Forida, the state with the highest proportion of senior citizens, projects an image of itself as the aging American's dream.
But nearly every other state does better at helping seniors age in their own homes. Florida was ranked 48th -- better only than Utah and Tennessee -- in a national study last year on average spending per senior on programs that help with tasks like shopping, cooking, housecleaning and bathing.
Advocates for seniors said they have advised lawmakers for years to spend more on home-based programs, which usually are cheaper than nursing homes and preferred by the elderly.
Instead, the Legislature has devoted 77 percent to 89 percent of its long-term care funding to nursing homes for the past 20 years, according to the Florida Policy Exchange Center on Aging, a multi-university consortium at the University of South Florida.
"While Florida is the bellwether state regarding aging demographics, we could hardly be further from a leadership position in terms of home- and community-based programming," center Director Larry Polivka wrote in a January report.
With other options lacking, seniors are either forced to be institutionalized or go without any help, Polivka said. Many seniors moved here from other states, and thus have no family to help them.
"What we're doing now is forcing people into nursing homes," said state Rep. Nancy Argenziano, R-Crystal River, who chairs the House Committee on Elder Affairs and Long-Term Care. "How many people in nursing homes really need to be there?"
She said doctors are sending people to nursing homes following hospitalizations because they can't get the non-medical support services they need at home.
Home-based programs can help people who are as impaired as those in nursing homes, according to the policy center. Half of Florida's nursing home residents and 40 percent of elderly living at home need help with all five activities of daily living -- eating, bathing, dressing, using the bathroom, and moving from bed to chair, the center said.
Changes could be coming. A state task force has begun meeting to write proposed legislation that could chart the future of long-term care in Florida. Argenziano is a member, and Polivka's agency is providing assistance.
And Gov. Jeb Bush has made it one of his priorities to offer seniors more options, said Annette Kjeer, executive director of the Northeast Florida Area Agency on Aging.
Last year, the Legislature increased funding for one of the state's largest home care programs by nearly one-third, using some of the state's tobacco settlement. It was the program's first funding increase in 10 years.
Also last year, the Legislature for the first time diverted a $7 million funding increase earmarked for nursing homes into home care programs.
The extra money has helped reduce waiting lists for home and community services from 13,000 people statewide in 1998 to about 9,000 today, according to the state Department of Elderly Affairs.
Some seniors have already been waiting as long as six months for help.
WAITING FOR HELP
Charles Watson creeps over from the couch in his modest Southside Jacksonville apartment to his motorized scooter. He has a back problem, diabetes, high blood pressure and arthritis.
"I'm about to where I can't hardly do anything for myself," said Watson, 65. "I can't take a bath; I can't hardly put my shoes on. . . . I can't walk about five minutes and I have to sit down."
But he doesn't consider himself ready for a nursing home.
"I ain't that bad," he said. "I can do most things I want to do, except put my clothes on and take a bath."
He figures he's actually needed someone to help him with bathing and transportation for the past five years. A year ago, he moved to Jacksonville from Georgia and called around to service agencies but didn't sign up for help when they told him about their long waiting lists. …