2001 Aging Services Environmental Scan

 

Overview

Our community is growing older. By the year 2020, it is estimated that nearly 165,000 Travis County residents will be age 60 or older (Texas Health and Human Services Commission), and individuals age 75 or older are the fastest growing segment of the older adult population. In addition to the increase in the number of older adults, more of these individuals will be ethnic and racial minorities.

By 2020, almost one in five Travis County residents will be age 60 or older, an increase of more than 100% from 2000.

Respecting our elders' might serve as a theme to guide civic commitment and political activism for the year.

Austin American-Statesman, January 1, 2001

These population shifts necessitate that the community review how it supports and provides services for older adults. In planning for these changes, it is important to remember that the vast majority of older adults want to live as independently as possible and remain living in their own homes.

KEY FINDINGS

Major Issues Impacting Older Adults

The likelihood that an older adult will be able to live independently depends on a variety of factors. The major determinants of independent living include adequate food and nutrition; affordable and quality housing, home repair, and home modification; physical and mental well-being; access to transportation; freedom from victimization; legal protections; and sufficient financial resources. Key findings around these conditions include:

  • Food and Nutrition: Up to 85% of older adults are malnourished, and only 35% of eligible older adults receive Food Stamps.
  • Housing, Home Repair, and Home Modification: There are approximately 5,630 elderly homeowners and renters in Travis County who have an unmet housing need, defined as the need for more income in order to afford housing or lower rent; the need for more space to alleviate overcrowding; or the need for housing repair to address substandard conditions such as faulty wiring, leaky roofs or other problems.
  • Physical and Mental Well-Being: Physicians are limiting the number of Medicare/Medicaid patients they serve due to low reimbursement rates which negatively impacts the ability of older adults to access primary care. The high cost of prescription drugs threatens the ability of older adults to access prescription medications. Suicide rates among older adults are higher than other age groups and as many as 17% of adults over age 60 have substance abuse problems.
  • Transportation: Transportation services are not coordinated or centralized. To access transportation services, older adults must call and make an appointment with one of several transportation providers. Non-profit organizations are attempting to fill in the gaps left by public transportation providers, but current demand is outpacing supply.
  • Victimization: In FY 1999, Adult Protective Services conducted 1,733 investigations and confirmed 966 cases of adult abuse, neglect, and exploitation in Travis County. The majority of abusers are known to the victim and 40% are adult children of the victim.
  • Legal Protections: Bill Payer and Money Management programs are important to help individuals stay in their own homes and prevent exploitation. Guardianship programs are also critical to protecting individuals against exploitation and abuse. Resources are needed to help would-be-guardians pay for legal services and fees to apply for guardianship.
  • Economics: In 1999, 10% of Travis County adults over the age of 64 were living below the federal poverty line. Poverty rates among older adults increase with age.

Current System For Care And Support Of Older Adults

Two systems exist to care for older adults - the formal Long Term Care System (LTC) and the informal system of family and friends (Caregivers):

  • The majority of care for older adults is provided by family members and friends. However, caregiving is reactive, not proactive. Most caregivers spend twice as many months providing care as anticipated. Societal trends are increasing the strain on caregivers which could negatively impact their ability to provide care.
  • The vast majority of LTC resources are spent on institutional care which is six times more expensive than community based care.
  • Nearly 70 public, non-profit, and private agencies provide a range of services to address the needs of Travis County's aging population. Despite this strong base of support, the increase in the total number of older persons will result in an increase in need for services.

RECOMMENDATIONS

The community has an opportunity to take positive steps towards improving the lives of older adults in Austin and Travis County. This assessment reviews key challenges facing older adults and the community. Ideally, the community will work towards developing a seamless continuum of services that are affordable and accessible. The following are a sample of recommendations for how to address the key challenges and begin strengthening the services that are available in the community.

Recommendations to Address Key Challenges:

  • Food/Nutrition: Strengthen outreach efforts to increase the number of individuals receiving Food Stamps.
  • Housing, Home Repair, and Home Modification: Consider developing centralized home modication and repair services to improve accessbility.
  • Physical and Mental Well-Being: Focus on ensuring availability of primary care and prevention services for older adults.
  • Transportation: Consider centralizing the dispatch for transportation services so that older adults can call one number to access transportation services. An alternative to centralized dispatch would be to develop a tiered transportation system in which services are organized by georgraphic location or level of need such as non-disabled, mobility impaired, escort needed, etc.
  • Victimization: Develop and implement a gatekeeper program that trains personnel such as police officers and utility workers to know the signs of abuse and to report suspicions to the appropriate agency.
  • Legal Protections: Increase volunteer recruitment efforts. More volunteers are needed to serve as money managers and guardians.

A PLAN FOR ACTION

It is difficult to prioritize any one issue as being more important than another - all the issues are interconnected. Food and nutrition impact physical and mental well-being. Transportation impacts access to every other service. However, it is not prudent or possible to tackle all of the issues at the same time. Therefore, it is recommended that, of all of the recommendations in this report, the following three issues be addressed first.

1. COMPREHENSIVE PLAN

Possibly, the most important step the community can take now is to establish a community planning body charged with developing and implementing a comprehensive community-wide plan to meet the needs of the older adult population. This plan should address the two key points of this report. First, older adults want to live as independently as possible in their own homes. Second, the older adult population is increasing and the composition is changing. The level and complexity of care needed by older adults is likely to increase and the community would be well served to plan now for this increase.

A comprehensive plan should:

  • Identify strategies that prevent and delay disability.
  • Ensure the availability and accessibility of community based care and in home supports.
  • Advocate for shifting resources to support community based services.
  • Expand and leverage resources to meet the increasing need.
  • Create a seamless continuum of services.
  • Prioritize issues to be addressed. Based on information collected for this report the issues of transportation and housing (including repairs and modifications) should be addressed first.

2. HOUSING

A service provider focus group conducted as a part of this process identified affordable and accessible housing as the single most important issue facing older adults. A local survey of older adults found that home repair and modification is top on the list of services they need. Addressing the housing needs of older adults requires making housing safer and more affordable. Planning in this area should also address this report's finding that local home repair and modification programs are overburdened and uncoordinated. Consideration should be given to developing centralized home modification and repair services.

3. TRANSPORTATION

Focus group participants and respondents to surveys conducted as part of the assessment also identified transportation as a critical issue for older adults in this community. Existing transportation services are not coordinated or centralized. Consideration should be given to developing a more centralized transportation system that is easier to use. Every effort should be made to work with existing transportation providers to improve services.

SUMMARY

The increase in the number of older adults will impact our community. The decisions the community makes today will impact every citizen who is faced with making decisions for him/herself, for his/her parents or other relatives. As a community, we have a unique opportunity to ensure that older adults are able to maintain quality of life and are able to get the care they need as they age. The Austin American-Statesman identified addressing the needs of older adults as a top priority for our community in 2001. The Aging Services Environmental Scan (ASES) report provides the basic information necessary to begin planning for the changes in our population. As individuals and families seek cost-effective ways to care for our elders, new policies can and should emerge. Engaging the community in a comprehensive planning process is clearly the next step.

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