Families and Elder Care

Overview

Growing old in America is challenging for the elders, their families and policy makers. Though the average American now lives into the eighth decade of life, many older Americans remain vulnerable to disease, loneliness and dependence on others. According to the U.S. Administration on Aging, those vulnerable populations include:

  • Three million Americans who are 85 and older
  • Those living alone without a caregiver
  • Members of minority groups
  • Older persons with physical or mental impairments
  • Low-income older persons
  • Those who are abused, neglected or exploited

Of the nine million Americans over age 65 who live alone, two million say they have no one to turn to if they need help, says the Administration on Aging. Eighty percent of those living alone are women. Many have limited incomes.

Consider, too, that America's older population grows increasingly diverse. By the year 2030, the number of older white Americans will increase by 97 percent, elderly black Americans will increase by 265 percent and Hispanic Americans by 530 percent, says the aging agency.

“The minority elderly tend to have shorter life expectancies and more serious health problems at younger ages than do white Americans,” the agency notes. “They are also sometimes less able to advocate for themselves because of cultural, language or educational barriers.” And, like women, they tend to have limited incomes.

Problems for older Americans take many forms. They can face age discrimination, elder abuse, employment problems, transportation barriers, alcoholism and depression, shortages of affordable housing, disease and debilitating conditions, malnutrition and financial swindlers, among others.

For older persons who have chronic conditions and difficulties taking care of themselves and their homes, increased medical costs and the need for supportive services often compound their problems, the aging agency points out.

To address these needs, the Older Americans Act of 1965 authorizes a variety of programs to help older Americans, especially those at risk of losing their independence. While some community-based programs have been established, many communities do not yet have the range of programs needs, according to the agency. Moreover, some communities report they have long waiting lists for services.

At the same time, many older Americans contribute a wealth of talent, experience and knowledge as community volunteers and employees, as grandparents, parents and friends. They hold the promise that all Americans can age with dignity, remain in good health and live independently. But we have a long way to go before that ideal is extended to everybody.

As the situation stands, “meeting the needs of older Americans goes beyond the needs of the government,” notes the aging administration. To accomplish this goal, the aging agency is calling on a wide range of individuals and groups – business, labor, government, religious and civic – to join forces.

General Principles

  • Empower individuals to live independently as long as possible
  • Assure that older individuals can age with dignity and pride
  • Provide affordable assistance for adults who need non-medical services, such as bathing, dressing and other daily activities
  • Support strategies, such as Meals on Wheels, that keep elders as independent as possible
  • Offer a centralized and impartial elderly services information center
  • Create financial incentives for family care services
  • Ensure care and services are delivered in a culturally sensitive manner

Conference Breakout Session Poster:

conference breakout session poster The full image is 35K.

Key web sites

  • Children of Aging Parents This site is run by a non-profit group based in Levittown, Pa. that assists caregivers of the elderly with finding reliable information, referrals and support. Call 800-227-7294.
  • Aging Network – Run by the U.S. Administration on Aging, this site offers directories of web sites for state agencies on aging, state legal assistance and area agencies on aging.
  • Agency on Aging Fact Sheets – The fact sheets from the U.S. Administration on Aging are designed for professionals in the field of aging, service providers and policymakers, among others. Each fact sheet includes an overview of the subject and details related to Administration on Aging initiatives. Also included are various resources listings that include federal agencies and national organizations as well as some suggested readings.
  • Internet Aging Resources -- Everything You and Your Family Need to Know About: Government Benefits, Healthcare, Social Security, Veterans' Benefits, Medicare and Medicaid, and Guardianship. Includes information about legal rights.
  • Elderpage: Information for Older Persons and Families – Run by the Administraition on Aging, this site contains information on a wide range of specific topics of concern to older Americans.
  • Independent Living Research Utilization -- This is a national center, based in Houston, Texas, for information, training, research, and technical assistance in independent living. Its goal is to expand the body of knowledge in independent living and to improve utilization of results of research programs and demonstration projects in this field. It is a program of TIRR (The Institute for Rehabilitation and Research), a nationally recognized medical rehabilitation facility for persons with disabilities.
  • Center for Biomedical Ethics at University of Pennsylvania – This site offers several articles written by the center's staff on ethical issues dealing with older people. Click on the library button.

Research highlights -- (downloadable in PDF format)

Models/best practices

  • Service Credit Banking in Managed Care is intended to help Health Maintenance Organizations (HMOs) and other managed care organizations respond to older members' needs for non-medical services such as transportation, shopping and light housekeeping. Currently, the Robert Wood Johnson Foundation has funded programs at six HMOs in Minneapolis, Minn., Woodland Hills, Calif., Seattle, Wash., Norwalk, Conn., Norfolk, Va. and Grand Junction, Colo. These programs are being evaluated by the University of Maryland Center on Aging.