Navigating our complex health care system can be confusing even for those in the best of health. But when you’re in a crisis, it can seem impossible. The anxiety can be particularly acute for those with limited English fluency, including members of Brooklyn’s sizable Russian- and Armenian-speaking population, for whom I serve as a conduit.
My work includes fighting for people to receive dialysis closer to home. I haggle with Medicaid over lifesaving prescription drug benefits, and help members tap into the federal benefits to which they’re entitled but perhaps do not access because they don’t know who to call.
I have a front seat to these complexities through my work as a senior member advocate with ElderServe Health (formerly RiverSpring Health Plans), a Brooklyn-based agency that provides home care aides to over 10,000 Brooklyn residents through Medicaid-funded Managed Long Term Care (MLTC) Plans.
It’s with this perspective that I’d like to advocate for two things:
We need a holistic, all-of-government approach to address our fast-growing aging population. And on the individual level, we need to start having tough conversations about what this could look like within our own families.
Baby Boomers placed their stamp on politics, pop culture and a population surge that’s now boomeranging back the other way, making New York one of the oldest states in the country. New York City’s senior population grew by nearly half a million in the last two decades. Here in Brooklyn, over 16% of the population is over the age of 65. That’s about 424,000 people.
Through my advocacy, I see firsthand the effects of our aging community.
Unlike previous generations, Baby Boomers are increasingly choosing to remain at home as they grow older. “Aging in place” presents its own set of challenges – particularly if seniors are socially isolated, have mobility issues, or have other difficulties in maintaining their independence. Baby Boomers are also living longer with multiple complex health conditions, including dementia, which is projected to surge, and with it, the need for a new way to think about supportive programming.
MLTC plans are invaluable for keeping people at home. But they’re a hidden secret: No one knows we exist until they need us.
We need to keep funding for programming like ours intact – not just in Washington, but also at the state and city levels.
New York is a leader in Medicaid spending, and programs like ours that provide in-home care cost significantly less than care provided in institutional settings while also achieving high rates of patient and family satisfaction.
Allowing people to remain in their homes has also been clinically proven to have better outcomes for mental and physical well-being while also helping the patient maintain their independence and preserving their access to friends and loved ones.
Other states should follow our lead.
Local services that are critical to aging in place also risk being underfunded, demonstrating the need for ongoing advocacy. Proposed budget cuts that would have reduced funding for senior services have thankfully been restored in the recently adopted city budget, preserving access to vital programs while also dedicating $5 million in funding for older adult center improvements.
All levels of government must start to wrap aging strategies into their decision-making processes and ensure services continue to scale according to the growing need of our aging population, as evidenced by the recently released state Master Plan for Aging, a massive blueprint designed to guide policymaking at all levels of government, as well as in the private sector.
We individually, too, have a role to play, which means within our own families, we need to realistically talk about what aging looks like and start future planning.
My days are often bookended by long phone calls with adult children struggling to care for both their aging parents and young children of their own. More than half of Americans in their 40s are now “sandwiched” between an aging parent and their own children. Over time, the challenges start to stack up. They include financial and psychological stress, time management issues and caregiver burnout.
Most Americans don’t discuss the possibility of long-term care, let alone prepare for it. This is a problem, we need to start having these conversations – now.
Yes, they can be difficult. And no one wants to admit the inevitable. But failing to plan could result in years of anxiety, economic strain and diminished quality of life – not just for our aging relatives, but for the entire family.
Investing in our seniors and proactively engaging in these conversations with our aging family members is difficult but needed. As a society, we need to prioritize both. Failing to do so will result in unnecessary pain, not only for seniors, but all New Yorkers.
Mariam Sukiasyan is a senior member advocate at ElderServe Health, formerly RiverSpring Health Plans. She lives in Brooklyn, and was named one of City & State’s 2025 Above & Beyond: Women for her patient advocacy.
