1. Welcome “Aging in Place on Cape Cod” Informational Meeting For
Elder Service of Cape Cod & The Islands
February 15, 2007
Presented by:
Warren Smith, Research Analyst
Senior Mobility Initiative on Cape Cod (SMICC)

2. Senior Mobility Initiative on Cape Cod (SMICC)
Independent, Non-Affiliated, Grassroots
Goals: Research, Education, Advocacy
Sponsored In Part By:
Family-Centered Institute, Inc.
Brewster, MA

3. “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 65th birthday.”[1]
1. Source: “Resource For Aging In Place,”

4. 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.

5. [underline added for emphasis]
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,

6. 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, )

8. Who is Involved?
Besides the seniors/elders themselves, many others are involved in creating a safe and appropriate “aging in place” environment.
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

9. 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

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

11. 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

12. 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 serious barrier

13. Frail Elders Currently: Future:
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.

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

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

16. 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

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

18. Predicted Population Growth
+ 20 Years
Today
Predicted Population Growth

20. Age 65+ Getting Up, Out and About on Cape Cod
“Senior Mobility”

21. 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

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

23. 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)

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

25. “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,

26. “Study Finds Loneliness May Lead To Dementia
Recent Research
“Study Finds Loneliness May Lead To Dementia
. . . Those who describe themselves as lonely were twice as
likely to develop the kind of dementia associated with
Alzheimer’s disease.” Los Angeles Times.
Reprinted in Cape Cod Times, 2/10/07

27. 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

28. Outside-The-Home .. Going To/From Home: On steps, walkways, driveways
.. 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)

29. 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.

30. Senior MoAbility Model
Computer Model
Developed by SMICC
Uses a “Knowledge Base”
To Predict Future
Senior Mobility Characteristics
and Future DEMAND For
Senior Mobility “Assists”

32. Senior MoAbility 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?

33. MoAbility Examples 1. Number of Senior/Elders Using a Wheelchair:
Town of Barnstable:
Age 65+………………
Age 75+………………
Age 85+ ………………

34. MoAbility Examples 2. Number of Licensed Drivers, Age 85+
Barnstable County 3, , , , , , ,250
Mid-Cape Region , , , , , , ,145
Town of Barnstable , ,480
ZIP Code (Marstons Mills)

36. MoAbility Examples
3. Number of Age 75+ Persons Needing Some Assistive Device When Walking (cane, walker, etc.):
Mid-Cape Region 2, , , , , , ,400
Town of Dennis , ,285
ZIP Code
(Dennisport)

38. Upon Request Other Towns Other ZIP code areas
Available Today: Predictions of Future Mid-Cape and Lower-Cape Populations (senior/elder resident counts: years )
On Our Web Site at:
Upon Request
Other Towns
Other ZIP code areas
Request by to:

39. 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?

40. Thank You for Participating Tell a Friend!
In Closing
Thank You for Participating
Tell a Friend!