ScienceDaily (Jan. 10, 2011) — A large proportion of Medicare expenditures for nursing home residents with advanced dementia, a terminal illness, is spent on aggressive treatments that may be avoidable and of limited clinical benefit, according to a new study by the Institute for Aging Research, an affiliate of Harvard Medical School, published in the online version of the Archives of Internal Medicine on Jan. 10, 2011.

The study examined Medicare expenditures for 323 nursing home residents with advanced dementia in 22 facilities in the Greater Boston area as part of the Choices, Attitudes, and Strategies for Care of Advanced Dementia, or CASCADE, study. According to the findings, the largest proportion of Medicare expenditures was for hospitalizations (30.2%) and hospice (45.6%). Medicare expenditures rose by 65 percent in each of the last four quarters before death, primarily due to an increase in both acute care and hospice services. Acute care costs were lower among residents who had either a Do Not Hospitalize (DNH) order, lived on a special care dementia unit, or did not have a feeding tube.

“Our study demonstrates that a large proportion of Medicare expenditures in advanced dementia are attributable to acute and sub-acute services that may be avoidable and may not improve clinical outcomes,” says senior author Susan L. Mitchell, M.D., M.P.H., a senior scientist at the Institute for Aging Research.

An additional 10 percent of Medicare expenditures were for care in a rehabilitation facility after hospitalization. Dr. Mitchell calls the benefits of skilled nursing or rehabilitative care for these patients “questionable,” given that most of them are totally physically functionally and cognitively impaired.

Strategies that promote high-quality palliative care may shift expenditures away from aggressive treatments for dementia patients at the end of life and more toward a comfort care approach, say the researchers.

“The strong association between the lack of a DNH order and higher acute care expenditures supports the notion that advance care planning may be a key step toward preventing aggressive end-of-life care,” says Dr. Mitchell, an associate professor of medicine atHarvardMedicalSchool. Among cancer patients, advance planning lowers costs in the last week of life, and lower costs are associated with a higher quality of dying experience.

Both hospice and palliative care focus on quality of life or “comfort care,” including the active management of pain and other symptoms, as well as the psychological, social and spiritual issues often experienced at the end of life. Unlike hospice, however, palliative care services do not depend on life expectancy and may be used in conjunction with curative treatments.

Estimates peg 2010 total health-care expenditures for dementia at $172 billion, which will continue to rise as the number of people experiencing the end stages of this disease increases. Currently, more than 5 million Americans suffer from dementia, a number that is expected to increase to almost 13 million in the next 40 years. Total Medicare and Medicaid payments (nursing home care is generally paid for by Medicaid after individuals have exhausted their savings) for patients with dementia are roughly three times higher than they are for those without dementia.

Dr. Mitchell’s team looked at Medicare health services used by the nursing home residents over 18 months, culling data from hospital admissions, emergency department visits, primary care provider visits, and hospice enrollment. Roughly one-third of all Medicare costs for dementia were for hospitalizations, which Dr. Mitchell says are burdensome for many of these patients because, among other reasons, they involve a physical transfer and dementia patients often become even more confused and agitated in an unfamiliar environment. Previous studies by Dr. Mitchell and others have shown that most hospitalizations for patients with end-stage dementia are for conditions such as pneumonia that could be treated as effectively and at less cost in a nursing home setting.

Hospice payments accounted for close to half of all Medicare expenditures even though only 22 percent of the nursing home residents received hospice care. Hospice has been shown to benefit residents dying with dementia, but it is greatly underutilized with this population.

Dementia is a group of symptoms severe enough to interfere with daily functioning, including memory loss, difficulty communicating, personality changes, and an inability to reason. Alzheimer’s disease is the most common form of dementia.

A 2009 study by Dr. Mitchell in the New England Journal of Medicine was the first to rigorously describe the clinical course of advanced dementia and to label the disease a terminal illness similar to other incurable diseases, such as cancer.

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: August 16, 2011

The researchers expected that seniors, when faced with mounting out-of-pocket costs, would switch to cheaper generics. In fact, that was one of the main arguments behind the coverage back when Medicare’s drug benefit was created in 2006. If seniors saw how much drugs cost, they’d be more thrifty consumers and seek out cheaper drugs, some reasoned.

But the current study shows that hasn’t been the case.

Rather than seeking cheaper alternatives to prolong entry into the doughnut hole, some seniors just stop taking their prescriptions once they reach the coverage gap or alter their dosing regimen to make their medication last longer.

The Affordable Care Act (ACA) will eliminate the doughnut hole by 2020 and until then, the law takes measures to help seniors defray the costs of the coverage gap.

For example, in 2010, many seniors received $250 checks in the mail, and this year 900,000 Medicare beneficiaries have already received a 50% discount on prescription drugs while in the doughnut hole.

But until the doughnut hole is truly closed in 2020 “beneficiaries may still be at risk of decreased drug utilization and adverse clinical consequences,” the authors wrote.

“In contrast to blunt cost-sharing approaches such as the coverage gap feature, more nuanced, clinically informed insurance strategies that specifically promote the use of drugs with high benefit and low cost may hold the most promise for governments and insurers seeking to improve the health of their citizens while reining in drug costs,” they concluded.

One alternative strategy, the authors wrote, would be to encourage the use of generic drugs from the outset in order to forestall entry into the coverage gap.

The study was funded through grants from the National Institute on Aging, the National Institute of Mental Health, the National Heart, Lung, and Blood Institute, Robert Wood Johnson Foundation, and CVS Caremark.

The study authors reported a number of conflicts of interest, including that lead study author is a consultant for a company that contracts with the Centers for Medicare and Medicaid Services; another author is a consultant to United Healthcare, which sells Part D plans, and receives research funding from CVS Caremark, Aetna, and Express Scripts, which all have Part D business. Another author worked at CVS Caremark during the study, and CVS Caremark provided funding and data for the study.

 Primary source: PLoS Medicine
Source reference:
Polinski JM, et al “Changes in drug utilization during a gap in insurance coverage: An examination of the Medicare Part D coverage gap” PLoS Med2011; 8(8): e1001075

Why Seniors are Moving from Institution Back Home

After living for three years in a nursing home following a stroke, Gail, 78, went through his life savings paying for the nursing home and eventually qualified for Medicaid. He had always wanted to and intended to move back home, but his condition required that he stay in the nursing home. His ex-wife, Sue, and a social worker at the nursing home informed him about a program called “Money Follows the Person” (MFP), which supports efforts to move institutionalized individuals back home.

In 2009, MFP enabled Gail to move into Sue’s house because she is his main care provider. The program allotted $1,500 for home services, modifications to the home in the form of ramps and a handicap accessible bathroom, 16 hours of personal care services each month, and attendance at adult day care each day. Gail’s health has remained steady, he is able to enjoy more of a routine life, and he is able to get the care he needs at home while surrounded by friends and family.

The U.S. Congress authorized the MFP as part of the Deficit Reduction Act of 2005. MFP was designed to assist states in rebalancing their long-term care systems and help Medicaid enrollees transition out of institutions and back to their communities.

Since 2008 when the first senior moved back home through the MFP program, an increasing number of states have been making stories like Gail’s a reality for seniors and others with disabilities. As of February 2011, 43 states and the District of Columbia participate in the “Money Follows the Person Rebalancing Demonstration Program.”  The significance of this program for seniors is found in its intention for establishing a strong foundation of person-centered, consumer-directed, and community-based services. Seniors are receiving the services they need in an environment that is more comfortable for their recovery and/or daily living. Ultimately, the service model is no longer provider-driven and institution-based, but rather it is more conducive to successful living because of the personalized approach. (Centers for Medicare and Medicaid Services).

More recently, with the passing of the Affordable Care Act in March of 2010, the MFP received a boost in funding and a time extension through September 30, 2016. Additionally, the MFP program expanded the eligibility requirements to include anyone who is in an institution for more than 90 consecutive days. The old restriction was anyone who had been institutionalized for six months to two years. The longer an individual has been institutionalized the more likely they are to have relinquished a community residence and it is often more challenging for them to again establish a community residence. Individuals who have been institutionalized for a shorter period of time may still have a home to which they still have access. 

States have their own methods for identifying appropriate candidates for the MFP program. Once identified, the individual has access to the designated funds for their case for a period of twelve months and receives assistance in achieving the needed transition services.

After the program is complete, the continuity of care in each state will vary. Generally, MFP participants may be able to access existing waivers. Participants will continue to be served through these waivers as long as they continue to meet the eligibility criteria.  Therefore, there will not be a lapse in services for MFP demonstration participants. Check with your state on the plans the Medicaid office has in place for the post-demonstration period.
 
Challenges that Affect the Program
While each state handles their grant money from the MFP program differently, each is working to gain foothold in providing opportunities for their institutionalized citizens to regain status as community members. Implementing a MFP program involves comprehensive and extensive planning at the state level as well as collaboration with Centers for Medicare and Medicaid Services. The two main challenges to the success of the program continue to be available housing and accessibility of community service providers.

Housing – The number of residential units available for Medicaid dependents is limited in any case, and states recognize the squeeze that the MFP program places on this issue. More and more states have launched a concerted effort in conjunction with other government agencies such as the U.S. Department of Housing and Urban Development (HUD) to increase their chances of creating and locating safe and affordable housing arrangements.

Examples of what states are doing specifically to address this problem include: Ohio has a housing specialist under the MFP umbrella whose job it is to build partnerships with housing officials. Michigan has 26 housing coordinators throughout the state who identify housing opportunities for MFP recipients (www.kff.org).

Community services – Already stretched thin, service providers who can provide Medicaid supported home- and community-based services (HCBS) are difficult to find. MFP aligns more individuals with service providers, but without enough service providers, the MFP program recipients may not have access to these services. States are working hard to develop HCBS services using MFP dollars because community services are typically more cost-effective compared to institutional care when measured on a per-person basis.

Examples of the most commonly expanded services that states are employing are: case management to coordinate transition; help with home modifications; and one-time housing expenses such as security deposits, use of assistive technology, and transportation (Kaiser Family Foundation). North Dakota has developed a 24-hour back-up nursing service.

All of these efforts are to create more opportunity for community-based service providers that will support the long-term care of seniors and people with disabilities in their homes by providing the care they need.

Successes for Seniors Now and Long-Term
Each year, the numbers of participants transitioning increases as solutions to barriers are identified and significant technical assistance helps states meet transition goals. As of December 2010, almost 12,000 individuals returned to the community as a result of these demonstration programs, with a reinstitutionalization rate of only about 3–4 percent.

The infrastructure that is creating avenues to affordable housing and HCBS continues to be strengthened through plans customized at the state level to provide support for seniors even after MFP is slated to end. This infrastructure is required if states plan to successfully extend the opportunity of transitioning institutionalized individuals for the long-term.

According to the Kaiser Family Foundation, “MFP is likely to continue to help states reorient their long-term services and support systems toward more community-based care. This program in conjunction with other ACA Medicaid policy options has the potential to expand Medicaid home and community-based services for many more seniors and persons with disabilities who desire to live in the community.” Kaiser Family Foundation expects this trend to extend beyond the life of the MFP program demonstration and have a positive long-term impact for seniors.

Resources:
To find out if you are eligible and to apply for MFP, contact the Department of Social Services or related Medicaid office in your state. To get to your state’s official website, most states follow the website address pattern of www.insertnameofyourstate.gov, i.e. www.colorado.gov.

Centers for Medicare and Medicaid Services:
www.cms.gov 

October is National Breast Cancer Awareness Month

Breast cancer is the second most common cancer in American women behind skin cancer.  Seniors are at an increased risk to develop breast cancer, so take time during National Breast Cancer Awareness Month this October to learn more about this deadly disease.  Here are a few facts regarding seniors and breast cancer, provided by the National Breast Cancer Awareness Month website (www.nbcam.org).

• The risk of developing breast cancer increases as a woman grows older, but the risk increases significantly for women age 60 and older.
• Breast cancer is not common in women younger than age 35, but it can occur.
• There is some evidence to suggest young African-American women are at greater risk for breast cancer than young Caucasian women.
• Medicare covers mammography screening every year for female Medicare .  Eligible women and their doctors may not know about this important benefit, so be sure to share this information with your female clients and their families. A series of publications regarding this benefit are available in English and Spanish.
• For more information about Medicare coverage, contact the Medicare toll-free hotline at (800) MEDICARE or the Medicare Web site, www.medicare.gov.

I don’t have to tell you that Alzheimer’s is a worldwide epidemic.  Currently, five million people in the U.S. have this disease, and there are more than 35 million globally.  By 2030, those numbers will double, and by 2050, they’ll more than triple.  Last year the worldwide cost of Alzheimer’s was more than $600 billion – if it were a country; it would be the 18th largest economy in the world.  That’s because it costs about four times as much to care for a senior with Alzheimer’s.   And there is no cure in sight, sadly.   

But what occurs to me is that until that cure is found, Home Instead CAREGivers ARE the treatment for Alzheimer’s.  Quality home care is the future.  Home Instead trains our CAREGivers to deliver on that care for your family! Our training program is paramount to your parent’s best quality of life & quality of care.  There is no greater differentiators for hiring a Home Instead CAREGiver we could offer today than our specialized Alzheimer’s program. 

  We have partnered with David Troxel, Dr. Amy D’Aprix and the University of North Carolina at Chapel Hill – to take gathered information and add their expertise to create a training that directly responds to family needs and is custom tailored to our Home Instead CAREGivers.  

If you have a family member suffering from Alzheimer’s and you are looking for some help at home, please visit our web site to learn more about Home Instead CAREGivers or call our office and ask us about our training programs. We’d be more than happy to share our expertize with you. You are not alone, We are your home care & Alzheimer’s Solution!

www.homeinstead.com/sonoma

The Elder Care Radio Show—July 2011
KSRO 1350 AM Fridays—12:30-1:00 p.m.KFRC 1550 AM & KNEW 910 AM Saturdays—8:30-9:00 a.m

I suspect I’m in the minority of people who are comfortable talking about death.  This month guests and I will discuss the subject in a gentle, educational way.  To dispel perceptions of “creepiness,” I invite you to e-mail a helpful tip or experience for me to share with other listeners at ElderCareShow@gmail.com.  I hope you will give yourself a 30-minute break each week to tune in to the live show or to a podcast.  Take good care,            Kira Reginato

Archives of The Elder Care Show are available on podcast at www.lifegcm.com.  Weekly downloads are also available at iTunes.com.

        July 1KSRO 1350                         July 2KFRC 1550                                   July 9KNEW 910

Patrick Arbore, Director of The Friendship Line

Institute on Aging, San Francisco

Patrick is one of my favorite guests.  He’ll discuss why we fear death, dislike talking about it, and what the fear of death can lead to:  depression, drinking in excess, and leaving our loved ones guessing at what our wishes might have been in the midst of their grief.  Let Patrick help you begin to become comfortable with the topic.

         July 8KSRO 1350                                July 9KFRC 1550                          July 16KNEW 910

Elvira Orozco, Funeral Director

Windsor-Healdsburg Mortuary, Windsor

 Do you realize that if you died tomorrow, your loved ones are responsible for completing extensive paperwork and carrying out your final wishes?  You can lighten the responsibility that falls to your family by becoming informed, making decisions, and even completing paperwork now.  Drawing on her 16 years in the mortuary business, Elvira will discuss options, services and costs.

           July 15KSRO 1350                           July 16KFRC 1550                        July 23KNEW 910

Ryan Lee, Author of “A Day in the Life of Death:  A Behind the Scenes Look at the Mortuary Business” 

Ryan is a graduate of the San Francisco College of Mortuary Science and, in addition to being a best-selling author, currently serves as a business consultant, writes for a number of national publications, and is a frequent lecturer.  He will talk about the funeral industry as a business and offer advice about being an informed consumer when dealing with funeral homes.                   July 22KSRO 1350           July 23KFRC 1550              July 30KNEW 910Kathy Curry, Manager, Fernwood Cemetery, Funeral Home and Crematory, Mill Valley Are you aware that the resources consumed to cremate one body are equivalent to the amount of energy one person uses in a month?  Kathy will explain the option of natural or “green” burial where there are no toxic embalming fluids, no vault, and only a biodegradable casket or burial shroud. Ryan Lee, Author of “A Day in the Life of Death:  A Behind the Scenes Look at the Mortuary Business”  During today’s program, Ryan will provide information about technology for funeral services including webcast funerals for those far away and digital biographies. We’ll have a special guest talk about selling real estate in probate.The Elder Care Radio Show thanks its sponsors:  Reliable Caregivers • SearchSeniorLiving.Com • Dr. Michael A. Fraga, Neuropsychologist • Arcadia Home Care and Staffing •Brookdale Senior Living • Golden Living Centers • Home Instead Senior Care • Institute on Aging • Jewish Home of San Francisco • Lifeline Personal Response and Support Services • Dr. Thomas Yatteau, Concierge Medicine

                 July 29KSRO 1350                     July 30KFRC 1550                 Aug 6KNEW 910

Ryan Lee, Author of “A Day in the Life of Death:  A Behind the Scenes Look at the Mortuary Business” 

During today’s program, Ryan will provide information about technology for funeral services including webcast funerals for those far away and digital biographies. We’ll have a special guest talk about selling real estate in probate.

The Elder Care Radio Show thanks its sponsors:  Reliable Caregivers • SearchSeniorLiving.Com • Dr. Michael A. Fraga, Neuropsychologist • Arcadia Home Care and Staffing •Brookdale Senior Living • Golden Living Centers • Home Instead Senior Care • Institute on Aging • Jewish Home of San Francisco • Lifeline Personal Response and Support Services • Dr. Thomas Yatteau, Concierge Medicine 

Be Inspired!         Be Intentional!      Be the change YOU want to see in the World!

My mom was Dignosed  in 1983 and with  treatment including a radical mastectomy I can say today, She IS  a 28 year SURVIVOR!!!!  She is an example of amazing strength!  She taught me so much just witnessing her battle with the treatment & the drainage tubes & rebuilding of her physical streagth and altered Body Image. Rebuilding her life, the one the doctors said she would most deffiantly loose on the opperating table & to make arrangments for her two  young children prior to suregery.  I must say her spritual streagth through, the worst of it, Nerver waivered!

My Mom IS a true Pink Ribbon Warrior! For my Mom  & my own Daughter Kerrry,  for your mom & your daughters, yours siter, your best friend …. I walk, I donate, I sponsor.  I want to see Breast cancer be only used in the past tence,  like an old dusty box found in the corner of a garage in a very old house. One day….but today, I WALK!

This disease affects so many,  yet we are so far from cure &  vaccination…. I have a client who just lost her sister to BC and that follows the death 3 yrs ago of their mother to the disease.     :-(    Unfortunatly this isnt a ramdom story, it is all to common. 

Walk! Walk to find a cure my friend!  Be inspired! Be intentional & Be the change we want to see in our World! One day this,  like so many other illness ( Alzheimer’s my other passion) will be only spoken on used in the past tense. Our children will tell their children of the great illnesses of our time which took so many lives. One day….But  today, WE WALK!

 Kerry, Julie Ann & Trudy~ photo above

Walk, Run, Join a team, or  Support one, Be inspired, Be intentional, Be the change you wish to see in the world! 

 Take Action. Take control. Make a change!

Join us at the San Francsico Avon Breast Cancer Walk on July 9th and 10th, stay hydrated & wear ur favorite sneakers!

~Julie Ann 

About the Avon Walk San Francisco

From the bustling downtown to the raw beauty of Marin, the Avon Walk San Francisco experience will embrace the very aspects of charm and diversity that make this city one of the world’s favorites. This Avon Walk weekend July 9 -10, 2011 will have you traveling across the Golden Gate Bridge and alongside the Sausalito waterfront. The legendary roller coaster hills are only a small price to pay as we walk together to address the unusually high occurrence of breast cancer in the City by the Bay.

IN IT for a purpose

We’ll walk up to 39.3 miles between Saturday and Sunday -all so that women and men can get the medical care they need regardless of their ability to pay, and leading research teams can receive vital support in their ongoing search for a cure.  For more specific details regarding the mileage per day, please see their  event page at :

http://www.avonwalk.org/san-francisco/

Wheather you live in historic Petaluma,  Santa Rosa, charming Rohnert Park, Windsor, the Sebastopol countryside or on a vineyard in sunny Healdsburg, you can listen to KSRO radio and Kira Reginato on Fridays from 12:30pm to 1 in the afternoon! Kira hosts gifted, talented & educated experts in Elder Care every week. You can now also hear her Sun. on KFRC too!

 There are archived shows on Podcasts so you dont ever have to miss a beat from Kira. You can even listen to shows I have been on with Kira talking about Home Instead’s ” Be a Santa to a Senior” program, or on how to hire home care, or our LIFECATCHING program and how we care for Alzheimer’s clients in Sonoma County. Below is the list of experts coming on Aprils shows with Kira. Give her a listen!

The Elder Care Radio Show  April 2011 Dear Listeners,    Baby Boomers are becoming senior citizens at the rate of almost 8000 each day!  They are grappling with the prospect of Social Security and when to apply for it, Medicare, and what the future holds for their financial security and social well-being.  April’s guests will discuss options available, steps to take and when, and mending broken family relatioinships to create support system insurance.  I hope you will give yourself a 30-minute break each week to tune in to the live show or to a podcast.  Take good care, Kira Reginato
	Lowell Kepke Deputy Communications Director Social Security Administration    Find out when you’re eligible and how to apply for Social Security.  Social Security is the largest source of income for most elderly Americans today, but it was never intended to be the only source of income after retirment.  Some project that Social Security funds will be drained by 2037.    KSRO 1350 AM:  Friday, April 1, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 2, 8:30 – 9:00 a.m.   Julie BennettHICAP Community Outreach Specialist We’ll talk about Medicare, Medicare D,  supplemental insurance plans, and why you might need one.  HICAP (Health Insurance Counseling and Advocacy Program) provides free and objective information and counseling about Medicare.  Volunteer counselors can help you understand your specific rights and health care options.KSRO AM 1350:  Friday, April 8, 12:30 – 1:00 p.m.KFRC AM 1550:  Saturday, April 9, 8:30 – 9:00 a.m.  Yvonne BaginskiOwner/PublisherBorn to Age Directories   April 16 is National Healthcare Decisions Day.  Yvonne is a senior advocate who publishes widely on caregiving, aging, chronic illness and community resources.  We will discuss the importance of Advance Healthcare Directives, the POLST form, and ways to ensure that your health care wishes are carried out.    KSRO 1350 AM:  Friday, April 15, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 16, 8:30 – 9:00 a.m.  Carol NelsonRetired R.N.Charles NelsonRetired Profesional Handyman  Listeners have heard me refer to my parents on past shows.  Now is their chance to be heard!  I will ask them how they set about their plans for retirement and find out how they now spend their time.  Their open discussion and disparate examples will provide food for thought about “real retirement.”   KSRO 1350 AM:  Friday, April 22, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 23, 8:30 – 9:00 a.m.  Jane IddingsAttorney and Elder Mediator   Cate Griffiths Executive Director RECOURSE Mediation Services What happens when you are in the hospital and the staff asks who they can call to get help returning you home?  Has it been years since you’ve spoken to your son or your sister?  If you are estranged from family, we will be getting advice on how to restore relationships so you have a support system in place. KSRO 1350 AM:  Friday, April 29, 12:30 – 1:00 p.m. KFRC 1550 AM:  Saturday, April 30, 8:30 – 9:00 a.m.
	About Kira ReginatoKira Reginato, host of The Elder Care Show, is a San Francisco native who has worked with older adults and their families to navigate the challenges of aging for more than 20 years.  She and her guests offer pragmatic advice and create an on-air community where listeners realize they’re not alone in facing the often difficult decisions of aging.  Kira brings insight, a compassionate personality, and humor to subjects that can be difficult to address.As President of Living Ideas For Elders, a consulting and case management firm she founded in 2007, Kira has been active in geriatric care professional associations, serving three years as chair of the Sonoma County Section on Aging, chair of the Petaluma Senior Care Connection, and co-chair of the Bay Area Chapter of the Western Regional National Association of Professional Geriatric Care Managers.  In 2010, the Petaluma Chamber of Commerce presented her with the Award for Excellence in Service to Seniors.
Weekly Downloads and Podcast Archives  Archives of The Elder Care Show are available on podcast at www.lifegcm.com/podcast.  To subscribe for weekly downloads, go to http://itunes.apple.com/us/podcast/the-elder-care-show-kira-reginato/id344595102.

by Linda A. Jacobsen, Mary Kent, Marlene Lee, and Mark Mather

(February 2011) In 2011, the oldest baby boomers—Americans born between 1946 and 1964—will start to turn 65. Today, 40 million people in the United States are ages 65 and older, but this number is projected to more than double to 89 million by 2050. Although the “oldest old”—those ages 85 and older—represent only 15 percent of the population ages 65 and older today, their numbers are projected to rise rapidly over the next 40 years. By 2050, the oldest old will number 19 million, over one-fifth of the total population ages 65 and older.

The United States has a smaller share of older persons than many developed countries, and its population is graying at a slower pace.¹ Japan currently leads the world with nearly one-quarter of its population ages 65 and older, followed closely by Italy and Germany. By 1980, the proportion of the population ages 65 and older in the United Kingdom, France, Italy, and Germany had already exceeded the level in the United States today. Between 1980 and 2010, the proportion ages 65 and older in the United States only increased by 2 percentage points, compared with a 14 percentage-point increase in Japan and a 7 percentage-point rise in Italy. However, the pace of population aging is projected to accelerate in the United States, Russia, U.K., France, Italy, and Germany in the next 30 years. Japan, already the “oldest” country in the world, will continue to age as the number of children and working-age adults shrinks relative to the population ages 65 and older. Even more striking is the projected acceleration of aging in many developing countries such as India, Mexico, Brazil, and China, where recent declines in fertility signal slower population growth and significant population aging in the coming decades. Population aging is rapidly becoming a global phenomenon.

Increases in the number of older Americans will have a profound impact on the age structure of the U.S. population. Back in 1970, children made up about one-third of the U.S. population, and only one-tenth were ages 65 and older. Today, the proportion who are children has dropped to about one-fourth, while the share who are elderly has risen to 13 percent. However, by 2050 fully one-fifth of the U.S. population will be ages 65 and older. Most of this increase will take place by 2030 as the last of the large baby-boom cohorts reaches age 65.

Rapid changes in age structure can have major social and economic consequences, especially when they are unanticipated. The postwar baby boom in the United States has strained local hospital, public school, and postsecondary education systems, as well as the labor force as these unexpected large cohorts have moved through the life cycle. U.S. population aging has been long predicted. However, it is not only the number and share of elderly that are important for policy and program decisions, but also their characteristics: health and disability status, living arrangements, kinship networks, and economic well-being. This Population Bulletin examines the current and future U.S. population ages 65 and older and considers the costs and implications of America’s aging population.

Reference

1. Kevin Kinsella and Wan He, “An Aging World: 2008,” U.S. Census Bureau, International Population Reports P95/09-1 (Washington, DC: U.S. Government Printing Office, 2009).

From the National Council on Aging’s press room…

Many 2010 New Year’s resolutions will likely focus on staying healthy and saving money.  Older adults can help keep both of these resolutions by using BenefitsCheckUp, a free, online benefits screening service developed and maintained by the National Council on Aging (NCOA). 

Beginning in January, federal changes to Medicare Savings Programs (MSP) and Medicare’s Low Income Subsidy (“Extra Help”) mean a simplified application process and greater eligibility for these important programs.  MSP provides support to seniors by helping with Medicare costs such as the monthly Part B premiums and, in some cases, other premiums, deductibles, and co-pays.  Medicare’s Extra Help assists with the cost of Medicare prescription drug coverage.  

BenefitsCheckUp: A service of the National Council on Aging

Seniors, particularly those with low income and limited resources, can access new information on these and other benefits programs, as well as an updated Medicare Rx Extra Help Online Application form by visiting www.benefitscheckup.org.

“Throughout the New Year, NCOA wants to help low-income older adults remain economically secure,” said Stuart Spector, senior vice president at NCOA. “Keeping up to date and taking advantage of needed benefits programs through BenefitsCheckUp provides an important strategy for vulnerable seniors.”

Good News for 2010

Effective this month, the Social Security Administration began taking relevant information from applicants’ Extra Help applications and submitting it to their state MSP offices to start an MSP application. By using the updated Medicare Rx Extra Help application available on BenefitsCheckUp, seniors can quickly and easily file their Extra Help application online with Social Security and, by doing so, save themselves a separate trip to their state Medicaid office. 

In addition, the 2010 asset limit for MSP eligibility increased to the same level as the Extra Help’s full subsidy ($6,600 per single and $9,910 per couple) for states that use the standard asset limits (some states offer more generous asset limits or have no asset limit for MSP). This means more people may be eligible for MSP and can in turn utilize the streamlined application to apply for the Extra Help and MSP at once— good news for many low-income seniors.

Savings in Seconds

It’s important for seniors to check their eligibility for the MSP and Extra Help programs now, as the New Year has brought changes, and people who weren’t eligible before may be eligible for these benefits in 2010.  BenefitsCheckUp has made updates to account for these changes, making it quick and easy for seniors to access updated information, eligibility rules and application forms.  Seniors should use BenefitsCheckUp as a resource to check their eligibility for additional benefits programs, including 2,000 federal, state, and local programs that can help with utilities, food, housing, and other basic needs. Enrollment forms for most programs are provided as part of BenefitsCheckUp’s interactive screening process.  Since 2001, more than 2.4 million people have used the service, identifying benefits valued at more than $7.8 billion. 

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About NCOA

The National Council on Aging is a nonprofit service and advocacy organization headquartered in Washington, DC. NCOA is a national voice for older Americans—especially those who are vulnerable and disadvantaged—and the community organizations that serve them. It brings together nonprofit organizations, businesses, and government to develop creative solutions that improve the lives of all older adults. NCOA works with thousands of organizations across the country to help seniors find jobs and benefits, improve their health, live independently and remain active in their communities. For more information, please visit www.ncoa.org – or call either of these folks about this news release:

• Connie Hofmann, Tel: 610-687-5495, chofmann@aboutscp.com 
• John Beilenson, Tel: 610-687-5495, jbeilenson@aboutscp.com

Here at Home Instead Senior Care of Sonoma County, we’re dedicated to bringing you the latest news about senior living and senior health care issues.  We serve all of Sonoma County, including Petaluma, Rohnert Park (where our office is located), Sonoma, Windsor, Santa Rosa and more.  Simply call us at 707-586-1516 for a free, no-obligation assessment of your senior home care and non-medical home care needs.