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Welcome“Aging in Place on Cape Cod”

Informational Meeting For The Community

January 23, 2007

Presented by:

Senior Mobility Initiative on Cape Cod (SMICC)

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Tonight’s PresentationWill include a science-based prediction of the future senior/elder population of Cape Cod—will include a demographic profile of the future population, with particular emphasis on the physical,

mental, and well-being characteristics of our seniors/elders that contribute

to a safe and appropriate aging in place environment and, ultimately to

their quality of life and longevity.

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AnnouncementsFUTURE-Oriented Presentation

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Informative Materials – Brochures Information about SMICC

SMICC:

Independent, Non-Affiliated, Grassroots

Goals: Research, Education, Advocacy

Information about our Sponsor (FCII)* * * * *

Simple Ground Rules!

Introducing our “Timekeeper”

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Introduce Yourself . . . please

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Independence!

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Changes Related To Aging“Physical [and Mental] changes:

• Decreased mobility and dexterity

• Decreased strength and stamina

• Reduced sensory acuity: vision, hearing, thermal sensitivity, touch, smell

• [Decreased mental acuity and abilities]

Social changes:• Isolation from friends and family:

• Due to loss of peers

• From children living far away

• Changing neighborhood.”[1]

1. Source: “Resource For Aging In Place,” www.seniorresource.com/ageinpl.htm

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Aging in Place

“Aging in place is growing older without having to move.”[1]

“Some 70% of seniors spend the rest of their life in the place where they celebrated their 65th birthday.”[1]

1. Source: “Resource For Aging In Place,” www.seniorresource.com/ageinpl.htm

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Social Isolation

“With age, sociologic changes occur between aging individuals and family and friends due to loss of peers and contemporaries - - spouse, siblings, other relatives, old friends and neighbors. This can lead to isolation unless a concerted effort is made to stay socially active.”1 Getting out and about in one’s neighborhood and in the community is the primary way of overcoming social isolation. [underline

added for emphasis]

1. Source: “Understanding Aging, ‘Birds who fly faster, live longer’,” seniorresource.com web site.

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Aging in Place

“While…[the] population of elderly require help with tasks such as cleaning, shopping, and

preparing meals, as well as activities of daily living such as bathing, dressing, eating and moving from bed to chair, their care can often be provided

at home

from the community”[1]

[underline added for emphasis]

1. Source: “Aging in Place: Findings from the Grantmakers In Health Resource Center,” Grantmakers In Health, www.gih.org

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Some Aging in Place Statistics

CURRENTLY:

70%-80% of 65+ currently “aging in place” (At least 38,000 on Cape)

FUTURE:

90% of “Baby Boomers” plan to “age in place” (Would mean about

70,000 on Cape by 2015, 100,000 by 2025,. . . . )

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Predicted Number of Persons Age 65+ "Aging in Place" on Cape Cod

Years 2005 - 2035

115,915

60,850

47,400

41,230

75,700

94,600

108,625

40,000

50,000

60,000

70,000

80,000

90,000

100,000

110,000

120,000

1 2 3 4 5 6 7

YEAR

2005 203520302025202020152010

Today

+ 20 Years

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Who is Involved?

• Home health care providers

• Police, Fire-Rescue-Ambulance

• Councils on Aging

• Home maintenance professionals

• Transportation services

• Elder law specialists

• Government officials–-Town, County

• Occupational therapists

• Geriatric care managers

• Hospice services

• Social workers/mental health therapists

And many, many more . . . . . . . .

• Families–-near, and far away

• Physical Fitness – Exercise Programs

• Hospitals, ERs, and clinics

• Medical and Dental professionals

• Remodeling contractors

• ADA–disability specialists

• Emergency management planners

• Food and product delivery services

• Friends, Neighbors

• Caregivers

• Utility companies

Besides the seniors/elders themselves, many others are involved in creating a safe and appropriate “aging in

place” environment.

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Safe and Appropriate Aging in Place “Environment”Medical – Healthcare: Medical and dental professionals

Home health care services

Occupational therapists

Hospitals, Emergency Rooms, clinics

Physical Fitness – Exercise Programs

Caregivers

Geriatric care managers

Practical: Home maintenance professionals

Remodeling contractors

ADA-disability specialists

Food and product delivery services

Financial planners – insurance companies

Legal professionals/para-professionals

Assistive technology specialistsSocial – Spiritual: Churches, synagogues, temples

Hospice services

Councils on Aging

Area Agency on Aging

Human/Social Service providers and agencies

Mobility: “Getting Up, Out and About on Cape Cod”

Transportation services

Van services - Volunteer drivers

Friends, neighbors, and family

Senior drivers, senior pedestrians

Public Safety: Police, Fire-Rescue-Ambulance – Emergency Planners - Utility Companies - Government

Officials

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Planning For “Aging in Place”

“…developing a plan to address aging in place means more than building more senior centers and congregate

meal sites. That’s because all the major facets of community life affect the ability of older adults to age in place from public safety, affordable housing, accessible

transportation, and health and social services to education, employment, and social and cultural

opportunities. In essence, the aging of the population will impact the entire social, physical and fiscal fabric of

our community.”[1]

[underline added for emphasis]

1. Source: “Is Your Community Ready for the Aging Boom?,” Sandy Markwood, CEO National Association of Area Agencies on Aging (n4a), www.n4a.org

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Ten “Best Practices” For Communities to Consider

as Their Populations Age• Preventive Healthcare

• Nutrition Education

• Age-Appropriate Fitness Programs

• Larger, Easier-to-Read Signage

• Preparation for First Responders

• Home Modification Programs

• Tax Assistance and Property Tax Relief

• Job Training, Retraining

• Engagement of Older Citizens in Community Boards/Commissions

• Single Point of Entry for Information and Access To Services

Source: “The Maturing of America – Getting Communities on Track for an Aging Population”

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Aging in Place on Cape Cod

Adult Living Alone

Age 65+

Age 75+

Groups Differ Quite Dramatically!

Based on The Human Condition Research – since 1994

Two Adults

Age 65+

Age 75+

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Cape Codders Who Are Aging in Place

(Two different household settings)• Adult Living Alone

– Similarities:• Age 65+, 75+ • Evenly distributed across Cape Cod

– Differences:• 18% over $45,000 annual income, but per capita income is highest• Fewer report a disability, and are in fairly good health, • Very low levels of caregiving• Slightly higher level of receipt of in-

home health aide services• Fairly heavy use of hospital

emergency room services• High dependence on PUBLIC transport

services (B-Bus, COA van, taxi)• High dependence on PRIVATE

transport services (family, friends,

neighbors)

• Two Adults in Home– Similarities:

• Age 65+, 75+• Evenly distributed across Cape Cod

Differences:• 45% over $45,000 annual income, but per capita income is lowest• Report considerable disability and more in “fair-to-poor” health• Quite a high level of informal caregiving• Lower level of receipt of in-home health

aide services• Very heavy use of hospital emergency

roomservices

• Very low dependence on PUBLIC transport

services (minor B-Bus usage)• Very low dependence on PRIVATE

transport

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Cape Codders Who Are Aging in Place

(Two different household settings)

• Adult Living Alone– Major Problems:

• Paying for medical, dental services, and prescription medicines

• Anxiety, stress, and depression• Lack of recreational opportunities

– Major Barriers to Services:

• Some difficulty paying health insurance deductibles/co-payments

• Services not accepting new patients/clients is somewhat a barrier

• Lack of transportation is a SERIOUS barrier

• Two Adults in Home– Major Problems:

• Paying for medical, dental services, and prescription medicines

• Higher anxiety, stress, and depression

• Lack of recreational opportunities

– Major Barriers to Services:

• Considerable difficulty paying health insurance deductibles/co-payments

• Services not accepting new patients/clients is a SERIOUS barrier

• Lack of transportation not a significant barrier

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Frail EldersCurrently:

About 5%-8% of Age 65+ Households on Cape Cod

include a “frail” elder – this is about 3,800 households.

.. 60% have “frail” 75-84 Y.O., 30% have “frail” 85+ Y.O.

Future:

At this rate, by 2015, 5,700 Cape households would

include a “frail” elder. By 2025, 8,800 households.

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Future Community Challenges are Driven

Primarily by the Aging of Our Baby Boomers

“Baby Boomers”

Born between 1946 and 1964 (19-year generation)

Started “Turning 60” in 2006

Already impacting our Councils on Aging

Question: Anyone here a “Boomer”?

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Cape Cod’s “Baby Boomers”

Estimated 63,000 “Boomers” Today:

51% Females 49% Males

Per U.S. Census Bureau Estimates.

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Age 60

The “magic” birthday!Now eligible for

Council on Aging Services

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Cape Cod’s “Baby Boomers”

• “Turning 60” (become COA-eligible)

– Average of 2,920 per year• 8 per day (everyday!)

– 1 every 3 hours

By 2010: Approx. 1 every 2.75 hours

By 2015: Approx. 1 every 2.5 hours (150

minutes)

By 2020: “Dipped” back to 1 every 3 hours

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Barnstable County(a.k.a. Cape Cod)

Population: 220,000

Seniors/Elders: 80,000

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Today

Predicted Population Growth

+ 20 Years

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“Joe”• Building Contractor• Framingham/Natick

area• Born in 1932• Married• Retired at age 59• Moved to Cape in 1991• Lived in New Seabury• Lived on Cape 7 years• Died in 1998 at age 67

• His diabetes led to retirement:– Leg problems– Poor Eyesight– Heart condition

• Services “Joe” Used:– Falmouth Hospital– VNA– Wheelchair Vans– Hospice & Palliative Care– Doctors, Nurses, and

Specialists

“Joe” Used Many On-Cape Services - Census Bureau “Missed” Him!

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Predicted MID-CAPE Region Population CountsThree Towns Combined (Barnstable, Dennis, Yarmouth)

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

1 2 3 4 5 6 7 8 9

Year

1990 2030202520202015201020052000 2035

(31,759)

(10,750)

(21,610)

(26,451)

(2,705)

Today

+ 20 Years

Age 85+ (7,500)

Age 75+ (29,500)

Age 65+ (54,650)

Age 60+ (64,000)

Age 55+ (73,600)

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Available: Predictions of Future

Populations Other Regions(by gender and age range)

Upon Request-Upper-Cape- Lower-Cape- Outer-Cape

- Individual Towns- Individual ZIP code areas

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One of Tonight’s Objectives

Expand the dialogue around senior mobility— abilities and the future demand for

senior mobility “assists”

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Age 65+ “Getting Up, Out, and About

on Cape Cod”- Inside-the-Home (or Nursing Home, Assisted Living Unit)

- Outside-the-Home:

.. Going To/From Home

.. Pedestrian Activities

.. Riding in Vehicles (car, van, bus, plane, etc.)

.. Driving Vehicles

.. Travel (local and long-distance)

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Inside-The-Home• Getting In and Out of Bed

• Walking about bedroom and bath

• Using Stairs

• Activities of Daily Living

• Preparing meals

• Housekeeping

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“Mobility”

“Mobility is the ability to move around one’s environment. It is essential to effective functioning--in carrying out

activities of daily living such as bathing, dressing, and walking.

Difficulty in performing these tasks is common to additional impairment, institutionalization,

and mortality in older adults.”[1]

1. Source: Mobility Research Center, the University of Michigan Geriatrics Center, www.med.umich.edu/geriatrics/moblab/index.htm

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Independence“Those who work with the elderly agree: A key to independence in later years is

the ability to visit friends or run errands without having to rely on the help of others.”[1]

1. Source: “Study Finds Limited Mobility For Elderly,” The Washington Post,” 3/19/06

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Outside-The-Home .. Going To/From Home

.. Pedestrian Activities:

On sidewalks

In banks, stores/malls

In social/religious settings

.. Riding in Vehicles (car, van, bus, plane, etc.)

.. Driving Vehicles

.. Travel (local and long-distance)

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Planning For Future Senior Mobility “Assist”

NeedsPlanning for future senior/elder mobility “assist” needs is central to efforts to improve the quality of life of seniors/-elders through (as appropriate to each individual’s own physical and mental abilities and desires):

• decreasing social isolation,

• helping seniors/elder get out of their house or institution, and

• by providing them with an opportunity for physical exercise and mental stimulation, as well as,

• the obvious benefits derived from being able to shop, do banking, visit the post office, and the other day-to-day activities desired by senior/elder citizens.

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Senior MoAbility Model

Computer Model Developed by SMICC

Uses a “Knowledge Base”To Predict Future

Senior Mobility Characteristics and Future DEMAND For Senior Mobility “Assists”

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Senior MoAbility ModelData-based predictions of future mobility of Cape’s senior/elders:

- what seniors/elder will be able to do

- how many will be doing it

- where will they be doing it

- when will they be doing it

- who will be doing it

- who will need assistance with their mobility:

What? When? Where? Who? How?

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MoAbility Examples

1. Number of Senior/Elders Using a Wheelchair:

2005 2010 2015 2020 2025 2030 2035

Town of Barnstable:

Age 65+……………… 355 400 485 580 750 860 980

Age 75+……………… 230 240 250 290 380 480 620

Age 85+ ………………. 90 100 105 105 115 140 195

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MoAbility Examples

2. Number of Licensed Drivers, Age 85+

2005 2010 2015 2020 2025 2030 2035

Barnstable County 3,150 4,300 4,700 4,730 5,050 6,400 9,250

Mid-Cape Region 1,575 1,750 1,830 1,775 1,860 2,238 3,145

Town of Barnstable 660 750 805 800 850 1,035 1,480

ZIP Code 02648 70 80 85 85 90 110 155 (Marstons Mills)

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3,150

4,300

4,700 4,630

5,050

6,400

9,250

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

1 2 3 4 5 6 7

Predicted Number of Licensed DriversAge 85+

In Barnstable County, MA Years 2005 - 2035

2005 203520302025202020152010

YEAR

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MoAbility Examples3. Number of Age 75+ Persons Needing Some Assistive

Device When Walking (cane, walker, etc.):

2005 2010 2015 2020 2025 2030 2035

Mid-Cape Region 2,770 2,840 2,925 3,245 4,160 5,120 6,400

Town of Dennis 545 565 595 690 910 1,100 1,285

ZIP Code 02639 90 95 100 115 150 180 215

(Dennisport)

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6,400

5,120

4,160

3,245

2,925

2,7702,840

2,000

2,500

3,000

3,500

4,000

4,500

5,000

5,500

6,000

6,500

7,000

1 2 3 4 5 6 72005 2010 2015 2020 2025 2030 2035

Today

+ 20 Years

Predicted Number of Age 75+ Persons in Mid-Cape Region

Needing an Assistive Device When Walking(cane, walker, etc.)

YEAR

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SMICC – Senior Mobility Initiative on Cape Cod

• Goals:– Research:

• Future DEMAND for senior mobility “assists”• Senior Mobility “Best Practices”

– Education:• Of the Cape Cod professional community,• Of seniors/elders, their families, friends, neighbors

– Advocacy:• For Senior Mobility “Best Practices” on Cape Cod

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SMICC Activities• Community Informational Meetings:

– Dec. 2007, Jan. and Feb. 2007

• Presentation at National Conference:– ASA/NCOA Conference, Chicago, Mar. 2007– Topics: Mobility Indicators, DEMAND Assessment,

“Knowledge Base”

• Membership Drive: Seeking -– Steering Committee members– Topic-Specific Sub-Committee members

• E.g. Sub-Committees on Senior driving, emergency preparedness, volunteer driver activities, senior fitness, etc.

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Q & ASome Key Questions For Group

Discussion:• What surprised you?• What seemed MOST important to you?• What else would you like to hear about?• What needs to be discussed in more depth? • Who else needs to “be in the room”?• What could we have left out?

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Opportunity For NetworkingTalk with others.

Tell others about YOUR activities.

Exchange contact information.Make plans to get together

again.Tell friends and colleagues

about tonight’s presentation.

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In Closing

Thank You for Participating

Tell a Friend!