The Challenges of Aging
by Sherrie Norris
The event was organized to recognize the work of the General Assembly members serving the High Country area and to provide a forum for attendees to advocate on behalf of other adults and their family caregivers.
A key participant was Ed Rosenberg, a member and alternate of North Carolina's Senior Tarheel Legislature and a professor of sociology and director of the graduate programs in gerontology and sociology at Appalachian State University.
Rosenberg provided statistical information about aging in America and, in particular, the challenges facing baby boomers.
America has entered a period of unprecedented aging, Rosenberg said, due to 2011 marking the beginning of the "boomers" reaching 65 -- "at the rate of 10,000 per day," which is expected to continue for another 18 years, he said.
"Boomers are now collecting Social Security, signing up for Medicare, some of them using Medicaid to pay for their long term care -- 10,000 every day for 6,570 days -- you get the picture," he said.But the numbers don't tell the whole story, Rosenberg said.
"For instance, the older the age group you look at, the higher the proportion of women. Women outlive men, and in many respects, they have different needs from men, as they age. To a large extent, solving the challenges of an aging population is solving challenges faced by older women," he said.
Meeting the needs
Rosenberg pointed out that the older population is also becoming more diverse, racially and ethnically, with already one in five elders is a racial or ethnic minority, a proportion that will increase.
Programs and services for older people will have to continue to adapt to clientele with varying cultural values and practices, Rosenberg said.
"Cultural competency will be a key component to effective service delivery," he said.
The boomers are different, too, he said, in terms of their values, beliefs and expectations, from their 'greatest generation' parents.
"If Area Agencies on Aging, senior centers, adult day care programs and all levels of institutional care want to thrive, they must proactively anticipate and prepare for this generational cultural sea change," he said.
Rosenberg drew laughter from the audience when he said, "Baby Boomers do not want bingo, shuffleboard and Lawrence Welk in our assisted living facility. We want Wi-i, Rolling Stones and Viagra."
Challenges Ahead for NC
Compared to America as a whole, Rosenberg said, North Carolina faces equal, if not greater challenges, in the years to come.
"Already, North Carolina ranks ninth among all states in the population age 65-plus; elders comprise over 13 percent of our populace. By 2030, that will be 20 percent. One in five of us will be a senior citizen," he said.
One of every four North Carolinians is a "baby boomer, he said. "Fifty-three of our counties have more people 60 and over, than under 18. By 2025 this will be true of 86 of our 100 counties."
For the next 20 years, Rosenberg said, "Our fastest-growing age group will be persons 75 and over, the age at which health problems, and thus health costs, take a marked upturn."
Four in 10 older Tarheels have at least one disability that impairs physical activities like walking, dressing, and bathing, or cognitive functioning, he said. "Women are 58 percent of North Carolinians 65 and over, and 70 percent of those 85 and over."
Of those 75 and over, Rosenberg said, there are three times as many women as men below the poverty level. "Already, about one in five older North Carolinians is a member of an ethnic minority group. Only one in five older North Carolinians has a bachelor's degree. Our state ranks 12th in terms of the percent of the population living in rural areas. And in rural areas, with lower population density, each unit of service, each Meal-on-Wheels costs more to provide."
No Surprises Here
Rosenberg reminded his audience that the growth of the older populations is no shock.
"If 'old age' starts at 65, he said, "we can predict the size of the older population quite accurately, 65 years in advance from the day they're born."
He referred to the term "tsunami of older people" as "no surprise," indicating that since the birth of boomers ended in 1964, we've had a 49-year notice.
"So why has America not better prepared?"
North Carolina is faced with rapid growth of our older population, in a largely rural state, with federal and state economies that are still shaky, he said.
Something to think about
Rosenberg offered three suggestions for decision-makers at the federal, state and local levels:
Don't be penny-wise and pound-foolish. Sure, you can save money by cutting funding for programs and services that serve our elders, such as Meals-on-Wheels. But, some of those elders receiving fewer meals will become malnourished, and as a result might fall, break a hip, require hospitalization Medicaid will have to pay for, not be able to return home, and spend the rest of their lives in a nursing home, that Medicaid will pay for. Even if you only look at that financially, a small short-term gain could well result in a large long-term loss. So think about what, really, is the most cost-effective use of our resources.
Use available expertise. Do you want the best possible information about North Carolina's elderly -- their needs, their challenges, the comparative effectiveness of different proposed solutions and legislative actions? The University of North Carolina's Institute on Aging, comprised of gerontologists from across the UNC system, has a wealth of information, materials, and knowledgeable personnel. Our state Division of Aging and Adult Services continues to impress me with its professionalism and the quality of its materials, analyses and initiatives. The Senior Tarheel Legislature and the state chapter of AARP can provide ideas and information gathered from the local, grass roots level of our state. Our AAOAs work tirelessly to provide and monitor aging-related programs for quality and cost-effectiveness.
See seniors not just as drain-on-state-resources, but also as a valuable resource unto themselves. These people are not "greedy geezers" -- they care, they volunteer, they want to help and give back. The first step toward using them as an asset is to believe that they can be an asset.
Sources for Rosenberg's data: A profile of people age 60 and over: North Carolina, 2012. Raleigh: NC Division of Aging and Adult Services.
A profile of older Americans: 2011. Washington, DC: Administration on Aging.
Urban and rural population by state. (Table 29.) Washington, DC: U. S. Bureau of the Census, 2011.