Earth: The Gray(ing) Planet

Published in Woonsocket Call on October 30, 2017

Last month, a National Institute of Health funded U.S. Census Bureau report was released announcing that the world’s older population is growing dramatically at an unprecedented rate. According to the newly released federal report, “An Aging World: 2015,” 8.5 percent of people worldwide (617 million) are aged 65 and over. This percentage is projected to jump to nearly 17 percent of the world’s population by 2050 (1.6 billion).

The new 165 page report, released on March 28, 2016, was commissioned by the National Institute on Aging (NIA), part of the National Institutes of Health, and produced by the U.S. Census Bureau.

“Older people are a rapidly growing proportion of the world’s population,” said NIA Director Richard J. Hodes, M.D. “People are living longer, but that does not necessarily mean that they are living healthier. The increase in our aging population presents many opportunities and also several public health challenges that we need to prepare for. NIA has partnered with Census to provide the best possible data so that we can better understand the course and implications of population aging.”

“An Aging World: 2015” is chock full of information about life expectancy, gender balance, health, mortality, disability, health care systems, labor force participation and retirement, pensions and poverty among older people around the world.

“We are seeing population aging in every country in every part of the world,” said John Haaga, Ph.D., acting director of NIA’s Division of Behavioral and Social Research. “Many countries in Europe and Asia are further along in the process, or moving more rapidly, than we are in the United States. Since population aging affects so many aspects of public life—acute and long-term health care needs; pensions, work and retirement; transportation; housing—there is a lot of potential for learning from each other’s experience.”

A Look at Some of the Details

The report noted that America’s 65-and-over population is projected to nearly double over the next three decades, from 48 million to 88 million by 2050. By 2050, global life expectancy at birth is projected to increase by almost eight years, climbing from 68.6 years in 2015 to 76.2 years in 2050.

In addition, the global population of the “oldest old”—people aged 80 and older—is expected to more than triple between 2015 and 2050, growing from 126.5 million to 446.6 million. The oldest old population in some Asian and Latin American countries is predicted to quadruple by 2050.

The researchers say that the graying of the globe is not uniform, “a feature of global population aging is its uneven speed across world regions and development levels.” The older population in developed countries have been aging for decades, some for over a century. “In 2015, 1 in 6 people in the world live in a more developed country, but more than a third of the world population aged 65 and older and over half of the world population aged 85 and older live in these countries. The older population in more developed countries,” says the report.

Meanwhile, the researchers report that in the less developed world, “Asia stands out as the population giant, given both the size of its older population (617.1 million in 2015) and its current share of the world older population (more than half).” By 2050, almost two-thirds of the world’s older people will live in this continent, primarily located in the eastern and northern hemispheres. “Even countries experiencing slower aging will see a large increase in their older populations. Africa, for instance, is projected to still have a young population in 2050 (with those at older ages projected to be less than 7 percent of the total regional population), yet the projected 150.5 million older Africans would be almost quadruple the 40.6 million in 2015, notes the report. .

The Graying of the Ocean State, Too

AARP Rhode Island State Director Kathleen Connell says that statistics gleamed from a new interactive online tool, the AARP Data Explorer, detailed by blogger Wendy Fox-Grage, a senior strategic policy advisor for AARP Policy Institute, suggests that Rhode Island for some time, has had the highest per capita 85 plus population of any state. But “Data Explorer also shows that Rhode Island was surpassed in 85 plus per capita in 2015 – second now to Florida by 1/10,000th of a percentage point. Interesting, by 1260, we are projected to rank 14th.

“Nationally, from 2010 to 2060, the 85-plus population will more than triple (260 percent), the fastest growth of any age group over that time period,” she says.

Connell says, “AARP Data Explorer clearly shows that the age 65-plus population will grow much faster than younger age groups. All three older age groups (65-74, 75-84 and 85-plus) will more than double between 2010 and 2060, while the younger age groups (0-17, 18-49, 50-64) will increase only slightly.”

“The growth of the age 85-plus population will significantly outpace all other age groups, once Boomers begin turning 85 in the 2030s,” adds Connell, noting that “This phenomenon will have significant impact on every aspect of society, ranging from our health care system to the economy.”

“People age 85-plus are the group most likely to need long-term services and supports (LTSS) to help them with everyday tasks. They not only have higher rates of disability than younger people, but they are also more likely to be living alone, without a spouse or other family member to provide them with assistance,” observes Connell.

Over the years, the Rhode Island General Assembly has enacted legislative changes in the way it delivers and funds aging services and supports for older Rhode Islanders and their family caregivers, says Connell.

According to Connell, early last year, AARP Rhode Island released, “Raising Expectations 2014: A Report Card for Rhode Island Long Term Services and Supports System Performance.” The report assessed the LTSS Scorecard and recommended policy goals.

Connell says that the results revealed that Rhode Island showed strengths. With the subsequent passage of key legislative proposals that included caregiver paid family leave and the CARE Act, the state has moved in the right direction, she says, stressing that “the policy report pointed to areas for improvement that state leaders should not ignore.”

“With the reauthorization of the Older Americans Act through 2019, and continued backing from Governor Raimondo, Rhode Island seniors and caregivers are benefitting from a host of home- and community-based programs,” says Director Charles Fogarty, of Rhode Island’s Division of Elderly Affairs. “A top priority for the agency is strengthening of those services so everyone can make it in Rhode Island. We are proud to partner with hardworking older Rhode Islanders and advocates; we are constantly listening to their suggestions which are helpful in providing direction on development of effective programming and policies,” he says.

Fogarty noted that during Governor Gina Raimondo’s first two budget cycles (FY 2016 enacted and FY 2017 proposed budgets), more than $1 million in additional general revenue funding has been allocated for programs such as Meals on Wheels, senior centers and other home and community care services. Seniors can remain in their homes with a high quality of life for as long as possible through the provision of affordable and accessible home and community-based services and living options preventing or delaying institutionalization.

Connell says a the nation’s population ages, Rhode Island now has an opportunity of showing other states, with growing age 85 plus populations what it takes to care for an aging population.

Rhode Island, too, can also teach the world community a thing or two about providing programs and services to their older citizens.

Aging Baby Boomers Woefully Unknowledgeable About Services

Published in Pawtucket Times on December 31, 2001

Are you a savvy shopper for services that you might one day need to purchase?

Many Americans are especially savvy when they purchase cars, electronic equipment or clothing.  But most are not when it comes to their knowledge of purchasing needed long-term care services, says a report recently released by AARP.

More than half (60 percent) of aging baby boomers age 45 plus say they are at least “somewhat familiar” with long-term care services currently available. However, they are woefully uninformed about the costs of, and funding sources for, long-term care services.

Yet with the graying of America’s population, the need for these services is expected to increase in the upcoming years. According to the 2000 U.S. Census Bureau projections, today’s 65 or older population numbers are expected to double to about 70 million in 2030, and the 85 and older population will also nearly double to about 8.5 million.  Those 85 years and older will be in the greatest need for nursing facility care.

“With the onset of the aging demographic revolution, essential that the general public not only learn about the long-term care options but understand their costs, and begin planning for their future care requirements,” said AARP CEO Bill Novelli. “Unfortunately, most of us pay little attention to the cost of such care until we or our loved ones needed it.  AARP sees  our role as informing and assisting people to make good choices.”

The AARP telephone survey asked a random sample of 1,800 Americans ages 45 and older questions  designed to measure their knowledge and understanding of the continuum of long-term care services, ranging from in-home care, assisted living to nursing home care.  In addition, to the national survey, five state-specific surveys were conducted with a random sample of 400 people age 45 and over in California, Florida, New Mexico, Washington and Wisconsin.

The survey findings suggested that aging baby boomers and seniors are generally not familiar or knowledgeable about the costs of long-term care services.  Only 15 percent could identify the cost of nursing  home care within plus or minus 20 percent of the national average of cost (about $ 4,654 per month).  Even 24 percent of those participating in the survey admitted that they did not even know the cost. And that’s not all – 51 percent estimated the cost too l ow.  So much for those savvy shoppers.

As for assisted-living facilities, one in four (27 percent) were able to come within a plus or minus 20 percent of the estimated median cost of care in an assisted-living facility while 38 percent said they did not know the national estimated median cost for assisted living per month, ranging from $ 2,000 and 2,500.

Meanwhile, survey participants continued to reveal their lack of knowledge by being generally unaware of how much an in-home visit from a skilled  nurse or aide costs.  The average Medicare reimbursement is $ 109 per a skilled nurse visit and $ 64 for a home visit by an aide.  The survey findings reported that they gave a wide range of answers, with no real consensus.  Thirty three percent even admitted they did not know the cost.

So, what about the aging baby boomers knowledge of long-term care insurance, one viable option to pay for the cost of long-term care services? About 31 percent said they have insurance that covers the cost of long-term care, when they probably didn’t.  Maybe it’s time for people to read the very small print in their insurance policies.  The Washington, D.C.-based Health Insurance Association of America estimates that only about 6 percent of Americas purchased such insurance.

Additionally, the survey respondents who said that they had insurance coverage for long-term care services were more likely to say they feel better prepared to meet the financial challenges of paying for care than those who say they do not have coverage (7 percent versus 39 percent).  This finding suggests that people who say that they long term care coverage when they do not may have a false sense of financial preparedness.

According to the new study, there is also a discrepancy between what people think Medicare and Medigap cover and what they actually cover.  More than half (55 percent), including those who say they are “very familiar” with long term care (58 percent), believe Medicare covers long-term nursing home stays.  And nearly a quarter say they would rely on Medicare to pay for such stays.  This is not the case.  Medicare does not cover long-term care nursing home stays.

The survey noted that 41 percent thought Medicare also covered assisted living care and more than 34 percent know whether it does or does not.  Medicare does not pay for assisted living.  And 57 percent correctly said that Medicare covers the cost of in-home visits from a skilled nurse. However, many respondents did not understand the difference between a home visit from a skilled nurse and a home visit by a home health aide.

More than half (52 percent) thought Medicare covers aide visits. In fact, Medicare covers only home health aide services for care that is medically necessary, not custodial care.

Kathleen S. Connell, AARP State Director, notes that this research study highlights the big gap between consumers understanding of long-term care services and its associated costs.  She adds that the findings reveal a great deal of confusion as to what long term care services are covered by Medicare and Medicaid.

“Aging baby boomers are now facing decisions regarding the purchase of long-term care services for their older parents. They will also be forced to deal with their need for services as they age and as longevity increases,” Connell says. “Consumers need to be come better informed about what Medicare and Medicaid pays for available long term care options for services that are actual costs of care.  They need to investigate different long term care insurance options, too,” she urges.

In Rhode Island there is a general recognition in agencies assisting seniors of the need for educating consumers and putting information into the hands of people who need it, Connell notes, adding that information specialists are available in local senior centers to assist in this effort.

Don’t wait until a sudden health crisis forces you to shop around for long-term care services.  Start today Become a savvy shopper by increasing your knowledge and understanding of different long-term care service options and  their associated costs.  Learn more about government financing programs, specifically Medicare and Medicaid, and private senior financing with long-term care insurance and Medigap policies.