The Medical Minute: Elder care -- it takes a village

By John Messmer
Penn State Family and Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

We're not getting any younger. And neither is the population at large. The over-65 and over-85 segments of the United States are growing quickly with Florida, West Virginia and Pennsylvania having the highest percentage of their populations over age 65 -- more than 15 percent. Most of the over-65 population live with a spouse, but about 20 percent of men and 40 percent of women live alone. About 10 percent live with family members. According to government statistics, about 20 percent of over-65 Americans have a chronic disability, such as memory impairment, difficulty seeing or hearing, or walking difficulties.

About a third of us have an older family member who needs a little extra help. Even if senior family or friends have general good health, needing assistance with things that once were done independently is fairly common. It could be meal preparation, bathing, shopping or double-checking medications. Fortunately, help is available through community resources.

The Older Americans Act mandates that states provide needed assistance for the aging population and established local Agencies on Aging. These area agencies on aging are a first point of contact for help, providing everything from food to medical assistance. Some of the services offered are: food (Meals on Wheels), legal assistance, completing medical forms, finding medical care, prescription drug services and financial evaluations.

Typically these services are provided free or on an ability-to-pay basis and may be available to those age 60 or even younger. A financial evaluation might show eligibility for Medicaid. Many people do not realize they may qualify for this medical plan designed for people with low incomes. Medicaid recipients who are also eligible for Medicare have their part B premiums and deductibles paid -- a significant cost-savings.

For people who want to stay active and get involved in the community, volunteer opportunities and job placement services for people over age 55 are available. Transportation assistance in many areas through discounts on public transportation or on special-needs vehicles, such as wheelchair-capable vans, also are offered.

Area agencies on aging typically have resources to assess a person's needs and aid in provision of such services as home health aids, nursing home placement or domiciliary care. For families who continue to provide for an elderly member but cannot be home all day, adult day-care services can be arranged.

However, one of the greatest concerns of elderly care is abuse. Abuse of older people can be through neglect of basic care: hygiene, food, adequacy of housing or abandonment; physical or emotional abuse; financial exploitation; or sexual abuse. Area agencies on aging are mandated to receive reports of suspected abuse 24 hours a day, seven days a week. Additionally, states also may have toll-free hotlines to report abuse. In Pennsylvania, the number is (800) 490-8505. Anyone can report suspected abuse or neglect. Reporters are immune from liability and protected from retaliation if the report is made in good faith.

Even with advance planning, people may find themselves suddenly in need of help for themselves, older parents or other family or friends. When assistance is needed, look for the area agency on aging in the phone book or go to http://www.aoa.gov/eldfam/How_To_Find/Agencies/Agencies.asp to search by state. The U.S. Department of Health's Administration on Aging Web site at http://www.aoa.gov has comprehensive elder-care information.

In Pennsylvania, the Department of Aging Web site at http://www.aging.state.pa.us/ has a wealth of information of benefit to older Pennsylvanians.

As people live longer, their needs may not be adequately met by the immediate family. In that case, they can turn to the greater village for assistance.