Erin McGann serves as the behavioral health liaison for the town of South Berwick, bringing more than 20 years of experience in behavioral health, criminal justice and community-based support services.

The situation facing elder care in Maine is a crisis, and we are failing some of our most vulnerable residents. Maine lacks sufficient nursing facilities, residential care settings and
trained staff to safely care for its rapidly aging population.

I currently have a client who has remained in the hospital for nearly three months because there is nowhere appropriate for them to go. They cannot safely return home, yet every nursing facility and residential care setting has extensive waitlists. This situation is not unique. Across Maine, hospitals are increasingly caring for elderly patients who no longer require hospitalization but have nowhere else to be safely discharged.

The problem is even more severe for individuals who rely on MaineCare. Many out-of-state facilities refuse to accept MaineCare reimbursement because payment rates are too low to cover the cost of care. As a result, families and care teams are left with very few options beyond state borders.

At the same time, Maine has had one of the highest rates of nursing home closures in the country over the last 15 years. Facilities are closing because they cannot sustain operations under chronic staffing shortages, rising costs, worker burnout and inadequate reimbursement rates. MaineCare reimbursement is simply not keeping pace with the true cost of caring for older adults with increasingly complex medical and behavioral health needs.

This issue is especially alarming given Maine’s demographics. Maine has the oldest median age in the nation at approximately 45 years old, and nearly 24% of the population is over age 65. Additionally, adults over age 85 are the fastest-growing age cohort both in Maine and across the United States.

Demand for long-term care services will continue to increase, yet our current infrastructure is shrinking rather than expanding. Without immediate action, the gap between available care and community need will only worsen.

Staffing shortages are one of the largest contributors to this crisis. Long-term care facilities struggle to recruit and retain direct care workers, certified nursing assistants, nurses and support staff. These jobs are physically demanding, emotionally exhausting and critically important, yet many caregivers are underpaid and overworked.

Burnout has become widespread since the COVID-19 pandemic, and many workers are leaving the profession entirely for better pay and working conditions elsewhere. When facilities cannot maintain adequate staffing levels, they are often forced to reduce admissions or close altogether, further limiting placement options for vulnerable elders.

This crisis reflects broader failures in policy and funding. We urgently need legislative action to strengthen long-term care infrastructure across Maine. This includes increasing MaineCare reimbursement rates so facilities can remain financially sustainable, expanding workforce development programs and creating incentives for individuals to enter and remain in caregiving professions.

Loan repayment programs, wage increases, childcare support and tuition assistance could help recruit and retain desperately needed workers. Maine also needs investment in additional residential care facilities, nursing homes and community-based programs that allow elders to receive safe care in the least restrictive environment possible.

Older adults who remain hospitalized for months because they have nowhere else to go often experience fear, confusion, isolation and emotional distress. Many elders already struggle with cognitive decline, anxiety, depression or medical trauma. Prolonged hospitalization and instability can significantly worsen these conditions. Being separated from familiar environments, routines and support systems strips many elders of dignity and autonomy during an already vulnerable stage of life.

Safety, stability, compassion and dignity are essential components of care. Elders deserve more than simply surviving within an overwhelmed system. They deserve safe placements, compassionate caregivers and opportunities to age with dignity and respect.

Maine’s aging population is not a temporary challenge that can be ignored. It is a growing reality that requires immediate investment, long-term planning and meaningful systemic change. If we fail to act now, more older adults will remain stranded in hospitals or unsafe situations, and families across Maine will continue to suffer the consequences of a system that is no longer able to meet the needs of its people.