OKLAHOMA COUNTY VITAL SIGNS volume 1, edition 5 April 2011
FOSTER NEW OPPORTUNITIES FOR OLDER ADULTS. ENCOURAGE CAREGIVER EDUCATION AND SUPPORT. IMPROVE THE QUALITY OF INDEPENDENT LIVING AND
INFLUENCE THE CONDITION OF ALL.
Independent Living Edition
WHEN ASKED WHAT THE
BIGGEST CONCERN ABOUT RETIREMENT WAS, MORE THAN
A QUARTER OF RESPONDENTS SAID
EVERY 70 SECONDS,
SOMEONE IN AMERICA DEVELOPS ALZHEIMER’S.
SOMEONE WILL DEVELOP THE DISEASE
EVERY 33 SECONDS.35 2
Welcome to the fifth issue of Vital Signs. This issue focuses on some of the challenges faced by older adults, and the need to assist them in remaining independent for as long as possible. For decades, researchers have forecasted the inevitable challenges that will face our nation as the baby boomer generation reaches retirement age. Among other concerns are independent living options, limited incomes, available funds in the Social Security program, health status, the cost and availability of healthcare services, and changes in workforce dynamics as the generation retires. The first of the baby boomer generation turned 65 in 2010. In Oklahoma, that translates to one in eight individuals now at age 65 or older, with over half of those Oklahomans living with some form of disability. Now no longer a forecasted future but instead a current reality, we must respond to this populationâ€™s growing needs, as aging is a circumstance we are all guaranteed to face â€“ both as individuals and as supportive family members. In this issue, we have attempted to address some of the challenges older adults must consider in order to live and thrive independently as long as possible. Undoubtedly, there will come a day when we, or those we care for, will need the information featured in this Vital Signs. With that in mind, we hope the following information will be used as a tool by everyone, especially those members of our community on the verge of retirement and the family members who care for them. If you have comments, please call the United Way staff at 405-523-3532 or send an email to firstname.lastname@example.org. Best regards,
Michael E. Joseph Chair, United Way Research and Community Initiatives Advisory Committee Director, McAfee & Taft
DIAGNOSIS: OKLAHOMA’S POPULATION IS AGING. CURRENTLY, 13 PERCENT OF THE STATE’S POPULATION IS 65 YEARS OF AGE OR OVER.1 BY 2030, NEARLY 20 PERCENT OF THE STATE’S POPULATION WILL BE OVER THE AGE OF 65.1 Who are Oklahoma’s older adults? They include individuals who are surviving on very little income, with one in six households living on a retirement income of $18,000.1 Ten percent are living on income below the federal poverty level, ranking Oklahoma 19th highest in the nation for older adults living in poverty.2 When it comes to saving and planning for retirement, only 36 percent of central Oklahomans ages 66-75 years have completed a “great deal” of planning towards their retirement.3 Similar to the health indicators for the entire state population, older Oklahomans have very poor health indicators, scoring an “F” rating in diagnoses for heart disease, chronic lower respiratory deaths, diabetes, and Alzheimer’s Disease.2 Oklahoma is also ranked eighth in the nation among states with the highest percentage (47 percent) of persons age 65+ who have at least one reported disability.2 Perhaps as a correlation to high rates of poverty and poor health, older Oklahomans rely heavily on public and non-profit aid programs. The Oklahoma Department of Human Services Aging Services Division reports that, in 2010, the network of 17 major Oklahoma older adult service programs reached 400,000 citizens in some service manner.2 The service network provided 18,000 days of adult day health care, two million passenger trips, and over 6 million meals in 2010.2 The living arrangements for older Oklahomans vary from full independence to multi-generational households, with 36 percent being householders who live alone and nearly a quarter living in a household with one or more people age 65 years and over.1 There are more than 75,000 Oklahoma grandparents who currently live with their grandchildren, and of that number, more than half are responsible for raising their grandchildren.1 Nationally, Oklahoma has the third highest percentage (57.2 percent) of grandparents who live with one or more grandchildren under the age of 18 and serve as their primary caregiver.1 This percentage far exceeds the national rate of approximately 42 percent.1
1. U.S. Census Bureau 2. Oklahoma Alliance on Aging 3. United Way of Central Oklahoma 2010 Household Survey
4. US News and World Report 5. Centers for Disease Control and Prevention 6. USA Today
Oklahoma’s older adult and baby boomer scenario mirrors the larger national picture. Nationally, the number of people age 65 and older is expected to more than double by 2050, increasing from 39 million to 89 million. 4 With the average life expectancy for someone living in the United States being 77.9 years5 —and the current expected retirement age being 65 years—individuals would potentially need to support themselves for an average of twelve years post-retirement. However, 41 percent of the lowest-income baby boomers are likely to deplete their financial resources after 10 years of retirement, putting them at risk of not having enough savings for basic needs and medical bills.6 Currently, the official method for determining levels of poverty relies primarily on the cost of food. Using this method, less than 10 percent of the nation’s elderly population lives in poverty. However, an alternative measurement developed by the U.S. Census Bureau, known as the “Supplemental Poverty Measure,” also takes medical and living expenses into consideration when determining poverty.7 When calculating older adult poverty using the supplemental measure, the rate jumps from less than 10 percent to more than 16 percent.7 Faced with meager financial resources, many older adults rely on their Social Security and Medicare benefits. Approximately 89 percent of people age 65 and over live in families with income from Social Security.9 Unfortunately, trustees now believe that the Social Security trust fund will be exhausted by 2037—four years earlier than originally estimated in 2008.10 The Medicare Hospital Trust Fund presents a more urgent cause for concern, with its fund depletion forecasted by 2017.10 Without the financial resources or medical coverage to pay for preventative care or basic medical treatment, older adults should pay greater attention to their personal health and diet. However, while the diets of older adults tend to be rich in nutritious foods such as fruits, dark greens, whole grains, milks, and oils, they are also heavy in saturated fats, sodium, and calories from solid fats, alcoholic beverages, and added sugars.9 This overconsumption of non-nutritional foods, combined with the fact that only 25 percent of adults age 64-75 years report regular physical activity5, helps to explain why 73.8 percent of older adults are overweight or obese.5 When obesity is combined with older age, an individual’s risk of developing Type 2 diabetes is increased—a fact illustrated by the nearly 27 percent of Americans age 65 and older currently living with diabetes.5 Additionally, half of all Americans age 65 and older are considered prediabetic.5 Prediabetes is a condition in which blood sugar levels are above normal but are not considered diabetic.5 Individuals with prediabetes are at greater risk for Type 2 diabetes, heart disease, and stroke.5 The greatest percentage of heart disease diagnoses in the nation is among adults age 65 years and older, affecting more than a quarter of Americans age 65-74 years—half of which are diagnosed with hypertension.5
CREDIT CARD DEBT
FOR ADULTS 65 YEARS AND OLDER
INCREASED BY 26 PERCENT
BETWEEN 2005 AND 2008.8 7. Huffington Post 8. National Council on Aging 9. Federal Interagency Forum on Aging-Related Statistics 10. CNNMoney.com
SENIOR SUMMIT In 2003, United Way of Central Oklahoma and Oklahoma County government held the first Senior Summit to bring attention to senior issues in central Oklahoma. Additional Summit partners included RSVP of Central Oklahoma, Sunbeam Family Services, Areawide Aging Agency, Metropolitan Better Living Center, and the Homeless Alliance. Due in part to discussions at the 2003 Senior Summit, a constitutional amendment11 limiting the fair cash value of a homestead for low-income seniors was approved by Oklahoma voter’s during the 2004 general election. The state constitutional amendment capped the fair cash value, as determined by law, on each homestead whose household income did not exceed the median income for the county (as determined by the U.S. Department of Housing and Urban Development) and whose head of household was 65 years or older. The Summit partners hosted Senior Summits in 2005 and 2008, with Inasmuch Foundation, Oklahoma Department of Human Services, and AARP joining the partnership to sponsor the 2008 “Envision 2020” Senior Summit. Envision 2020 was designed to assist central Oklahoma’s seniors in articulating what services were needed to make the community senior friendly. Attendees included individuals who had recently retired or who planned to retire in the next few years. They participated in breakout sessions and voted on the best ideas at the end of each session. The participants voted on their top priorities, which are discussed below: Where and how do people want to live? Regardless of where they lived or what their income was, participants needed a wide variety of home-delivered goods and services. They also wanted more options in terms of universal home design and community living design. They wanted to live in communities with parks, sidewalks, walking and bike trails. What would an ideal community have in terms of leisure and volunteer activities and work opportunities? Above all else, participants wanted access to a variety of information—volunteer opportunities, senior services, cultural activities, work opportunities—in a variety of media formats. In regards to work, many participants needed to continue working out of financial necessity, but wanted to work under more flexible terms and serve as mentors to new employees. What can we do to meet your transportation needs? The participants wanted more collaboration among transportation entities, paired with innovative ideas about the current transportation system. They wanted handicap accessible, affordable, door-to-door transportation options. They agreed that public transportation could only be part of the solution based on Oklahoma City’s wide geographical area.
11. State of Oklahoma Constitution
What are some of your deepest concerns regarding the next stages of your life? Fundamentally, the participants needed to be vital, involved, and self-sufficient for as long as possible. They needed to feel secure, financially and physically. They needed communication and stability within their families. Finally, they wanted to see an organized plan involving a variety of public and private entities to address these needs community-wide. What needs could be met with improvements in technology? The participants expressed a desire to not only be aware of new technology, but also be able to master new technological advances. They suggested classes at Vo-Techs, libraries, and community centers, as well as a directory to capture all the available learning opportunities. In December 2009, voters approved MAPS 3, a seven-year, nine-month, one-cent sales tax initiative that began on April 1, 2010 to improve the quality of life in Oklahoma City. As part of the MAPS 3 plan, $50 million will be spent on developing four to five health and wellness aquatic centers for active seniors. Each center will reflect the unique needs of its surrounding senior community. The MAPS 3 plan also includes $10 million for 70 miles of sidewalks to connect public buildings and make major streets pedestrian-friendly. An additional $40 million is allocated for 50 new miles of walking, bicycling, and running trails at the Oklahoma River, Lake Overholser, Lake Stanley Draper, and Lake Hefner. View the Envision 2020 Senior Summit report on United Wayâ€™s website at http://www.unitedwayokc.org/ learn/independentliving/seniorsummit
RETIRING WITH DEBT, RESORTING TO BANKRUPTCY Many older adults are retiring with debt and incomes that cannot meet their financial needs. The nonprofit CESI Debt Solutions12 conducted a national survey on retirement and debt in June 2010. Of the retired respondents, 37 percent retired before age 55, and 37 percent retired between 50 and 60.12 Only 26 percent retired between ages 60-70 – the age range when “full retirement age” or “normal retirement age” occurs for most benefit packages and Social Security – and zero of the respondents retired after age 70.12 Age at retirement can play a significant role in sustaining a livable income and avoiding debt. If older adults waited until age 66 to retire, their monthly Social Security check would be 25 percent more than if they retire at 62.13 If they waited until age 70 to retire, their check would be 75-80 percent more than at age 62.13
Nothing Saved 9%
$0-$9,999 Saved $10,000-$49,999 Saved $50,000-$99,999 Saved $100,000+ Saved
When respondents were asked if they had delayed retirement at all because of outstanding debt, an overwhelming 96 percent said no.12 With that percentage in mind, it is not surprising that the fastest growing age demographic in bankruptcy filings is age 65 and over.14 There are several reasons why older adults may resort to bankruptcy. Many rely on their Social Security income, which has not had a cost-of-living adjustment since 2008.15 Others depend on pension and retirement accounts that were affected during the recession.13 Medical expenses, such as long-term care costs and out-of-pocket expenses, also take a toll on their already diminished financial resources.13
The Social Security Retirement Estimator provides estimates based on a person’s actual Social Security earnings record. Actual benefits will vary slightly because Social Security records are continuously updated, the estimate includes assumptions about individual’s careers and income, and actual benefits include future inflation. http://www.socialsecurity.gov/estimator/
12. CESI Debt Solutions 13. The Oklahoman 14. Pottow, John
15. Social Security Administration
When faced with borrowing money from family members or living on credit, a large number of older adults are choosing the latter option. Unfortunately, 67 percent of elder bankruptcy filers cite credit cards—and the fees and interest rates associated with them—as the reason why they went bankrupt.14 Using data from the Consumer Bankruptcy Project (CBP), researcher John Pottow offers four possible reasons14 why older adults turn to credit cards: • • • •
Cognitive or other mental frailties. Simply put, many older adults are taken advantage of by limited time offers and small print provisions when applying for credit cards. Covering. Elder borrowers can live off credit and accrue a high balance in relative secrecy, without their friends and families knowing. Isolation. Either socially or financially, older adults may rely on credit cards as a last resort simply because they do not have access to other types of credit. Strategy. Compared to their younger counterparts, older adults may have a better understanding of how bankruptcy works and realize they can accrue extravagant credit card expenses and erase them later by filing for bankruptcy. However, this reason is the most uncommon of the four.
Another leading reason for elder bankruptcies is medical expenses.14 Of the older adult respondents to the CBP survey, 59 percent said they changed their lifestyles prior to filing bankruptcy in order to afford their medical expenses.14 When asked specifically if medical reasons led to bankruptcy, 39 percent of older respondents said yes.14 Thirty percent of the older adult filers also said they spent more than $5,000 or 10 percent of their annual household income on out-of-pocket medical bills.14 With the threat of diminishing savings, mounting debt and bankruptcy, many older adults are returning to work after a few years of retirement. In July 2010, the number of older adults who were out of the workforce and expressed an interest in returning to work was 66 percent higher than it was at the start of the recession in 2007.16
For those older Oklahomans who are struggling with debt and considering bankruptcy, Consumer Credit Counseling Service of Central Oklahoma17 is available to provide confidential budget and debt counseling, assist with the creation of a debt management plan, and help those who have experienced financial hardships previously make wiser money management choices.
16. American Association of Retired People (AARP) 17. Consumer Credit Counseling Service of Central Oklahoma
Executive Director, Rebuilding Together OKC, Inc.
Independence is precious. It provides the freedom to go and do as you please and take care of yourself. There are low-income seniors in our community fighting to maintain their independence every day. Regardless of their home’s condition, 89 percent of our elder adults prefer to stay in their homes. Some are battling health issues, some financial – some both. One in eight Oklahomans is age 65 years and over.1 By 2030, it is projected that one in three Oklahomans will be at least 65.1 Nationally, the fastest growing segment with the greatest likelihood of living in poverty is age 85 and older.9 Keeping people in their homes is gaining steam nationally as baby boomers hit retirement and life expectancies continue to rise. A baby boomer turns 50 every 7.5 seconds.5 Those turning 50 today have half of their adult lives ahead of them and many are outliving their savings. According to the National Governors Association, the average American will have saved about $30,000 for retirement.18 Per a 2009 MetLife Survey19, the average cost for one year in a nursing home was $79,935, the average annual cost of assisted living was $37,572, and the alternative home health aide rate was $21 per hour. Rebuilding Together helps by serving those who simply cannot afford to make critical home repairs and modifications. Formerly Christmas in April, our name changed in 2001 to Rebuilding Together because it isn’t just one Saturday a year anymore. We became increasingly aware that while a one day volunteer-driven blitz is still of great value, there are things we can do throughout the year that make a significant impact. We are constantly reminded of what many of us take for granted – heat, roofs that don’t leak, stable floors, functional windows and doors, and running water. We realize that many of us overlook the challenges of aging in place – daily activities like bathing, cooking, turning knobs, reaching cabinets, getting up and down steps, and maneuvering throughout a home with a walker - or perhaps simply being able to get in and out of your home if wheelchair bound. Because these challenges are commonly overlooked, we felt led to provide assistance with all of the above year-round. Our clients are mostly widows with an average age of 72 and average income of $1,100 per month. Some survive on as little as $500 per month. They have typically been in their homes 20+ years and many raised their families there. It is difficult to choose between food and medicine or home repairs. Among our clients is a double amputee who crawled into the bathroom on his knees - the door wasn’t wide enough to accommodate his wheelchair. Another fell getting out of the bathtub and laid there for six hours before someone found her. There are many stories to tell, but suffice to say some repairs can be simple, others not. We owe our seniors the ability to remain independent and remain in the homes they provided for so many of us. We believe all people deserve to age with grace and dignity.
18. National Governors Association 19. MetLife
HOUSING A variety of housing options exist today for older adults and individuals with disabilities, offering a break from the one-size-fits-all housing option of yesterday. Whether individuals are interested in community-based services, home care, assisted living facilities, or nursing homes, central Oklahoma has numerous older adult housing opportunities to choose from.
AGING IN PLACE For most older adults, remaining in their home—oftentimes referred to as “aging in place”—is the most affordable and convenient option. Thankfully several central Oklahoma organizations are available to help older adults remain in their homes. There is a concept in homebuilding called “universal design.”16 Simply put, universal design means that, at the time a home is built, it is designed in such a way that it remains “livable” for a much greater portion of a person’s lifetime. The design concept utilizes features that provide ease of mobility and navigation at any stage of life, such as: wider doorways and hallways, single level rooms, elimination of stairs at the entrance, lever door handles, and more practical counter and cabinet space. Other common features16 of universal design include: • Higher electrical outlets • Lower light switches • Kitchen with side-opening ovens • Bathrooms with wheelchair accessible showers • Full extension drawers • Pullout shelves • Bathroom counters with knee space underneath • Toilets at chair height with maneuverability space and access • Front loading washers and dryers • Lower level microwave for easier access • Cabinets with magnetic catches that open when pressed • Single lever faucets
For those living in an existing home, there are various modifications16 that can be made to make the home more livable, such as: • Wheelchair ramps • D-shaped handles rather than knobs on cabinet doors • Clutter elimination • Good lighting, including nightlights throughout the house • Handrails in hallways and wherever steps are present • Non skid mats inside and outside the bath/shower • Handheld, flexible shower heads and a bath/shower chair • Raised toilet seat extender • Grab bars in bathroom and shower Depending on one’s physical abilities or disabilities, their home may require modifications or repairs that they themselves are unable to do. At Rebuilding Together OKC20, the sole purpose is to keep seniors in their homes and allow them to age in place. In doing so, they utilize thousands of volunteers, in-kind materials, and donations to make repairs and modifications to the homes of lowincome, elderly homeowners in the Oklahoma City metro area. Sunbeam Family Services21 provides a Senior Companion Program with trained volunteers who visit individuals in their homes each week to provide companionship, support, and assistance with necessary daily activities that allow them to remain in their home for as long as possible. Results from a 2009 survey showed that 100 percent of those homebound seniors surveyed felt less isolated and lonely as a result of the regular visits by their Senior Companion volunteer. As a result of their senior companion visits, 94 percent of Sunbeam’s older adult clients were able to remain in their own home.21 RSVP of Central Oklahoma22 provides Telephone Buddies to vulnerable elderly citizens, ensuring daily contact with the outside world. Telephone Buddies make regularly scheduled phone calls to check on the individual’s physical and mental health, provide companionship, link them with community resources, and verify that their basic human needs are being met.
20. Rebuilding Together OKC 21. Sunbeam Family Services 22. RSVP of Central Oklahoma
INFORMAL CAREGIVERS For other adults, 24/7 care and assistance may be necessary, but assisted living centers may not be desirable or affordable. In these situations they may move in with a loved one, who in turn will provide continual care. Commonly referred to as â€œinformal caregivers,â€? adult children and relatives provide 75 to 80 percent of all long-term care in the United States. 4 Sunbeam Family Services21 provides a comprehensive training course called Caregivers Fundamentals. The Caregivers Fundamentals program offers resource assistance, caregiver education, counseling, caregiver support, and free respite care when caregivers need a brief break from their caregiver responsibilities. Many caregivers who need to continue working turn to adult day care services for assistance and peace of mind. Adult day care services provide assistance through a variety of services in a safe and supportive environment. One such organization, Daily Living Centers23, aims to deter premature placement in nursing facilities by providing a safe environment for adult day health care services, such
MORE THAN 19 MILLION AMERICANS
CARE FOR SOMEONE
OVER THE AGE OF 75.4
23. Daily Living Centers 24. Metropolitan Better Living Center
as therapeutic exercise, medication administration and health monitoring, educational activities, meals, and social activities that include bingo, weaving, dancing, and oil painting. Daily Living Centers also partners with Grace Living Center in Bethany to provide 24 hour respite care for caregivers, allowing them to travel for short periods of time while also maintaining their loved oneâ€™s normal routine. Another central Oklahoma organization, Metropolitan Better Living Center24, offers therapeutic, health, and social services to the aged, aging, and developmentally disabled, as well as respite care for their loved ones. The Center also provides exercise and therapy programs that include endurance, strengthening, stretching and balancing exercises to help build muscle and improve balance and flexibility. Through their memory enhancement program, memory skills and cognitive training procedures are utilized to improve short and long term memory capabilities. The Center also uses sing-alongs, dancing, and story-telling as tools to share memories and promote inter-generational socialization.
ASSISTED LIVING Assisted living communities generally strive to nurture their residentsâ€™ independence by offering minimal, as-needed assistance and promoting personal choices for social, healthy lifestyles. In an assisted living community, individuals may be permitted to bring their own furnishings and decorate their rooms according to their tastes. Assisted living centers commonly provide transportation for residents to medical, social, and religious activities, as well as offer daily organized social activities on-site. In northeast Oklahoma City the Urban League of Greater Oklahoma City25 built a 60-unit senior residence, Mt. Olive Senior Cottages. Available to individuals 62 years and older with qualifying incomes, Mt. Olive features one or two-bedroom independent living facilities at rates of $483-587 per month with utilities included.25 Mt. Olive also includes a washer and dryer in each unit, a clubhouse with fitness facilities, walking paths, gardening opportunities, on-site computers, and adaptable units for individuals with disabilities. Urban League also provides activities, transportation, nutrition classes, medical consultations, and budgeting/ credit counseling classes at Mt. Olive. Temple Gardens Senior Apartments is another affordable housing option in northeast Oklahoma City for low-income adults age 62 and older.27 Much of the natural landscaping was preserved during the construction of Temple Gardens to help blend the apartment community into the local neighborhood. In addition to its pleasant surroundings, residents of Temple Gardens enjoy natural lighting throughout their kitchen and dining areas, as well as large common areas for socializing.28 Temple Gardens also provides residents with on-site health screenings and education events.
THE AVERAGE COST OF ASSISTED LIVING IN OKLAHOMA IS
AT LEAST $2,200 PER MONTH.26
25. Urban League of Greater Oklahoma City 26. Oklahoma Assisted Living Association 27. Oklahoma Housing Finance Authority 28. Kenyon Morgan Architects
NURSING HOMES When and if an adult requires the services of a nursing home, they and their family members have the ability to research the quality of available homes based on criteria such as health inspection ratings, nursing home staff data, and fire safety inspection results. Search options include: Nursing Home Compare: This tool has detailed information about every Medicare and Medicaid certified nursing home in the country. www.Medicare.gov/nhcompare Oklahoma Nursing Home Compare: This tool allows the Oklahoma Health Care Authority and the Oklahoma Department of Health to work with nursing homes to provide quality long-term care facilities for Oklahomans. www.oknursinghomeratings.com Member of the Family: This tool provides information about 16,000 Medicare and Medicaid certified nursing homes in the United States. Also available is the National Watch List of homes recently cited for violations, as well as an Honor Roll of facilities found to be deficiency-free. www.memberofthefamily.net Assisted Senior Living: This tool is a compilation of federal, state and public information on more than 70,000 senior living options. www.assistedseniorliving.net
EMERGING SENIOR LIVING HOUSING OPTIONS Several years ago U.S. News and World Report published an issue entitled, “Taking Care of Mom and Dad: A Boomer’s Guide.”4 The publication presented several housing options, two of which are discussed below. Senior Livable Communities A senior livable community is an emerging concept that unites independent living, assisted living, and nursing home services on one campus. In some cases, such as in Beacon Hill, Massachusetts, neighborhoods adopt an annual dues system to cover a wide-range of services for residents over age 50. Services include a weekly ride to the grocery store and doctor appointments. In New York, social workers, health professionals, and other necessary social services are brought directly to “naturally occurring” retirement communities, such as apartment complexes or neighborhoods.
Senior Cohousing In Davis, California, a group of longtime friends created Glacier Circle, the first elder cohousing community in the country. At Glacier Circle, residents own their apartment or townhome, all of which are attached and wheelchair accessible, as well as a portion of a common building with a kitchen, dining and living room, and an apartment for a housekeeper. Together, the residents share chores and maintenance expenses. They are free to cook meals in their own home, or share a meal in the common building a few times each week. As a result of Glacier Circle’s success, other groups across the nation started their own cohousing communities, including one in Oklahoma. Read more about Oklahoma’s first cohousing community, OakCreek, in Stillwater, OK at www.oakcreekstillwater.com or other elder/senior cohousing communities at www.cohousing.org
TRANSPORTATION Due to the extent of Oklahoma City’s urban sprawl, public transportation may be central Oklahoma’s biggest challenge. The Oklahoma City metropolitan area spans eight counties, with Oklahoma City proper being roughly 621 square miles in size.29 The METRO Transit bus system covers 465 miles of the metropolitan area31, which means roughly 75 percent of Oklahoma City receives mass transit services. Regardless of transit coverage, many individuals are incapable of reaching a bus stop due to physical limitations, distance, and street traffic barriers. Additionally, 40 percent of Oklahoma’s older adult population live in rural households2, placing them beyond the limits of traditional mass transit services. In 2001, the Central Oklahoma Transportation and Parking Authority (COTPA) analyzed the state of Oklahoma City’s transportation needs and produced multiple recommendations for a long-range transit service plan30, including the need to augment public transportation services for older adults and individuals with disabilities as both populations approached historical increases. Currently, METRO Transit offers “Share-a-Fare” and METRO Lift services31 for older adults and individuals with disabilities to help them maintain independence by arranging personalized transportation. A report by the Surface Transportation Policy Project (STPP), “Aging Americans: Stranded without Options32,”provides insights into the transportation realities for older adults. Using data from the National Household Transportation Survey, as conducted by the Federal Highway Administration, the STPP team determined: • More than one in five Americans (21 percent) age 65 years and older do not drive, either because of declining physical or mental abilities, a concern for personal safety, or because they lack access to a vehicle. • More than 50 percent of non-drivers age 65 years and older stay home on any given day partially because they lack transportation options. Populations affected more than others include rural communities and sprawling suburbs, households without a car, and older African-Americans, Latinos, and Asian-Americans. • Older non-drivers have a decreased ability to participate in the community and economy. Compared with older drivers, older non-drivers make 15 percent fewer trips to the doctor, 59 percent fewer shopping trips and visits to restaurants, and 65 percent fewer trips to social, family, and religious activities.
29. City of Oklahoma City 30. Central Oklahoma Transportation and Parking Authority 31. METRO Transit
32. Surface Transportation Policy Partnership
In order for older adults to remain independent, they must be able to travel to the grocery store, pharmacy, doctorâ€™s office, and regular social activities that promote continued interaction with others. In lieu of farreaching and readily available mass transit services, central Oklahomans turn to community organizations such as RSVP of Central Oklahoma and the Salvation Army for transportation assistance. RSVP of Central Oklahoma33 links volunteers age 55 and older with essential community needs throughout central Oklahoma. RSVP volunteers are happy to meet the transportation needs of low-to-moderate income seniors through the â€œProvide-A-Rideâ€? program, using their personal vehicles to drive seniors to medical appointments. In addition to companionship and a sense of usefulness, RSVP volunteers receive mileage reimbursement and free accident/liability insurance coverage while on volunteer assignments. The Salvation Army Senior Services program34 provides handicapped accessible transportation to meal sites and grocery, clothing, and prescription shopping. Salvation Army provides senior centers for meals and activities five days per week, as well as meal home delivery and senior adult special events.
33. RSVP of Central Oklahoma 34. Salvation Army Oklahoma City Command
HEALTH In October 2010, the Centers for Disease Control and Prevention declared Alzheimer’s the sixth-leading cause of death in America, placing it ahead of diabetes.5 Of the 5.3 million Americans currently diagnosed with the disease, 74,000 live in Oklahoma.35 Alzheimer’s can be financially, physically and emotionally draining, which is why knowledge—about the disease, warning signs and where to find support—is especially important. Ten Warning Signs of Alzheimer’s35 1. Memory loss that disrupts daily life. Forgetting recently learned information is one of the most common early signs of dementia. 2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps to place a telephone call. 3. Problems with language. People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. 4. Disorientation to time and place. People with Alzheimer’s disease can become lost in their own neighborhoods, forget where they are and how they got there, and not know how to get back home. 5. Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately, wearing several layers on a warm day or little clothing in the cold. 6. Problems with abstract thinking. Someone with Alzheimer’s disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are and how they should be used. 7. Misplacing things. A person with Alzheimer’s disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl. 8. Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid mood swings—from calm to tears to anger—for no apparent reason. 9. Changes in personality. The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful, or dependent on a family member. 10. Loss of initiative. A person with Alzheimer’s disease may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities. For more information about Alzheimer’s/dementia, please contact the Oklahoma and Arkansas Chapter of the Alzheimer’s Association: 6465 South Yale, Suite 312 Tulsa, OK 74136-7810 Phone 918.481.7741 24/7 Helpline: 800.272.3900 FAMILY CAREGIVERS IN http://www.alz.org/alzokar/
IN 2009, THERE WERE 126,673 ALZHEIMER’S/DEMENTIA
OKLAHOMA WHO PROVIDED
WORTH OF UNPAID CARE.35 35. Alzheimer’s Association, Oklahoma and Arkansas Chapter
For older adults, falls and the injuries associated with falling can be life changing. According to the Centers for Disease Control5, falls are the leading cause of injury death for adults age 65 and older. Falls are also the most common cause of nonfatal injuries and trauma requiring hospital admission.5 In 2009, 2.2 million older adults received emergency medical treatment for nonfatal fall injuries.5 With 20 to 30 percent of people who fall suffering injuries such as lacerations, hip fractures, and head traumas, it is not surprising that their injuries can limit their mobility and independence. Even individuals who fall without suffering any injuries may develop a fear of falling and subsequently limit their activities, leading to a decrease in physical fitness—a decision that actually increases their risk of falling.5 There are several proactive steps5 older adults can take to reduce their risk of falling, including: • Exercise regularly • • • • •
Review medications with a doctor or pharmacist to reduce side effects and interactions that may cause dizziness or drowsiness Have annual eye exams Reduce tripping hazards in the home, add grab bars and railings, and improve interior lighting Maintain a diet that provides adequate calcium and vitamin D Get screened and treated for osteoporosis
ONE IN EVERY THREE ADULTS AGE 65 AND OLDER
36. Oregon Research Institute, Promoting Physical Activity Across the Life Span
One way to gain better balance and reduce fall potential is through regular exercise, and the practice of tai chi is gaining in popularity as one of the most effective methods. The Oregon Research Institute’s36 Tai-Chi: Moving for Better Balance program has proven to improve balance, improve physical performance, and reduce falls by as much as 55 percent. Locally, free tai chi classes are offered to the public at several locations, including the following: Metro Technology Center Springlake Campus (1900 Springlake Drive, Oklahoma City, OK): Wednesdays and Fridays from 11:30 am – 12:30 pm in the Business Conference Center. Call 595-4486 for details. St. Luke’s United Methodist Church (222 NW 15th Street, Oklahoma City, OK): Wednesday evenings from 6:30 – 7:30 pm. Call 232-1371 for details. First Unitarian Church (600 NW 13th Street, Oklahoma City, OK): Saturday mornings at 8:30 am. Call 232-9224 for details. The Lincoln Park Senior Center 37 provides older adults with opportunities to socialize, stay fit, and eat a healthy lunchtime meal. Operated by the YMCA of Greater Oklahoma City through a partnership with the City of Oklahoma City, the Center’s daily activities include walking, chair aerobics, dominoes, ceramics and sewing classes. The Center also provides transportation to activities for adults age 60 and over.
36. Oregon Research Institute 37. YMCA of Greater Oklahoma City 38. PEW Research Center
For: For: Addressing:
Action Improved Quality of Independe nt Living
There are multiple recommendatio ns to help everyone – regardless of age or perspective – address the inev challenges that Oklahoma will face itable as the baby boomer generation reac hes retirement age. For individuals approaching retirem ent: Anyone thinking about retirem ent should consider their age at reti and how it will affect their monthly rement Social Securit y benefit income. At the sam e time , they should review any outstanding debts and the combine d total of their savings and retirem ent accounts. For individuals already in retirement: It is essential that retirees maintai n a healthy, active lifestyle. Light such as walking or tai chi classes, exercise, will help ensure continued mobility and sus tain ed ene rgy levels. Healthy diets that include dark greens, whole grai ns, and fruits while avoiding saturate d fats , sod ium , and added sugars are also encouraged. Engagement in soc ial activities, such as volunteer opp ortu nities with local organizations and schools, will help individuals remain involved in their local communities . For architects, contractors, and hom e builders: Architectural firms and construction companies should con staf f positions that are solely focu sider sed on developing and implementi ng universal design concepts in new construction projects. Additionally , companies should encourage trai ning opportunities to educate staf universal design modifications for f on existing structures. For companies with older employe es and employees approaching reti rement: Companies undoubtedly ben from the skill sets and knowledge efit of employees who have been in the workforce for 35-40 years. Therefo employers should consider adoptin re, g policies that enable older employe es to remain in the workforce long as flexible scheduling and shorter er, such work days. When employees are read y, com pan ies sho uld also consider the option of a gradual reduction in wor k hours to help individuals ease into retirement. For individuals who are currently cari ng for someone or who will one day serve as a caregiver: Caregivers sho thoroughly evaluate all possible hou uld sing and assistance options and ava ilab le care give r sup por t programs to ensure the greatest level of care and independence for their loved ones. Communication and mutual respect key elements for a successful care are plan. Of the 60 Par tner Agencies currentl y funded by United Way of Central Oklahoma, more than one-third pro services for central Oklahoma’s sen vide ior adults. Many are mentioned thro ughout this issue of Vital Signs and resources is provided on United Way a list of of Central Oklahoma’s website at ww w.unitedwayokc.org/agency-direc tory For additional information on specific services, individuals are urged to contact local organizations or United of Central Oklahoma. Through con Way tinued communication and collabo rati on, our community can and will effe positive change to benefit central ct Oklahoma’s older adults.
COMMITTEE MEMBERS Research and Community Initiatives Advisory Michael E. Joseph, Chair Successful Kids Ms. Allison Loeffler Dr. Carol Hardeman Ms. Lonnetta Smith Strong Families Mr. Chad Wilkerson Mr. Craig Knutson Mr. Jim Buchanan Mr. Steve Shepelwich Mr. Michael Davis Ms. D.J. Thompson Mr. Bill Robinson Healthy Citizens Ms. Bev Binkowski Mr. Jon Lowry Ms. Jackie Jones Ms. Mary Anne McCaffree, M.D. Ms. Linda Larason Independent Living Mr. Jim Roth Mr. Cordell Brown Ms. Christi Jernigan Dr. Doug Reed Ms. Deborah Copeland Community Preparedness Dr. Nancy Anthony Mr. Doug Rex At Large Ms. Jane Abraham Mr. Drew Dugan Mr. James Elder Mr. Steve Kreidler Mr. Perry Sneed Mr. Tim TallChief Mr. Robert Toler Mr. Tim Oâ€™Connor
STAFF MEMBERS Debby Hampton Blair Schoeb Ashleigh Sorrell Rose Katy Bergman
BIBLIOGRAPHY American Association of Retired People (AARP) (2009, September 30). What Is Universal Design? http://www.aarp.org/ Associated Press. (2010, December 28). Baby boomers face retirement worries. The Oklahoman, pp.1B, 6B. CESI Debt Solutions (2010, November). National Retirement and Credit Card Debt Survey. Results retrieved from http://cesidebtsolutions.org/blog/?p=540 Centers for Disease Control and Prevention (2011, January). Number of Americans with Diabetes Rises to Nearly 26 Million. CDC Division of News and Electronic Media Press Release. http://www.cdc.gov/media/releases/ Centers for Disease Control and Prevention (2010, August). Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009. Series 10: Data from National Health Interview Survey No. 24. Retrieved from http://www.cdc.gov/nchs/data/series/sr_10/sr10_249.pdf Centers for Disease Control and Prevention (2008). Overweight/obesity, ages 20+: US, 1988-2008. Retrieved from Health Data Interactive via http://www.cdc.gov/nchs/hdi.htm Centers for Disease Control and Prevention (2008). Physical Activity, ages 18+: US, 1997- 2008. Retrieved from Health Data Interactive via http://www.cdc.gov/nchs/hdi.htm Centers for Disease Control and Prevention (2007). FastStats: Life expectancy. Retrieved from http://www.cdc.gov/nchs/fastats/lifexpec.htm Centers for Disease Control and Prevention (n.d.). Audience Insight: Boomers. http://www.cdc.gov/healthmarketing/pdf/ AudienceInsight_boomers.pdf Central Oklahoma Transportation and Parking Authority (2001). Long- Range Transit Service Plan. http://gometro.publishpath.com/reports-studies Consumer Credit Counseling Service of Central Oklahoma (2011). Home Page. http://www.cccsok.org/ Daily Living Centers (2011). Home Page. http://www.dailylivingcenters.org/ Delaney, A. (2011, January 13). Elderly Poverty Jumps According To Census Bureau's Alternative Research Measurement. The Huffington Post. http://www.huffingtonpost.com/ Dugas, C. (2010, August 11). Boomers wanting to work past retirement age find limited options. USA Today. http://www.usatoday.com/money/ Federal Interagency Forum on Aging-Related Statistics (2010). Older Americans 2010: Key Indicators of Well-Being. Retrieved from http://www.agingstats.gov/ Federal Interagency Forum on Aging-Related Statistics (2000). Older Americans 2000: Key Indicators of Well-Being. Retrieved from http://www.agingstats.gov/ Fried, M. (2010). Alzheimerâ€™s Association, Oklahoma and Arkansas Chapter. http://www.alz.org/alzokar/
BIBLIOGRAPHY CONTINUED Johnson, K and Wilson, K. (2010, January). Current Economic Status of Older Adults in the United States: A Demographic Analysis. National Council on Aging. http://www.ncoa.org/assets/files/pdf/ Kempthorne, D. (2004). Confronting America’s Aging Crisis. National Governor’s Association. Kenyon Morgan Architects (2011). Affordable Senior Facilities: Temple Gardens. http://www.kenyonmorganarchitects.com/ Larson, C. (2006, November 27). Taking Care of your parents: A guide to making the wisest senior-living choice. U.S. News and World Report, pp. 61-66. MetLife (2009). The 2009 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs. MetLife Mature Market Institute. http://www.metlife.com/mmi/research/09-market-survey.html Metropolitan Better Living Center (2011). Home Page. http://www.metropolitanbetterliving.com/ Oklahoma Assisted Living Association (2011). Home Page. http://www.okala.org/ Oklahoma City, City of (2010). About Oklahoma City. http://www.okc.gov/about/index.html Oklahoma City, City of (2010). Transit Services. http://www.okc.gov/transit/index.html Oklahoma Housing Finance Authority (OHFA) (2007). Senior Apartments in Oklahoma City Recognized by Oklahoma Housing Finance Agency with Apex Award. OHFA Press Release. http://www.ohfa.org/ Oklahoma State Constitution (2005). Limit on fair cash value on homestead. O.S. §. Article 10 Section 8C. Retrieved from http://www.oscn.net/ Oklahoma Department of Human Services Aging Services Division (2010, September). OKDHS Aging Services Division: Going beyond just core services. Presented at the September 2010 OKDHS Commission Retreat by Lance Robertson, State Aging Director. Presentation retrieved from http://www.okallianceonaging.org/ PEW Research Center (2011). The Databank Daily Number. http://pewresearch.org/databank/dailynumber/ Pottow, J. (2010, August 31). The Rise in Elder Bankruptcy Filings and Failure of U.S. Bankruptcy Law. University of Michigan Law & Economics, Empirical Legal Studies Center Paper No. 10-015. University of Michigan Public Law Working Paper No. 210. Retrieved from http://ssrn.com/abstract=1669298 RSVP of Central Oklahoma (2011). Home Page. http://rsvpokc.cavemanwebsites.com/ Rebuilding Together OKC (2011). Home Page. http://www.rebuildingtogetherokc.org/ Rix, S. (2010, August). The Employment Situation, July 2010: Little Changed Since June. American Association of Retired People (AARP) Public Policy Institute. http://www.aarp.org/ Sahadi, J. (2009, May 12). Recession hits Social Security hard. CNN Money. http://money.cnn.com/ Social Security Administration (2011). Information about 2011 Social Security Cost-of-Living Adjustment. http://www.ssa.gov/cola/ Sunbeam Family Services (2011). Home Page. http://sunbeamfamilyservices.org/ United States Census Bureau (2011). 2005-2009 American Community Survey 5-Year Estimates, Oklahoma. Retrieved from http://factfinder.census.gov/ United States Census Bureau (2003). Grandparents Living with Grandchildren: 2000. Census 2000 Brief. Retrieved from http://www.census.gov/prod/2003pubs/c2kbr-31.pdf United Way of Central Oklahoma (2010). Quality of Life Household Survey. Survey conducted via phone by Cole Hargrave Snodgrass and Associates, September 7-13, 2010. Urban League of Greater Oklahoma City (2011). Home Page. http://www.urbanleagueok.org/
BABY BOOMERS WILL
TURN 65 EVERY DAY FOR THE NEXT
United Way of Cent ral Oklahoma P.O. Box 837 Oklahoma City, Okla homa 73101 www.unitedwayokc.o rg 405 -236-8441
Vital Signs is a publication of United Way of Central Oklahoma. For questions or comments, please contact Blair Schoeb, Sr. Vice President, email@example.com or Ashleigh Sorrell Rose, Director of Research, firstname.lastname@example.org.
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Published on Apr 26, 2011