and whether there is any relationship between brain volume, adverse driving experiences and medical history as it relates to the ability to drive safely.

At UConn Health Center on Aging in Farmington, Dr. Kevin Manning, a neuropsychologist and assistant professor of psychiatry, is conducting a separate study using a Patterson Grant, defining what aging factors affect driving ability, identifying correctable difficulties that could help extend the driving lifetime and measuring how loss of a driver’s license is associated with the risk of depression and mortality.

“This is becoming a bigger issue, especially with baby boomers who are more independent than their parents were,” Manning said. “It’s a generation that does not want to be dependent on someone else when it comes to getting around and is more reluctant to give up driving, which is the key to independence.”

“Hopefully our study will help identify early signs of mild cognitive impairment that are not associated with dementia,” Manning said. “And even if we can prolong driving for a year, it would make a good difference when you look at the population as a whole.”

The Federal Highway Administration reports that there were about 24.4 million licensed drivers 70 and older in 2014, and that those drivers travel fewer miles than others but keep their licenses longer. The number of licensed drivers age 70 and older increased 38 percent between 1997 and 2014.

By 2030, 85 percent to 90 percent of the 70 million Americans 65 and older will still be licensed and driving, the American Automobile Association says.

In Connecticut, there are an estimated 2.6 million licensed drivers, with just over 322,000 of them 70 years or older in 2015. Connecticut has no restrictions on license renewals; a driver 65 and older can renew a license for 6 years or 2 years, the option is a personal choice.

Marottoli, whose research is funded through the Women’s Health Research at Yale’s Pilot Project Program, is using data collected from about 2,700 women on how, why and when they drove, as well as whether they had any adverse events, such as crashes or tickets. Marottoli said the information would be compared to a previous study done on elderly male drivers.

Marottoli, medical director of the Dorothy Adler Geriatric Assessment Center, said, “The important issue is whether older women are more likely to stop driving than men and do they live longer after that cessation. I think we are going to find more commonalities than differences, but I want to use this research to have a better understanding of gender differences and determine if there are interventions to keep them on the road longer, and if not, look at transitioning to other transportation to keep them mobile.”

Manning hopes to prolong drivers’ days on the road, focusing on identifying potential medical and cognitive challenges in older individuals; establishing benchmarks with a series of tests, assessing the degree of driving competence; and, when possible, teaching patients how to compensate for driving errors so that they can stay on the road.

Among the tools he uses is a state-of-the-art driving simulator that tests patients on a variety of driving maneuvers and hazards. The simulator prompts the “driver” to maneuver a simulated vehicle along a roadway that is on a computer screen. The test helps pinpoint cognitive declines like vision problems, range of motion or other physical changes in driving ability while also testing response time and the capability to follow speed limits, traffic signals and other driving rules.

“We know that when someone can no longer drive, there is an increased risk of depression and mortality because you are taking away their independence,” Manning said. “We want to keep drivers and others safe so when we see through our testing that a driver is having issues like difficulty judging a turn or preparing for oncoming traffic, we can train them to handle driving errors we have identified.”

“The research is intriguing,” said Nora L. Duncan, state director of the AARP Connecticut, which hosts classroom programs to assess and re-educate elderly drivers.

“Anything that helps preserve independence and allows people to age in the community of their choice is worth exploring, both in terms of extending safe driving abilities and in terms of expanding alternative transportation options,” Duncan said.

Sherry Brown, 69, of Hartford, said she learned a lot from her experience with her elderly mother, who lived in the South and, despite reluctantly giving up her driver’s license, refused to move to Connecticut.

“I have built a house near my daughter so I have someone I can turn to for transportation,” Brown said. “I see it as a partnership, not an inconvenience,” she said. “I know how worried and unhappy and scared I was knowing my mom was driving. I don’t want to do that to my family.”

The state needs more professionals to focus on geriatric care while also addressing other ways to meet the increasingly complex care needs of older residents, says the American Geriatric Society (AGS).

In Connecticut, only 134 certified geriatricians are currently practicing—caring for a 65-plus population that topped 577,000 in 2015, according to the AGS. And that population will continue to grow, the AGS says, with an elderly population of 956,000 expected by 2030. That’s a 40 percent increase, and will require an estimated 340 geriatric specialists to meet that treatment need.

iStock Photo.

In Connecticut, there are only 134 certified geriatricians practicing.

“We need to increase the number of trainees going into careers in geriatrics,” said Nancy Lundebjerg, chief executive officer of the American Geriatrics Society and a Connecticut native. “Aging is an area where there will be tremendous opportunities for those with specific training in care of older adults, especially as we boomers enter our golden years.”

But Dr. Mary Elizabeth Tinetti, chief of geriatrics at Yale University School of Medicine, said a way to remedy the shortage is to train all practitioners in the fundamentals of elder care.

Tinetti, who directs the Yale Program on Aging, said most older adults don’t necessarily need a geriatric specialist. Rather, they need physicians—including family medicine, cardiologists, endocrinologists, pulmonologists, surgeons and advance practice nurses (APRNs) who are trained in geriatric principles and who can provide geriatric skills.

There are multiple reasons why it’s so difficult to recruit and train geriatricians, according to Dr. Gail Sullivan, director of the geriatric medicine fellowship at the University of Connecticut School of Medicine. Primary care is very unpopular due to its comparatively lower pay combined with what she calls the “hassle factors”—too much paperwork, confusing government information technology requirements, keeping abreast of the myriad medications for multiple chronic conditions like diabetes, heart disease, dementia, arthritis and high blood pressure.

“If you realize that you’re going to work really hard and be pretty miserable and also not get paid for it, it’s a potent combination, especially when coupled with our youth-obsessed society,” Sullivan said. At UConn, only two weeks are devoted to geriatric care in the medical curriculum. And in many years, Sullivan said she has trouble filling the few available geriatric residency slots.

Overwhelmed And Underpaid

Many students go into medicine because they want to cure disease, but that’s often not possible in a geriatric population, said Dr. Bruce Koeppen, dean of the School of Medicine at Quinnipiac University. “What geriatrics is all about is the management of chronic disease. For a good portion of students and young physicians, that doesn’t excite them.”

The scope of geriatric practice is also daunting, Koeppen pointed out. They have to know a vast amount of information, something about every single aspect of the body, including psychiatry. It can be overwhelming for many students.

He thinks medical schools need to demystify what geriatric practice is really like. At Quinnipiac, students spend time embedded with primary care physicians in the community. This allows them to actually deal with geriatric patients. An elective in geriatric medicine, which encompasses hospice and palliative care, is offered to fourth-year students.

Tinetti said, “Most older adults, even if they have multiple conditions, can still be taken care of by a well-trained and skilled generalist—an APRN or physician. It’s only a small group of people who are beyond the capabilities of general practitioners and that’s when there needs to be a referral to a geriatric specialist.”

One way to maximize the scarcity of available specialists is to co-manage care, an increasingly common process where doctors, physician assistants and APRNs work together to provide optimal care for the patient.

It’s About the Money

Loan forgiveness may tilt the scales toward geriatrics for some prospective physicians. Most medical students face upwards of $200,000 in loan payments after graduation. Loan forgiveness is already an option for some graduates working in underserved communities, according to Tinetti. So perhaps physicians who agree to take care of vulnerable older adults could get part of their student loans forgiven.

Another part of the solution, she said, is changing our cultural perceptions of aging and paying those who care for the elderly more. “We live in a country that doesn’t want to accept growing older or death,” she said. “If you paid some of the other specialists less and paid geriatricians more, it would change things overnight. It’s about the money.”

The current reimbursement system rewards procedures, rather than patient management. If you sit down, talk to a patient and manage their medicines, but don’t do a procedure, reimbursement rates are drastically lower than if you spent the same time doing a procedure, Koeppen explained. “There’s a lot of talk about reforming the reimbursement system, but the problem I see is that it will become very divisive, because I don’t see the pie getting any bigger.”

More doctors is one solution, but Nora Duncan, the director of Connecticut AARP, wonders what can be done to keeps costs down, help people gain access to the services they need and continue to allow them to stay home and age in place. The solution may lie in technology.

AARP supports funding more remote care services for qualified patients. Medicare, the federally financed health program for older adults, already pays for some virtual services. The legislature just approved a bill requiring the state-funded Medicaid program, which covers some low-income seniors, to do the same. The governor signed the bill Wednesday. It takes effect July 1.

“By extending Medicaid for telemonitoring, it holds the promise of helping people stay home instead of going to a nursing home,” Duncan said. This approach means care providers can monitor patients and maximize limited resources without always requiring an in-person visit. It will also help solve access issues for those in rural areas or who lack transportation.

But in a tight budget year in Connecticut, it’s a fiscal issue.

A proposal that would increase the minimum assets that a spouse living in the community can keep — from $23,844 to $50,000 – in order for his or her partner to be eligible for Medicaid nursing home care is being backed by elder advocates, who say the increase would help seniors, especially women, remain able to live independently. But the move is being opposed by the Department of Social Services on the grounds it will shift millions in costs to the state-funded Medicaid program.

The proposal would affect couples with combined assets of between $23,844 and $100,000. Currently, when qualifying for Medicaid, couples split their assets evenly, and the nursing-home-bound spouse must spend down his or her portion to $1,600. That means if a couple has $60,000, each spouse gets $30,000, and the institutionalized partner must spend his or her share down to $1,600, usually by paying for initial nursing home care. Under the new proposal, the community spouse would be able to keep $50,000 in assets.

By reducing the amount of money assigned to the institutionalized spouse, he or she would become eligible for Medicaid assistance sooner. One month of accelerated eligibility for 30 clients per month, for example, would result in a net cost to the state of about $1.1 million a year, according to a fiscal note on the proposed change. Those costs could multiply, as some enrollees could have three or four months of accelerated Medicaid eligibility.

But elder law attorneys backing the change say the state’s financial worries are shortsighted and overstated. Allowing the community spouse – often the wife — to keep $50,000 could keep her out of poverty, off government programs, and in the couple’s home, they argue.

“It’s hard enough for a spouse to deal with putting a loved one in a nursing home,” said attorney Jack Reardon of New London, president of the Connecticut chapter of the National Academy of Elder Law Attorneys. “We don’t need to yank the rug out from under them . . . These are people already of meager means. This is a way to offer them some protection.”

Attorney Matthew Stillman of Guilford, the organization’s public policy director, noted that the state has shifted its focus away from institutional care for the elderly, to community-based care.

“If the state’s goal is to keep people in their homes, in the community, why wouldn’t we give them the means to do that?” he said.

Stillman and other supporters of the bill say that raising the asset allowance for spouses could save money in the long run by keeping the spouses off public assistance longer and by giving them a cushion for health or other emergencies that could otherwise impoverish them.

“If we deprive a healthy spouse of the basic resources they need for independent living, we increase the likelihood that she/he will prematurely follow their spouse into a nursing home,” the Connecticut chapter of the AARP said in testimony to the legislature.

Stillman said the couples affected by the change are people of modest means.

“We’re talking about people who have lived their whole lives and have less than $100,000,” excluding the value of a home and car, he said.

In all states, federal Medicaid law provides special protections for the spouses of Medicaid applicants, to make sure they have some minimum support to continue to live in the community while their partner is receiving long-term care, usually in a nursing home. But states have the right to decide how much the non-institutionalized spouse may keep, within a range.

Connecticut’s allowance — $23,844 – is the lowest allowed. A number of other states, including Massachusetts, Vermont, Maine and Illinois, provide the highest allowance — $119,200 – according to testimony from the Connecticut Bar Association. At that highest level, the wife in a couple with $100,000 in assets could keep the entire amount, and Medicaid would pick up the nursing home tab.

Connecticut historically has had the lowest spousal allowance permissible, with the exception of 2010-11, when the legislature raised the allowance to the maximum level for one year — then lowered it back down.

In recent testimony, DSS maintained that the current policy is “fair and reasonable and supports the original intent” of the federal government’s spousal protection policy. The agency said the state’s minimum was “in line with most other states.”

The potential savings from keeping spouses more financially solvent are hard to gauge. The proposed bill would require the state to report back on the costs and savings associated with the change.

Medicaid nursing home care costs an average of $6,000 a month in Connecticut, according to estimates.

Even experienced drivers feel the effects of aging when behind the wheel. “It’s harder to turn around now to look for blind spots,” he said. “Backing up is a real issue too,” especially when he drives the Jeep they tow along for in-town use.

Age-related decline in mobility, flexibility and reaction time can seriously impact driving and safety. Some simple, targeted exercises may ease normal age-related physical changes and help keep Crocker – and many of the 700,000 older Connecticut drivers — safely on the road.

A study by The Hartford Center for Mature Market Excellence and the M.I.T. Age Lab looked at the effects of exercise on older drivers’ strength, flexibility, coordination and range of motion. Participants used a specially designed exercise program and an X-Box. Drivers who exercised for 15-20 minutes daily reported greater ease in turning their heads to look in blind spots when changing lanes or backing up, compared with a similar group that did not exercise.

The exercise group could also rotate their bodies easily to scan the road when making right hand turns compared with non-exercisers. “When you think about the risks in intersections, that’s a very positive outcome,” said Jodi Olshevski, a gerontologist and executive director of The Hartford Center, part of The Hartford Insurance Company. The group was also able to get in and out of their cars more quickly, which translates to improved flexibility, something “so essential to be able to respond to all of the various actions that are required for driving,” she said.

The study was important in establishing a connection between exercise and a specific fitness program and driving ability, added Olshevski.

“We wanted to look at the impact of physical fitness on driving skills of older drivers before they have really significant health issues,” she said.

There were over 2.4 million licensed drivers in Connecticut in 2012, according to the latest figures available from the National Highway Traffic Safety Administration (NHTSA). Connecticut Department of Motor Vehicle data show that one in five drivers is age 65 or older.  In Connecticut, 50 of the 332 fatal traffic crashes involved older drivers in 2012, according to the NHTSA.

Frank Pagerino, AARP’s State Coordinator for Driver Safety, said, “Most older driver don’t complain about their physical ailments, but when we start talking about it, they admit they can’t walk, or it’shard to bend down, or turn their necks.’’  That affects their ability to conduct maneuvers like lane changes, which require turning the torso and neck to make sure there’s no oncoming traffic, he said.  AARP is a partner with The Hartford Insurance Company, offering car insurance to mature drivers.

Older adults have a higher crash rate per mile driven and are frailer. So when they crash, their chances of injury or death is greater compared with a younger driver in that same crash, according to Yale doctoral student Nancy Knechel.

Knechel conducted a separate analysis on the effects of various interventions on improving skills of older drivers. She found that exercise was the best approach to maintaining driving ability in older adults compared with other activities like cognitive training.

Driving is more than getting from point A to B, she said. Seniors who don’t drive have less social interaction, more depression, and worse overall health. “Even though it seems like a quick Band-Aid to take them off the road, it probably creates bigger problems,” Knechel said.

In a 2013 national telephone survey of 1,107 drivers age 50 and older, turning their heads to look at blind spots, getting in and out of a vehicle, and reaching and adjusting the seat belt ranked as the top three physical challenges.

“The real question is what can people do to try to extend their ability to stay safe on the road as long as possible. That’s why we wanted to look at the role of exercise as an empowerment model, rather than a reactive ‘oh you’ve got to get off of the road’ model,” Olshevski said.

Many newer cars have built-in technology that addresses age-related challenges, like blind spot warnings, light-sensitive headlights and backup cameras. Fifty-one percent of consumers surveyed by the Hartford Center said they would feel safer with at least one of these technologies in their car.

AARP’s Pagerino cautioned that technology is also a distraction, because “you’re taking your eyes off the road to look at a screen and your concentration gets blurred. I’m a bit leery, but that’s what’s coming down the pike.”

And now? They’re aging together, in such large numbers that futurists warn of a silver tsunami. In Connecticut, the group is, says Julia Evans Starr, executive director of the Connecticut Commission on Aging, “almost impossible to wrap your arms around.”

But someone has to. By 2030, the commission says that Connecticut’s over-65 population could grow by 64 percent. And most of those seniors aren’t retiring to sunny Florida. According to AARP, 90 percent of Americans stay put after retiring. Most remain in the same county – and even the same house, if they’re able.

The changing demographics caught the attention of the state’s leaders. Gov. Dannel P. Malloy recently re-established a state Department on Aging, and appointed former state Sen. Edith Prague – who was once the state’s commissioner on aging – as its head. In the most recent legislative session, state legislators debated a couple of age-centric bills, including one passed by both chambers that seeks to address seniors’ ability to age in place.

Orlando J. Rodriguez, senior policy fellow at Connecticut Voices for Children, recently published a report in “The Connecticut Economy” that called Connecticut, already the country’s seventh oldest state, a “retirement haven.” That’s especially true for seniors who are disabled or poor and can take advantage of credits for local property taxes with the Connecticut Homeowner’s Elderly/Disabled Tax Relief Program. And this is particularly important as the tsunami prepares to crash. By traditional measures of poverty, six percent of Connecticut’s seniors are poor. Using something called the supplemental poverty measure, the figure more than doubles, to 13 percent.

That traditional measure was developed in the ‘60s, with few changes in the intervening years. The newer means, first used in 2011 by the Census Bureau, takes into account things like tax payments, work expenses, and benefits such as SNAP, which used to be known as food stamps.

Of the state’s towns, Rodriguez says that Bridgeport should see the largest rise in seniors – 6,800 — between 2010 and 2025.

So what are towns doing to prepare? Not much, says Rodriguez. Town planners tend to pay attention to shrinking school enrollment, but few consider what’s happening on the other end of the bench.

Connecticut towns that stand the best chance of weathering the tsunami are ones – like New Canaan – that have started planning already. Jim Lisher is chair of the town’s Health and Human Services Commission. He said that in the last four years – in part because of the recession — town senior case workers saw a 300 percent increase in their workload.

Recent senior-friendly changes in New Canaan include the installation of benches along town walkways, development of assisted living and affordable housing for seniors, and a pilot Telehealth wellness program that gives town seniors medical equipment so they can keep track of things like blood pressure, and also puts them in frequent touch, via technology like iPads, with a nurse. The program began with 10 seniors ages 70 to 85, and is set to expand, Lisher said. The idea is to keep seniors out of institutional care and allow them to age in place, which is less expensive, and it’s what most seniors prefer. The town looked specifically at housing and health care, because, said Lisher, “the two are joined at the hip.”

Rodriguez said other towns would do well to start planning.

“We’re not looking far into the future,” he said. “We’re looking at 10 years.”

Connecticut Medicare recipients have saved an average of $1,174, according to the HHS’ press release.

Nationally, HHS said the savings have hit more than $6 billion for 6.3 million people with Medicare since the ACA became law on March 23, 2010.

Advocates say the health care law is making Part D prescription drug coverage more affordable by gradually closing what is known as the “donut hole.”  This is the gap in coverage where beneficiaries were paying the full cost of prescriptions out of pocket while also paying premiums.

Frances G. Padilla, president of the Universal Health Care Foundation, said the announcement was good news. “This is one of the real advantages of the Affordable Care Act,’’ she said. “This remedies a serious problem for our seniors.”

While critics of the act have warned that the provision would hurt the economy and prompt employers to cut jobs, Padilla said she has seen no evidence of that in the state.

The AARP in Connecticut is also pleased with the “many successes” of the act in the three years since its passage, said spokeswoman Jennifer Millea.

“Americans young and old, including thousands here in Connecticut, are already experiencing valuable savings and benefits that were previously unavailable or unaffordable,’’ Millea said, in an e-mail. “By closing the drug coverage gap or ‘donut hole’ over time, the ACA is saving individual seniors in Connecticut hundreds of dollars annually – savings that they can now use to pay for food, housing and other necessities.”

In 2012, the coverage gap kicked in when Medicare recipients had spent $2,930 on prescription drugs and were forced to cover an additional $1,770 for medication, according to the National Committee to Preserve Social Security & Medicare.

In 2010, the ACA sent those who reached the ”donut hole” a one-time $250 payment. Since 2011, the law has phased in discounts on brand-name and generic prescription drugs, with the aim of closing the gap entirely by 2020.

This year, the health care law increases the savings to 52.5 percent of the cost of most brand-name drugs and 21 percent of the cost of covered generic medication, HHS said. The department also said the law made Medicare more secure and provided those who enroll in Part D plans with more high-quality choices.