Mr. President,

You need to pay more attention to seniors. America knows the story of your grandmother who, in declining health, had the advantage of a close relative, your sister, who could afford to be absent from work to care for her in the comfort of her home. How many of us had personal thoughts and personal stories with the same issues? How many wonder, “What will I do if mom breaks a hip, or if dad keeps driving when he shouldn’t?” How many have no answers and nowhere to turn?

Yet for millions of Americans, the kids don’t live near the parents. America is a land where opportunity, for education and for work, is less and less likely to be there in our hometown, where our relatives live. Even for those who do live nearby, adult children need to hold down full-time jobs, and cannot just drop everything to respond to unexpected emergencies. The so-called sandwich generation is left to care for both children and parents.

Aging at home with dignity is what seniors want most, and what government supports least. During the election we heard about social security, Medicare and universal health insurance, but almost nothing to respect the dignity and comfort of seniors who want to live out their years in a familiar home for as long as possible, before multiple frailties point to assisted living or nursing homes.

The support systems needed for aging at home revolve around so-called “instrumental activities of daily living” such as preparing meals, managing money, shopping for groceries or personal items, taking medicines on time and in correct doses, performing light or heavy housework, home and yard maintenance, driving a car and using a telephone.

With the economic recovery front and center, it is likely that the more costly elements of a health reform package will take time to develop, and time to fund. Yet an Aging At Home initiative could employ hundreds of thousands, if not millions, of social service workers in state-designed pilot programs aimed at creating the peace of mind yearned for by children who live away from their parents, and parents who are reluctant to impose on the kids and dread having to go into debt to buy into expensive assisted living facilities.

Long-term care issues, especially support for seniors to live as long as possible in their homes, were not on any major candidate’s high-profile radar screen. They were neglected in the debates, and only barely mentioned on issues Web sites.

There are never going to be enough assisted-living apartments for all of us. Ninety percent of seniors will not qualify for Medicaid and cannot afford assisted living in dedicated facilities.

We do not need to start from scratch. Nationally, there are models out there, such as Beacon Hill Village and Cambridge At Home in Massachusetts. In Hawaii, senior centers such as Lanakila, Moiliili, Kapahulu, Palolo and Waikiki have developed similar programs, but have struggled for funding to keep them going and to reach out to greater numbers of seniors who live nearby. Limited and unreliable support from the state. No substantial help from the feds.

If it is not a big-ticket item, with the monster power of the insurance industry, or hospitals, or Medicare or Medicaid—it just doesn’t seem to matter. But it matters. A Living At Home initiative would save millions.

I challenge anyone to survey their co-workers or any group of adults, and find out how many are worried about what to do with Mom or Dad. This quiet anxiety will only continue to grow. It is time to start the journey to respect and respond to the growing senior population.

Former State Rep. Jim Shon

Honolulu