Housing, economic crises affect seniors’ health; briefing on long-term care

Many of you may have focused on Alzheimer’s disease and AIDS in the past few weeks, with major international conferences on both subjects. If you’re like me, you probably missed other developments on the aging beat while trying to keep up. Here are a few recent reports that may have escaped your attention:

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Health Reform
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Nightmare on Main Street: Older Americans and the Mortgage Market Crisis, from AARP

This is the most comprehensive examination to date at how the housing crisis has affected older Americans. The key findings, as described on AARP’s website:

“As of December 2011, approximately 3.5 million loans of people age 50+ were underwater-meaning homeowners owe more than their home is worth, so they have no equity; 600,000 loans of people age 50+ were in foreclosure, and another 625,000 loans were 90 or more days delinquent. From 2007 to 2011, more than 1.5 million older Americans lost their homes as a result of the mortgage crisis.”

The New York Times was one of the few publications to write about the AARP report. An excerpt from that story highlights the economic insecurity that many older adults are experiencing:

“(O)lder Americans are losing their homes because of pension cuts, rising medical costs, shrinking stock portfolios and falling property values, according to Debra Whitman, AARP’s executive vice president for policy. They are also not saving enough money. Half of households whose head is between 65 and 74 have no money in retirement accounts, according to the Federal Reserve.”

What are the health care implications? Older adults without secure housing are less likely to seek ongoing care and more likely to develop preventable complications from existing conditions as they struggle to keep afloat.

Watch for a tip sheet on the economic status of older adults on the AHCJ website in the months to come.

Securing our Future: Advancing Economic Security for Diverse Elders, from the Diverse Elders Coalition

Another look at the economic crisis and older Americans, this documents the special challenges faced by seniors of African-American, Hispanic, Asian American and Pacific Islander (AAPI) and other heritages. As noted in the introduction, all these groups experience disproportionately high poverty rates:

“Nearly 10 percent of AAPI elders have incomes below the Federal Poverty Thresholds, and one-third of Hmong, one quarter of Cambodian, and 15 percent or more of Laotian, Korean, Vietnamese, and Samoan elders have incomes below the Thresholds, compared to 9 percent of all American elders and 7 percent of non-Hispanic white elders. Similarly, while African American older adults make up only 9 percent of the elderly population, they represent 21 percent of the elderly population living below the Federal Poverty Thresholds. And one out of every six (18 percent) of older Hispanics live in poverty. According to a more nuanced measure of economic well-being, the Senior Financial Stability Index, 52 percent of African American elders and 56 percent of Latino elders are “economically insecure,” meaning they do not have adequate resources to maintain a secure standard of living for the remainder of their lives.

“While there are no public data sources on elder LGBT poverty (a significant problem in and of itself), a study by the Center for Social Policy at the University of Massachusetts Boston found that 24 percent of lesbians and 15 percent of gay and bisexual men have incomes below the Federal Poverty Thresholds, compared to 19 percent and 13 percent of heterosexual women and men, respectively; this disparity is also shown to persist as LGBT people age.”

It’s obvious but still worth noting: when seniors are poor and marginalized, they’re less able to afford medical care and less likely to have access to health care services.

The Diverse Elders Coalition also has launched a blog written by staff from member organizations, including Asociación Nacional Pro Personas Mayores; National Asian Pacific Center on Aging; National Caucus & Center on Black Aged, Inc.; National Hispanic Council on Aging; National Indian Council on Aging; Services and Advocacy for GLBT Elders; and Southeast Asia Resource Action Center.

See AHCJ’s tip sheet on Diversity in Aging, by Paul Kleyman, for more details on this topic.

Assisted Living and Residential Care in the States in 2010, from AARP

This issue brief looks at long-term care facilities other than nursing homes for older adults. The category includes assisted living, adult foster care, boarding homes, adult care homes and other options. It’s a useful overview that highlights trends and data available in another comprehensive AARP report on long-term services and supports for older adults.

Takeaway messages include:

  • Assisted living is expanding, with more than 51,000 facilities reported in 2010, up from more than 38,000 facilities in 2007. (The definition of facilities is broad and encompasses all non-nursing home types of care for people who need assistance with daily activities.)
  • There is significant variation among states in terms of the availability of assisted-living options.
  • Several states are tightening regulations governing assisted living.
  • The federal government plans to enact new regulations that would make assisted living more broadly available through state Medicaid programs.
  • A large number of assisted-living residents (42 percent) have Alzheimer’s disease or some other type of dementia. More than half (54 percent) are 85 years of age or older.

Reporters might want to know what the picture looks like in your community. Are assisted-living centers expanding? If so, what types and in what locations? Do facilities take Medicaid patients or only private pay patients? (Medicare doesn’t pay for assisted living.) What kinds of regulations govern assisted living in your area? Which government agency oversees this type of long-term care facility? What does that oversight consist of? What trends are emerging?

See AHCJ’s tip sheet on Senior Housing, by Richard Peck, for more information and resources on this subject.

Judith GrahamJudith Graham (@judith_graham), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society.

If you have questions or suggestions for future resources on the topic, please send them to judith@healthjournalism.org.

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