How the Older Americans Act Facilitates Aging in Place

More than 90% of adults over 65 prefer to stay in their current residence.

May was “Older Americans Month.”

Americans are living longer, and most seniors choose to live in the comfort of home, which is referred to as “Aging in Place.”1 More than 90% of adults over the age of 65 report that they would prefer to stay in their current residence as they age.2

Older adults are diverse in many ways, including ethnic and racial backgrounds, spiritual and religious beliefs, socioeconomic and financial status, sexual orientation and education. Older adults, defined as those over 65 years, now comprise 14.9% of the US population.3 US life expectancy has increased such that women can expect, on average, to live another 20.5 years past age 65, and men can expect to live 18 years past age 65.4,5

A little over 50 years ago, in 1965, Congress passed the Older Americans Act (OAA).6 The intent of the Act is to help people aged 60 years and older maintain maximum independence in their homes and communities with the support to do so.7 The overarching objective of the 1965 law is to authorize generic social service programs. However, in subsequent amendments, Congress authorized directed programs under several titles of the act.

Title I of the Act sets the intent and represents a turning point in the nation’s perspective on financing and delivering community services to elders. The tenets of the Act, set forth in what is considered the preamble Title I, are as follows:

America’s older adults are to have an adequate income in retirement; be in the best physical and mental health that science can make available regardless of economic status; obtain and maintain suitable housing that is adapted to special needs and affordable; full restorative services for those who require institutional care and an array of community-based services and in-home long-term care services that are to adequate sustain and support older adults in their community and homes as well as support their family and other care givers; opportunity for employment without age discrimination; retirement in health, honor and dignity; participating in and contributing to meaningful activity within the widest range possible; efficient community services, to include access to affordable transportation, supportive affordable living arrangements, coordinated services with a focus on maintaining the continuum of care for frail and vulnerable older individuals; immediate benefit from research knowledge, which can sustain and improve health and happiness; and lastly freedom, independence and the free exercise of initiative in planning and managing their lives, safety and protection from abuse and neglect.6

Under its 7 titles, the Act has supported the “aging service networks,” which are comprised of 56 state agencies on aging; more than 600 area agencies; more than 250 Indian Tribal and Native Hawaiian organizations; nearly 20,000 service providers; thousands of volunteers; as well as research and training programs. These current structures provide the community and home-based elder services that exist today.7,8

Major services included in the aging network are: access to services which include outreach information regarding services and benefits, care management and transportation; nutrition, which includes congregate and home-delivered meals and nutrition counseling; home and community-based long-term care, which includes home care, chore, and personal care; disease prevention and health promotion, which might include physical fitness, immunizations, and a home safety assessment; and “Vulnerable Elder Rights Protection,” which includes the long-term care Ombudsman; prevention of elder abuse, neglect, and exploitation and legal assistance.7,9

The mandated services provided to older Americans by the Act are critical and essential to ensuring that elders can “Age in Place” safely and to the best of their abilities. Services are essential to the health and well-being of older Americans, especially considering the aging population. Everyone must be aware of the components of the Act and how the mandated services under the Act facilitate “Aging in Place.” This is especially true for health providers, those who work with the elderly, and elected officials to understand, as well as older Americans and their family and friends. We must continue to support and finance the “Aging Networks” and other services provided through the Act.

References

1. Rowles GD, Bernard M. (2013).

Environmental Gerontology: Making Meaningful Places in Old Age

. 2013; New York: Springer Publishing Company.

2. AARP. Beyond 50.05: A report to the nation on livable communities: Creating environments for successful aging. 2005. http://assets.aarp.org/rgcenter/il/beyond_50_communities.pdf. Accessed June 1, 2017.

3. United States Census Bureau. 2015 Population Estimates.

https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=PEP_2015_PEPAGESEX&prodType=table Accessed June 1, 2017.

4. Arias E, Heron M, Xu J. United States Life Tables, 2012. National Vital Statistics Reports. 2016;65(8). National Center for Health Statistics, Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_08.pdf. Accessed June 1, 2017.

5. World Health Organization. Life expectancy increased by 5 years since 2000, but health inequalities persist. May 19, 2016. http://www.who.int/mediacentre/news/releases/2016/health-inequalities-persist/en/. Accessed June 1, 2017.

6. US Government Publishing Office. Older Americans Act of 1965, Title 42 U.S.C § 3001. https://www.gpo.gov/fdsys/granule/USCODE-2010-title42/USCODE-2010-title42-chap35-subchapI-sec3001. Accessed June 1, 2017.

7. United States Congress. Serving seniors through the Older Americans Act: Hearing before the Subcommittee on Higher Education and Workforce Training, Committee on Education and the Workforce, US House of Representatives, One Hundred Thirteenth Congress, second session. 2014; Washington, DC: US Government Publishing Office.

8. Niles-Yokum K, Wagner DL. The Aging Networks: A Guide to Programs and Services, 8th edition. 2015; New York, NY: Springer Publishing Company.

9. Older Americans Act of 1965 (Public Law 89—73) [As Amended Through P.L. 110–246, Effective May 22, 2008.] https://www.fns.usda.gov/sites/default/files/OAA65.pdf. Accessed June 1, 2017.

Additional Reading:

O’Shaughnessy CV. The Aging Services Network: Accomplishments and Challenges in Serving the Growing Elderly Population. Nation Health Policy Forum Background Paper. 2008; Washington, DC: The George Washington University. https://www.nhpf.org/library/details.cfm/2625. Retrieved April 11, 2017. Accessed June 1, 2017.