State of the American Senior


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Families Caring for an Aging America


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Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.




Providing Healthy and Safe Foods As We Age


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Does a longer life mean a healthier life? The number of adults over 65 in the United States is growing, but many may not be aware that they are at greater risk from foodborne diseases and their nutritional needs change as they age. The IOM's Food Forum held a workshop October 29-30, 2009, to discuss food safety and nutrition concerns for older adults.







How Policies Make Citizens


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Some groups participate in politics more than others. Why? And does it matter for policy outcomes? In this richly detailed and fluidly written book, Andrea Campbell argues that democratic participation and public policy powerfully reinforce each other. Through a case study of senior citizens in the United States and their political activity around Social Security, she shows how highly participatory groups get their policy preferences fulfilled, and how public policy itself helps create political inequality. Using a wealth of unique survey and historical data, Campbell shows how the development of Social Security helped transform seniors from the most beleaguered to the most politically active age group. Thus empowered, seniors actively defend their programs from proposed threats, shaping policy outcomes. The participatory effects are strongest for low-income seniors, who are most dependent on Social Security. The program thus reduces political inequality within the senior population--a laudable effect--while increasing inequality between seniors and younger citizens. A brief look across policies shows that program effects are not always positive. Welfare recipients are even less participatory than their modest socioeconomic backgrounds would imply, because of the demeaning and disenfranchising process of proving eligibility. Campbell concludes that program design profoundly shapes the nature of democratic citizenship. And proposed policies--such as Social Security privatization--must be evaluated for both their economic and political effects, because the very quality of democratic government is influenced by the kinds of policies it chooses.




Retooling for an Aging America


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As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.




Real People, Real Problems


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Social Isolation and Loneliness in Older Adults


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Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.




Services for Senior Citizens


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Older Americans Act Programs


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