Aging Services: Why We Need to Rethink the System
When we talk about aging services, there are three main types of support people rely on:
Facilities — nursing homes, assisted living, independent living.
Home care — support delivered in a person’s home that is mostly non-medical.
Medical home care — care tied to health conditions and medical oversight.
Right now, all of these get tangled up inside the Medicaid system. Medicaid was designed as a safety net — to make sure people without resources could still access medical support. That’s important. But here’s the problem: aging services aren’t medical. They’re about daily living. Housing, food, safety, dignity, stability. By tying them to Medicaid, we’ve created a system that’s bloated, inefficient, and crushing families under paperwork instead of lifting them up.
👉 We’ve let Medicaid become a monster it was never meant to be — carrying everything from childbirth to 24/7 care. Aging services don’t belong inside Medicaid. They belong in a system that treats them like infrastructure — lean, local, and built to last.
I’ve seen this play out up close. At the Plant Home, where I served on the board, things fell apart. But something unusual happened. People with very different perspectives — politically, personally, professionally — came together. And that’s what has ultimately kept it open. Not one person, not one agenda. A willingness to listen across differences.
That’s what matters. It’s not about whether a town is red or blue. I’ve seen both struggle. What makes the difference is openness. Communities that stay open — that let multiple truths sit at the same table — find solutions. The Plant Home didn’t survive because of its zip code or its politics. It survived because people refused to close the door on one another.
That’s what aging services need now. Openness. Stability. A system families can count on that doesn’t shift every time the political winds change.
If we build aging services as infrastructure, rooted in openness and grounded in reality, families will finally get what they’ve been promised all along — dignity, stability, and choice.
