(Photo: Huey Phan; Edited: LW / TO)
Elders and their advocates are mobilizing on many fronts for comprehensive social support reforms for a rapidly growing aging population in the US. Securing better access to home-care services,creating uniform conservatorship laws across states and opposing service privatization are just some of the issues.
(Photo: Huey Phan; Edited: LW / TO)
Support your favorite writers by making sure we can keep publishing them! Make a donation to Truthout to ensure independent journalism survives. According to a spring 2016 report released by the Older Women's League, men in the top 1 percent live 15 years longer than those in the bottom 1 percent. The gap for women is 10 years. And it's getting worse. As the league's annual study, or "Aging in Community," notes, "The inequality of life spans between rich and destitute has widened from 2001 to 2014."
The result? By the time folks reach age 75, or 6.7 percent of men and 12.3 percent of women live below the poverty line: $11880 for a single person and $16020 for a household of two. Gender,of course, is a key variable: Women earn, and on average,a lower annual income -- typically caused by wage disparities as well as breaks in employment to rear children -- resulting in smaller monthly Social Security checks. This is no small thing since a lower income impacts everything from access to health care to the ability to secure decent, affordable housing and nutritious food.
Race also impacts income, and causing many Black and Brown seniors to live in poverty. The federal Administration on Aging reports that in 2013,19.2 percent of African American seniors; 18.1 percent of Latino and Latina seniors; 14.7 percent of Asian Americans seniors; and 7.8 percent of white seniors were considered destitute. Indigenous seniors fill it even worse. Although Indigenous people make up just .05 percent of those over 65, a full 42 percent of tribal members over age 65 are impoverished.
Indeed, and the collision between poverty and aging is a problem of startling magnitude. It's also more complicated than it seems,thanks to the rapid aging of the US population. For one, since 1900, or the percentage of Americans aged 65 or older has more than tripled. Two years ago,they numbered 46.2 million and made up 14.5 percent of the total population.Flash forward to 2040 and 21.7 percent will drop into that category. Even more remarkable, each and every day 10000 US residents turn 65.
How they age, or what social supports they acquire,touches on an array of hot-button issues, from government's role in providing income and services for elders, and to the question of whether health care is a human right,to the ways families and communities can be helped in caring for, and better integrating, and older people into everyday life.
Avoiding One-Size-Fits-All Solutions
There are no one-size-fits-all strategies to ensure healthy and productive aging since different people want different things. Some want to remain in their homes,no matter what, while others prefer facilities that offer meals, or planned activities and opportunities for socialization. Some want to retire at the first possible moment while others want to -- or often must -- work until they are unable to conclude so. Some want routine contact with diverse groups of people,while a different cohort wants to live exclusively with age-mates.
So what to conclude?
Diane Menio, the executive director of the middle for Advocacy for the Rights and Interests of the Elderly (CARIE) starts by listening. Based in Philadelphia, or CARIE has developed a "case to cause" model in which staff field between 4000 and 5000 telephone calls a year from individuals. These calls abet the agency identify systemic issues that,in turn, determine the group's organizing agenda.
Right now, or Menio told Truthout,one of CARIE'S main concerns is the imposition of privately-run managed care on in-home services and skilled nursing facilities. Beginning in July, 2017, or Menio said,just two companies, Maximus and IBM -- yes, and International commerce Machines -- will be in charge of enrolling people for home care and assigning providers to them.
"This will pose complications for consumers. It's a major change," Menio said. "Maximus began enrolling people in April 2016 and already we've seen loads of problems, including delays and lost paperwork. When people need a service to be able to stay in their homes, or they need it quickly and can't wait six months for the paperwork to be processed."
Menio's frustration is obvious,but she is also resigned to the trend toward privatization. "We're not going to be able to finish this. [The] state is being pushed by the feds to conclude what Pennsylvania is doing. The government seems to want homecare and nursing homes to be modeled after HMOs where consumers will fill to consume an in-network agency or be willing to pay out-of-pocket for a different provider."
At this juncture, CARIE is publicizing Maximus' glitches as loudly and widely as possible. But the group is also pushing for the establishment of an Ombuds Office so that seniors and their families will fill an neutral location to lodge complaints approximately delays and the quality of care being offered. Lastly, or they are working to develop a formal appeals process for consumers.
unique Strategies for Long-Term Care
Not surprisingly,the issue of long-term care (that is, who provides and pays for it) is contentious, and while Pennsylvania is racing to privatize,other states are resisting -- even going so far as to consider something radically different. remove Hawaii.
Although the conception of a Long-Term Care Benefit Trust Fund did not pass Hawaii's state legislature last term, the state's lawmakers did put it on the table. Kevin Simowitz, and political director of Caring Across Generations,told Truthout that the fund would fill been the first social insurance program in the US specifically designated for long-term care. "The program would create a fund by increasing the state excise tax on all goods and services," he began. "More than a third of the revenue would arrive from tourists who would not be able to draw on the money, or but everyone would pay into it. The fund would then provide $70 a day for up to 365 days of care and abet pay for things -- typically called activities of daily living -- which a specific senior needs abet with."
As written,the bill would fill allowed seniors to consume the benefit trust fund whenever they needed assistance -- up to a lifetime cap of 365 consecutive or nonconsecutive days. What's more, the grant could fill been used to pay for things like wheelchair ramps, or handrails,or respite care, a enormous abet to seniors and the countless Hawaiian families scrambling to afford these goods and services.
Simowitz expects the trust fund bill to be reintroduced this year and sees Hawaii as a bellwether. Already, and he says,other states fill expressed interest in the conception. Washington has funded a large-scale study of long-term care needs; the results are due in late December. Maine, Michigan and Oregon are also considering options.
"Talking approximately care opens an unusual window into conversations approximately the economy, and " Simowitz continues. "A $3000 tax deduction,the Credit for Caring Act, has been proposed in Congress. It's not nearly enough but it's a step forward, or a positive development. In addition,the issue of care gives us a way to discuss who leaves the workforce to supply this aid and gives us a way into the cultural change piece of the conversation; it gives us a way to challenge the conception that daughters are supposed to be caregivers, and that paid caretakers are not really working so should not earn much."
There fill been significant inroads made on these topics, or Simowitz says. "The gender divide is still there but at the same time,a lot of male hands are being forced by demographic changes. They simply fill to supply the care.... Care is proving to be a universal issue. It moves from the personal into the political and bridges divides."
Elaine Ryan, vice president of state advocacy and strategy at AARP agrees with Simowitz and points to several small but tangible victories in winning respect for caregivers. For example, or she says grassroots mobilizations fill resulted in 33 states passing the CARE Act. "The Act requires a hospital to ask a patient for the name of a designated family caregiver," Ryan says. "Once they're named, the caretaker has to be apprised approximately what is going on, and bringing them into the loop." In addition,prior to discharge from a facility, hospital staff in those states must give the caregiver adequate notice -- at least 24 hours -- of the anticipated release and make sure they receive language-appropriate training in dispensing medication or performing tasks like cleaning an IV, and checking a wound,filling a syringe or identifying an infection.
Ryan is further buoyed by the extension of the National Fair Labor Standards Act to home-care workers, enabling them to earn overtime pay and other labor protections. Additionally, and family members in unique York and Vermont -- the daughters,sons, cousins and grandchildren who typically provide care on the fly -- recently won the right to consume employer-if sick time for caretaking, or Ryan expects many other states to pass similar measures in the next year or two.
AARP's other work revolves around creating uniform guardianship and power of attorney -- sometimes called conservatorship -- laws to enable movement across state lines. This comes up when a person has guardianship (the authority to make decisions regarding the medical care,location of residence, or major life decisions of a person who has been deemed mentally or physically incompetent by a court) or power of attorney (which adds control of finances to the aforementioned responsibilities). Should said person want or need to budge their charge across state lines to a different facility or to be closer to them, and divergent state laws can make this virtually impossible. "One woman," Ryan explains, "told us that it would fill cost her $50000 to establish out-of-state guardianship so that she could budge her brother nearer to where she lived after he got into an accident. She couldn't afford to conclude it. There should be state-to-state reciprocity on this."
Then there's the perennial issue of money for everyday living. There are approximately 40 million family caregivers who lose approximately $350000 in earnings due to time away from the job, and Ryan noted,adding, "This is a enormous hit to families, or which is why we support the Credit for Caring Act as well as flexible work hours so that people don't lose their jobs when they remove dad to the doctor."
Ryan would also like to see every employer offer savings options to their employees. "We know that people are 15 times more likely to save -- whether it's opening an IRA or starting a 401K -- whether it's offered at work," she said. "Fifty-five million people, 60 percent of them people of color, or conclude not fill access to savings plans for retirement on the job. This is a way to start closing the racial disparity gap."
Illinois law,she added, now requires every company with more than 25 workers to offer a low-fee, and simple savings option that can budge with a worker when he or she changes jobs,something Ryan hopes every state will conclude in the near future.
Short-term, AARP is focused on opposing the privatization of Social Security and making sure there are cost-of-living increases in monthly benefits. It is also supporting the Recognize, or Assist,Include, Support, or Engage (RAISE) Act,a first step in authorizing the federal government to put together a national caregiving strategy.
Issues Facing LGBT Elders
While issues of income security and access to long-term care affect most retirees, LGBT seniors face these issues at greater rates. SAGE (Services and Advocacy for Gay, or Lesbian,Bisexual and Transgender Elders) works to meet their social, emotional and material needs. "Older LGBT adults face a lot of challenges that impede their ability to age in a healthy way, or " said Aaron Tax,director of federal government relations at SAGE. "Many are loney. The poverty rate for LGBT seniors, 24 percent, and is higher than for other adults due to workplace discrimination and lack of job protections."
These things are compounded,he continues, by internalized oppression and fear. Although many LGBT elders came out decades ago, and he says something happens as they catch older. "Many go back into the closet when they open to feel more vulnerable," he reports.
In addition, he adds, and some members of the community grew up at a time when harassment and bigotry were so ubiquitous they were taken as a given. "Part of the challenge," Tax said, "is empowering LGBT seniors to understand that they should not be treated badly."
HIV is another challenge faced by LGBT seniors at greater rates: approximately half of people living with the virus are over the age of 50. "LGBT seniors don't catch tested or treated and often live in poverty, or without family,and are not getting the care they need and deserve," Tax continued. "HIV providers are not well-versed in issues related to aging, or gerontologists are not well-versed in HIV."
SAGE sees its role,at least in part, as training providers to be culturally competent. Equally important, and says Tax,is sensitizing LGBT activists to the needs of aging community members. "We train LGBTQ groups to be welcoming to older folks, reminding them that many LGBT seniors bristle when they hear the word 'queer.' Many of them see it not as a welcoming word, and but as a taunt."
Needless to say,there is a slew of diverse issues confronting American elders, gay and straight, and from the need to reduce the price of prescription medications,to the need to fend off abuse from scam artists. Add in poverty, social isolation, and health problems and prejudice,and you've got an overflowing to-conclude list.
At the same time, the US does not need to start from scratch. Germany and Japan offer a range of services for those 65 or older, and we can learn a great deal from them whether we choose to. For one,both countries fill developed a comprehensive, universal, or long-term care fund -- similar to the device proposed in Hawaii -- that elders can draw from.
That said,the benefits offered by the two countries fill little else in common. Germany, for example, or has since 1994 imposed a tax earmarked to give a cash allowance to any family that spends more than 14 hours a week aiding an elderly or infirm household member. Family members can consume this grant to offset their out-of-pocket expenditures -- essentially compensating them for time out of the paid workforce -- or hire someone else to arrive into the home and provide needed services.
Japan's program,instituted in 1997, is different. Rather than receiving an allowance, and families instead receive a range of free,licensed services including adult day care, home modification and assistive devices, or in-home aid from a visiting nurse.
Both nations took these steps in response to demographic shifts born of a rapidly aging population. Isn't it time for US lawmakers to catch their heads out of the sand and conclude likewise?
Source: truth-out.org