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How to better care for our elderly and frail

Julissa Rivera, right, the head of HR at Blaire House of Tewksbury nursing home, in her office on Dec. 6.Jim Davis/Globe Staff

A call to action, not more tax dollars

The seriousness of our nursing home crisis, especially the severe shortages of available nursing and other support staff, is undeniable (“Nursing homes fear breaking point near,” Page A1, Dec. 18).

We also agree fundamental structural change is essential: more nursing instructors; caregiver career ladder training opportunities; and greater support for immigrants to care for the expected growth in the elder population. Instead of pouring more tax dollars into an antiquated nursing home system, we must prioritize home- and community-based services, which the vast majority of people prefer.

The transformational action plan promoted by Dignity Alliance Massachusetts has six major components:


▪ Nursing home ownership transparency

▪ Nursing home financial accountability

▪ Home- and community-based services expansion

▪ Direct care workforce development and livable compensation

▪ Number of nursing homes reduced and single-occupancy rooms increased

▪ Secretary of Elder Affairs restored to a Cabinet position reporting directly to the governor

As the nursing home industry’s Tara Gregorio expressed so clearly, “There is no greater purpose than taking care of our elderly and frail.” Advocates, including Dignity Alliance Massachusetts, are in full agreement.

The incoming Healey-Driscoll administration has the opportunity to lead the Commonwealth to such greatness.

Paul Lanzikos

Former secretary of Elder Affairs

Arlene Germain

Former executive director of Massachusetts Advocates for Nursing Home Reform

Richard T. Moore

Former state senator

Dr. Lachlan Forrow

The writers are members of Dignity Alliance Massachusetts.

Assisted living care can help nursing home shortage

As labor shortages put growing pressure on residences that care for older adults, our state support policies need to keep up. Massachusetts could help seniors (and keep more affordable residences open) by enhancing rates for Massachusetts’ support programs, such as Group Adult Foster Care, Program of All-inclusive Care for the Elderly, and Senior Care Options.

Unlike many other states, Massachusetts does not extend its Medicaid waiver to cover assisted living. Currently, our waiver only allows older adults who qualify to choose between home care services or skilled nursing facilities. It does not provide them with the popular option between those settings on the continuum of care — to live and receive care in assisted living. We could fix this by allowing the waiver to cover assisted living, which would be a cost-effective approach to both save the Commonwealth dollars and provide independence and quality of life to older adults.


By strengthening financial support for assisted living, we have an opportunity to improve the lives of older adults who just need a little help to remain active and independent in the communities they love.

Brian Doherty

President and CEO

Massachusetts Assisted Living Association