The Price of a System Out of Balance
I’m stepping away with my boys for some much-needed family time this weekend. But before I go, I want to share something I’ve been carrying for years.
Families in Maine — and across the country — deserve the truth about what’s happening in long-term care. Not as jargon, not as spin, but as the reality families face every day.
In Sanford, Mayflower Place opened in 2000 with the promise of both housing and care. By 2023, the housing was still there — but the care was gone. The residents who needed hands-on help had to leave. Those who stayed had only an apartment, not the support they thought would come with it.
I’ve lived this dilemma before. Years ago, when I served on the board of a century-old nonprofit home, I watched leaders do everything they could to protect both housing and care. The same impossible choice surfaced over and over: it was easier to keep the building standing than to sustain the services families depended on. Even that process was excruciating. I don’t pretend to know all the answers — but I know how much it cost the people involved. That moment changed me.
And I’ve seen the flip side, too. Early in my career, I worked in what I sometimes call the “cruise ship” model of senior living: independent living facilities. They look like assisted living, but they aren’t licensed to provide medical support. The truth is, my building only worked because of one woman — I’ll call her Mary.
Mary wasn’t staff. She couldn’t be. Instead, she built her own small business, charging families a reduced hourly rate to cover the gaps (Current home care rates in Maine are somewhere between $35 - $55. Her rate was significantly below that). She stretched herself across dozens of households, doing the quiet, invisible work that made life manageable. Without Mary, the whole place would have collapsed. From what I hear, there isn’t a Mary there anymore. You can make your own judgment about what that means.
Here’s what all of this has taught me: the way we fund long-term care in this country is broken from the start. Medicaid (MaineCare here) was never designed to meet today’s realities. Thousands of older adults sit on waitlists for services while others scrape by with the bare minimum. The dollars don’t follow the people, and the people are the ones who pay.
And when care disappears, the fallout doesn’t stop at the family’s doorstep. It drains savings, pushes adult children out of the workforce, and leaves local businesses short of employees. What looks like a family problem is really an economic one.
For families, it’s devastating. One week your parent has help with meals, medications, and safety checks. The next week, the support is gone — but the apartment is still there. The walls stay. The care vanishes. Families are left scrambling.
This is why I do the work I do now. Because if we only talk about housing, we miss the heart of the issue: older adults don’t just need a roof, they need care inside those walls. Until we find a way to braid the two together, we’ll keep watching the same painful story repeat itself.
At Maine Aging Partners, my mission is simple: help families cut through the noise, see the system clearly, and make choices that protect both housing and care. Because older adults deserve more than walls — they deserve dignity.
