PREPARING FOR OUR golden years in middle age is usually focused on fattening a 401(k), keeping up with the hottest ranked retirement cities and thinking about how we might adapt a home for aging in place. But are you giving much thought to who’ll take care of you when your health, mobility and independence decline?
If you have kids, you may feel some security knowing there’s a ready-made shortlist of people who might look after you – although it’s not a guarantee they’ll be able to help. But a growing number of people are heading into old age without any children to put on the list of potential caregivers.
In 2016, nearly 15 percent of women ages 40-44 hadn’t given birth and were childless, up from 10 percent in 1976, according to the U.S. Census Bureau. A 2013 report from AARP projects that by 2040, about 21 percent of the older, disabled population will be childless.
AMERICA HAS AN AGING population, and as such, more and more people are considering options for where and how they’ll live after retirement. Sorting through those choices and determining which is the best one for your particular situation can be challenging.
Continuing Care Retirement Communities are one option you may consider. Sometimes called life plan communities, CCRCs offer most anything older adults may need as they move through the stages of aging, says Andrew J. Carle, an adjunct professor in the department of health administration and policy and founding director of the program in senior housing administration at George Mason University in Fairfax, Virginia. “The gist of it is they include the full continuum of care options,” meaning everything from independent or assisted living to memory care and skilled nursing care.
Not just focused on health care and assistance in daily living, CCRCs address the range of needs seniors will face after retirement and typically offer housekeeping and dining options, transportation, wellness and fitness programs, recreational activities and a wide range of social activities and outings for residents.
A new series of eight chartbooks is now available in the Data Sources section of ACL’s AGing Integrated Database (AGID) website about the National Survey of Older Americans Act (OAA) Participants.
The NSOAAP data provide ACL and the aging network with information on outcomes that demonstrate the effect and overall quality of Older Americans Act Title III services. Service recipient demographics, as well as health and well-being indicators are also collected. The 12th National Survey of Older Americans Act Participants (NSOAAP) was collected in 2017.
Some fun facts from the data:
More than 20% of Homemaker (31%), Case Management (26%), Transportation (22%), and Home-delivered Nutrition (32%) clients are 85 years old or older.
More than 95% of clients across all six services report that that the people who provide the services are courteous.
IF YOU WERE BORN between 1946 and 1964, you count yourself, of course, as part of the baby boomer generation that is the largest in American history. And boomers age just like everyone else. In March 2018, the U.S. Census Bureau reported that by 2035, adults aged 65 and older will number more than 78 million. By comparison, kids aged 18 and younger are expected to total just 76.4 million, meaning that in short order, the number of seniors in the country will outnumber children for the first time in American history.
As they continue to age, many people need some help in completing the daily tasks of living. Faced with the decision of how to address these needs, thousands are settling on the option of an assisted living facility.
Definitions of assisted living can vary from state to state and facility to facility, but “we generally define it as another long-term care option for folks that generally don’t need 24/7 skilled nursing care, which is what most long-term nursing homes provide,” says Rachel Reeves, director of communications for the National Center for Assisted Living, a non-profit organization representing about 4,000 assisted living facilities across the country. For many people, assisted living means they need help with some aspects of daily living, such bathing, dressing, toileting, eating or transferring to bed at night. “Assisted living really focuses on supporting individuals with those activities, but then also maximizing independence and socialization in a home-like environment,” Reeves says. Currently, the NCAL reports that there are more than 835,000 Americans residing in assisted living facilities.
Providing insight into the changing post-retirement landscape, a new survey by Home Instead, Inc. revealed that more than half (53 percent) of workers approaching retirement in the next five years believe they will likely return to work.
According to the Home Instead, Inc. survey, money is an important overall factor in desire to return to work. However, the second most important motivator for those who have retired was fighting boredom (44 percent) or keeping their minds sharp (22 percent), while finding new challenges and fulfillment were the second and third most important motivators for those pending retirement. In terms of their next move, the majority of both those approaching retirement (68 percent) and those who have “unretired” and returned to work (65 percent) said they will change or have changed industries.
“Today, more aging men and women are redefining what their next chapter looks like, seeking out new career opportunities that serve their skills, passions and life goals,” said Jeff Huber, president and CEO of Home Instead, Inc. “We are seeing the desire among seniors for a second career to not just fulfill a monetary need, but source of personal fulfillment later in life. In fact, many of our own professional caregivers are seniors themselves.”
Mary Walsh and Beverly Nance did considerable research in 2016 before deciding to move into a continuing care retirement community outside St. Louis.
They took a tour of Friendship Village Sunset Hills and were impressed by its pool and fitness center, a calendar crammed with activities, the newly built apartments for independent living. They had meals with a friend and with a former co-worker, and their spouses, all of them enthusiastic residents.
“We’d met other people from the community, and they were very friendly,” said Ms. Walsh, 72, a retired manager for AT&T. “I was feeling good about it.”
Like most C.C.R.C.s, Friendship Village — a “faith-based” but nondenominational nonprofit — includes assisted living and a nursing home on its 52-acre campus, an important consideration.
It is a time of reckoning for Connecticut’s private, nonprofit social services.
After two decades of flat or reduced funding from its chief client — state government — community-based agencies are struggling to retain both their programs and the low-paid staff who deliver care for thousands of poor, disabled and mentally-ill adults and children.
Depending on the vantage point, Connecticut’s nonprofit social services sector is viewed as either the best means to preserve the state’s safety net or as the cheapest route to drive down government spending.
Those in the first category — relatives and advocates for the state’s most vulnerable citizens — are waiting to see whether Connecticut will fulfill the program of comprehensive, neighborhood-based care that was envisioned nearly four decades ago when the movement away from institutionalized care began.
Communication breakdown among nurses and doctors is one of the primary reasons for patient care mistakes in the hospital.
In a small pilot study, University of Michigan researchers learned about potential causes of these communication failures by recording interactions among nurses and doctors, and then having them watch and critique the footage together.
Several themes emerged to help explain the poor communication, and both nurses and physicians improved their communication styles, said Milisa Manojlovich, U-M professor of nursing, who defines communication as reaching a shared understanding.
One barrier to good communication is that the hospital hierarchy puts nurses at a power disadvantage, and many are afraid to speak the truth to doctors, Manojlovich said.
A new phase of the state’s Community HealthChoices program kicks in this week, with the end of a safeguard designed to protect the aged or disabled participants against service changes or cuts.
The change comes with some of the 80,000 southwestern Pennsylvania participants in the 6-month-old program still finding shortcomings in the coordination and communication that are supposed to be CHC hallmarks, helping people with health issues get more support to live at home.
“They didn’t fulfill what they promised,” said Theresa Quail, explaining that she has been waiting months for modifications to her home in Richeyville, Washington County, to help her avoid falls. “They said things would be easy and more beneficial for us, but I’ve yet to see any advantages.”
Officials from the state and its contracted managed care organizations have maintained that despite some individual problems with service coordination, transportation and other issues, the program has largely served consumers well since its Jan. 1 debut in 14 southwestern Pennsylvania counties. It required some 80,000 individuals covered by Medicare and Medicaid to pick one of three managed care organizations to coordinate any subsidized long-term care services they might need, such as in-home personal assistance.
Five months after a scathing report found that injuries, serious medical conditions and even deaths of those with developmental disabilities living in group homes often go overlooked, federal officials are responding.
In a four-page informational bulletin issued this week, the Centers for Medicare and Medicaid Services’ Center for Medicaid & CHIP Services said that it “takes the health and welfare of individuals receiving Medicaid-funded Home and Community-Based Services (HCBS) very seriously.”
The agency described its new bulletin as the first in a series of guidance documents it plans to issue in response to a January joint report from the U.S. Department of Health and Human Services Office of Inspector General, Administration on Community Living and Office for Civil Rights.