Back to Expectations of Government Among Aging KentuckiansFrom Planning for the Future
p. 49-58, published 2002
The ability of older citizens to participate in the lives of their communities is vitally important. Thus, their ability to use and access transportation helps us to determine how successfully they can get needed goods and services and maintain social contacts that enhance quality of life. A recent survey by the AARP found that in addition to age, health and disability status (HDS) is an indicator of transportation mode use, problems, or personal mobility in those 50 and older. Among similar age groups, those with excellent HDS were more likely to have gone out on the previous day or in a typical week to drive or to walk regularly and less likely to be passengers in cars. Comparisons among age groups revealed that older persons who were less disabled than those in younger cohorts were more likely to be mobile. The survey results also found driving to be the most common mode of transportation, with ride sharing a close second, especially as age increases. However, for those most reliant on ride sharing, feelings of dependency and imposition on others can be an obstacle. To gauge how independently mobile older Kentuckians are, we asked if they had driven a car in the previous month.
Loss of independence occurs among older Kentuckians as mobility becomes limited.
Percent of Persons Who Have Driven a Car in the Last Month, by Age, KY, 2000
A majority of the sample reports recent driving experiences. However, this declines to nearly two thirds of the sample of persons aged 75 and older.
As the ability to drive declines, the more seniors rely on others to conduct basic activities such as buying groceries and visiting the doctor.
Policies that address the link between poor HDS and mobility would include providing modes of transportation that would be more accommodating to those in need.
One possible way government can assist elders with access to transportation, particularly in rural areas without public transportation, is to subsidize providers of transportation in communities.
As medical advances increase the health industry’s ability to prolong life, many people survive in spite of severe incapacitation that prevents them from making decisions regarding their health and medical care. Every year, 2 million people die in America—80 percent in hospitals, hospices, or nursing homes. Chronic illness, such as cancer or heart disease, accounts for two of every three deaths. It is estimated that approximately 70 percent of these people die after a decision is made to forgo life-sustaining treatment.
In these situations, many believe that family and medical practitioners should be made aware of the wishes of the individual for whom decisions are being made and that legal provisions specifying desired medical courses of action should be made in advance. Such advance directives can be a living will, in which the person gives specific instructions, or a medical power of attorney, which names another person to make decisions on the person’s behalf. We asked Kentuckians if they had made any choices concerning end-of-life decisions, legal or otherwise, and if they had shared these wishes with their families.
About a third of Kentuckians aged 45 and older have neither informed their family nor made legal provisions regarding end-of-life medical choices.
Of those who had informed their families of the medical choices they preferred, more than two thirds had made legal provisions regarding these wishes.
Only approximately 20 percent of those who had not told their families of their choices had made legal provisions ensuring their implementation.
Out of the entire sample, 311 respondents had neither told their families of their choices should they become unable to make them themselves nor had they made any legal provisions regarding what should be done in such an event.
For the family members, friends, and neighbors who provide most of the care for frail older citizens, the importance of public programs that lend support cannot be overstated. An unknown service, however, is of little benefit. To learn more about the level of awareness about services widely available to the elderly, we asked respondents to indicate how familiar they are with a range of public services that help alleviate financial and caregiving responsibilities.
As shown, we found that only small proportions of our respondents, in all likelihood those who are using or have used or inquired about these services, report being “very familiar” with them. The highest levels of familiarity were found with those programs that assist caregivers. Overall, these findings suggest a fairly low level of familiarity with elder-care services among precisely those individuals who are or will be most likely to need them in years to come.
Older Kentuckians have only a limited awareness of a range of services that lend caregiving and financial support.
Levels of Familiarity with Available Elder-Care Services, KY, 2000
As our population ages, the needs of dependent frail elders are expected to tax society’s resources and challenge its capacity to respond in new and creative ways. The lack of satisfaction many Americans with disabilities have expressed about the ways in which their needs are being met institutionally resulted in the Olmstead decision which appears to prohibit states from discriminating in the kind of care they provide people with disabilities—including frail elders. Citizens, this ruling concludes, have the right to care in their own homes and communities when appropriate and if the state has the resources, currently an obstacle of significant proportions for states. Increasingly, advocates of older persons are expected to continue pushing for alternatives to institutional care, namely home- and community-based services, to meet their care needs. We asked the general adult population aged 18 and older in Kentucky if they had ever used or inquired about any of the array of institutional and home- and community-based elder-care services and how satisfied they were with the availability and affordability of high-quality services in their communities.
Satisfaction with elder-care services diminishes among older Kentuckians as their experience with these services increases.
At approximately 71 percent, a majority of Kentuckians say they are at least somewhat satisfied with the availability of high-quality elder-care services while fewer than half, approximately 46 percent, are satisfied with the affordability of services.
However, only about one quarter of these respondents have actually used or inquired about these services, with most doing so on behalf of someone else.
Based on the results of statistical regression analysis, the likelihood that a person is at least somewhat satisfied declines if he or she has actually used or inquired about elder-care services.
Generally, as income and education levels rise, satisfaction declines.
Older Kentuckians are more likely to be satisfied with both aspects of elder-care services in their community than those aged 64 or younger, possibly because of the growing number of adult children who must negotiate the cost and availability of these services.
Americans are known internationally for their community and national pride. This pride is often manifested in high levels of volunteerism. Since Baby Boomers constitute such a large segment of our society, the level of volunteerism among members of this age group could have a considerable impact on the well-being of our nation. Indeed, we ultimately may come to rely in part on the civic involvement of older citizens to help meet the needs of their generation if public resources should fall short.
In addition to the social benefits to be gained from the volunteerism of older citizens, King reports on studies demonstrating that volunteer activity itself can be a positive quality-of-life factor as individuals age, providing feelings of usefulness, mental challenge, and social integration. Volunteerism may also provide role continuity by replacing some of the labor force activity older citizens lose after retirement. Certain volunteer roles also provide opportunities for many frail elders to remain engaged despite physical disability.
Volunteerism among older Kentuckians is a positive social and personal force that enriches elders’ lives and their communities.
The results of our retirement survey show that more than 40 percent of Kentuckians 45 years old and older indicated volunteering an average of 12 hours per month in the previous year.
A greater proportion of those aged 45 to 64 volunteered than those over age 65, but at a lower average monthly rate of 10 hours compared to 15 hours.
Policymakers have a unique opportunity to draw on a resource that could help meet the needs of its citizens. By promoting and encouraging volunteerism among elders, society can help close gaps in services that are unmet by the private and public sectors, and, in the process, enrich the lives of those elders who receive and give.
Across the country, organizations, agencies, and policymakers are beginning to explore the opportunities provided by our aging population. They are asking how they can attract and use this active and independent population to solve community problems. With a budget of $203 million, the principal federal vehicle for senior volunteerism is the National Senior Service Corps. Other organizations, such as the Retired Senior Volunteer Program, currently provide approximately 500,000 elder volunteers who contribute a collective 112 million hours, with a value estimated at $1 billion.
Americans are volunteering 20 percent more than they did 20 years ago, and seniors are responsible for nearly all of this increase. Like senior Americans, senior Kentuckians are eager to contribute their time and talents. However, it is difficult to detect whether this activity will continue as Baby Boomers enter this age group. To assess whether this contribution will be sustained or perhaps increased, we asked Kentuckians about past volunteer activity and their expectations for future civic involvement.
Kentuckians volunteer routinely now and expect to volunteer more in their elder years.
Meeting Needs Through Volunteerism
Our results indicate that the volunteer activity of the future elderly population will likely be similar to that of our current elderly population.
Larger proportions of younger cohorts expect to volunteer more 10 years in the future than those from the cohort aged 65 and older.
Compared with the older cohorts, smaller proportions of the younger cohorts, those younger than 65 years old, say they volunteer more now than they did 10 years ago.
This pattern of answers indicates that younger Kentuckians expect to volunteer routinely in their later years and, therefore, replenish and expand through the sheer numbers of future retirees the amount of time volunteered.
Those interested in taking full advantage of this volunteer pool may want to explore new methods of involving retirees by offering unique experiences, challenging positions, and greater flexibility to would-be volunteers.
The consensus on elders and information technology has been one of incompatibility. Indeed, computers were first marketed solely to the young due to these perceptions. While some evidence supports the view of current elders as technology averse, future elders will, in all likelihood, be computer literate. Some studies also suggest ways in which today’s elders can be successfully introduced to information technology and an increasing receptivity to computer use among seniors. Although most seniors learn to use computers on their own, it has been observed that the best learning environments utilize senior instructors.
More intuitive application programs and interfaces of the early 1990s have spurred growth in the purchase of personal computers among all age groups. Between 1995 and 1998, surveys show that home computer ownership among those aged 55 and older rose from 29 percent to 40 percent. While these national results are encouraging, a digital divide still exists in Kentucky along the lines of age. The likelihood of having access to a home computer diminishes with age among Kentuckians, even while controlling for other factors such as income and education.
Although computer use among older Kentuckians lags that of Kentucky’s general adult population, this proportion has grown steadily in recent years.
More than a third of Kentuckians aged 45 and older have access to a computer in their home.
This represents a slight increase from the 28 percent rate found for older Kentuckians in 1996.
By comparison, among all Kentuckians aged 18 and older, 55 percent have access to a computer in their homes.
Approximately half of older Kentuckians do not use a computer.
As of September 2001, approximately 37 percent of Kentuckians aged 50 and older had access to a computer in their homes compared to 68 percent of those aged 25 to 49, 63 percent of those aged 18 to 24, and 95 percent of those aged 9 to 17.
Lack of access to and use of a computer cuts seniors off from what is fast becoming a preferred communication tool, as well as valuable, useable information that can enrich and improve their lives.
Like computer use, Internet and e-mail use also decline with age, but what elders lack in numbers they make up for in enthusiasm. Pastore reports that a 1999 study by Media Metrix found that as Americans aged 50 and older become more accustomed to the online medium, they begin to outpace their younger cohorts in the amount of time they spend online. Compared to 18- to 24-year-olds, they spend on average 6.3 more days per month on the Internet, stay logged on 235.7 minutes longer, and view 178.7 more unique pages per month.
According to Pastore, one study by the Pew Internet & American Life Project found that 52 percent of seniors aged 50 to 54, 43 percent of those aged 55 to 59, 34 percent of those aged 60 to 64, and 23 percent of those aged 65 to 69 are online. Although only 15 percent of Americans aged 65 and older go online, they avidly use the Internet to remain in contact with family, look up information on hobbies, seek financial information, read the news, and check weather reports. Most wired seniors are married men who are highly educated and enjoy relatively high retirement incomes. A large portion of online seniors said they were encouraged to go online by family members.
Online activity declines with age, but recent national studies indicate an enthusiasm among today’s seniors unmatched by younger users.
Internet and E-mail Use in Past Year by Kentuckians Aged 45 and Older, 2000
Approximately 37 percent of Kentuckians aged 45 and older accessed the Internet during the previous year, compared with approximately 63 percent of Kentuckians aged 18 and older.
Although senior Internet use lags behind that of the full population, we have seen an improvement over the 27 percent of Kentuckians aged 45 and older who reported having accessed the Internet in the previous year in 1998.
As the data show, the proportion of those who use these forms of information technology declines with age.
Connected and actively engaged elders are more likely to enjoy a higher quality of life, and the Internet and e-mail can be important tools in helping achieve these goals.
Of interest to businesses, approximately one fifth of the older population is already making e-commerce purchases, and this proportion will likely grow as seniors increasingly embrace this technology.
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