Impact of Aging and Chronic Disease on Seniors in Calhoun County
The community meeting in Calhoun County discussed the impact of aging and chronic diseases on seniors. Factors affecting the quality of life for older adults were addressed, including the prevalence of chronic diseases like heart disease and diabetes. Statistics show a significant number of seniors suffering from chronic conditions, leading to increased healthcare costs. Health efforts need to focus more on public initiatives to improve the well-being of seniors.
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The Impact of Aging in Calhoun County April 27, 2017 The Coordinating Council meeting
Know Us: Alex Lueth, CPA, CEO, CentraCare What has the greatest impact on the quality of life for seniors? Hear Us: Carl Gibson, Ph.D., Director, Calhoun County Office of Senior Services What do we need and want? See Us: Karla Fales, CMBA/HcM, CEO, CareWell Services SW, f/k/a Region 3B Area Agency on Aging How are the needs of seniors now different than in past decades?
Know Us What has the greatest impact on quality of life for older adults in our community?
Know Us What has the greatest impact on quality of life for older adults in our community? Answer: Chronic disease
Impact of Chronic Disease Quality of life for seniors is significantly impacted by chronic disease 92% of seniors have one chronic disease 77% have a least two chronic conditions 75% of money spent on health care is spent on chronic disease Yet, only 1% of health dollars spent on public efforts to improve health
Heart Disease 90% of Americans aged 55+ are at risk for hypertension or high blood pressure Women are more likely than men to develop hypertension A majority of men aged 75 and over have Hypertension Second leading cause of death in Calhoun County
Diabetes Diabetes affects 12.2 million Americans aged 60+, or 23% of the older population 57 million Americans aged 20+ have pre-diabetes In Calhoun County, it is the 5th leading cause of death
Michigan Calhoun Causes of Death Age 75-84 Age 75-84 All Causes of Death 22,154 346 1.Heart Disease 26% 26.9% 2.Cancer 24.3% 22% 3.Chronic Lower Respiratory Diseases 7.8% 9.5% 4.Stroke 5.8% 4% 5.Alzheimer's Disease 4% 2.6% 6.Diabetes Mellitus 3.4% 3.2% 7.Kidney Disease 2.3% 1.2% 8.Unintentional Injuries 2.2% 2.6% 9.Pneumonia/Influenza 2% 2.9% 0.3% - 10. Intentional Self-harm (Suicide) All other Causes 21.8% 25.1%
Years of Potential Life Lost Three leading causes of YPLL Unintentional injuries Falls, substance abuse, accidental drug overdose, automobile accidents Cancer Heart disease
Impact of Chronic Disease Premature death Frequent hospitalizations Loss of independence Uncoordinated healthcare duplicative and unnecessary tests/procedures Adverse drug events Increase in healthcare costs Burden on caregivers physical, mental, and emotional well-being Potential years of life lost
Hear Us The needs of seniors in our community are consistent and well known? True or False
Hear Us The needs of seniors in our community are consistent and well known? Answer: Maybe?
Services/Needs Assessment Services predicated on needs in the community: known and unknown 2013 Priority NeedsThemes Heterogeneity of population surveyed poor/wealthy; poor health/healthy; isolated/lonely/engaged; rural isolated/dense urban areas; need supportive services/vibrant Communication issue: Between agencies in network; between aging network and CBOs; between aging network and general public.
Needs and Concerns Needs Public education Outreach Service awareness Transportation Health concerns including health disparities Connection and influence Physical and mental health connected Those with worst physical health also report financial issues Reality check Tension around supporting living independently at home and the ability to provide and maintain a rural or deteriorating home
2016 Community Needs Assessment Priority needs identified Most important for helping seniors live independently in community Services which we need more of in the community Transportation Information On Senior Services & Programs Chore Services, Home Repair In-Home Healthcare Nursing/Physician/Personal Care Prescription Drug Assistance
Oral Health and Prescription Drugs are two examples that illustrate the rise/fall of demand over time Impact of programming on need is uncertain Rise and Fall and Rise 2000-2006 Prescription Needs Rose and then Decreased DENTAL, along with Food and Transportation Expand Medicare Part D Prescription demand shifts
DENTAL NEEDS INCREASE ALONG WITH FOOD & TRANSPORTATION DENTAL PROGRAM STARTS AND MILLAGE RENEWALS 1996 2000 ($thousands) Calhoun Hlth Plan 83 Grace Health-FHC Fountain Clinic 35 sub-totals 118 2002 2006 2010 2016 UWay 120 27 27 174 0 0 0 0 0 0 104 89 193 130 127 257 144 244 $424 36 CCSS Rx Disc Card 45 339 103 23 $38 Food/Nutrition 298 379 242 430 $487 Senior Transportation 240 335 335 435 $435
ORAL HEALTH 2020 GOAL: Expand Adult Benefit in Publicly- Funded Health Coverage Dental coverage and increased access to dental care positively impacts health and well-being DentaQuest Foundation 465 Medford Street Boston, MA 02129
In State Medicaid programs, there are often annual dollar limits (often $500 to $2,500) or procedure restrictions, e.g. limits on numbers of fillings or crowns, types of crowns that can be used on certain teeth, and how often root canals are covered. Calhoun County Millage: Allowable treatment Prophylaxis, and periodic recall when possible Tooth extraction Prosthetic services (dentures) Silver or composite fillings Abscess reduction by medication Abscess reduction Root canals and crowns (if deemed least invasive alternative) Fees for services are limited to published Medicaid covered rates plus a 15% additional incentive.
Summary Certainly the mix of programs and services offered though OSS and AAA should be considered and rebalanced to better meet existing needs. Calhoun seniors are diverse and fairly well serviced Could benefit from better information, more collaboration, improved targeted support Creative approaches to service the needs of those living in more rural areas are needed Seniors may not identify a need until there is a need The end here is just the beginning
See Us What else influences seniors and their quality of life?
See Us What else influences seniors and their quality of life? Economic insecurity, changes in population, dementia and isolation are critical issues.
Economic INSecurity Income is lower Woman earned less so have less in retirement ($4,500 less in SS) Age discrimination in employment Yet 28.3% of seniors in Calhoun County had earnings from wages 64% depend on SS for 90% or more of their income Less than 60% have other retirement income Higher debt, less savings, fewer pensions 1/3 of households had no money left over at end of month 61% still have debt (median total debt was $40,900) 25 million seniors live below 250% of poverty ($29,425) - economically insecure by definition Calhoun: 9% of seniors below 100%, 11.6% below 150% Income is generally fixed while expenses are not Changes in source of income post-retirement will impact boomers most Mean retirement income is less than $20,000 a year
What impacts economic security? Kinship care Impacted by substance abuse Housing challenges Incarcerations Lack of awareness of benefits 3 out of 5 seniors eligible for SNAP are not enrolled Return of generational households (2008) Housing bias limits care options Higher mortgage debt than previous generations Cost of health care Reduction in pensions and Social Security
Population in Calhoun County is Changing 17% of population are over age 65 23% of population are children These two populations will intersect in the future as the rate of exit of younger populations is less than the rate of exit of older adults The number of seniors and the number of school aged children is already nearly identical in Battle Creek
Alzheimers Disease and Related Disorders 14% of adults over age 71 have some form of dementia 1 in 10 people age 65 or older have Alzheimer s dementia Risk of Alzheimer s double for women Impact on caregivers is significant 580 Million in unpaid caregiving $317 Million the additional healthcare costs for CAREGIVERS!
Isolation Its a big deal. The Facts Older adults that describe themselves as lonely have a 59% greater risk of functional decline Older adults who experience persistent loneliness have a 45 percent greater risk of death
What is it more prevalent today? 29% of people aged 65-plus live alone 50% of woman over age 75 live alone 1 in 5 adults over age 50 Prolonged isolation can be as bad for your health as smoking 15 cigarettes a day
Negative Health Affects of Loneliness and Isolation are asosciated with higher rates of:
What are the factors that put someone at risk? Living alone* or lacking social supports Mobility or sensory impairment* or cognitive challenges Major life transitions or losses* Low income or limited financial resources Being a caregiver Rural, unsafe or inaccessible neighborhood Language barriers Transportation access challenges
Solutions to Combat Isolation Senior centers Groups specific to older adults such as senior luncheon groups Offer support groups or educational programs for widows/widowers Advertise community programs and opportunities Use the self assessment with older adults When doing assessments, be aware of the impact of isolation on health status Get involved! Ask an elderly neighbor if you can help them or just talk with them
What are the solutions? Prevention More attention to preventing illness causing disability and lower quality of life Better integration of community services and health care social determinants of health, impact of isolation on health outcomes to be considered (Be) Proactive Engage seniors in the important conversations about the impact of health on quality of life, economic security and life expectancy Structure communities to help seniors remain engaged intergenerational programming, volunteer opportunities, senior employment programs Senior Centers are still meaningful options help them be successful Be attentive to and advocate against major changes in Social Security and other funding that impacts older adults Planning Teach younger generations about the importance of saving, planning and lifetime health management Create systems and infrastructure that are cognizant of the needs of seniors Dementia friendly communities and age-friendly communities
QUESTIONS AND DISCUSSION
