1 Welcome “Aging in Place on Cape Cod” Informational Meeting For The Community January 23, 2007 Presented by: Senior Mobility Initiative on Cape Cod (SMICC)

2 Tonight’s Presentation Will include a science-based prediction of the future senior/elder population of Cape Cod—will include a demographic profile of the future population, with particular emphasis on the physical, mental, and well-being characteristics of our seniors/elders that contribute to a safe and appropriate aging in place environment and, ultimately to their quality of life and longevity.

3 Announcements FUTURE-Oriented Presentation * * * * * Informative Materials – Brochures Information about SMICC SMICC: Independent, Non-Affiliated, Grassroots Goals: Research, Education, Advocacy Information about our Sponsor (FCII) * * * * * Simple Ground Rules! Introducing our “Timekeeper”

4 Introduce Yourself... please

5 Independence!

6 Changes Related To Aging “Physical [and Mental] changes: Decreased mobility and dexterity Decreased strength and stamina Reduced sensory acuity: vision, hearing, thermal sensitivity, touch, smell [Decreased mental acuity and abilities] Social changes: Isolation from friends and family: Due to loss of peers From children living far away Changing neighborhood.” [1] 1. Source: “Resource For Aging In Place,”

7 Aging in Place “Aging in place is growing older without having to move.” [1] “Some 70% of seniors spend the rest of their life in the place where they celebrated their 65 th birthday.” [1] 1. Source: “Resource For Aging In Place,”

8 Social Isolation “With age, sociologic changes occur between aging individuals and family and friends due to loss of peers and contemporaries - - spouse, siblings, other relatives, old friends and neighbors. This can lead to isolation unless a concerted effort is made to stay socially active.” 1 Getting out and about in one’s neighborhood and in the community is the primary way of overcoming social isolation. [underline added for emphasis] 1. Source: “Understanding Aging, ‘Birds who fly faster, live longer’,” seniorresource.com web site.

9 Aging in Place “While…[the] population of elderly require help with tasks such as cleaning, shopping, and preparing meals, as well as activities of daily living such as bathing, dressing, eating and moving from bed to chair, their care can often be provided at home from the community” [1] [underline added for emphasis] 1. Source: “Aging in Place: Findings from the Grantmakers In Health Resource Center,” Grantmakers In Health,

10 Some Aging in Place Statistics CURRENTLY: 70%-80% of 65+ currently “aging in place” (At least 38,000 on Cape) FUTURE: 90% of “Baby Boomers” plan to “age in place” (Would mean about 70,000 on Cape by 2015, 100,000 by 2025,.... )

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12 Who is Involved? Home health care providers Police, Fire-Rescue-Ambulance Councils on Aging Home maintenance professionals Transportation services Elder law specialists Government officials–-Town, County Occupational therapists Geriatric care managers Hospice services Social workers/mental health therapists And many, many more Families–-near, and far away Physical Fitness – Exercise Programs Hospitals, ERs, and clinics Medical and Dental professionals Remodeling contractors ADA–disability specialists Emergency management planners Food and product delivery services Friends, Neighbors Caregivers Utility companies Besides the seniors/elders themselves, many others are involved in creating a safe and appropriate “aging in place” environment.

13 Safe and Appropriate Aging in Place “Environment” Medical – Healthcare: Medical and dental professionals Home health care services Occupational therapists Hospitals, Emergency Rooms, clinics Physical Fitness – Exercise Programs Caregivers Geriatric care managers Practical: Home maintenance professionals Remodeling contractors ADA-disability specialists Food and product delivery services Financial planners – insurance companies Legal professionals/para-professionals Assistive technology specialists Social – Spiritual: Churches, synagogues, temples Hospice services Councils on Aging Area Agency on Aging Human/Social Service providers and agencies Mobility: “Getting Up, Out and About on Cape Cod” Transportation services Van services - Volunteer drivers Friends, neighbors, and family Senior drivers, senior pedestrians Public Safety: Police, Fire-Rescue-Ambulance – Emergency Planners - Utility Companies - Government Officials

14 Planning For “Aging in Place” “…developing a plan to address aging in place means more than building more senior centers and congregate meal sites. That’s because all the major facets of community life affect the ability of older adults to age in place from public safety, affordable housing, accessible transportation, and health and social services to education, employment, and social and cultural opportunities. In essence, the aging of the population will impact the entire social, physical and fiscal fabric of our community.” [1] [underline added for emphasis] 1. Source: “Is Your Community Ready for the Aging Boom?,” Sandy Markwood, CEO National Association of Area Agencies on Aging (n4a),

15 Ten “Best Practices” For Communities to Consider as Their Populations Age Preventive Healthcare Nutrition Education Age-Appropriate Fitness Programs Larger, Easier-to-Read Signage Preparation for First Responders Home Modification Programs Tax Assistance and Property Tax Relief Job Training, Retraining Engagement of Older Citizens in Community Boards/Commissions Single Point of Entry for Information and Access To Services Source: “The Maturing of America – Getting Communities on Track for an Aging Population”

16 Aging in Place on Cape Cod Adult Living Alone Age 65+ Age 75+ Groups Differ Quite Dramatically! Based on The Human Condition Research – since 1994 Two Adults Age 65+ Age 75+

17 Cape Codders Who Are Aging in Place (Two different household settings) Adult Living Alone –Similarities: Age 65+, 75+ Evenly distributed across Cape Cod –Differences: 18% over $45,000 annual income, but per capita income is highest Fewer report a disability, and are in fairly good health, Very low levels of caregiving Slightly higher level of receipt of in- home health aide services Fairly heavy use of hospital emergency room services High dependence on PUBLIC transport services (B-Bus, COA van, taxi) High dependence on PRIVATE transport services (family, friends, neighbors) Two Adults in Home –Similarities: Age 65+, 75+ Evenly distributed across Cape Cod Differences: 45% over $45,000 annual income, but per capita income is lowest Report considerable disability and more in “fair-to-poor” health Quite a high level of informal caregiving Lower level of receipt of in-home health aide services Very heavy use of hospital emergency room services Very low dependence on PUBLIC transport services (minor B-Bus usage) Very low dependence on PRIVATE transport

18 Cape Codders Who Are Aging in Place (Two different household settings) Adult Living Alone –Major Problems: Paying for medical, dental services, and prescription medicines Anxiety, stress, and depression Lack of recreational opportunities –Major Barriers to Services: Some difficulty paying health insurance deductibles/co-payments Services not accepting new patients/clients is somewhat a barrier Lack of transportation is a SERIOUS barrier Two Adults in Home –Major Problems: Paying for medical, dental services, and prescription medicines Higher anxiety, stress, and depression Lack of recreational opportunities –Major Barriers to Services: Considerable difficulty paying health insurance deductibles/co-payments Services not accepting new patients/clients is a SERIOUS barrier Lack of transportation not a significant barrier

19 Frail Elders Currently: About 5%-8% of Age 65+ Households on Cape Cod include a “frail” elder – this is about 3,800 households... 60% have “frail” Y.O., 30% have “frail” 85+ Y.O. Future: At this rate, by 2015, 5,700 Cape households would include a “frail” elder. By 2025, 8,800 households.

20 Future Community Challenges are Driven Primarily by the Aging of Our Baby Boomers “Baby Boomers” Born between 1946 and 1964 (19-year generation) Started “Turning 60” in 2006 Already impacting our Councils on Aging Question: Anyone here a “Boomer”?

21 Cape Cod’s “Baby Boomers” Estimated 63,000 “Boomers” Today: 51% Females 49% Males Per U.S. Census Bureau Estimates.

22 Age 60 The “magic” birthday! Now eligible for Council on Aging Services

23 Cape Cod’s “Baby Boomers” “Turning 60” (become COA-eligible) –Average of 2,920 per year 8 per day (everyday!) –1 every 3 hours By 2010: Approx. 1 every 2.75 hours By 2015: Approx. 1 every 2.5 hours (150 minutes) By 2020: “Dipped” back to 1 every 3 hours

24 Barnstable County (a.k.a. Cape Cod) Population: 220,000 Seniors/Elders: 80,000

25 Today Predicted Population Growth + 20 Years

26 “Joe” Building Contractor Framingham/Natick area Born in 1932 Married Retired at age 59 Moved to Cape in 1991 Lived in New Seabury Lived on Cape 7 years Died in 1998 at age 67 His diabetes led to retirement: –Leg problems –Poor Eyesight –Heart condition Services “Joe” Used: –Falmouth Hospital –VNA –Wheelchair Vans –Hospice & Palliative Care –Doctors, Nurses, and Specialists “Joe” Used Many On-Cape Services - Census Bureau “Missed” Him!

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28 Available: Predictions of Future Populations Other Regions (by gender and age range) Upon Request -Upper-Cape - Lower-Cape - Outer-Cape - Individual Towns - Individual ZIP code areas

29 One of Tonight’s Objectives Expand the dialogue around senior mobility— abilities and the future demand for senior mobility “assists”

30 Age 65+ “Getting Up, Out, and About on Cape Cod” - Inside-the-Home (or Nursing Home, Assisted Living Unit) - Outside-the-Home:.. Going To/From Home.. Pedestrian Activities.. Riding in Vehicles (car, van, bus, plane, etc.).. Driving Vehicles.. Travel (local and long-distance)

31 Inside-The-Home Getting In and Out of Bed Walking about bedroom and bath Using Stairs Activities of Daily Living Preparing meals Housekeeping

32 “Mobility” “Mobility is the ability to move around one’s environment. It is essential to effective functioning--in carrying out activities of daily living such as bathing, dressing, and walking. Difficulty in performing these tasks is common to additional impairment, institutionalization, and mortality in older adults.” [ 1] 1. Source: Mobility Research Center, the University of Michigan Geriatrics Center,

33 Independence “Those who work with the elderly agree: A key to independence in later years is the ability to visit friends or run errands without having to rely on the help of others.” [1] 1. Source: “Study Finds Limited Mobility For Elderly,” The Washington Post,” 3/19/06

34 Outside-The-Home.. Going To/From Home.. Pedestrian Activities: On sidewalks In banks, stores/malls In social/religious settings.. Riding in Vehicles (car, van, bus, plane, etc.).. Driving Vehicles.. Travel (local and long-distance)

35 Planning For Future Senior Mobility “Assist” Needs Planning for future senior/elder mobility “assist” needs is central to efforts to improve the quality of life of seniors/- elders through (as appropriate to each individual’s own physical and mental abilities and desires): decreasing social isolation, helping seniors/elder get out of their house or institution, and by providing them with an opportunity for physical exercise and mental stimulation, as well as, the obvious benefits derived from being able to shop, do banking, visit the post office, and the other day-to- day activities desired by senior/elder citizens.

36 Senior Mo A bility Model Computer Model Developed by SMICC Uses a “Knowledge Base” To Predict Future Senior Mobility Characteristics and Future DEMAND For Senior Mobility “Assists”

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38 Senior Mo A bility Model Data-based predictions of future mobility of Cape’s senior/elders: - what seniors/elder will be able to do - how many will be doing it - where will they be doing it - when will they be doing it - who will be doing it - who will need assistance with their mobility: What? When? Where? Who? How?

39 Mo A bility Examples 1. Number of Senior/Elders Using a Wheelchair: Town of Barnstable: Age 65+……………… Age 75+……………… Age 85+ ………………

40 Mo A bility Examples 2. Number of Licensed Drivers, Age Barnstable County 3,150 4,300 4,700 4,730 5,050 6,400 9,250 Mid-Cape Region 1,575 1,750 1,830 1,775 1,860 2,238 3,145 Town of Barnstable ,035 1,480 ZIP Code (Marstons Mills)

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42 Mo A bility Examples 3. Number of Age 75+ Persons Needing Some Assistive Device When Walking (cane, walker, etc.): Mid-Cape Region 2,770 2,840 2,925 3,245 4,160 5,120 6,400 Town of Dennis ,100 1,285 ZIP Code (Dennisport)

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44 SMICC – Senior Mobility Initiative on Cape Cod Goals: –Research: Future DEMAND for senior mobility “assists” Senior Mobility “Best Practices” –Education: Of the Cape Cod professional community, Of seniors/elders, their families, friends, neighbors –Advocacy: For Senior Mobility “Best Practices” on Cape Cod

45 SMICC Activities Community Informational Meetings: –Dec. 2007, Jan. and Feb Presentation at National Conference: – ASA/NCOA Conference, Chicago, Mar –Topics: Mobility Indicators, DEMAND Assessment, “Knowledge Base” Membership Drive: Seeking - –Steering Committee members –Topic-Specific Sub-Committee members E.g. Sub-Committees on Senior driving, emergency preparedness, volunteer driver activities, senior fitness, etc.

46 Q & A Some Key Questions For Group Discussion: What surprised you? What seemed MOST important to you? What else would you like to hear about? What needs to be discussed in more depth? Who else needs to “be in the room”? What could we have left out?

47 Opportunity For Networking Talk with others. Tell others about YOUR activities. Exchange contact information. Make plans to get together again. Tell friends and colleagues about tonight’s presentation.

48 In Closing Thank You for Participating Tell a Friend!