overview of issues facing older adults

1. SENIOR CONCERNS
By:
Claire E. Cunningham
clairec529@msn.com
January 2011

2. Introduction
This is not a classic problem/solution paper. Instead it’s meant to be a
discussion-starter. I am just beginning to learn about the concerns facing
people as they age. I have opinions but no answers. I see that different
programs are being tried, but it seems we’re in that messy stage where we
don’t yet have enough data to tell us what’s working best.
My interest in issues facing older adults comes from three sources.
• First is my 92-year-old mother who calmly faces the challenges life throws
at her and deals with them. Through her I’ve become aware of some of the
not-so-pleasant things our older adults face.
• Second is the fact that I am part of the aging baby boomer cohort and have
a personal interest in what’s in store.
• Third is that so many friends, colleagues, and acquaintances are faced with
how to serve the needs of their aging parents.
I wish I had fixes to recommend, but I don’t. I believe an important part of the
solution is changing attitudes towards aging. My expertise in marketing and
communications could help with this task.
I’ve included some of the programs I know of as “Solution Ideas”, but the list’s
not complete. Let’s keep sharing so we know what’s being tried and how it’s
going.
Claire E. Cunningham Page 2

3. Method
To get smarter about issues facing seniors, I posed a question on an Internet
forum of professionals who provide care services to seniors. The question was:
What do you see as the top 3 issues facing seniors besides health,
insurance, and where to live?
A four-week discussion ensued, with over 30 people participating. While this
wasn’t a scientifically conducted survey, responses pointed clearly to two major
issues:
1. The desire for independence
2. The negative realities of isolation and loneliness
Since gathering these answers I’ve talked to experts, researched programs, and
attended a local conference to learn more about solutions.
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4. #1 Issue:
Independence – How to hang on to it
Is it any surprise that in this, the land of the free and home of the brave,
retaining independence is a major issue for older adults? As children,
teenagers, and young adults we strive to separate ourselves from our parents
and move out into the world on our own. We want to make our own decisions
and even our own mistakes (of course, a safety net is appreciated).
Seniors are loath to give up their hard-won independence. They want CHOICE.
Their choice. Not decisions forced on them by circumstances or family.
Several issues relate to independence:
1. Housing: Most seniors (some studies say as many as 90%) want to stay in
their own homes as long as possible. This can require a multitude of
services plus overall coordination. For others, though, the freedom of a
planned retirement community is ideal.
2. Finances: Whether it’s Social Security, savings, a pension, or a
combination of sources, retired adults have concerns about whether
they’ll have enough to fund retirement. With life expectancies increasing,
a stagnating economy, and rising medical and housing costs, money
concerns are very real.
Some baby boomers who were looking forward to comfortable early
retirements have been hit by unemployment, shrunken 401Ks, or
disappearing pensions. Retirement may have to come later for this
generation, and government programs like Social Security and Medicare
may be not be able to handle the boomers.
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5. 3. Transportation: When an older adult gives up driving, he or she becomes
dependent on family, friends, and/or public transportation to get around.
Appointments, shopping, and social get-togethers transform from
independent, often spontaneous, activities into events that require
planning ahead and asking for help. Asking for assistance can be
demoralizing.
4. Nutrition/meals: For some seniors getting nutritious meals consistently is
a problem.
 Perhaps she doesn’t know how to cook.
 Could be he can’t get to the grocery store.
 Maybe the loss of a spouse has left her too depressed to eat.
 Possibly money worries mean he skips meals.
Poor nutrition can lead to physical and mental health issues.
5. Health care/insurance: As we age we’re more apt to have medical issues –
arthritis, hearing loss, macular degeneration, high blood pressure…. Just
ask an actuary. The need for medical care goes up as we get older.
6. Personal and/or health care: When a senior can no longer do a task for
himself or herself, their concerns are who will do it and will the provider
have their best interests in mind. Options and choices may soften the
feeling of loss.
Solution Ideas
Issue #1: Independence
There appears to be focus on this issue in some states. I know my own state of
Minnesota has put huge amounts of time, thought, and creativity into this, in
anticipation of the aging of the population.
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6. 1. Housing
The Village Movement: This is a grassroots community initiative that
coordinates the delivery of services to seniors in a neighborhood. It’s
basically neighbors helping neighbors and allows elders to stay in their
homes. It can also alleviate loneliness by building connections within a
community. Based on a Boston, MA, model, these initiatives require
commitment, drive, and organization to set up and run.
Age-in-Place Services: There are for-profit and non-profit organizations that
will put together the services an individual or couple needs to stay in their
home. These services can include organizing, de-cluttering, remodeling,
transportation, and home health and personal care services.
Retirement communities and other housing: There is a building boom in
communities for seniors. There are many forward-thinking communities that
offer a wealth of services and activities.
For many seniors, though, the cost of renovating a house to make it age-in-
place friendly is beyond their means, as is moving into a retirement
community, as is hiring help. What can they do? Can we make all options
available to everyone?
2. Transportation: Many communities have some sort of fixed-route transit
system; however, it may be difficult for seniors to get to a transit stop.
Mobility services provided by some communities for the handicapped and
elderly require advance planning. Regular cabs are expensive. Some lucky
communities have Independent Transportation Networks (another
community-based co-op initiative), but not enough.
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7. 3. Nutrition: The long-established Meals-on-Wheels program provides over 1
million meals a day across the country through both delivery services and
central locations. Deliveries and meal participation can also provide
important human contact and interaction.
Meals-on-Wheels and similar programs are available in many places, but not
all. How can we ensure that no senior goes hungry?
4. Health care/insurance: Medicare is a wonderful program, but the decision
of what type of coverage to get can be horribly confusing.
5. Finances: Good planning can help with money issues, but finding a
trustworthy advisor can be daunting. Sharks and scams abound, and
seniors have become wary
How can the confusion and wariness be eased? Perhaps having trained
advisors available is the answer. See #6 below.
6. Training for professionals: There are now more and better trained
professionals serving the senior population. Social gerontology is growing,
as is the field of geriatric medicine. There is also Certified Senior Advisor
training for legal, financial, real estate, personal care, and other
professionals who serve elders. Is this training helpful? If so, how do we
promote it?
7. Technology: Wireless phones, computers, and assistive listening devices are
some of the technological advances that can keep seniors independent and
connected. Some states offer funding; however, seniors may also need
training and advice to ensure they have the right things and know how to
use them. How can we ensure the right tools and training get to the right
people?
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8. #2 Issue:
Isolation and Loneliness
This may be a more tricky issue to deal with than independence because it
involves the way in which our society views and deals with people as they age.
Attitudes are difficult to change, and the process can be complex and time-
consuming.
Certainly, getting older is not seen as glamorous. We tend to value youth
rather than experience. Older adults are often ignored or avoided.
Unless a senior has strong family connections or is active in a multi-generational
community, s/he may become isolated as friends stop driving, become
incapacitated, or die. The illness or death of a spouse can be devastating.
Isolation leads to loneliness which can exacerbate depression. These combine
to create health problems and diminish quality of life.
There are several issues related to the isolation of seniors.
1. Attitudes/Value: We are a cult of the new. We worship youth. Is it any
wonder we don’t value the contributions and experience of our elders?
2. Community/connections: Connections with other people can keep us
healthy. However, as people age their connections may fall apart – friends
and spouse are no longer there; family members may have moved away.
Even the most socially-adept senior can find it a daunting task to build a new
community. Those who are introverted may find it impossible.
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9. 3. Hearing: The prevalence of hearing loss increases as people age. (It’s
estimated that three in ten people over 60 have some degree of hearing
loss. About 14% of those 40-59 have some type of hearing problem.)
Hearing loss can adversely affect a person’s ability to communicate and stay
connected. Because there is a significant social stigma attached to hearing
loss, many do not seek treatment. Others may not have insurance coverage
that includes hearing aids.
4. Need for Meaningful Activity: Some people love the freedom of retirement
and find plenty to fill their days. Others yearn for ways to use their time and
talents in a way that contributes something.
5. End of Life: Death comes to us all, but no one wants to talk about it. The
fact that seniors are statistically closer to death may be why they are
avoided.
Solution Ideas
Issue #2: Isolation and Loneliness
This is a complex issue, and solutions need to be tailored for each person since
the need for interaction is individual. Some things like exercise classes,
technology, and even a Meals-on-Wheels program do double-duty, supporting
aspects of independence and alleviating isolation
1. Community/Activity
Exercise Programs: SilverSneakers is a national example of an senior
exercise program, but there are many local classes as well. These programs
improve health and fitness and also help reduce loneliness by getting the
individual involved in a group.
Companion Programs: There are volunteer companion programs in various
communities that provide a chance to build connections.
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10. Meaningful Activity: SCORE, “grandparenting” programs, and volunteer
opportunities are available.
Community connections: Exercise groups, volunteering, interaction with
companions, service providers, or caregivers may be sufficient for some but
not for others.
How do we ensure that each individual has access to connections they need
to stay healthy?
2. Hearing Loss: There are many choices in hearing aids to alleviate this loss,
and there are providers available. Changing attitudes towards hearing loss is
a major issue that needs to be tackled. While there is some funding available
for hearing aids, perhaps the better answer is improving insurance coverage
so it pays some of the cost of hearing aids.
3. End Of Life
Hospice care: Great services are available, but there is a lack of
understanding about the concept.
Attitudes: Death is a universal experience, so shouldn’t we put as much care
and effort into it as we do birth? Legal and medical details such as Advance
Directives and wills are important, but they don’t get at the human issues.
How can we educate about end-of-life issues and increase our level of
comfort with the realities of death and dying?
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11. 4. Attitudes/Value
Changing the value our society places on older adults requires a shift in
attitude – a process that may be spurred by the number of baby boomers
and their tendency to be out-spoken and have high expectations.
How can we harness the energy of the baby boom group and use it to
change attitudes?
Report by
Claire E. Cunningham
clairec529@msn.com
Claire E. Cunningham Page 11