Tag Archives for golden years

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.

Strengthening the Safety Net for Seniors Living in Poverty

Published in RINewsToday on July 15, 2023

A recently released U.S. Census Bureau report should send a message to Congress and spur the efforts of aging advocates to protect older Americans from financial hardship and poverty.  Some consider the “golden years” to be age 60, or 65, and over.  But it’s not so golden for millions of retirees.

According to a recently released U.S. Census Bureau’s report, “Profile of Older Adults by Poverty Status: 2021,” 8.3% of the nation’s population age 65 and over are living in poverty.    

The Census Report, released on June 25, 2024, uses data from the Survey of Income and Program Participation (SIPP), to draw a profile of the 4.7 million older adults who lived in poverty in 2021. This longitudinal survey provides comprehensive information on the dynamics of income, employment, household composition and government program participation.

Poverty in your later years

Here are a few data nuggets from the latest Census Report’s findings…

According to the report, two-thirds of older adults living in poverty in 2021 were women. Limited time in the workforce, raising children or serving as a caregiver, have decreased Social Security benefits, leading to income insecurity in their later years. Older adults living below the poverty line were more likely than those “non-poor” to have never married, says the report, noting that this limits the chance of these individuals to accumulate financial resources with a spouse or to obtain financial incentives (such as tax benefits) associated with being married.

And yes, living alone can be hazardous to your pocketbook, notes the Census report. In 2021, most older adults in poverty (62.9%) lived alone, compared to only 26.3% of those not in poverty.

In addition, among older adults in poverty who lived with at least one other person, 65.5% lived with a spouse, 29.9% lived with a child and 11.2 percent lived with a grandchild, noted the report’s findings.

A snapshot of poverty in Rhode Island

According to Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of Rhode Island,” the Census Bureau released a “significant and must-read report.”  

“The data shows that almost five million older adults across the nation are living in poverty, and details how gender and social characteristics contribute to poverty status and wealth,” says Maigret. “Two-thirds of the nation’s older adults living in poverty are women, which is like the poverty profile of older adults in Rhode Island, as are the higher rates of poverty for older persons of color.

Maigret noted that a comprehensive 2014 report on RI Older Women she researched for The Women’s Fund of RI documented the high poverty rate of older women in the state – 9.7% for men and 11.3% for women. The Women’s Fund report also found about 20% of older RI adults living in poverty were more likely to be Hispanic or non-Hispanic Black. 

“Unfortunately, things have not improved,” she says, noting that the poverty rate for older Rhode Islanders has increased to 12.3% (US Census ACS 2022 estimates) which is higher than the 10.9% national poverty rate for older adults.

“Providing data on the poverty status of older adults is important for our state policymakers. It is also critical for them to understand the notable gender differences as women outnumber men in the state’s older population (56% vs 44%), have greater healthcare expenses, are more likely to live alone and need long term supports,” states the former Director of the state’s Department of Elderly Affairs (DEA), now referred to as the Office of Healthy Aging.  Older RI women also have lower Social Security benefits than men (about $5,000 less) and 37% less pension benefits, she says.

Maigret notes that most older Rhode Islanders are not wealthy with  many falling into what is termed the “forgotten middle.” A specifically, term used to describe those individuals with income not low-income enough to be on Medicaid but not enough to meet basic needs–estimated at $30,000/year for a single renter in good health (Elder Index). 

Twenty-seven percent of our older households have income below $25,000 (US Census) which is not sufficient to meet basic needs. This is why we must both improve some of the programs that can help them financially and better inform them of available benefits, she says. 

Tackling poverty in the Ocean State

According to Susan Sweet, founder of the Rhode Island Minority Elder Task Force (RIMETF) (riminorityeldertaskforce@gmail.com), a 501 © (3) nonprofit, established in 1992 after a survey found that elders from minority groups were not being serviced by aging network providers, “The survey revealed that Senior Centers, Adult Day Centers, and other state and local programs had almost no staff who were able to communicate with clients who had limited or no English language skills, and paid no attention to cultural differences in different populations,” she noted.

“While there has definitely been some improvement, most older Rhode Islanders of different cultures and/or languages must seek assistance from the few programs that are specifically directed to them,” says Sweet, a former state associate director of DEA, and advocate for seniors facing hardships and low-income difficulties.

“But they are not the majority of those who barely survive because of a lack of funds and support. Coming from all backgrounds, many poor elders are struggling to meet basic needs such as shelter, food, medicine, medical care, utilities and other necessities”, says Sweet.

“Older adult needs appear to be much worse than they were in the early 2000s. Inflation, Covid, lack of adequate housing options, as well as difficulty in accessing existing assistance programs are pushing these individuals to an existence that threatens their health and their life,” warns Sweet.

State programs that exist for the purpose of helping poor, older adults often have long application periods and stringent rules that create very little ability to respond to emergency situations,” according to Sweet.

Sweet says that RIMETF’s most extensive work is in direct assistance to poor elders for basic needs. “We provide mini-grants , generally in the range of $200 – $400, to low-income elders in dire circumstances by paying directly to providers of goods and services such as rental entities, utilities, fuel companies and gift cards for items such as food, clothing, medicine, and household goods. “Our members also assist to get people on payment plans, programs, services, and better situations that may prevent future emergencies and enable longer-term solutions,” she says.

RIMETF has no paid staff and its Board membership consists of a diverse group of health and social work representatives, program administrators, community members, Senior Center and Community Action staff members, housing specialists, and advocates from other aging programs. The older adults who need help are identified by the group’s membership and demographic information and records are kept by the organization.

The nonprofit group is funded by private foundations such as Nursing Placement Foundation, Rhode Island Foundation, Tufts, Harriet Boucher Foundation, Dexter Fund as well as municipalities including the Cities of Providence, East Providence and Pawtucket.

Both Maigret and Sweet call for more to be done by the Rhode Island lawmakers next session to strengthen the safety net for struggling older Rhode Islander’s to protect them from poverty.

“Yes, absolutely more work needs to be done,” says Maigret. ”Data from the national profile and corresponding state data provide strong evidence of the need to continue advocacy to fight for policies to ensure Rhode Islanders enjoy economic security in their older years.” 

“Policies are a necessary part of the work, but oversight and quality control of state and private programs and services is vital to ensure that actual help is available in a timely manner; currently, oversight is lacking,” says Sweet, calling for state programs and policies to be better monitored and evaluated by those who deal with poor older adults and know the hardships suffered by them.  

“The reality of increasing poverty among elders requires a grass roots understanding of the lack of support actually available to meet their needs,” says Sweet.

To get a copy of the Census Bureau’s report,  “Profile of Older Adults by Poverty Status: 2021,” go to https://www2.census.gov/library/publications/2024/demo/p70-193.pdf

To read “Older Women in Rhode Island: A Portrait, Woman’s Fund Rhode Island 2014,” go to https://wfri.org/assets/older-woman-rhode-island.pdf