By Jennifer Crane, MS, CDP
The rapid growth of the older population that is over age 85 offers a number of challenges to the ability of family members and caregivers to provide appropriate benefits, programs and services to this demographic group. These challenges include a shortage in available helpers, financial considerations, and a reduction in function that can occur with age. In order to address this growing crisis, there must be a focused collaboration between family members and caregivers to design and implement policies geared to addressing these challenges.
Old age, old-old age, and oldest-old age comprise distinct categories via comparing persons aged 75–84, 85–94, and 95+ on demographics, health, function, and wellbeing.
As the numbers of the old-old and oldest-old increase, it becomes more difficult to meet the various needs that this age group presents. Often, the informal network that has been so integral to a person’s support to this point starts to become more limited owing to increased isolation and the aging of helpers. Formal services can be difficult to come by, due to a shortage of workers and the resulting waiting lists. Often the only solution for the oldest-old among us involves institutionalization, which is not always the desired outcome. (Wacker & Roberto, 2014).
Financial considerations can include limited income and financial resources, higher medical costs, and issues relating to long-term care arrangements. Some commentators suggest that the rapidly aging population will trigger a fiscal crisis, because the dependency ratio has been steadily increasing (Wacker & Roberto, 2014). Others suggest that a new vision of American life that focuses on activity and engagement throughout the lifespan will alleviate the financial problems that could otherwise result from an aging population (Wacker & Roberto, 2014). In any case, administrators and program directors who service this population need to take these factors into consideration as they design and implement policy.
One need that won’t go away with a change in lifestyle is the need for people to deliver services to the growing numbers of the old-old and oldest-old. This includes care aimed at aging in place as well as institutionalization, and all levels in between. Formal training and salary are challenges that add to the financial burden of caring for those 85 and over. This is especially true when a person is experiencing cognitive decline. The older a person is, the higher their chance of developing cognitive issues. Often this means institutionalization, which requires workers to handle the required care (Wacker & Roberto, 2014).
Programs such as senior centers, adult day care facilities, and in-home aids can provide assistance and respite, but can also be difficult to adequately staff. Financial limitations of these types of programs, along with training issues make it difficult to find an adequate number of workers. The cost of care for the 85+ category of the older population combined with the funding provided by insurance and Medicare can restrict services that can be delivered. More specialized training is needed for people who help with older adults with cognitive decline, which will lead to more expense and staffing difficulty. Given the mounting impediments to providing services and programs to this population, those individuals who create the policies and programs must look for creative ways for funding and implementation that balance financial and staffing needs, while not sacrificing quality of care, especially for those with cognitive decline.
If you have any questions, please contact Age With Dignity on our contact page at https://www.agedignity.com/contact.
References
Cohen-Mansfield, J., Shmotkin, D., Blumstein, Z., Shorek, A., Eyal, N., & Hazan, H. (2013). The Old, Old-Old, and the Oldest Old: Continuation or Distinct Categories? An Examination of the Relationship between Age and Changes in Health, Function, and Wellbeing. The International Journal of Aging and Human Development, 77(1), 37–57. https://doi.org/10.2190/AG.77.1.c
Wacker, R. R., & Roberto, K. A. (2014). Community resources for older adults: Programs and services in an era of change (4th ed.). Thousand Oaks, CA: SAGE Publications, Inc.
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