The State of Aging in the Nation's Oldest State: Maine

If you reside in northern New England, you regularly read headlines about how your state is one of the country's oldest. After each round of stories, state officials and the local chattering classes intone on what is to be done to lure more young people to Vermont, New Hampshire or Maine.

Analysis in this vein is an understandable and important response to such information, but it isn't the only matter of public discussion that ought to arise from these demographic findings. Rarely does the conversation provoked by such stories consider the day-to-day experiences of the older adults who make up significant portions of these states' populations.

At the moment, Maine is the nation's oldest state. The median age of its residents is 45.1 years, more than six years higher than the national average. Nearly 23% of the state's population is 65 or older compared to 16.8% nationally. (Florida, at 21.7%, is in third place, after Vermont.)

Maine is the only state with more residents aged 65 or older than 18 or younger. Many older Mainers are still working. In 2022, adults 65 and over made up 8.2% of the state's workforce, the highest rate of any state.

Four counties in Maine (Piscataquis, Oxford, Hancock and Aroostook) have median ages just over or just under 50. The state's youngest county, Androscoggin, has an average age of 41, still well above the national average of 38.8.

Recently, the state of Maine created a "Cabinet on Aging" to coordinate the efforts of state agencies serving the needs of Maine's older adults. Among the agencies brought together under this working group are health and human services, public safety, transportation, labor and community and economic development.

The Cabinet on Aging will examine challenges faced by many older Mainers. Undoubtedly, many of the economic, social and transportation-related problems they will find will resemble the experiences of residents of many other predominately rural regions and states.

At the same time, large numbers of people in the Pine Tree State, both older and younger than 50, are going to significant trouble to make sure that the state's oldest residents continue to thrive materially and socially. State agencies, nonprofits and individual volunteers succeed every day at improving the lives of older adults across Maine.

That's not to say that older adults in Maine don't face substantial troubles. The rising costs of housing, medicine, heating and daily essentials force many older residents to make hard choices about where to spend their limited incomes.

COVID highlighted a wide range of related problems facing older adults in Maine, including food insecurity, limited housing options and, for many, loneliness. During the pandemic, the distribution of Meals on Wheels in the state of Maine doubled while significant efforts were made to improve internet access for older adults. The Cabinet on Aging will bring into focus the complex challenges faced by older state residents.

"Many of the people we serve are facing pretty significant financial challenges," said Megan Walton, CEO of the Southern Maine Agency on Aging and the chair of the Maine Area Associations on Aging. "About a third of the people we serve here in Southern Maine are in poverty."

The state's agencies on aging serve older Mainers with the greatest social and economic needs through direct home-based services, case management, balance and wellness courses and caregiver support. The Southern Maine Agency on Aging has made significant outreach to new Americans in the area's Arab American and Cambodian communities. They also work to identify gaps in care for older Mainers and to adapt to the evolving needs of state residents aged 65 and older.

Walton emphasizes that the number of people they serve who are in financial need is much higher due to rapid increases in the cost of living. Last year, the Southern Maine Agency on Aging served 28,000 people in the urban, suburban and rural communities surrounding Portland, the state's largest city.

Credit: Courtesy of Southern Maine Agency on Aging

"I still get told by individuals in the community, 'I've never heard of Southern Maine Agency on Aging,' " Walton said, wondering how well the agency would be able to serve the region's older population if everyone did know about their organization. Typically, the agency responds to inquiries for help within a day or two.

"We serve people who are usually pretty isolated," Walton said. "That are socially isolated or geographically isolated or culturally isolated. We're here to provide services and support that impact that loneliness and social isolation."

A lack of transportation is a major factor in social isolation for older adults in Maine. People who can no longer drive have limited options for public transit in this predominately rural state, even in Maine's most densely populated counties.

A visit to the Maine Medical Center, the state's largest hospital, that takes 10 minutes by car can take hours by bus, Walton said.

"Historically, we've relied on family caregivers, and there are just fewer and fewer people that can provide that regular social connection for the older population," she said. Whether their family members are working or have moved to another state, many older Mainers have lost significant ties to their communities and networks of support.

Local nonprofits play a profound role in helping the state's agencies on aging to support older residents in their communities. Walton cites the partnerships her agency has with local organizations including churches, community centers and groups that provide home care.

More than 250 local partners help make possible the services available to older adults in southern Maine. Community partners organize everything from weekly coffee hours for older men to grocery store shuttles to transportation for medical appointments.

Older Mainers do much of this volunteer work themselves. Roughly 30% of residents aged 65 and over report volunteering regularly, well above the national average of 22% for citizens 65 and older.

Roy Gedat exemplifies the volunteer spirit evident in Maine. Gedat, aged 71, is a retired human services worker who resides in Naples, Maine, an hour west of Portland. He volunteers regularly with Americorps and Goodwill of Northern New England.

"I'm the old one. Everyone else there is young," Gedat said.

Gedat grew up on Long Island, later moved to Boston and settled in Maine in 1980, where he has resided ever since. He and his wife are in good health, live near their children and grandchildren and regard themselves as financially comfortable.

"For many people who don't have the economic security that we have, it's a totally different story," Gedat said, citing the increasing cost of living in Maine, a state that was historically among the most affordable places to live in the country.

Gedat cites snow removal as a significant issue facing older adults in Maine. "You couldn't live here if you couldn't snow shovel or get it shoveled," he explains.

While challenges abound in southern Maine, older residents of the state's northernmost counties are the least likely to have their needs met. For example, a significant waiting list persists for Meals on Wheels in northern Maine.

Walton cites her colleagues with the Aroostook County Agency on Aging as an example of the challenges faced in the state's most rural regions. At 6,828 square miles, Aroostook is one of the largest counties east of the Mississippi. Though larger than three U.S. states, Maine's northernmost county has just 67,000 residents.

"Even to do something as simple as a weekly meal delivery, a volunteer or staff member may have to drive four hours simply to get food to somebody," Walton said. 

Downeast Community Partners is a nonprofit community action agency that provides services for Washington and Hancock counties, both located in rural northeastern Maine. At the moment, Hancock County has no open beds at nursing homes or long-term care facilities. The program's efforts are the last line of defense for many residents who would otherwise be forced to move to a facility far from their home.

The nonprofit has hosted an adult day service in Hancock County called Friendship Cottage since 2008. The program provides a safe and welcoming space for older residents on weekdays. It oversees its clients' taking medications, helps with their personal hygiene and provides them with a range of activities.

Friendship Cottage has a nurse on-duty for 30 hours each week to oversee wound care and nail-care. Anne Ossana, the director of adult day service programs, is a licensed social worker with 40 years of experience in the practice.

"When they come to the adult day program, we have breakfast and lunch that are served," Ossanna said. "We have activities. Sometimes, people from the community come in for pet therapy or for music or socialization."

Many of the people in the program have known each other for years. Ossana emphasizes the social component of the center's work, putting older adults in a position to interact with peers in a safe setting.

"It keeps them engaged. It keeps them connected to their community. It helps them sleep better at night. They come home and they've had a really good day and they're tired," Ossana said. The center is only open 40 hours per week, which can be challenging for older adults in need of services after hours and on weekends.

Additionally, Downeast Community Partners offers a membership program called At Home, which is available in the Blue Hill Peninsula of Hancock County. For a fixed 5% of a resident's income, At Home guarantees four round-trip rides per month to medical appointments. The program places residents with volunteers who can take them grocery shopping or to other activities or services in the community. A nurse can also visit a client's home to help them manage their medication or take care of basic medical needs.

"Most of these people are pretty independent, except for they don't drive," Ossana said.

"Often times, it is adult children that are caring for an older parent in their home. It's really giving that respite and peace of mind for the caregivers that their aging loved ones are being taken care of during the day," Ossana said.

"Not having enough nursing home beds available in Hancock County is extremely challenging for all of the community service programs working with aging people. Sometimes, we're not really equipped to provide the level of care that is necessary and it's also very hard for their families," Ossana said.

Catholic Charities Maine is one of the state's largest and most active nonprofits. The organization supports numerous programs that help thousands of residents of all faiths each year. Programs aimed at older adults fall into two categories: volunteer companionship and independent support.

"The volunteer companionship program helps people feel less isolated in the community," said Kathy Mockler, communications director for Catholic Charities Maine. Older adults are paired up with a person with similar interests. Frequently, a recent retiree volunteer is paired with an older person.

"They may go in and play cards, read them the newspaper, or run an errand with them," Mockler said, noting that pairings in the volunteer companion program often last for many years.

Catholic Charities Maine's independent support program has been in operation for more than 50 years and serves residents in all 16 counties. The program provides housekeeping services, including laundry and meal preparation.

"The program's purpose is really to keep someone independent in their home. People are comfortable in their home. That's where they feel safe," Mockler said.

"We do have a waiting list for our independent support services. The challenge is hiring enough staff to go in and do the work. It's very rewarding but it can also be very challenging to go into someone's home and be that sort of lifeline," Mockler said.

Catholic Charities Maine supports a network of 28 food banks in Aroostook and Washington counties, the state's most rural.

Moving forward, the experts interviewed for this story all favor a model of service delivery built around the idea of keeping as many people as possible in their own homes.

"When we think about caring for older people, we have a tendency to think about assisted living or nursing homes or institutional settings," Walton said. But a recent survey by AARP found that 85% of adults 65 and older said they want to age in place at their home.

"A shift in resources, attention and policy making toward the home and the community-based side would be a huge win for our state," Walton said.

Despite challenges, the people of Maine are persevering in the face of the state's demographic transformation. While significant gaps exist in care, a range of agencies, nonprofits and committed individuals are working to ensure that the state's older residents can age with dignity and on their own terms.

"What I witness here is an incredible sense of community and neighbors helping neighbors," Walton said.

"A lot of times family moves away. The younger generation wants to go off and see the world or move to a bigger city," Mockler said. "That makes these programs all the more critical. Many older residents do not have anybody else to look in on them."

Gedat said Maine is like a small town. "You know a lot of people and have contact in a lot of areas and they're pretty much lifelong connections," he said. "It's a place where your neighbors actually are your neighbors." That can be a bit unnerving on a trip to the grocery store. Your hopes of getting in and out quickly will almost certainly be dashed by the several familiar faces you run into by the time you check out.

As far as problems go, this is a good one to have. And that spirit animates Mainers' response to the challenges that come with being the nation's oldest state.