planning to make^ n.e . indiana elder-friendly

Philip B. Stafford, Ph.D. , Director, Center on Aging & Community, Indiana Institute on Disability & Community

Indiana University

Planning to Make^N.E. Indiana Elder-Friendly

So what is a livable community for older

adults?

…an elder-friendly community?

Central Avenue 1960 Bruce Tibbo, St. Pete Times

Green bench graveyard 1969 Tom Bennett St. Pete Times

Central Avenue 1984 Maria Vesperi

Central Avenue, 1999

Not “When is old age?”

but“Where is old age?”

“Old people everywhere.”

Christopher AlexanderA Pattern Language

Our work should help create good places to grow up and

grow old…

livable, lifespan communities

Indiana Partnerships for Lifespan Communities

“…a comprehensive, participatory, and data driven initiative to create good places

to grow up and grow old in Indiana.”

Aging in PlaceInitiative


Years One and Two: Groundwork

State level partnerships and Steering Committee

Professional Development workshops statewide

Fund Development for statewide survey and community

engagement


The first application of the AdvantAge Initiative on a

statewide basis

· Six neighborhoods of Chicago, IL

· Indianapolis, IN · Jacksonville, FL · Lincoln Square, NYC · Maricopa County, AZ · Orange County, FL · Puyallup, WA · Santa Clarita, CA · Upper West Side, NYC · Yonkers, NY · RWJ CPFOA Communities· National Survey

· Grand Rapids, MI · Contra Costa County, CA · Parsippany, NJ · Newaygo County, MI · St. Joseph County, IN · Elkhart County, IN· Kosciusko County, IN· LaPorte County, IN· Marshall County, IN· El Paso County, TX· Chinatown, NY

· The State of Indiana

AdvantAge Initiative Survey Conducted in:

· Develop a model of an “elder friendly” community

· Develop a method to measure community “elder-friendliness”

· Help communities interpret and use this information to create action plans to support older residents’ health, well-being, and independence as well as their social and civic engagement

AdvantAge Initiative Strategy

• Consumer surveys – catalyst

• Focus groups

• Census data• Other

statistics (assets, health, crime)

• Framework• Indicators• Benchmarks• Technical

assistance

• Raise awareness

• Set priorities• Design action

plans• Allocate

resources• Monitor

progress

DATA INFORMATION ACTION

Reproduced by permission of The AdvantAge Initiative

Center for Home Care Policy & Research Visiting Nurse Service of New York

Optimizes Physical and Mental Health and

Well Being

· Promotes healthy behaviors

· Supports community activities that enhance well being

· Provides ready access to preventative health services

· Provides access to medical, social, and palliative services

Addresses Basic Needs

· Provides appropriate and

affordable housing

· Promotes safety at home and in the neighborhood

· Assures no one goes hungry

· Provides useful information about available services

Promotes Social and Civic Engagement

· Fosters meaningful connections

with family, neighbors, and friends

· Promotes active engagement in community life

· Provides opportunities for meaningful paid and voluntary work

· Makes aging issues a community-wide priority

The Four Domains of An Elder-Friendly

Community Maximizes

Independence for Frail and Disabled

· Mobilizes resources to

facilitate “living at home”

· Provides accessible transportation

· Supports family and other caregivers


Year Three: 2008• Statewide Survey

4,500 older Hoosiers, 15 samples of 300 +5 samples for Neighborhood NORCs (U. Indy Center for Aging & Community)

• Local engagement16 mini-grants to support local community participation, e.g.:

• public awareness• convening stakeholders, steering committees• small pilots • participatory research to supplement survey data • inclusion of adults with developmental disabilities

• Engagement with philanthropyMaterials and workshops for Indiana Grantmakers Alliance, United Ways, etc.

ADDRESSES BASIC NEEDS

Housing Is Modified To AccommodateMobility And Safety

“% of 65+ householders with home mod needs”

The Domain

The Dimension The

Indicator

Percentage of people age 60+ who want to remain in their current residence and are confident they will be able to afford to do so

Unweighted N=289Weighted N=102,355


Disagree3% Agree*

97% VeryConfident

64%

Not VeryConfident**

36%

Neither/DK/RF

1%

We asked respondents whether they agree or disagree with the following statement: “What I’d really like to do is stay in my current residence for as long as possible.”

For people who answered “agree” we calculated the percentage of adults age 60+ who were very confident/not very confident that they will be able to afford to live in their current residence for as long as they would like.

*Agree includes those who said Strongly agree or Somewhat agree.**Not Very Confident includes those who said Somewhat confident, Not too confident, Not confident at all, Don’t know, or Refused.

Figure 2.1, Indiana-Area 3§

Note: Percentages may not add up to 100% due to rounding and/or missing information.

Source: AdvantAge Initiative Community Survey in Indiana 2008

§ Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties.

‡

‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution.

‡

Percentage of householders age 60+ in housing units with home modification needs*



One or more modification

needed 13%

No modifications

needed87%

Planning to modify

83%

Not planning to modify

*People were asked whether their current residence needs any significant repairs, modifications, or changes to improve their ability to live there over the next five years.

*People who said that their homes need modification were asked if they plan to make the change over the next five years.



15%

2%DK/RF


§ Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties.‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution.

‡

‡

Type of modification needed

2%

3%

3%

3%

4%

5%

9%

9%

<1%

Cosmetic/minor repairs

Medical emergency response system

Accommodations for disabilities

Structural changes/ major repairs

Better heating in the winter

Better cooling in the summer

Fix problem with insects/rodents

Other

Bathroom modification





‡

‡

‡

‡

‡

‡

‡

Percentage of people age 60+ who are satisfied with the neighborhood as a place to live*




Not VerySatisfied**

16%

Very Satisfied84%

*People were asked how satisfied they are with their neighborhood as a place to live.**The category “Not very satisfied” includes those who said they were somewhat satisfied, somewhat dissatisfied, or very dissatisfied with their neighborhood.



DK/RF<1% ‡


Percentage of people age 60+ who are satisfied with the neighborhood as a place to live,* by demographics

18%

15%

16%

12%

23%

16%

81%

85%

83%

88%

77%

84%

Not Very Satisfied** Very Satisfied

Note: Percentages may not add up to 100% due to rounding and/or missing information.Unweighted N= 300Weighted N= 106,028


*People were asked how satisfied they are with their neighborhood as a place to live.**The category “Not very satisfied” includes those who said they were somewhat satisfied, somewhat dissatisfied, or very dissatisfied with their neighborhood.


Total

Age 60-64

Age 65-74

Men

Women

Age 75+


‡

‡

‡

Percentage of people age 60+ who feel safe/unsafe in their neighborhood*



*People were asked whether safety in their neighborhood is excellent, very good, good, fair, or poor.


Safety-Good18%

Safety-Excellent/Very Good

76%

6%


Safety-Fair/Poor


DK/RF<1%


‡‡

Prevalence of Perceived Neighborhood Problems

12%

14%

14%

15%

16%

17%

17%

17%

22%

26%

27%

28%

30%

31%

Streets need repair

Distance from parks

Traffic

Not enough arts/culture

Crime

Poor public service

Streets too dark

People don’t get involved

Public transportation


Distance from shopping

Lack of affordable housing

Rundown buildings

Noise

*People were read a list of fifteen neighborhood problems and were asked to indicate whether each item posed a big problem, small problem, or no problem in their neighborhood.


Unweighted N= 300Weighted N= 106,028Traffic lights too few/too fast


Percentage of people age 60+ who do not know whom to call if they need information about

services in their community*




*People were asked to indicate the best resource, such as a person or an organization, in their city, town, or county to get information on various services.

Do Not Know Whom to Call

21%

Family/Neighbors

City/County/Office of Aging/Social Services/

Other Agency34%

Church/Synagogue

Other2%

Internet/Phone Book/Other Media

Senior Center13%


3%

Medical Center/Health Professional

14%

9%


‡

‡

‡

4%

Percentage of people age 60+ who do not know whom to call if they need information about services in their community,* by demographics

23%

20%

23%

26%

11%

21%

Unweighted N= 300Weighted N= 106,028




Total

Age 60-64

Age 65-74

Men

Women

Age 75+


‡


Percentage of people age 60+ who do not know whom to call if they need information about services in their community,* by demographics (cont’d)

25%

19%

28%

20%

27%

13%

21%Total




Education >HS

Education <HS

Live w/others

Ex/vg/good health

Fair/poor health

Live alone



‡


‡


88% 86% 84% 84% 83% 77%68% 66%

47%36%

6% 7% 10% 8%6%

9% 12%

11%21%

6% 7% 9% 7% 9%17% 23% 22%

42% 43%

7%

Don't Know

No

Yes

SeniorCenter

Meals-on-

wheels

VisitingNurse

Special Trans-portation

Hospice CongregateMeals

HomeHealthAide

Home-maker

Service

HomeRepairService

Respite


Percentage of people age 60+ who are aware/unaware of selected services in their community*

*Respondents were asked whether these 10 services are available in their area.Unweighted N=300Weighted N=106,028



‡‡

‡

‡

Percentage of people age 60+ with adequate assistance* in ADL and/or IADL activities



No Limitations85%

One or More ADL/IADL

15%All Needs Are Met

41%

One or More Unmet Need

59%



*People were asked whether they need assistance with the following activities: ADLs- taking a bath or a shower, dressing, eating, getting in/out of bed/chair, using/getting to a toilet, getting around inside the home and IADLs-going outside the home, doing light housework, preparing meals, driving a car/using public transportation, taking the right amount of prescribed medication, keeping track of money and bills.

*People who answered “yes” were asked whether they get enough assistance with these activities. Unmet need was defined as not getting help or not getting enough help for one or more ADLs and/or IADLs for which assistance was needed.

Source: AdvantAge Initiative Community Survey in Indiana 2008§ Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties.

‡


Percentage of people age 60+ who have one or more limitations with ADL and/or IADL activities,* by demographics

11%

17%

18%

13%

12%

15%





Total

Age 60-64

Age 65-74

Men

Women

Age 75+


‡

‡

‡

‡

Percentage of people age 60+ who have one or more limitations with ADL and/or IADL activities,* by demographics (cont’d)

20%

12%

39%

8%

15%

14%

15%Total





Education >HS

Education <HS

Live w/others

Ex/vg/good health

Fair/poor health

Live alone


‡

‡

Percentage of people age 60+ who thought they needed the help of a health care professional because they felt depressed

or anxious and have not seen one (for those symptoms)*



4%Has seen a

health professional

74%

Has not seen a health

professional26%

Did not need professional

help95%



*People were asked whether in the past year, there was a time when they thought they needed the help of a health professional or a counselor because they felt depressed or anxious.

*People who answered “yes” were asked whether they obtained the professional help or counseling they thought they needed.


Needed professional

help


DK/RF1%


‡ ‡

‡

‡

Percentage of people age 60+ who report being in good to excellent health*

Fair/poor**21%

Excellent/very good/good79%




*People were asked: “Would you say that, in general, your health is Excellent, Very good, Good, Fair, Poor, or Very poor?”**Includes people who said their health was Fair, Poor, or Very poor.


DK/RF1%


‡


Percentage of people age 60+ who report being in good to excellent health,* by demographics

78%

79%

75%

82%

79%

79%

21%

20%

24%

18%

20%

21%

Excellent/very good/good Fair/poor**

Note: Percentages may not add up to 100% due to rounding and/or missing information. Unweighted N= 300Weighted N= 106,028


*People were asked: “Would you say that, in general, your health is Excellent, Very good, Good, Fair, Poor, or Very poor?”**Includes people who said their health was Fair, Poor, or Very poor.


Total

Age 60-64

Age 65-74

Men

Women

Age 75+


‡

Percentage of people age 60+ with a usual source of care*




*People were asked whether there is a place that they usually go when they are sick or need advice about their health.

Have a usual source of care

95%5%


No usual source of care


‡

DK/RF<1% ‡

Percentage of people age 60+ who failed to obtain needed medical care*



Needed medical are

44%

Obtained care96%

Did not need medical care

56%



*People were asked whether in the past year there was a time when they thought they needed medical care because they felt sick.

*People who answered “yes” were asked whether they saw a medical professional when they felt sick.

Did not obtain care4%



DK/RF1%


‡

‡

Percentage of people age 60+ who had problems paying for medical care*

Problem paying for medical care




No problem paying for

medical care96%

*People were asked whether there was a time in the past 12 months when they did not have enough money to follow up on tests or treatment recommended by a doctor.


4%


‡


DK/RF<1%‡

Percentage of people age 60+ who provide help to the frail or disabled*

Provide care21%




Do not provide care

79%

*People were asked whether they provide help or care, or arrange for help or care, for a relative or friend who is unable to do some things for him/herself due to illness or disability.



DK/RF<1% ‡


8%

10%

24%

26%

31%Non-relative friend

Another relative

Spouse/partner

Parent or in-law

Child

Other


Relationship between caregivers age 60+ and care recipients*

Note: Percentages may not add up to 100% due to rounding and/or missing information.*People who said they provide care were asked “What is this person’s relationship to you?”




0%


‡

‡

‡

‡

Number of hours per week spent on caregiving among people age 60+ who provide help to the frail or disabled*

More than 10 hours21%



*People who said they provide care were asked “On average how many hours per week are you caring for … ”

4-10 hours24%

1-3 hours 43%

Don’t Know12%





‡

‡

‡

Number of years people age 60+ provide help to the frail or disabled among those who provide help*

More than 3 years

42%




*People who said they provide care were asked “In total, how long have you been caring for … ”

1-3 years37%

<1 year15%

6%



Don’t know


‡

‡

Percentage of people age 60+ who get respite/relief from their caregiving activity*



Provide caregiving

21%

Do not provide

caregiving79% Get respite

66%

No respite34%

*People were asked whether they provide help or care, or arrange for help or care, for a relative or friend who is unable to do some things for him/herself due to illness or disability.

*People were asked whether they get relief from their caregiving responsibilities.





‡DK/RF<1%

**PSA (prostate cancer screening) test for men only (Unweighted N=151; Weighted N=45,921) ***Mammogram for women only (Unweighted N=149; Weighted N=60,107)

Percentage of seniors who received each preventive service in the past year

*People were asked whether they had any of the preventive measures or tests above in the past 12 months.

Figure 11.1, Indiana-Area 3§ Rates of screening and vaccination for various conditions among people 60+*

77%71% 69%

57%52%

22% 22%

97%

Physical Exam

Blood Pressure

HearingTest

Eye Exam

Flu Shot

Mammogram***

PSA Test**

Bone Density

TestUnweighted N= 300Weighted N= 106,028



Percentage of people age 60+ who had a mammogram* in the past year, by demographics

49%

64%

41%

52%



*Mammogram for women only


Total

Age 60-64

Age 65-74

Age 75+


‡


Percentage of people age 60+ who had a mammogram* in the past year, by demographics (cont’d)

51%

54%

46%

53%

50%

54%

52%


*Mammogram for women only


Total

Education >HS

Education <HS

Live w/others

Live alone

Ex/vg/good health

Fair/poor health




‡

Percentage of people age 69+ who participate in regular leisure time activity*




*“Regular leisure time activity” is defined as 1) light or moderate activity that causes light sweating or a light to moderate increase in breathing or heart rate and occurs five or more times per week for at least 30 minutes each time, and/or 2) vigorous activity that causes heavy sweating or large increases in breathing or heart rate and occurs three or more times per week for at least 20 minutes each time. People who engage in other combinations of the two types of physical activities described above are included in the category “some activity.” Those who are unable to or do not engage or seldom engage in physical activity are included in the category “no activity.”

No activity36%

Regular leisure time activity

43%

Some activity

21%



Percentage of people age 60+ who participate in regular leisure time activity,* by demographics

34%

38%

51%

34%

19%

36%

18%

23%

15%

24%

24%

21%

39%

43%

58%

43%

34%

48%

No activity Some activity Regular leisure time activity





*“Regular leisure time activity” is defined as 1) light or moderate activity that causes light sweating or a light to moderate increase in breathing or heart rate and occurs five or more times per week for at least 30 minutes each time, and/or 2) vigorous activity that causes heavy sweating or large increases in breathing or heart rate and occurs three or more times per week for at least 20 minutes each time. People who engage in other combinations of the two types of physical activities described above are included in the category “some activity.” Those who are unable to or do not engage in physical activity are included in the category “no activity.”

Total

Age 60-64

Age 65-74

Men

Women

Age 75+



‡ ‡

‡

Percentage of people age 60+ who participate in regular leisure time activity,* by demographics (cont’d)

45%

32%

56%

31%

40%

31%

36%

15%

23%

9%

23%

20%

23%

21%

45%

43%

40%

34%

45%

40%

47%

No activity Some activity Regular leisure time activity

Total




*“Regular leisure time activity” is defined as 1) light or moderate activity that causes light sweating or a light to moderate increase in breathing or heart rate and occurs five or more times per week for at least 30 minutes each time, and/or 2) vigorous activity that causes heavy sweating or large increases in breathing or heart rate and occurs three or more times per week for at least 20 minutes each time. People who engage in other combinations of the two types of physical activities described above are included in the category “some activity.” Those who are unable to or do not engage in physical activity are included in the category “no activity.”


Education >HS

Education <HS

Live w/others

Live alone

Ex/vg/good health

Fair/poor health


‡

‡

Percentage of people age 60+ who have access to public transportation*

No45%




Yes45%

*People were asked whether public transportation is available in their community.

Yes, but too limited to be

useful Don’t know

6%5%



‡


‡

Means of transportation used most frequently*

Drive a car87%

Ride in a car13%




*People were asked which means of transportation they use most frequently.**Includes taxi, walk, special transportation, and other.

Other,** <1%




‡

Public transportation

<1% ‡

Percentage of people age 60+ who socialized with friends or neighbors in the past week*

Did not socialize

33%

Socialized67%




*People were asked if they got together with friends or neighbors during the past week.



Percentage of people age 60+ who attended church, temple, or other in the past week*

Did not attend38%

Attended61%




*People were asked if they went to church, temple, or another place of worship for services or other activities during the past week.



RF<1%‡


Percentage of people age 60+ who attended movies, sports events, clubs, or group events in the past

week*

Did not attend27%

Attended73%




*People were asked if they went to a movie, play, concert, restaurant, sporting event, club meeting, card game, or other social activity during the past week.



Percentage of people age 60+ who engaged in at least one social, religious, or cultural activity in the past week

None9%

Engaged in one or more activity

91%






Percentage of people age 60+ who participate in volunteer work*

Do not participate in volunteer work

57%

Participate in volunteer work

43%




*People were asked if they do volunteer work and if so what type of volunteer work they do.




Number of hours people age 60+ spend volunteering, among those who volunteer*


*People who said they volunteer were asked how many hours they usually spend per week doing volunteer work.Note: Percentages may not add up to 100% due to rounding and/or missing information.

8%

16%

18%

59%Less than five hours per week

Five to nine hours per week

Ten hours or more per week

Don’t know



‡


Percentage of people age 60+ who would like to be working for pay*



Not working76% Would not

like to work for pay

78%



*People were asked what their current employment status is. *People who were not working were asked whether they would like to be working for pay.

Working part time

11%

Would like to work for pay

20%


Working full time12%


DK/RF2%


‡

DK/RF<1%‡

Percentage of people age 60+ who would like to be working for pay,* by demographics

19%

21%

10%

29%

25%

20%



*People who were not working were asked whether they would like to be working for pay.

Base: Currently not working


Total

Age 60-64

Age 65-74

Men

Women

Age 75+


‡


‡

Percentage of people age 60+ who would like to be working for pay,* by demographics (cont’d)

21%

20%

30%

17%

21%

20%

20%


*People who were not working were asked whether they would like to be working for pay.

Base: Currently not working


Total

Education >HS

Education <HS

Live w/others

Live alone

Ex/vg/good health

Fair/poor health



‡


‡

‡

From Information to Knowledge

• “We’d buy half a loaf of bread if somebody offered it to us.”

• “When I cross a busy street I start to limp so cars will pay attention.”

Who knows

about the issue?

Who cares about it?

Who can do something about it?

Stakeholders

Community

Change

“Every human community, if it is to last, must exert a kind of centripetal force,

holding local soil and local memory in place.”

Wendell Berry

Contact Information• Philip B. Stafford, Ph.D.• Director, Center on Aging and

Community, Indiana Institute on Disability & Community, 2853 East Tenth, Bloomington, IN, 47408

• (812) 855-2163• [email protected]

mailto:[email protected]

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