1 Good News.....Bad News Chapter 11

2 Future Concerns n Good News: – more of us are living longer in better health, more independently, and with greater security – most of us will be the beneficiaries of technological and biomedical advances – there will be more opportunities for growth and personal enhancement in later life

3 Bad News n advances carry considerable economic and social costs n we will be faced with increasingly difficult resource choices, ethical dilemmas, and political decisions n there may likely be more years of dependency in later life

4 Effects in the next century n Will the US economy continue to expand? n Will the young adult and middle-age women continue to enter the full-time work force at current rates? n How will the demand for other federal expenditures change over the next 50 years? n “ All of these will effect the quality of lives of elder Americans in the next century”.

5 Social Perceptions & Attitudes n As this population increases our attitudes and perceptions will also undergo a change n As this population increases it is becoming more diverse, so no single way of understanding our elders n We can predict fertility, mortality and migration, but what other factors must we speculate?

6 Other Factors n Will health care costs continue to escalate? n Will family structures change? n How secure is our Social Security System? n Will older adults continue to retire early? n Will Americans’ savings rate improve?

7 Concerns: n 1. Some differences between today’s elderly and elderly of the future n 2. Concerns over generational equity and distributions of resources are likely to become more pressing n 3. How the burden of economic support and social and medical care will be distributed

8 First Concern: Future Elders n Higher level of education and probability of being married n Family size decreasing n Gap in life expectancy is narrowing n Number of women in work force for a longer time period n As elderly population grows, so does voters

9 Work life n Evidence is showing a change, but right now most elderly retire as soon as they are able to (finances & health) n Demand for elder workers is not there n Age Discrimination in Employment Act n Will see them planning for retirement differently n Work, education, and volunteerism will become more integrated in their lives

10 Elder workers n Better health than previous generations n Interest in continuing to work n Have fewer sick days n Punctual, reliable, experienced and loyal to employer

11 Life-long learning n There has been an increase in the adult college population n Why? Life transitions, a satisfying activity, opportunity to meet people, way to fill up free time n It has been observed that adult education increases during periods of rapid social change

12 Volunteerism n Have seen considerable growth, yet largely underutilized resource relative to potential contribution they could make n Self-Esteem = most common response to why they volunteer

13 Second Concern: n Generational Equity – Concern that as elderly population grows, it draws more of our national resources away from the needy younger population – A large proportion of these impressions are misleading – Much of the cost burden supporting an aging population is related to the costs of increased demand for medical care and health care resources

14 Third Concern: n Providing for the elderly: – Three sources of resources and support: n family,public government sector, private business sector n Family- unlikely that younger generation can sustain the burden n Private Sector- probable but question the quality and sustainability of private sector options n Public Sector- involves long-standing social contact that will need to be sustained at current level

15 n Most countries are not equipped or ready to cope with the growth of elderly population n U.S. compared to Sweden n U.S. : -all S.S. recipients are eligible for Medicare – Medicaid is major source of funding for long- term care – Medicaid is income-based (payment for health care regardless of age, who do not have private resources to pay for medical care

16 n Many elderly require more social than medical care but have neither the family nor other social support or financial resources to elect any other option than nursing home care. n Access to in-home and community-based services is limited and fragmented. n Sweden : offers a different model based on different social and political philosophies.

17 Sweden n Policy governing the elderly is NOT age- specific n 1982: Social Service Act - provides municipal social services to all persons who need them regardless of age n 1983: Health and Medical Services Act - provides health care and services to all members of society regardless of age

18 n All members of society are supported through a tax system that takes about 1/2 of a working person’s income n Directs support toward independent living n (46% of those older than 70 live alone) n It is estimated that family and friends provide 2/3 of all care

19 Summary n What we’ve discussed is the way we might find the future- there are no certainties n What we do see is Americans living longer, healthier, and more productive lives n When we discuss the concerns they should be placed on national level, and not just concerns of the elderly (age-blind concerns)

20 Good News....Bad News

21 It’s been a fun class, thanks.