The Best of…AARP Report Sheds Light on the Needs of Older Disabled Persons

Published May 26, 2012, Pawtucket Times   

           AARP, a Washington, DC-based aging advocacy group, generates a new report to provide direction to the nation’s policy makers as to how to keep America’s age 50 and over disabled population independent and in  control of their daily lives. 

           According to the latest AARP study, lack of affordable services, a fragmented delivery system and the caregiver’s limited knowledge of the delivery system, are barriers that keep age 50 and over Americans with disabilities from living active and independent lives. 

           The AARP report, “Beyond 50 2003: A Report to the Nation on Independent Living and Disability,” incorporates data obtained from the first ever national survey of Americans age 50+ with disabilities, documenting the gap between what they say, need, and what is available to them. 

           “Long-term independence for persons with disabilities is an increasingly achievable social goal, AARP Policy and Strategy Director John Rother says in a written statement released with this report.  “But it will require time and the collective creativity of the public and private sectors,” he added. 

           “Meanwhile, even minor changes can lead – at least in the short-term – to important life-style improvements for those with disabilities today,“ Rother said.  On the other hand, long-term improvements will require fundamental policy changes.

           “As the influx of Boomers enters their 50’s and 60’s, they will bring their attitudes of competitive consumerism to health care delivery, and will demand greater choice and control of available services,” explained Rother.   “The good news is that there is time to prepare for those demands, he said.  “Along with improvements in medicine and health, we are seeing some declines in disability.  New technologies are also extending Americans’ years of independence.”

           According to the AARP report, 46 percent of the over 50 respondents with disabilities (including nearly 60 percent of those between the ages of 50 and 64) believe that having more control over decisions about services and the help they need would bring a major improvement in the quality of their lives.   However, they report that their greatest fear is loss of independence and mobility.

           The AARP report, the third in a series of comprehensive studies on the status of Americans over age 50, found that 51percent of older persons with disabilities are managing independently; 49 percent are not receiving any regular help with daily activities, such as cooking, bathing and shopping.  More than half of those with disabilities (53 percent) tell researchers that they were unable to do something they needed or wanted to do in the past month – quite often basic tasks such as household chores or exercise.

           Most (88 percent) of the assistance the older disabled persons reported receiving is volunteer assistance from family or other informal caregivers.  Sixty one percent strongly prefer this type of assistance with everyday tasks, while only one out of three uses any community-based service. 

            The AARP report found that independence, for older disabled persons, can be easily enhanced by using assistive equipment (such as walkers and wheelchairs) and new technologies that are now more widely available.  However, caregiver assistance with daily activities will take more time and resources.   The researchers estimate that as many as three million persons over age 50 with disabilities (almost 25 percent) need more assistance than they receive now with daily activities. 

           Furthermore, the report said that persons 50 and older with disabilities place inadequate health insurance on the top of their list of issues that are not being adequately addressed. Specifically, Medicare coverage still does not pay for prescription drugs and assistive equipment is not covered by some health insurance.

           Adds Rhode Island AARP Director Kathleen Connell, many of the issues addressed in the newly released AARP report are not just about today’s persons with disabilities, but about all of us, who if we live long lives (and longevity is increasing) are likely to face disability.

           “This is about long-term independence and not long term care, which refers not just to what we need during the most vulnerable and frailest stages of our disability, as ‘long term care’ suggests, but to what we want during what, in most cases, is a longer, more functional stage of disability,” Connell tells All About Seniors.

           While minor fixes would make a difference, other improvements will require longer-term fundamental changes and more public dollars.  Based on the “Beyond 50” findings, AARP has outlined a number of policy changes for making critical long-term improvements:

  • Older persons with disabilities must be insured against the high costs of accessing long-term supportive services.  Ways must be found to share the risk of these unpredictable costs more widely among public and private sources. 
  • Public funding for long-term supportive services needs to be reoriented toward more options for home and community-based care. The nation also must provide more options for “consumer-direction” in publicly funded programs.
  •  Communities need to be made more physically accessible for more people with disabilities.
  •  Information and services need to be more navigable for those who are trying to learn more about available long-term services and whether or not they are eligible.
  •  America’s health care system must adjust its focus to enhance functioning and health-related quality of life, not just provide acute and curative care.

             The “Beyond 50” report found that people with disabilities 50 and older give their community poor grades (between C+ and B- in their efforts of making it possible for them to live independently. In many communities, the researchers say, that public transportation is oftentimes rated poorly.

          The researchers say that the troubling findings reveal that the nation is ill-prepared to meet the calls of age 50 and over persons with disabilities for more control and independence in the lives.    

           AARP’s report is a wake up call for state and national policy makers who will be charged with making sound policy decisions for a grayingAmericawith disabilities.  If policy makers heed the recommendations of AARP’s report, systemic changes may well give dignity to millions of older persons with disabilities who only want to remain independent and control of their daily lives.  Just like the rest of us.

           Herb Weiss is a Pawtucket-based writer covering aging, health care and medical issues.  The article was published in May 2003 in the Pawtucket Times.  His articles also appear in state and national publications. He can be reached at hweissri@aol.com.

Complete Streets Legislation Stalled in House Committee

Published May 19. 2012, Pawtucket Times

            A properly designed road system helpsolder Rhode Islanders to successfully “age in place” and stay safely and comfortably in their homes for as long as they choose. But the benefits of so-called Complete Streets design benefits people regardless of age, abilities or mode of transportation.  AARP Rhode Island has joined a broad-based coalition of 17 aging, health and transportation groups and smart growth advocates to push state policy makers into making the Ocean State’s streets, highways and byways more accessible and safer for all users. Out of 2,111 legislative proposals submitted this year for consideration by the Rhode Island General Assembly, H 7352 and S 2131, its companion measure in the Senate, would accomplish this lofty goal.

          Coalition members fear that their efforts to make sure that the state’s transportation infrastructure becomes more user friendly for all ages and abilities is in jeopardy with the House Committee on Municipal Government which has held H 7352 for further study.  While the Senate passed the companion measure (for the second year in a row) last month, this House Committee might just kill the legislation unless it can be resuscitated. 

The Details of H 7352

            The legislationwould require that whenever the state is building or modifying a road, planners and designers must consider Complete Streets design conceptsthat is, considering safe travel by all users, current and projected, particularly pedestrians and bicyclists of all ages and mobility capabilities.  Features of Complete Streetsdesign include sidewalks, paved shoulders suitable for use by bicyclists, lane striping, bicycle lanes, “share the road” signage, “road diets” (narrower lanes to discourage speeding and leave room  for pedestrians and bicyclists), roundabouts, crosswalks, pedestrian control signalization, bus pull-outs, curb cuts, raised crosswalks and ramps and traffic-calming measures.

            Meanwhile, this legislation allows common-sense exceptions, such as on interstate highways, where pedestrians and bicyclists are prohibited, and on projects where the space is too limited or costs would be disproportionate to the use such features would likely get.

            Furthermore, this legislation also requires the State’s Department of Transportation to issue a report within two years detailing what it has done to comply with the law, how it has changed its guidelines on such features as lane width, design speed and more, and what best practices the agency has employed.  It would also be required to include information on exceptions made, and why they were made.

            In a press release touting the passage of S 2131, bill sponsor, Senator Louis P. DiPalma, noted that the legislation’s goal is to plan streets that encourage people to use healthy, greener, transportation modes whenever possible, contributing in their own health as well as the wellbeing of the environment.

            “Cars shouldn’t be the only consideration when public roads are being built.  The health and environmental benefits of walking, bicycling and other active modes of transportation are well know, and we should be building our roads in ways that are safe for those activities and encourage people to choose them,” said Senator DiPalma.

Pushing for Safer Roads, Highways and Byways

            In her testimony before the House Committee on Municipal Government, AARP State Director Kathleen Connellsaid the goal of H 7352 is to direct the Department of Transportation  to plan with all users in mind.  “Making it easier for older people to get around is an obvious reason we’re involved, but Complete Streets design promotes public safety, helps revive our towns and cities and increases property value,” she said.

            Molly Clark, Manager, Health Promotion and Public Advocacy for the American Lung Association, also testifying to support H 7352, predicted that Complete Streets design that would promote walking and bicycling and this would ultimately improve the health of Rhode Islanders.

             Also attending the Committee Hearing, Co-Chair John Flaherty, of the Coalition for Transportation Choices, advocated for 21st century transportation system “that’s good for the economy, good for the environment and that provides clean, healthy and affordable transportation choices for all Rhode Islanders.”

            There is no fiscal note estimating the true costs of H 7352 due to the multitude of factors that must be considered.  However, bill supporters believe that this legislative proposal does not necessarily add costs to the road construction project.

            Addressing concerns about the legislative proposals “possible” fiscal impact on the State’s budget, Senator DiPalma notes that H 7352 has been crafted in such a way to reduce the fears of fellow lawmakers that there could be initial and future costs if the legislation is enacted.  Provisions would protect the state’s coffers by requiring common sense exceptions to take effect if a road construction design project incurs a cost that is disproportional to its benefits, he says.

It’s All About the Economy

            Doing it right the first time makes economic sense,” says AARP Associate Director for Advocacy Deanna Casey.

             Enacting H 7352 is just good economic policy, adds Scott Wolf, Executive Director of Grow Smart Rhode Island.  According to Wolf, “forRhode Islandto thrive economically it needs to attract and retain talented young people. These people, research shows, are looking for places that are vibrant, user friendly and possess an abundant natural and architectural beauty.” 

            Wolf stated “Rhode Island has many of these ingredients but we need to be much more user friendly with regard to transit, walk ability and bike ability to maximize our appeal to this new segment of workers. He added, “Adopting an aggressive complete street strategy that requires all roads built to accommodate bikes, pedestrians, and mass transit as well as autos could do a lot to increase our appeal to this critical cadre of mobile young talented workers.”   

             In these tough economic times usually a price tag on a legislative proposal is just enough for General Assembly leadership to doom a legislative proposal’s passage by not taking action on it.  Just refer it for further study.  Complete Street supporters are puzzled by the inaction in the House panel because of the protections built into the measure to rein in initial or future costs of a project.  At press time, the City of Pawtucket along with eight other cities and towns, have already passed resolutions supporting the Complete Street legislation being considered by the Rhode Island General Assembly and another eight communities are also considering supporting this legislation by enacting  resolutions.  Most important, the State’s Department of Transportation is not even blocking passage but endorsing it.

           According to the National Complete Streets Coalition, in 2011 alone “over 140 jurisdictions adopted a policy, up from 80 that committed to Complete Streets in 2010. In total, 352 regional and local jurisdictions, 26 states, the Commonwealth of Puerto Rico, and the District of Columbia have adopted policies or have made written commitment to do so.”

           Elections are looming and House and Senate leadership are looking to adjourn in early June.  The Rhode Island General Assembly must move quickly in the waning days of the 2012 legislative session to join 26 states that get it.  House leadership must do the right thing to make streets, highways and byways more accessible and safer for all Rhode Islanders, regardless of age, abilities or modes of transportation.   That is to pass H 7352.    

             Herb Weiss is a Pawtucket-based writer covering aging and health care issues.  His Commentaries are published in two Rhode Island Daily’s The Pawtucket Times and Woonsocket Call.