“CREATING ELDER FRIENDLY
COMMUNITIES,
CREATING OUR FUTURE HOME”
2003 National Public Policy Education Conference
September 21-24, 2003
Salt Lake City, Utah
Sponsored by the Farm Foundation
Presented by:
Nina R. Keller, MSW, LSW
Assistant Director/Director of Planning
Area Agency on Aging District 7, Inc.
Rio Grande, Ohio
1
WHO ARE WE REALLY PLANNING FOR?
Over 80% of older persons want to remain at home
as they age (AARP, Livable Communities: An
Evaluation Guide, 1999)
WE, the older adults of tomorrow, will have an
even stronger desire to remain independent . . . .
We have grown up in the era of the automobile,
women working outside of the home, and an
improved economy supporting the ability to make
choices never before possible. We are accustomed
to having options.
2
“While Americans have given some thought to the
living situation they would like to have as they
age, many have not taken into account the
potential deterioration of health and physical
ability that may occur in the later years of life . . .
Many consumers simply seem to be in denial
regarding the possibility of increasing frailty,
exhibiting what may be an unrealistic sense of
optimism about the future.”
(AARP, These Four Walls… Americans 45+
Talk About Home and Community, 2003)
3
A FEW SUPPORTING STATISTICS
 Between the years 2010 and 2030, the Baby Boomer
generation (Americans born between 1946 and 1964)
will become older adults.
 By 2030 (only 27 years in the future) the 65 and older
population in the United States is expected to reach 70
million persons, twice their number in the year 2000.
 By 2030, older adults will grow from 12.4% of the
population to 20%
- (US Health and Human Services, 2001)
4
A FEW MORE STATISTICS
Between 1990 and 2000, the population aged 85 years
and older experienced the most rapid growth of the older
population, increasing by 38%.
The number of Americans aged 85 and over is expected
to increase from 1.5% of the total population in 2000 to
3.8% in 2040. This population will be the most frail, and
require the most medical intervention and services.
Hetzel, L. and Smith, A. (October 2001)
The 65 Years and Over Population: 2000.
US Census Bureau, October 2001
5
“Through land use planning and regulation,
public investments, private financing, and
dominate societal values, we have created
communities that present significant obstacles
to the continued independence of older adults
. . . . The sprawling automobile-dominated
landscape seriously limits the continued
mobility and independence of older people.”
(Funders’ Network For Smart
Growth and Livable Communities, 2001)
6
“The ability to move about the community,
maintain a home, have access to goods and
services, and retain strong social ties, is directly
impacted by planning and community design
decisions. Sound community planning can
enhance the quality of life for older persons.”
(Marcus Molea, Planning, Development
& Evaluation Chief, Ohio Department
of Aging, 2003)
7
NOT ALL OLDER ADULTS LIVE IN FLORIDA
Northern states have significant percentages of population over
age 65.
 Only 4% of older adults move out of state at retirement time.
 There is a growth in the number of individuals age 85 and
over who return “home” from warmer climates when their health
declines.
 The phenomenon of the “rural rebound” impacts
communities’ abilities to respond effectively to the needs of older
adults.
8
WHICH OF THESE IS YOUR COMMUNITY?
9
CHALLENGES TO RURAL AREAS
A significant number of rural areas are medically-underserved
with high rates of chronic disease
A significant number of individuals living in rural areas are at
or below the poverty level
Healthcare worker shortage
Geographic distance which creates social isolation
Less funding due to population-based formula
Less available community resources due to lower tax base
Structure of the community , i.e., small town nucleus with
individuals living throughout the countryside
 Turfism
10
The current “baby boomer” generation can also be
called the “sandwich” generation: having children
or grandchildren to raise while caring for an aging
parent.
Working towards an elder-friendly
community can have a positive impact on the
burden of care giving. Many people do not define
themselves as care givers . . . They “just take Mom
to the store or the doctor, help fix meals, find
someone to stay at night, or provide personal care
or other services after a hospitalization”.
11
“THERE ARE ONLY FOUR KINDS OF
PEOPLE IN THE WORLD . . .
Those Who Have Been Caregivers
Those Who Are Currently Caregivers
Those Who Will Be Caregivers
Those Who Will Need a Caregiver”
- Rosalynn Carter
12
Those planning to address the issue of
elder-friendly, age-sensitive or lifestyle
communities should keep in mind that
preferences and concerns will change with
the different life experiences, resources, and
expectations of the cohorts represented in
the “aging” population.
13
A FRAMEWORK FOR MOVING TOWARDS
“LIVING WELL” COMMUNITIES
Define community and interest
Establish a core group to facilitate the project
Research resources for and models of elder friendly communities
Start identifying stakeholders and other supportive partners
Assess your senior population
Assess your community, from both an infrastructure and service
perspective
Determine short- and long-range goals
Work to complete the plan
14
ASSESSING THE COMMUNITY
Written surveys
Focus groups
Telephone interviews
Face-to-face interviews
Physical observation and investigation
15
FROM AWARENESS TO
COMMITMENT
“COMMUNITIES FOR A LIFETIME” INITIATIVE
(Florida Department of Elder Affairs)
“NORTH CAROLINA: A LEADER IN AGING”
(North Carolina Division of Aging)
“ALBERTA FOR ALL AGES: DIRECTIONS FOR THE FUTURE”
(Government of Alberta, Canada)
“AGING INITIATIVE, PROJECT 2030”
(Minnesota Department of Human Services)
16
“BUILDING
COMMUNITIES
FOR
THE FUTURE”
BLUEPRINT
This is an initiative by the Governor, and is coordinated
by the Florida State Department of Elder Affairs. They
provide a specific process and toolbox for communities to
get started.
17
PARTNERS FOR CREATING CHANGE:
 Chief Elected Officials – the commitment begins with
the support and leadership of the local government
 Business Leaders – understanding the economic value
and business sense in addressing this “future”
Health Care Organizations and the medical community
 Chambers of Commerce and other civic organizations
Local Parks and Recreations
18
 Planners – responsible for long and short-term land use
plans
 Developers, builders, architects – regarding housing
and community facility development
 Local Citizens/Volunteers – should include older adults
Faith-based Organizations
 Representation from the agricultural community, such
as the Farm Bureau
19
Public Safety
 Education
Regional Planning Councils and Metropolitan Planning
Organizations (if these exist in or around your rural area)
– communities need to work in conjunction with counties
and regions. These organizations can often offer technical
assistance in planning, grant writing and loan applications,
economic development, etc.
Area Agencies on Aging & other Aging network
partners
20
Area Agencies on Aging
Established in Federal legislation through the Older
Americans Act as the primary planning and coordinating
agency for elder services within each state.
 Currently there are over 650 area agencies on aging
throughout the United States and their territories.
 Area agencies may be a not-for-profit organization or
may be a part of city, county or state government.
21
Area agencies on aging manage a wide variety of
federal, state and local funds to support a variety of
programs. They also may provide direct care services
within their community.
Area agencies on aging and the network that they
support can be one of the most valuable resources when
developing elderly friendly communities.
 For information on Area Agencies on Aging, log onto
www.n4a.org (National Association of Area Agencies on
Aging, www.eldercare.gov, or call the Eldercare Locator
at 1-800-677-1116.
22
ELDERLY FRIENDLY COMMUNITIES PROJECT
(Calgary, Alberta, Canada)
This project focused on the need to develop supportive
communities for seniors and their families by assessing the
current state of services at the neighborhood and city-wide
levels. The project completed a focused assessment of the
assets, capacities and needs of seniors and their families in
four communities, drawing upon the insights of seniors
themselves. Focus groups were held, with five involving
seniors and their families, one involving service providers,
and one with community leaders and experts (clergy,
police, community associations).
23
Based on the focus groups, the following themes
emerged:
1) Being Value and Respected
* Caregiver contributions
* Attitudes towards seniors
2) Staying Active
* Recreation
* Physical and Mental Health
* Isolation
3) Making Ends Meet
* Finances
24
4) Building Community
* Social supports
* Volunteerism
* Community Development
* Senior residences
* Culture and Language
* Community-specific information peer support
5) Feeling Safe
* Safety
* Infrastructure
25
6) A Place to Call Home
* Housing (transition)
* Instrumental support (i.e., home maintenance)
* Location focused
7) Getting Around
* Physical access
* Transport
8) Getting What You Need
* Services
* Benefits information
26
ILLINOIS RURAL LIFE PANEL:
SURVEY OF OLDER ADULTS
(Prepared by the Community Research Services, Illinois
State University)
1) A 64-question survey mailed throughout the state of Illinois
produced 1200 responses from individuals aged 60 and over
2) A survey was also completed by 160 community leaders and
service providers
3) Workshops were provided to communities in the state based
on the survey information
27
The Illinois survey tool included:
General community information, such as “Why have you stayed
in your community? If you plan to move, why?
Importance of the following characteristics of public facilities
and services: handicapped access (ramps, lifts, automatic doors);
nearby parking; good lighting, wide aisles in stores, large print
labels, generously-timed stop light
Use of public facilities such as library, senior center, grocery
store, park district. If the individual did not use the facilities, why
not, (i.e., too far, poor access, poor lighting, no transport, too costly,
don’t want to)
28
Availability or need of job opportunities, educational programs,
recreation/social opportunities, and opportunities to volunteer
How respondents found out about opportunities (church,
newspaper, senior center, word-of-mouth, etc.)
Safety and security, (i.e., have they been a victim of crime, what
poses the greatest threat, how safe do they feel, how emergency
services would rate)
Transportation, including what their current mode of
transportation is, do they have to routinely leave their community
for services, what type of transportation is needed, and does the
current transportation service meet their needs in terms of
affordability, accessibility, routes, pickup times and places, etc.
29
Health and Medical Care, including status of their health, types
of health care coverage, future health care concerns, etc.
Housing, including type and condition of residence, and
supportive services available
Support, such as meals, housework, yard care, snow removal,
shopping, companionship; who provides the help and are additional
services needed; and does respondent currently provide help to
another older adult and if so, what is provided
Demographic information of the respondents, including
education, ethnicity, current employment, career and retirement,
income sources and sufficiency of that income
30
FLORIDA’S COMMUNITY ASSESSMENT MODEL
1) Physical
a) Accessibility (ADA standards) – accommodations
have been made to allow for individual mobility,
regardless of functional impairments
b) Housing (universal design) – the design of
products and environments to be usable by all
people, to the greatest extent possible, without the
need for adaptation or specialized design
31
2) Transportation
a) Accessibility – to goods and services; having
available means of transportation that are convenient
and affordable
i) synchronized traffic signal timing and
upgraded crosswalks to improve pedestrian safety
and traffic flow patterns (increased crossing time/
decreased wait time); making signals more audible
ii) having larger, easier-to-read signs
iii) encouraging use of environmentally-friendly
transportation modes, such as bicycles or car
pooling
32
3) Land Use
* Parks, trails, waterways, greenways
* Regional planning for accommodations
4) Community Development
* Business partnerships
* Friendly businesses
* Employment
* Volunteerism
5) Health
* Physical
* Mental
33
6) Education
* Lifelong learning
7) Cultural and Social
* Recreation
* Spiritual
* Intergenerational activities
34
What’s wrong with this picture?
35
…and this picture?
36
…and this picture?
37
…and this picture?
38
…and this picture?
39
SERVICE PROGRAM IDEAS . . .BEYOND THE
BASICS:
Elder-Friendly Business Certification
- developed by Elders in Action, Portland,
Oregon
- available to private, non-profit organizations
through a licensing agreement
- evaluators from licensed agencies shop
businesses anonymously and review the
effectiveness of telephone and customer service,
and building layout and access
- provide feedback and training to the business’
management so the business can be certified as
“Elder Friendly”
40
TRIAD
- consists of a three-way effort among the
sheriff, county police chief(s), and AARP or
older/retired leadership in the area
- their goal is to work together to reduce
criminal victimization of older citizens, and
enhance delivery of law enforcement services
-TRIAD is governed by a local, senior advisory
council called S.A.L.T. (Seniors and Law
Enforcement Together)
41
- an example of some of the programs sponsored by
TRIAD are:
* involvement in neighborhood watch
* providing personal safety tips
* knowledge of current frauds and scams
* telephone call-in programs
* court watch activities
* refrigerator cards with emergency medical
information
* home security information and inspections
* elder abuse prevention, recognition and
reporting information
* adopt-a-senior visits for shut-ins
42
ROSS COUNTY, OHIO S.A.L.T. COUNCIL
Recipients of the AAA7-sponsored “William A. Jenkins
Trailblazer Award”, 2003
43
Home and Community-based Waivers
- waivers granted by the Federal government
through the Centers for Medicare and Medicaid
Services
- to utilize Medicaid funding to provide in-home
services to targeted populations
- requires State matching funds; therefore, it is a
State-level decision to apply for such a waiver
- an example is Ohio’s PASSPORT Medicaid
Waiver Program, serving individuals age 60 and
over
44
INTERGENERATIONAL ACTIVITIES
CONGREGATE DINING
45
This “Intergenerational Walk” spans three generations
46
CERTIFICATE in
INTERGENERATIONAL STUDIES
Initiated by the University of Rio Grande in the Fall of 2003
Composed of four classes:
* Introduction to Aging
* Intergenerational Studies
* Work with Elders
* Intergenerational Community Service
Taught by professors of social work and sociology
Includes classroom lecture, discussion, and service learning
47
MOBILE DENTAL CLINIC: A UNIQUE
UNIVERSITY PARTNERSHIP
The Ohio State University Geriatric Dental Clinic
48
ADDITIONAL IDEAS:
Senior Farmer’s Market
Sensitivity to Aging training
Elder Abuse training
Single-point of entry
Specialized Rural Transit program
49
SPECIALIZED COMMUNITIES:
We always want options . . .
and it’s more than just golf!
50
CREATING ELDER FRIENDLY
COMMUNITIES,
CREATING OUR FUTURE HOME
MEANS WORKING TOGETHER
TO CREATE LIVABLE
COMMUNITIES, NOT JUST FOR
THE ELDERLY BUT FOR
EVERYONE –
WON’T YOU JOIN US?
51
CONTACT INFORMATION:
Nina R. Keller, MSW, LSW
Assistant Director/Director of Planning
Area Agency on Aging District 7, Inc.
P.O. Box 500, F32-URG
Rio Grande, Ohio 45674
Phone: 800-582-7277
FAX: 740-245-5979
E-Mail: nkeller@aaa7.org
www.aaa7.org
52