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 Social and Economic Outlook for An Aging Society

Introduction:  The overall position of older Americans (by Harry Moody)

       "The overall position of older Americans has improved substantially in the last two decades. But, the stereotype that most older people are affluent is mistaken.  When we look behind the average figures we see that 3.3 million older Americans still fall below the poverty line.  We also see enormous variation among subgroups of the aging and an even larger group of older people who have been brought above the official poverty line but still remain near-poor and vulnerable".

A.        It is important to keep in mind the key ideas emphasized in this discussion:

    1.         The diversity of the aging population, including dramatic differences in                 
                well-being among subgroups.

    2.         The impact of cumulative disadvantage. [this means that ] earlier life course 
                experience influences what old age will be like.

    3.         The socially agreed upon expectations we have about old age, including attitudes 
                toward the meaning of retirement.

B. By itself, population aging does not dictate the shape of things to come, and there is certainly no cause to be  
    gloomy about the coming of an aging society. The point to remember is that the life one leads as a younger person  
    will affect prospects for old age. The social and economic outlook for an  aging society, then, is not simply
    something to be predicted but something to be constructed.  The decisions we make today depend on thoughtful
    consideration of the controversies that will shape the  aging society of tomorrow."

I. Diversity, Income and the Elderly- The distribution of income among the elderly

The government defines poverty as an annual income of $23,850 for a family of four, $19,790 for a family of three and $15,730 for a family of two.

"The U.S. poverty rate hit its highest level in 11 years in 2008 as the worst recession since the Great Depression threw millions of Americans out of work". http://www.reuters.com/article/idUSTRE58943C20090910 In 2013 the official poverty rate was 14.5%

Traditionally a disproportionate number of ethnic groups have higher than average poverty rates . The two largest minorities in the United States, African Americans and people of Hispanic origin, show official poverty rates that are at least twice as high as those among non-Hispanic Whites

• 11% whites
• 25 to 35% (depending on report cited) black elders
• 24.4% Hispanics elders
• 25% widowed women

Because of the recession and resulting  increase in the poverty  The American Recovery and Reinvestment Act of 2009 was passed. This act addressed what some argued, that we needed to  catch the single people who fall between the cracks at 125% of the Federal poverty level (somewhere around $1100. per month income (2015 figures) and 150% (or around $1700) of the poverty level .

 

1. African Americans - Financial demographics
   Today nearly 9% of elders are black. That's the largest minority group in the aging population. that number is increasing.  By 2020, 21% are projected to be people of color, and by 2050 this percent is anticipated to increase to 33% (Manuel, 1988).
    

• There are more black women than black men because the life expectancy for black males (like Native Americans) is lower than for white males. Do you know why? 
  
• Blacks are less likely to be married than other ethnic groups resulting in lower household resources.
  
• And although they sufferer from more functional impairments from chronic illness they are less likely to be admitted into nursing homes.
  
• Blacks are more likely to live with other family members ( not a spouse) than whites

As a result of the Civil Rights movement, the Black middle class has grown so much that it now outnumbers the poor thus creating  a deep class division among African Americans

The middle class have moved to better neighborhoods, leaving behind the underclass.

Elders who lacked earlier opportunities in life to accumulate retirement funds have either been left in the inner-city, with high crime rates, deteriorating neighborhoods, and threats of violence, or they have been left in rural areas, with lack of transportation, or medical and social services.

In 2012 Over 1/4 (28%) of the black population is locked into deprivation and chronic welfare, unemployment, high-school dropouts, and single parent families. Lack of opportunity affects their life course perspective since Social Security and pensions are based on life wages. Historically, many of the jobs available to blacks (often domestics or laborers) did not include pensions .  For blacks over aged 65 the poverty rate is just over 19% http://blackdemographics.com/households/poverty/

 Low income  can result in  :

• poorer health (research shows a correlation between income level and health)
  funds for medical care, proper foods and prevention measures.
• no retirement savings
• substandard housing (not adapted for frail elderly, often in deteriorating neighborhoods)
• low self-esteem
• increased susceptible to exploitation.
• many are un-retired (aged 55 and over who need jobs but cannot find them)
• Here is an excellent web site if you would like more discussion on this demographic group http://cas.umkc.edu/casww/blackeld.htm . The demographic data  is a bit outdated but the consequences of such are educational.

2.  Latino – financial demographics

Older Latinos are not a homogeneous group ( they are not all from the same countries). There is no clear cut definition of who they are.

• Central and South Americans
• Puerto Rican
• Cuban
• Mexican American and other Spanish speaking countries
  
• Among Hispanic elders living in the United States, nearly 49 percent are of Mexican descent, 15 percent are of Cuban descent, 12 percent are of Puerto Rican descent, and 25 percent are of other Hispanic heritage http://seniorhealth.about.com/library/news/blhaa.htm

 

Latinos are  the fastest growing ethnic population in the U. S with a high rate of poverty among the elders ( 24%).

They too lacked  pension plan coverage during their working lives in lower paying jobs.  

• They suffer from health problems such as diabetes and obesity which are common in elderly Hispanics but 
  because they are suspicious of governmental services, (i.e.. deportation issues or language and cultural barriers) they don’t utilize older American’s act programs. 
  One theory is that many are not in this country legally and fear deportation. Other theories point to 
  a dominate white culture that is not sensitive to their cultural needs..
  

	Lack of education, language barriers, cultural values, and money issues also results in isolation and non-utilization of resources.
	Some experts argue that service utilization is also low because services in the United States are  most often modeled after the values of "whites" and are unfriendly to Latinos   (e.g. clinics have small exam rooms which results in no space for family support which traditionally  accompanies Latino elders to appointments.  The priority placed on family vs. work or self care, often  gives the impression of laziness and thus public scorn.

3. Asian- financial demographic

A. Asian's also are not a  homogeneous group. They comprise the:

•  Chinese
•  Filipino
•  Japanese
•  Korean
•  Vietnamese
•  Lao &Thai
•  Cambodian& Hmong 
•   and others

B. No single description of the Asian community’s culture, language, or religion can be made.

There is an additional difficulty for second generation Asian's who are citizens of the U. S.   Parent's reminders  of the traditions of their home land (country of origin) keep these children locked between two cultures. These second generation Asian Americans have been acculturated into (adopted as their own) traditional American views. This dichotomy leaves them feeling confused about their identify as an American or as a native of their parent's country.  They are likely to be more educated and acculturated than their parents.

C. Elder care among the American born, who are acculturated, may be a burden. Historically in many Asian countries the eldest son has assumed the responsibility for his elder parents. Generally elders have enough savings for retirement, however they may live with their families, and  many are cut off from their culture. This can result in high rates of isolation. 

Family problems often are kept within the family structure which also results in under utilization of services.

4. Native Americans- financial demographics

American Indians and Alaska Natives (AI/ANs) are a heterogeneous population with approximately 560 federally recognized tribes residing in the rural and urban areas of 35 states. 

 During 1990-2000, the American Indians and Alaska Native population increased 26%, compared with 13% for the total U.S. population. Of all racial/ethnic populations American Indians and Alaska Natives  have the highest poverty rates (26%)- a rate that is twice the national average. Along with these socioeconomic burdens are persistent, and often increasing, health problems. 

Diabetes affects American Indians and Alaska Natives  disproportionately when compared with other racial/ethnic populations and has been increasing in prevalence during the past 16 years. Diabetes continues to alter American Indians and Alaska Natives disproportionately and is becoming more common among younger populations. 

Interestingly, cancer mortality rates among American Indians and Alaska Natives  were lower than cancer mortality rates for all U.S. racial/ethnic populations combined. From Centers for Disease Control and Prevention MMWR2003 52 pg 697,702,704

 

American Indians  suffer from extremely high unemployment rates. Few jobs exist on the reservations and loyalty to the tribe prohibits working off the reservation.  Lack of income, leads to poor nutrition , poor healthcare, and low life expectancies. Reservations are seldom places where Native American life style can thrive. Often when there is farm land available on a reservation, there is no water; where there is water, there is no farmland. 

If they leave the reservation to search for work, they are threatened with loosing  touch with family, lifestyle, and culture. This can also leave many older Native Americans  on the reservation without support while younger community members seek work in the city.

5. Women- financial demographics

Women typically lead lives much different than older men. Traditionally, they spend many years caring for children and family. Women provide three quarters of all personal care giving in the U. S.

Because of care taking roles women are more  likely to work part-time or have gaps in their work histories. When they do work outside the home, they are not as likely to be covered by an employer sponsored pension.

Women make up three quarters of all older Americans living in poverty and  are twice as likely as older men to be poor ( because they live longer they outlive their spouses (and his retirement income) and  their savings. . Thus they are far more likely to need public benefits.

Traditionally women hold lower paying jobs than men which include inadequate or nonexistence benefits, and few opportunities for advancement. There still exists discrimination in the workplace, especially in midlife and older women. Women still earn about 70% of what men do.

Even though there are government programs that can provide cash benefits, as well as assistance in paying for food, housing, health care, and home energy costs, each year thousands of eligible women do not apply. One reason cited is that the application processes and eligibility requirements can be complicated and confusing. 

Refer to your handout Long-Term Care Finance and Policy Issues to see the confusing array of services. Note the program sponsors on one side and the service on the other. Many different sponsors offer the same service but have different entry requirements. 

II. Using History as Our Guide:

1. There is an old saying in this country that generals prepare for the next war by fighting the last one over again. As a society, we tend to do the same thing, to look back at past experiences to guide our thinking about the future. 

For example, the stock market crash in the 1930's taught us many things about the importance of insuring banks and not over valuing stocks. I'm sure if you think about it you can think of many other examples where experience has guided social policy. Another example, might be the requirement  to have a driver's license, or pay taxes? Experience has taught us what needs to be done to experience an orderly society. 

Yet, we can't anticipate the changes that will be brought about by population aging by looking backwards. Why? Many things are very different from the "historical"  aging of Americas. 

• Population aging is unprecedented. As you learned  in the chapter on demographics, the graying of America is a new phenomenon. 
  
• Population mixes are changing. Do you remember from your readings and lecture which ethnic groups are increasing in size? 
  Many are immigrants with language, cultural, and income barriers that challenge our old ways of doing business. 
  
• Social class is changing. For example, the boomers are not saving for retirement like their parents did. Why? 
  For one thing the booming economy after World War II made savings easier than was possible for the post Viet Nam War era where inflation and high interest kept young families out of the housing market.  For the boomers their investments have floundered, housing market has dropped and job layoffs at their peak earning time disappeared.

For an optional learning experience, you can log on to this site to learn more about Boomers and retirement. http://sorensenwealth.com/educational-information/time-isnt-on-baby-boomers-side

• Gender mix is changing also. For the first time in history there is an increasing  number of older women in our population. 
  Women have always outlived men (longer average life expectancy) but not in the record numbers that are beginning to develop now. More older women may mean more poor elderly who require more services to remain in the community. 

  For these and other reasons, it is  important to remember that the answers to yesterday's problems may not give us creative solutions to new challenges that we face for tomorrow.  

2. Examples of historical solutions that need new solutions today

Social Security: has proven to be a vital program protecting older Americans from the threat of poverty in old age. If we were to ignore all government cash transfers ,such as Social Security, 44% of American's ,over the age of 65, would fall below the poverty line. 

But Social Security  is a pay as you go system. That means that the workers paying taxes now are providing the income for retirees who are currently drawing benefits.

With the population pyramids changing (do  you remember that from week 2?) many believe that there will be fewer workers to pay taxes for an increasing number of beneficiaries. The old system simply won't work. However, that view may be changing with the advent of immigration and increased birth rates in America. 

Think of this, a larger portion of the younger working population will soon be minorities. Will they be willing to pay the tab for the retiring Boomers? Will we  need to think in new ways about immigration, pensions, and retirement in the future? Watch these two videos.
https://www.youtube.com/watch?v=49GavdGWtac

https://www.youtube.com/watch?v=ttZ8qoS9xIw&feature=player_detailpage

Medicare : has been an important means of guaranteeing access to medical care for older people.  It was not designed to address the problems of costly long- term care.  Can our laws afford to favor costly institutionalization? How will we address the needs of larger numbers of elderly people who need help to remain in their own homes?

Because of the increasing numbers of people over the age of 65 the United States as a society will need to consider what social structures, institutions, and policies will best  provide for the needs of this growing population. How will we support the levels of services we've come to expect for our elderly in America?

 

III. Social Structures:

Social structures are the institutions, laws, rituals and values of a society. They create  patterns of behavior that  reflect the accepted patterns of values and beliefs among people. 

Social structures can operate at two levels.

1. Those representing important components of society (institutions). Components of a society include family, work, the state or government, religion, the legal system, and education.
   

2. Those of a whole society (laws, rituals, values etc).
   These social structures shape individual practices in marked ways through the establishment of social rules or norms, and the distribution of power and resources.
   

   These rules and resources govern practices such as:

   • entry into school
   • the timing of marriage
   • exit from the paid labor force
   • receipt of government-sponsored health care

   Through rituals, such as weddings, birthday celebrations ,or retirement, individuals celebrate these accepted life transitions and use them to give meaning to their lives.
   

Directly individuals and groups can challenge social structures through organized resistance to dominate ideas. This process was made apparent during the 1960's when social structures at all levels were challenged. The large scale resistance to the Viet Nam war is just one example. 

Indirectly individuals and groups challenge social structures through non-adherence to social norms (rules); such as ignoring marijuana laws,  driving with out seat belts, or stretching income tax rules.

 

The interplay between individuals and social structures provides the vital force that brings  about social change.

The pace of change between 
individual lives and social structures 
is often uneven.

Social structures can be slow to change but people can effect change in their lives very rapidly to meet their individual needs.

In other words, social structures can "lag behind" individual lives.

For example: For the past few decades, middle aged women from the middle and upper classes have returned to school when care giving responsibilities have lessened. Women are directly challenging the notions of "student" and "experienced" worker by adapting their unpaid home working skills for use in the classroom or paid labor force.

America still has a cultural lag in facing the future. Moody notes that the age that people first leave the workforce to retire has been going down, while the age for leaving school has been going up. Could we find that sometime in the 21^st century people will leave college at age 38 and immediately retire?

Of course this is nonsense, but as a society we have less knowledge than we ought to about the interaction between individual lives and our wider society. There is little research to guide what is happening as America ages.

Moody also notes that "Failure to think deeply about population aging is a weakness in Gerontology. We know more about individual aging than about the opportunities or structures that affect the whole life course". In other words, we are not investigating deeply enough the social structures that people are challenging to meet their needs. 

Social structures that affect older adults:

Some social structures have more importance in structuring the lives of older adults. Lets look at three of them: family, work, and the State. As you read about these structures ask yourself "what structures will we need to put in place to help older adults find social opportunities in society"?  This is great materials to consider when writing your FINAL Research Social Policy Presentation

IV. Family as A Social Structure:

"Family" can be thought of in several ways. Its meaning has changed over time and across cultures. How "family" is defined legally has implications far beyond the home. Consider these:

• insurance coverage eligibility- i.e.. same sex partners, or partners living without marriage applying for employer based medical benefits. 
  
• tax bracket status- i.e. claiming as a dependent a step-parent
  
• pension levels and distribution- benefits for live-in partners
  
• child custody decisions- for step-grandparents or grandparent's rights
  
• probate outcomes- who gets what in remarriages and divorces
  
• decisions about medical intervention-same sex or domestic partnership couples inclusion in life 
  and death medical interventions
  
• immigration options

Family as a social structure represents a symbolic union where an individual receives their needs for love, support and  reciprocated help.

Family members exchange assistance such as:

• financial support
• advice
• companionship, and love
• they share a history that comes from long term relationships with kin 

Family conflict can play a real and serious role in the live of older people too. While disagreement and conflict can coexist with affection and support it can also lead to negative memories and decreased willingness to help in times of need. Despite this-- the social structure of family remains powerfully important.

1. Changes in family structures

One of the most profound changes that has influenced the family 
structure is the lengthening of the average life expectancy. 
Having longer lives means having increased time in family roles.

• On average adult children today experience twice as much shared 
  time with a living parent as their counterparts did in 1800 .

This means that there is more potential for contact and support from parents but they may also have more responsibility for aging parents.

• Longer life span has also increased the potential for extended 
  intergenerational relationships; grand parenting and great grand
   parenting were less common in 1900.
  
• In addition, longevity has increased the importance of sibling 
  relationships and makes them a vital sense of security in old age.
  

• Recent decreases in marriages and an increase in people who are 
  more likely to marry later, has resulted in fewer children and more 
  children being born outside of a traditional marriage.

These trends have also changed the family structure. Living together outside of marriage, belonging to step and blended families, living in non-traditional households is becoming more common. Because of this family and kinships often are not bounded by marriage, adoption, or biology.

These alternatives lead to several implications for older adults.

• First of all they are affected by the practices of their children. They will need to make decisions about how to negotiate their changing kinship networks. Children born outside of traditional marriage, and step- grandchildren can challenge visitation and support efforts. 
  
• Second, older individuals are more likely to enter old age while divorced or in short term remarriages. Ex and short-term spouses may not be as likely to provide the depth of personal care that long term spouses typically gave in the past.
  
• As a result, care giving may fall more to stepchildren, siblings, and other long term family members.

V. Work

 Focusing on paid work, the meaning and experience of work is extremely complex. When we meet someone, after learning their name, the next most usual question is  "what type of work do you do?" We categorize and judge people by their work titles and in turn, people derive self-esteem, personal worth, and value from their work. 
Historically, after a number of years in the work force, and once one reached a certain age, they retired (actually, the institution of retirement with a pension began after WWII). 

Transitions in and out of work are no longer clearly delineated at any stage of life. The process of exiting paid work is not simple. Individuals might view retirement as a separate social structure, or as boundaries between retirement and work becoming increasingly blurred. Some who retire may not stay retired. Many may retire from more than one job. 

For example, I retired from the Public Health Department after many years of service. I then entered an entirely different career, one which built on my previous work experiences. I expect to be working at my new career for at least 15 years before I retire again. At age 65 I may find  yet another career.

Changes in economies can result in changes in the value of retirement income. For example: Flux in interest rates can lower retirement incomes.

Many retirees derive a large portion of 
their retirement income from investments made throughout their working lives. Theses investments 
earn interest which is drawn off and spent to replace work income. When interest rates drop, the amount which can be drawn off declines resulting in less income for the retiree.

Pension devaluation can also occur and lower retirement incomes. As inflation rises,  many older type pensions do not contain inflation factors (previsions that increase the amount of the pension monies as the cost of living increase). The value of one's pension can go down and thus purchasing power. For example, if a retiree's pension check is worth $100.00 today, after a 5% inflation period,  it would  take $105.00 to purchase what the $100.00 did before the inflation occurred.  Each year as inflation increases, (historically around 3-5 % per year) the retirement income loses value. 

Today’s marketplace emphasizes advanced technological skills Many entry level jobs require high levels of education. Because of this many of the skills of older adults are obsolete leaving menial, and minimum wage jobs available to older adults who once were high wage earners. 

Overall availability of jobs has shifted from manufacturing jobs to a service based economy. That is, America does not manufacture  products in the numbers that it did after WWII, when today's cohorts of older people first entered the work force. Today, most manufacturing jobs are sent overseas where labor costs are cheaper.

Instead of production or manufacturing products, public and private service jobs dominate the American work place.  These types of jobs are less likely to be the career jobs that the elderly entered into as young adults.

    Do you know what service sector jobs are? Here are a few examples. Notice that no production of products is involved in these jobs.

Wholesale & retail trade
Health & social services
Amusement, recreation & personal services
Accommodation & food services
Education
Transportation, storage & communication
Business services
Finance, insurance & real estate
Public administration
Source:	Labor Force Survey	Cops forecast (1994)

Historically, corporate downsizing and restructuring has reduced the demand for senior workers. Companies found  it cost effective (cheaper) to hire two lower paid inexperienced younger workers to replace life-time senior workers who have climbed the pay scale. This restructuring saves employers valuable labor costs while displacing the senior from the work force.   

Because of these factors, many older workers who are pulled back into the workforce may opt for part-time entry level jobs or create a self-employment status. Often the older worker can not generate the income they did when they were employed, and must settle for minimum wage jobs. As the population ages, and younger workers are in short supply this may change.

Things are changing : A new report issued by the census data shows that there is lack of replacements for many retiring workers. 

The top 10 expected shortages will occur in: elementary school teaching, nurses, administrators in education and public administration, financial managers, lawyers, social workers, teacher's aides, plumbers and postal clerks. What will this mean in terms of what our work force will look like by 2020?    

• check out this article from the American City Business Journal

1. Exiting the work force 

Exit from the work place for older adults in low paying jobs is often more about health issues and disability than gaining leisure time.

• As pointed out earlier, African Americans in the U. S. have had an unequal footing in the labor force and this persists into retirement years. With significantly higher rates of disability they are often forced out of the work force before 
  adequate retirement funds have been established. We will look at this phenomenon closer in the coming chapters on retirement income. You will see that opportunity structures (access to good paying jobs) during primary working years affects opportunities and access to resources during retirement.
  

VI. The State:

As managers of resources the state provides for social welfare in later life thorough programs such as Social Security and Medicare. Additionally, the State regulates many activities at all stages of the life course. For example, the state establishes the timing of entry into school, the age one can drive a car, entry into marriage, the State sets rules for tax collection  and distribution of those taxes. 

Through legislation the State also establishes rules about its citizenship. Rules that govern employment, health care and many other things that shape not only individual lives but older people's lives in profound ways. The State manages resources (by collecting and distributing taxes) and thus maintains social order.

 As the largest social structure the State has incredible power over individual lives.

For example, the State can privilege some groups over others. During the civil rights era for example many groups were privileged over others.  The State's programs and policies reflect the ideologies of those in control. If liberals are in control, social policy tends to be more generous towards the environment, entitlements, and needs based programs. When conservatives are in control, business and industry are favored. 

Here is another example of the State's affect on our thinking.   The state has played a major role in constructing what people think of as "old age".

• Since the 1930’s in the U. S. older people were designated as all people over the age of 65, 
  the age limit for receiving Social Security benefits, an entitlement program. The age of 65 
  is an arbitrary age. There is no significant physical or psychological event that happens on one's 
  65th birthday that makes them significantly different from age 64 or age 66.

Do you remember how the age of 65 was established as a retirement age? Here is a hint http://www.ssa.gov/history/puzzles/slide1.html

Otto von Bismarck was the first statesman in Europe to devise a comprehensive scheme of social security  offering workers insurance against accident, sickness and old age. During the 1860's, while looking for an appropriate age for retirement, he noted that 90% of his crew on board sailing ships were dead at the age of 65, thus he concluded age 65 to  be the appropriate age to offer old age insurance. Today, 90% of the population is alive at age 65. Remember, average life expectance was just 40 or 45 years in the 1860's. Today with increases in longevity, von Bismarck's appropriated age would be equal to age 108.

State policies (that regulate the age of Social Security eligibility) also require that people forfeit income if they retire early or delay retirement. Public  pensions now increase if retirement is delayed up to age 70 (historically it was age 65). After that if a person continues to work, paying into Social Security there are no increases in benefits . 

 Other regulations shape our decision making. Certain laws have a particularly strong 
 impact on older people.

• One example is the right to die regulation. This issue encompasses various forms of euthanasia and assisted suicide.
   At debate is "when does an individual become unable to make his or her own life and death decisions"? 
  
• Another example are the laws surrounding autonomy and competency which are extremely relevant to older people. States are in the practice of appointing  surrogates and guardianships (someone to act as a decision maker for the older adult) which in turn affects the health care and financial outcomes in the lives of older people. 
  
• Through funding,  the State also supports research and development in the fields of science and technology. Remember, the State privileges some groups over others?  It's programs and policies reflect the ideologies of those in control.  

How are research issues chosen? 
One way is through position and power. When Elected Officials are personally affected by aging parents, ( such is the case currently in California's Legislature) laws, rules and funding are more likely to be allocated to programs and research projects  that affect older adults. Our current president has an interest in the oil business and if you agree with it or not, he wants to drill for oil in pristine Alaskan territories. His policies reflect his ideology. 

• Which areas are funded for research and which programs are funded can have a big impact not only on our lives, 
  but especially on the lives of older adults.

Today, because of demographic shifts and increased longevity, you have seen in previous lectures that by 2020 the needs of older adults will probably exceed the State's ability to provide.

Three developments are challenging whether the State can maintain the income security for the elderly at current levels. 

• the accelerated rate of population aging
• anticipated rises in public expenditures (like Medicare)
• the trend toward early retirement 

VII. Aging and the Life Course

The basic question Moody asks is "what should the role be for the public sector (the State) in caring for it's citizens, not only in later life but at all stages along the life course (i.e. from birth to death)? 

Some groups, including Gerontologist, have challenged the notion of a "life course" that is  segmented by age. Meaning a society that allocates funds and opportunities based solely on age. They  argue instead for an age integrated society.

Remember, many programs provided to  young people allow them a healthier life and thus the ability to grow old. (e.g.. immunizations) and many programs for the elderly (e.g. social security) give families financial independence from their parents. (How many of you would be subsidizing your parents or grandparents income if the did not receive Social Security? Research suggests many of us would be doing so.

That would mean that all individuals could move between education, paid and unpaid occupations and  leisure activities at any age (that they are capable of the activity).

They argue that there is a lack of productive and meaningful role opportunities for the rising numbers of strong, healthy and capable older people. If they were given the opportunity, many could continue to contribute to society thus reducing the number of years they would rely on entitlement programs. Gerontologists argue that this could significantly reduce the costs of caring for the increasing numbers of elders. 

 

Dependent elderly are often shifted  into impersonal institutionalized care at a cost that is threatening both entitlement and needs based programs. 

• Because resources of the State are increasingly in demand, there has been a policy shift from the
   "needs" of older adults to the State's "ability" to handle the increasing costs.
  
• Moody argues that as a society we are focused on crisis and budget cutting and not on 
  research to solve our problems. In other words we are reacting to the problem 
  and not focusing on a solution.
  

 

VIII  Summary And Last Thoughts - Reverse Mortgage:

 States with their entitlement programs, age based rules, and general legislation, act as major providers and regulators in the lives of older people.

Today we grow old very differently than our grandparents did. It does little good to look back as we anticipate the 21^st century.

How we age is not a given or fixed fact about human life. Both individual aging and population aging are socially and historically constructed.

Social Security income has reduced the poverty of many older adults, however because there is such a wide variation of income among the elderly, the numbers are misleading.

In spite of the fact that approximately 75% of people over age 65 are homeowners, the value of home equity has made little impact on most elderly household's  standard of living. Remember they are house rich and cash poor. 

How can the elderly rep benefits from this asset?

• one method is reverse mortgage which converts equity into a monthly income. 
  Then upon death the lender owns the property. Seldom is the actual value of the house achieved by the owner.
  
• few elderly have take advantage of this however, opting instead to leave a legacy to heirs. 
  Here is a site that addresses Reverse Mortgage from Boston College. 
   Look for the link to Reverse Mortgage   http://portal.hud.gov/hudportal/HUD?src=/program_offices/housing/sfh/hecm/rmtopten

How will society deal with the equity of homes, while elderly people draw from needs-based programs? Should they be allowed to continue to leave large estates to their children even though the State picked up large sums for medical or end of life care? This is another social structure that would benefit from research. 

 Estate recovery"  can take a senior's  home to pay for medical expenses incurred, after they die . Before the economic crisis it was seldom used.
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Estate-Recovery.html

"A Medi-Cal user can make a gift of the home and not be penalized, by acting within the Medi-Cal rules. As examples, homes can be given to spouses and to children with disabilities, and to children who have lived in the home for at least two years and provided care that helped the Medi-Cal user avoid institutionalization. Further, depending on the circumstances, it is possible to make a gift of the home to others without penalty.

 

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