National survey says care for older adults needs urgent rethinking 

Published in RINewsToday on January 27, 2025

With President Trump’s administration beginning and a new Congress poised to rethink, among other issues, Social Security, Medicare and federal aging programs and services, it might be prudent for the president and lawmakers to take a quick glance at the findings of a recently released national survey, “Meeting the Growing Demand for Age-Friendly Care: Health Care at the Crossroads.”

This 52-page national report, was released on Sept. 17, 2024 by Emeryville, California-based Age Wave, a think tank that studies the social, financial, healthcare, and business impacts of aging and The John A. Hartford Foundation (JAHF), a New York based-foundation dedicated to improving care of older adults. The survey was conducted by The Harris Poll, a marking and analytic company tracking public opinion in existence for over sixty years ago.  

According to the U.S. Census Bureau, America’s population of adults over 65 is expected to skyrocket, from 56.1 million in 2020 to 82.1 million by 2050. The enormous  increase in the number of older adults is forcing states, Congress, and the private sector to rethink their approaches to health care, social services, housing and more, to help older adults live well as they age.

As millions of Baby Boomers (born 1946 to 1964) age, living longer than previous generations and seeking ways to maintain wellness and independence to age in place, this nationwide survey shows deep dissatisfaction among older Americans aged 65 and over with health care and services they receive that do not meet their specific needs and preferences. 

Finding Policy Solutions to Maximize “Golden Years”

The national survey reported that four in five older adults (82%) say the U.S. health care system is not prepared for the growing and changing needs of America’s aging population. Just one in 10 (11%) give the health care system an ‘A’ grade. Instead of the status quo, older adults say they want solutions that will maximize their golden years, like interventions that make care more affordable, innovations to reduce or prevent cognitive decline and health care providers who understand what matters most to them when assessing care options.

“Older adults are stuck in a health care system that is not responsive to their goals and preferences. Boomers want health care that maximizes their health and ability to function, and they want their providers to listen to them,” said Terry Fulmer, JAHF’s president, in a Sept. 17 statement announcing the release of the report. “It is not too late to pivot to age-friendly care, which prioritizes the needs and desires of older adults in their care plan. There are many innovative approaches to help older adults live every year to its fullest, not just increase the number of years they live,” she says.

International longevity and aging expert, Ken Dychtwald, founder and CEO of Age Wave, added: “The United States is on the brink of an age wave of unprecedented proportions, and American health care requires a radical and immediate rethink to match our health spans, or being able to live every year to its fullest, to our lifespans.”

Dychtward urged policy and business leaders to prepare for older adults making up a large and growing percentage of the U.S. population. “Everyone knows this day has been coming, but our survey shows that older adults do not like the choices or care currently offered to them. And the fact that although we spend more per capita on health care than any country in the world yet have worse lifespans and health spans is cause for alarm,” he said.

The age 65 and over survey respondents called for America’s health care system to offer “age-friendly care.” Most older adults (94%) say it is more important to maintain quality of life than it is to live as long as possible.

Only three in five older adults with a health care provider (58%) report that their providers currently ask about what matters to them. Though older adults fear Alzheimer’s and dementia more than any other health condition, for example, less than half (40%) say their health care providers routinely evaluate their cognitive health and brain functioning. Similarly, less than half of older adults (45%) say their health care providers evaluate their mental health, and although the ability to walk freely without pain is top of mind for older adults, just 55% say their medical care providers evaluate their mobility and physical fitness. 

The national survey findings indicated that the older respondents say that there are not enough qualified care providers. Nearly all older adults (94%) say that health care providers should be trained on the unique health issues of people 65 or older, but only 10% of medical schools require a rotation in geriatric care, compared to 96% that require a rotation in pediatric care. 

Between 2000 and 2022, the U.S. population of adults aged 65 and older rose 60%, but the number of geriatricians dropped by a whopping 28%. says the report. 

Not surprisingly, the survey findings indicate that health care costs are viewed as “unaffordable” and of a bigger concern to older adults than living expenses, inflation, tax increases and an economic downturn or recession. For instance, just 16% give an ‘A’ grade to satisfaction with their out-of-pocket costs. Older adults are especially concerned with the cost of long-term care, stressing that one of their greatest concerns is not being able to afford future health and long-term care needs (68%), and that the government should prioritize having Medicare cover long-term care (80%).

Differing Views of the Quality of Nursing Home Care

An estimated 36 million Americans have a family member or friend living in a nursing home or memory care facility today, according to the survey. Just 37% of those adults ages 18+ say their family member or friend living in a nursing home or memory care facility receives high-quality care. Only half (50%) say these facilities are the safest place for them.

There must be more coordination between primary care providers and other health care providers. While 52% of Medicare beneficiaries see more than three physicians per year, half of older adults from the survey say their primary care provider does not coordinate their treatment with their other health care providers. The report notes that this may be attributed to the increasing shortage of primary care providers, which makes it less likely for people to have a usual source of primary care or long-term relationship with a primary care provider.

As noted in Primary Care in Rhode Island, in 2024, from 200,000 to 400,000 Rhode Islanders lack access to a primary care provider, resulting in a shortage of 133 to 266 primary care physicians to treat them.

Finally, more than half of older adults (56%) say it is challenging and very stressful to navigate the current health care system, while nearly two in three (62%) say health insurance plans provide too many confusing choices. Research has shown that more than half (55%) mistakenly believe Medicare will cover a long-term stay in a nursing home, the report added.

As the new Congress begins its debate on aging policy, regardless of political party, the national survey reports that their older constituents want public policies enacted that support quality care.  The survey findings indicate that adding long-term care to what Medicare covers is supported by most Republicans (76%), Democrats (84%) and independents or people with other political affiliations (79%). Additionally, there is bipartisan support for improving quality at U.S. nursing homes also earns bipartisan support (Republicans 62% support, Democrats 68% support, independents or people with other political affiliations 65% support). 

“Better federal and state policies can encourage the development of age-friendly health systems, that focus on improving patients’ well-being and quality of life,” predicts JAHF’s Fulmer. “Policies could include new options for affording long-term care insurance and developing a federal strategy to ensure disadvantaged populations are prioritized in a national strategy for age-friendly care,” she says.

Report Offers 5 Key Suggestions to Improve Care to older Americans 

After reviewing all survey findings, JAHF identified five key recommendations to improve health care provided to older adults and to promote healthier, happier aging.

JAHF calls for promoting age-friendly care that can assist the nation’s older adults maintain their health, ability to function, thus maintaining their independence in the community. Pursuing scientific breakthroughs could bring the end to diseases like Alzheimer’s adds JAHF, calling for social isolation must be addressed. 

Assist family caregivers with skill-building tools, policies that allow flexibility in taking paid leave and ensuring care providers coordinate among multiple providers the health care system easier to navigate. 

Finally, JAHF calls for the creation of a ‘national master plan for aging’ that will be focused on meeting the needs of older adults. This plan would identify and address barriers that contribute to inequities, also creating a strategic plan that would provide a roadmap to reform the financing of long-term care, enhance the quality of nursing home care and to create systems to assist people to age in place at home rather than being admitted to acute and congregate settings. 

“We are at a unique crossroads. However, changing America’s health care system to meet older adults’ expectations is possible, practical and could lead to greater health at a far lower cost—and can benefit the government, private enterprise and consumers,” said Dychtwald. “Older adults deserve health care partners who understand what they are going through, have the skills to most effectively support their patients and act on what their customers want,” he says.

The Nuts and Bolts Behind the Study 

The study was conducted by Age Wave on behalf of The John A. Hartford Foundation and in partnership with The Harris Poll. After thorough review of secondary research and through qualitative research with older adults through online focus groups, a  nationally representative online survey was conducted from April 17 to May 9, 2024. Of 5,023 adult (age 18+) respondents, 2,516 were age 65 and older. Data were weighted where necessary to align them with their actual proportions in the population, including by age, gender, race/ethnicity, region, education, household income, size of household, marital status, and political party affiliation. 

Note:  The full report, Meeting the Growing . for Age-Friendly Care: Health Care at the Crossroads, can be found at https://www.johnahartford.org/images/uploads/resources/The_Growing_Demand_for_Age-Friendly_Care_Report_FINAL.pdf.

To watch the “Webinar: What Older Adults Want: Emerging Breakthroughs & Opportunities for Age-Friendly Care, go to https://www.youtube.com/watch?v=ZK6D4-G3KPw.

National Groups Call for Making Pneumonia Vaccines Available to Age 50 and Over Adults

Published in RINewsToday on October 21, 2024

Within days, a loose coalition of 21 advocacy groups are pushing for the Centers for Disease Control and Preventions (CDC)’s Advisory Committee on Immunization Practices (ACIP), which meets on Oct. 23 and Oct. 24, to lower the routine age-based recommendation for all pneumonia vaccines to age 50. 

These groups, working on behalf of millions of older Americans, immunocompromised, underserved patient populations and consumers, see the value of increasing the accessibility of effective vaccines for respiratory viruses. 

 ACIP’s October agenda may include a vote on lowering the routine, age-based recommendation for pneumonia vaccines to add those ages 50 to 64 to the existing two groups in the age-based recommendation, those under 5 and over 65.

 According to Bob Blancato, Executive Director of the National Association of Nutrition and Aging Services Programs (NANASP), CDC typically holds three ACIP meetings each year with one occurring in February, one in June and one in October. “The upcoming meeting is especially critical because we are right in the middle of respiratory season, so any change they make to their recommendation can greatly benefit older Americans while the threat of pneumonia is very much still circulating in our environments,” he says.

“Also, just given the fact that there are only three meetings a year, it is important that the committee take the opportunities to improve policies during each meeting so we aren’t further restricting access to protections that so many in our population will benefit from,” adds Blancato.

This coalition, composed of aging, consumer, health and multicultural advocacy groups, calls for federal policies that support the well-being of older adults that remove barriers to accessing innovative and effective vaccines, given the real benefits they offer in preventing serious health outcomes, says Blancato.

 Preventing Pneumococcal Disease in Adults

According to CDC, pneumococcal pneumonia, meningitis, and bloodstream infections (sepsis) kills tens of thousands older Americans each year, including thousands of older adults age 54 and over.

CDC estimates that 150,000 older Americans are hospitalized with pneumococcal pneumonia each year.  About 1 in 20 individuals who get pneumococcal pneumonia will die.  The death rate is higher for those individuals age 65 and older.

Persons surviving pneumococcal meningitis can suffer from hearing loss, seizures, blindness, and paralysis, says CDC.  For those afflicted with pneumococcal bloodstream infections, treatments require hospitalization, often requiring weeks or months of treatment before returning to normal activities.

Getting conjugate and polysaccharide pneumococcal vaccines can reduce a person’’s chance of contracting or dying from pneumococcal disease, notes CDC.

 Protecting the Older At-Risk Ethnic Population

 The Oct. 15 letter to ACIP, co-authored by the National Association of Nutrition and Aging Services Programs (NANASP), National Caucus and  Center on Black Aging (NCBA) and the National Hispanic Council on Aging (NHCOA), stated that lowering the age would increase vaccination rates for at-risk ethnic populations.  Over 53 percent of Black, 41 percent of Hispanic, 50.2 percent of Asian Americans have been vaccinated for pneumonia, compared to 69 percent of White adults, noted the correspondence. It also stressed that by offering a vaccine to persons ages 50 to 64, who experience a decline in their immune system, would receive protection while their immune systems are still able to produce a robust response.

 “It has been over three years since ACIP first presented data at the June 2021 meeting showing that lowering the age-based recommendation would improve vaccine equity,” said NANASP’s Blancato. “There is no reason to delay this further,” he says.

“Too many Black and Hispanic individuals face chronic illnesses like diabetes, heart disease and cancer, due to lack of preventable health care early in life. Far too many are already sick by the time they are currently eligible for pneumococcal vaccinations,” said Yanira Cruz, President and CEO of the National Hispanic Council on Aging (NHCOA), “Getting more adults in these populations vaccinated at a younger age is a great step forward in vaccine equity”.

“I’ve had pneumonia and it knocked me out for nearly three months,” said Karyne Jones, President and CEO of National Caucus and Center on Black Aging (NCBA). “I contracted the disease when I was 64 – I know first-hand the value of getting younger people vaccinated against this deadly disease.  I ask members of ACIP to fully support lowering the recommendation to age 50 for all adults for all available pneumococcal vaccines.”

In addition to the group letter, an online petition organized by NANASP has garnered more than five thousand signatures from Americans across the nation.

“As we begin the respiratory disease season, our policies should be about promoting protection versus limiting across to vaccines.  The support for lowering the age-based recommendation is clearly there so now is the time for ACIP to act,” continued Blancato.

If ACIP lowers the recommended age of providing vaccinations to persons age 50 and over, commercial plans and Medicaid would be mandated to cover its cost.  Medicaid plans would be required cover the costs for low-income recipients as soon as the recommendation is approved by the CDC Director – like for Medicare Part D plans.

By offering coverage of pneumococcal vaccinations, to persons ages 50 to 64, would offer critical protections to these individuals before their immune system wanes.  This cost-effective approach would reduce serious illness, ultimately reducing hospitalization and death. 

The CDC should streamline and lower the age recommendations for routine pneumococcal vaccinations, starting at age 50.  It’s a no-brainer decision. 

Here is a listing of groups signing correspondence to CDC’s Advisory Committee on Immunization Practices: National Association of Nutrition and Aging Services Programs; National Caucus and Center on Black Aging; National Hispanic Council on Aging; Alliance for Aging Research; ALS Association; American Public Health Association; American Society on Aging; COPD Foundation; Generations United; HealthHIV; HealthyWomen; National Alliance for Caregiving; National Consumers League; National Grange; National Hispanic Health Foundation; National Minority Quality Forum; Sepsis Alliance; The American Society of Consultant Pharmacists; USAging; US Black Chambers, Inc.; and Vasculitis Foundation.

AARP study on older adult stereotypes in on-line images. We think they can help

Published in RINewsToday on September 30, 2024

Following on the heels of an intense national media debate of President Joe Biden’s age and his ability to govern, a new AARP study finds a positive shift over the past five years in how adults 50-plus are portrayed online in marketing and media imagery. Researchers found that negative sentiment in online media and marketing images dropped from 28% in 2018 to just 10% in 2023.

AARP’s analysis compared images from 2018 to 2023, revealing the strengths and limitations in how aging is portrayed in media and marketing.  

AARP’s Media Landscape Review analyzed a random sample of over 1,000 online images and 500 videos featuring adults 50-plus from brands and thought leaders posted on news sites and social media with at least two million followers or readers. But political content was excluded.

According to Lauren Goodson, AARP Research Director of Growth, Enablement & Membership, AARP conducted the initial study to demonstrate the opportunity for companies/brands to more accurately and honestly represent older adults. The 2018 study found 28% of online images portrayed adults 50-plus in a negative manner compared to just 4% of those under the age of 50. “We are encouraged to see that efforts by AARP and other organizations to raise concerns about ageism have resulted in significant improvement over the past 5 years, says Goodson, noting that no decisions have yet been made about a third wave of the study.

The research findings indicated that the age 50 and over population is pictured as more active and independent, less fearful, and more likely to use technology, reflecting a growing recognition of older adults’ active lifestyles and valuable engagement in society.

While the results were promising about the decrease of ageism on the internet, note researchers, they stressed that challenges still remain.  Social media images of older workers aged 50 and over in the workplace remained unrealistically rare, they say, while depictions of this age group spending time with family actually fell over the past five years.

“At AARP, we have been leading the fight to combat ageism in marketing and media imagery, and it looks like the creative industry is starting to really listen,” said AARP Chief Communications and Marketing Officer Martha Boudreau, in a Sept. 23 statement announcing the study’s findings. “As the old saying goes, a picture is worth a thousand words. In the age of social media, and with the ubiquity of advertising across people’s daily lives, this is truer than ever. The images we see shape what we think and can even influence how we act towards one another. Progress has been made in improving how 50-plus adults are portrayed but we still have a lot of work to do. Studies like these point the way forward and give us a solid roadmap for how to continue to make things better,” she adds.

AARP’s study details positive improvements showing a shift “from decline to vitality.” For instance, aging was viewed as more active than before.  The researchers say that the portrayal of America’s older adults has “moved from fear-based, with an emphasis on financial and medical themes, to active and healthy lifestyles.  When reviewing on-line images and videos, findings show that 26% of people 50-plus shown in images were physically active, compared to 15% in 2018.

The AARP research findings revealed a striking increase in depictions of adults 50-plus using technology. In 2023, 33% of images showed people 50-plus using tech devices, up from just 4% in 2018.  The study’s findings, indicating an uptick in the use of tech devices, better reflects this age cohort’s acceptance of technology, challenging outdated ageist stereotypes and highlighting the reality of their digital use.

As they age, nearly 80 percent of America’s older adults aged 50 and over want to age in place in their community, choosing not to be placed in an assisted living or nursing facilities.  The study showing 73 % of static images showing people at home vs. 39 % in 2018, reflects that this trend has been more visibly reflected in media in recent years

Meanwhile, just 8% of static images showed people in a retirement community compared to 15% in 2018. The researchers say it’s a sign that retirement centers are less likely to be the visual shorthand for aging, with recent images elevating independence over medical worries or reliance on assistance.

Even with positive changes, there is more room for improvement especially with portrayal of older adults in the workplace.  Despite older workers making up over one-third of the workforce, the study found only 14% of social media images show age 50 and older adults at work, this being almost unchanged from 13 % in 2018. Researchers say, “this under representation misses both on what people 50-plus are adding to the economy and what long, satisfying careers are adding to their lives.” Also, how long people are working or have gone back to work due to outliving income streams, a negative, but realistic image.

As to mobility challenges, AARP’s study reveals a substantial gap in representing mobility challenges among age 50 and over adults.  The findings indicate that only 1% of images show consumers with mobility aids, despite 12% of these older adults, in fact, regularly using a mobility device for assistance walking or navigating stairs. 

Finally, the study found a significant decline compared to 2018 in people aged 50 and older shown in multi-generational families. There was a significant decline compared to 2018 in these older adults shown in a family situation (17% to 9%) or with their grandchildren (13% to 6%), this suggesting a major opportunity for social media to more accurately reflect an important source of joy and meaning for many over 50. This finding suggests a need for the social media and marketing companies to better portray the important family roles and relationships older adults have, as these connections become more significant as one ages.

Finally, the research tracked still images and video content, with video proving to be more successful at showing adults 50-plus interacting with others, outside the home and using technology.

Every picture tells a story, don’t it?

“Those of us in communications often search for images to use to accompany stories, says Nancy Thomas, publisher of RINewsToday, a state-wide new site, noting that usually original images, with credits to photographers and artists are used. “Whether we buy them from a photographer or image service or use ones provided in what is called a Media Library on such platforms as WordPress, searching for just that right image to illustrate an article we’re publishing can be extremely difficult if the image you want is first that of an “older person,” admits Thomas.

Thomas, who ran a marketing company and held senior communications positions for over 30 years, says “it’s the hardest search we’ll do.”

According to Thomas, common searches for “a dog and family,” a “child in daycare”, “people camping” or “networking” are pretty simple, but it is more difficult to find group shots featuring accurate age spectrums and finding no person looking older than 40. “Looking back years ago,” she says, “there were no people of color, but today that has changed significantly.”

“But older people? Aging? You might find them in a nursing home setting, in a bed, with a younger person holding their hand. And then there is the active couple, running gently at the water’s edge. Or sitting at a Thanksgiving table,” quips Thomas.

“But to find an older person at work? At a training meeting? Maybe even doing the training?  It’s hard to find. At a computer? Only if someone is at their shoulder, ‘helping them’. But no doctors – they all look 30 years old. No accountants. No writers. Or even people in therapy. All young,” she says.

“It’s a conundrum, and entirely unfair for small communication and marking firms and news sites. “We’ve written to WordPress expressing our suggestion that the next time they make paid assignments to add to their Media Library they think about common images to show older people in everyday settings. At work. Watching television. Cooking. Doing art. Having a spa day. At the playground with their grandchildren. Shopping. As the medical expert. Or technician,” says Thomas, noting that “All images amazingly absent.”

Thomas adds: “When we do find images of older men and women, how often are they in muted colors? Wearing sweaters. Or, of course, there are the handsomely grey-haired men with the twinkle in their eye.  We wonder what AI will bring to the table, being programmed, as it were, by younger people?  Request an image of grandma and grandpa playing with their newborn grandchild – see what you get,” she asks.

“Let’s push back against being seen, regardless of our age, as either “the wealthy” or “the impoverished” – most of us, regardless of our age, are somewhere floating up and down in the middle. A healthy dose of realism led by the photographs we show, and the images we keep, is due all the way around,” says Thomas. 

A suggestion for AARP – beyond studies – to solution!

Thomas went on to suggest one thing AARP could change much of this. They could create a bank of photos that groups could use with “approved” AARP images (even giving an AARP credit line so small websites and publication sites could dramatically improve their images overnight – not only would AARP be creating an almost instant solution, they could add a small fee to subscribe to the service that would help fund their future studies into issues of concern for aging Americans.

On-line Imagery Should Accurately Reflect Society

According to Betty Galligan, APR, president of Pawtucket-based Newberry Public Relations and Marketing, as the AARP study points out, the creative media industry has a long way to go in portraying life as an older person in today’s society. In addition to photo and video imagery on news sites and social media platforms, streaming video content is an opportunity that holds a lot of influence to normalize the way we see 50-plus adults. “It would be wonderful to see a romantic series or movie featuring an older leading man or woman who uses a wheelchair or walker to get around. Or to show more older heroes and heroines in the workplace. “The Intern” movie with Robert DeNiro and Anne Hathaway comes to mind, as does the stereotype of Meryl Streep’s character in “The Devil Wears Prada”,” she says.

Online media shapes and informs public opinion, and its influence is evident in the way people view older adults, says Galligan. “The recently released AARP study reveals a positive shift because the 50-plus population today is indeed way more active than in past generations,” she said.

 “We all know a grandparent who is using text messaging, TikTok and technology to keep up with their grandchildren. We also know older folks who are athletic and energetic well into their 80s, sometimes more so than their younger counterparts. Marketing imagery should hold up the proverbial mirror to society and reflect this,” adds Galligan, who has worked in the Boston and Providence advertising sector for nearly 40 years.

In the past, successful advertising and marketing was ideally aspirational, reflecting what consumers desire to be versus what they actually are,” observes Galligan. “At its core, it can be deceptive. Images depicting stereotypes of a thin model smoking, for example, drove sales for cigarette brands especially among women who used smoking as a diet aid,” she said, stressing that today’s realism is in vogue.

“Popular reality TV shows, the “celebrification” of ordinary people, citizen  journalism on social media platforms all play a role in portraying the average person (including older adults) in ways we’ve not experienced before,” notes Galligan.

Galligan notes that people are healthier than in past decades, living longer and with more vitality. In general, the 50-plus market segment has greater disposable income, so it’s no wonder that brands are embracing this demographic reality. “Marketing has become bolder and more inclusive than before – case in point, ads depicting older same-gender couples and ladies wearing disposable garments for incontinence, says Galligan.

To get AARP’s 2018 Media Landscape review, go to https://www.aarp.org/research/topics/life/info-2019/age-representation-in-online-media-images.html.

To get AARP’s latest (2024) latest Media Landscape review, go to:

https://www.aarp.org/content/dam/aarp/research/topics/aging-experience/demographics/ageism-online-media.doi.10.26419-2Fres.00852.001.pdf.

Learn more about this study at AARP.org/50plusmedia.