Aging in Place

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Aging in Place

• Judith L. Warren, Ph.D.
• Professor and Gerontology Specialist
• Texas Cooperative Extension
• Texas AM University System
• September 2003

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Demographics of Aging in America

• Increasing numbers of older adults
• Migration to sunbelt
• Out-migration of youth in rural areas
• Aging in place
• Gender and income
• Increasing Hispanic population
• Household configuration
• Education
• Health and healthcare access

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Core Issues in an Aging Rural Society

• Economic Development/Human Capital
• Work and Volunteer Issues
• Careers in an Aging Society
• Independent Living
• Housing and Services
• Chronic Health Conditions
• Elder Care
• Formal and Informal
• Family Caregiving

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Percent of Population by Age Group 2003 2050
Source U.S. Census Population Projections

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Greatest Growth in Old-Old

• 85 Age group increased 38 between 1990/2000
• 95 Age group increased 34.7
• Centenarians (100)
• 1990 - 37,306
• 2000 50,454
• Greatest live in New York and California
• Greatest live in South Dakota and Iowa

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States With HighestProportion of 65 (2000)
Florida 17.6 South Dakota 14.7 North Dakota 14.3
Pennsylvania 15.6 Rhode Island 14.5 Arkansas 14
West Virginia 15.3 Maine 14.4 Iowa 14
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Baby Boomers are allin the same state
the state of denial
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Age 65 Males per 100 Females

• Ratio declines with each age group
• Increase in male to female ratio since 1990
• Are men getting healthier?
• Are women at increased health risk?

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Poverty Levels 1959 1998
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Sources of Income Net Worth

• Main source continues to be Social Security and
  Pensions
• Between 1984 and 1999, the median net worth for
  65 head of households increased by 69 for
  45-64 it declined by 23
• 1999 Median for White - 181,000
• for African Americans - 13,000

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Labor Force Participation

• Decline in participation rates
• Most decline occurred prior to 1980
• Today, 8-10 boomers expect to work part or full
  time
• Under 30,000 income -1/5th of boomers are at risk

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Percent of U.S. Population by Race Hispanic
Origin
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Percent of Population Over 65 by Race Hispanic
Origin
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Marital Status of 65 (1998)
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Living Arrangements For 65
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Household Type Expenditure

• In 2000, 25.8 householders lived alone 9.2 of
  these householders were over 65.
• 21 of all household units were over 65 years of
  age 10.9 65-74 7.8 75-84 and 85 2.3.
• Housing burden varies by income with the bottom
  1/5th of the median household income spending
  36 and the top 1/5th spending 26 of their
  income on housing.

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Educational Attainment of 65 (1998)
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Chronic Health Issues of Older Adults

• Arthritis
• Diabetes
• Hypertension
• Chronic Sinusitis
• Vision
• Osteoporosis
• Hearing

• Varicose Veins
• Heart Disease
• Deformity/Other
• Emphysema
• Dementia
• 34 are affected by more than 1 condition

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Chronic Diseases, Complications and Disability
Will Increase

• Today, obesity affects 20-30 of 4th graders 50
  of 9th 10th graders
• 2010 50 of 20-30 year olds will have diabetes
• 2020 50 of 30-40 year olds will have
  complications and disability
• 2020 50 loss in workforce 50 depend on
  Medicare/Medicaid/disability income

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Functional Limitations in 85

• Walking 35
• Getting outside 45
• Bathing 30
• Transferring 22
• Dressing 17
• Using toilet 14

• Eating 4
• Preparing Meals 28
• Managing 26
• Using the phone 21
• Light housework 31

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Percentage of Total Out-of-pocket Expenditures
Allocated to Health Care in Households Headed by
Persons 65
Income Level
Source Consumer Expenditure Survey,
Non-Institutionalized Elderly,

Chartbook 2000, U. S.
Census
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Percent of Elderly in Nursing Homes
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Caregiver Profile

• Est. 45-52 million individual caregivers
• 10-25 of population provides care
• Women represent 74 of primary caregivers
• Spouses provide 36 of care daughters 29 and
  sons, 8
• Average caregiver 63 years old
• 69 live with care recipient

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Grandparent Caregiving

• 11 of grandparents care for grandchildren for at
  least 6 months
• At least 55 of children in relative care live
  with a grandparent
• 77 are female grandparents
• 62 are non-Hispanic white
• Factors increasing chance for raising
  grandchildren poverty level being
  African-American and divorce, drug abuse or
  incarceration of childs mother

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The Two Americas of Retirement Security

• More Secure
• Steady employment
• Married, dual income
• Employer pension
• 401(k) plan
• Health insurance
• Home equity
• Long-term investments

• Less Secure
• Intermittent employment
• Divorced or single
• No pension
• No 401K
• No health insurance
• Rent
• No long-term investments or savings for
  emergencies

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Core Issues in an Aging Rural Society

• Economic Development/Human Capital
• Work and Volunteer Issues
• Careers in an Aging Society
• Independent Living
• Housing and Services
• Chronic Health Conditions
• Elder Care
• Formal and Informal
• Family Caregiving

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Economic Development Human Capital

• Rural mainstays schools, nursing homes,
  hospitals, small businesses
• Long-term care jobs at poverty or near-poverty
  level 92 turnover in Nurse Aides Frontline
  caregivers increasingly non-English speaking
• Aging workforce
• 22 eligible to retire in 2005
• Greater proportion of health care professionals
  are 55 than other occupations
• Increased need for geriatric training

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Work Financial Security

• Leading economic indicator of family hardship not
  unemployment but no health insurance
• 2/3 of working poor have no health insurance
• Personal savings remain low compared to other
  developed countries

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Independent Living

• Housing
• Services

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1997 Title III Service Use

• Lower usage rates in rural vs. urban areas
• Rural, non-Hispanic Black elders participate at
  disproportionately higher rates than other 60
  users
• Non-white Hispanic elders participate at
  disproportionately lower rates than other 60
  users

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Independent Living

• Prevent Chronic Disease
• Managing Chronic Disease

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Elder Care

• Formal and Informal Care
• Family Care

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Summary

• We are an Aging Society-undeniably
• Economic disparity between population segments
  continues to grow affecting health and quality of
  life outcomes
• Disparity between rural and urban areas continues
  with high percentages of elders in rural areas
  and a declining economic base
• Rural areas have opportunities to focus on health
  and care solutions
• Public policies are needed which reward disease
  prevention and foster smaller scale eldercare
  solutions