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Planning to Make^ N.E . Indiana Elder-Friendly

Planning to Make^ N.E . Indiana Elder-Friendly . Philip B. Stafford, Ph.D. , Director, Center on Aging & Community, Indiana Institute on Disability & Community Indiana University. So what is a livable community for older adults? …an elder-friendly community?.

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Planning to Make^ N.E . Indiana Elder-Friendly

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  1. Planning to Make^N.E.Indiana Elder-Friendly Philip B. Stafford, Ph.D. , Director, Center on Aging & Community, Indiana Institute on Disability & Community Indiana University

  2. So what is a livable community for older adults?…an elder-friendly community?

  3. Central Avenue 1960 Bruce Tibbo, St. Pete Times

  4. Green bench graveyard 1969 Tom Bennett St. Pete Times

  5. Central Avenue 1984 Maria Vesperi

  6. Central Avenue, 1999

  7. Not “When is old age?”but“Where is old age?”

  8. “Old people everywhere.” Christopher Alexander A Pattern Language

  9. Our work should help create good places to grow up and grow old…livable, lifespan communities

  10. Indiana Partnerships for Lifespan Communities “…a comprehensive, participatory, and data driven initiative to create good places to grow up and grow old in Indiana.” Aging in Place Initiative

  11. Indiana Partnerships for Lifespan Communities • State level partnerships and Steering Committee • Professional Development workshops statewide • Fund Development for statewide survey and community engagement Years One and Two: Groundwork

  12. Indiana Partnerships for Lifespan Communities The first application of the AdvantAge Initiative on a statewide basis

  13. Six neighborhoods of Chicago, IL Indianapolis, IN Jacksonville, FL Lincoln Square, NYC Maricopa County, AZ Orange County, FL Puyallup, WA Santa Clarita, CA Upper West Side, NYC Yonkers, NY RWJ CPFOA Communities National Survey Grand Rapids, MI Contra Costa County, CA Parsippany, NJ Newaygo County, MI St. Joseph County, IN Elkhart County, IN Kosciusko County, IN LaPorte County, IN Marshall County, IN El Paso County, TX Chinatown, NY The State of Indiana AdvantAge Initiative Survey Conducted in:

  14. Develop a model of an “elder friendly” community • Develop a method to measure community “elder-friendliness” • Help communities interpret and use this information to create action plans to support older residents’ health, well-being, and independence as well as their social and civic engagement

  15. AdvantAge Initiative Strategy DATA INFORMATION ACTION • Consumer surveys – catalyst • Focus groups • Census data • Other statistics (assets, health, crime) • Framework • Indicators • Benchmarks • Technical assistance • Raise awareness • Set priorities • Design action plans • Allocate resources • Monitor progress

  16. Indiana Partnerships for Lifespan Communities • Statewide Survey • 4,500 older Hoosiers, 15 samples of 300 • +5 samples for Neighborhood NORCs (U. Indy Center for Aging & • Community) • Local engagement • 16 mini-grants to support local community participation, e.g.: • public awareness • convening stakeholders, steering committees • small pilots • participatory research to supplement survey data • inclusion of adults with developmental disabilities • Engagement with philanthropy • Materials and workshops for Indiana Grantmakers Alliance, United Ways, etc. Year Three: 2008

  17. The Domain ADDRESSES BASIC NEEDS The Dimension Housing Is Modified To Accommodate Mobility And Safety The Indicator “% of 65+ householders with home mod needs”

  18. Figure 2.1, Indiana-Area 3§ Percentage of people age 60+ who want to remain in their current residence and are confident they will be able to afford to do so Not Very Confident** 36% Disagree 3% ‡ Agree* 97% Very Confident 64% Neither/ DK/RF 1% ‡ Unweighted N=289 Weighted N=102,355 Unweighted N=300 Weighted N=106,028 We asked respondents whether they agree or disagree with the following statement: “What I’d really like to do is stay in my current residence for as long as possible.” For people who answered “agree” we calculated the percentage of adults age 60+ who were very confident/not very confident that they will be able to afford to live in their current residence for as long as they would like. Note: Percentages may not add up to 100% due to rounding and/or missing information. *Agree includes those who said Strongly agree or Somewhat agree. **Not Very Confident includes those who said Somewhat confident, Not too confident, Not confident at all, Don’t know, or Refused. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  19. Figure 3.1, Indiana-Area 3§ Percentage of householders age 60+ in housing units with home modification needs* ‡ 2% DK/RF 15% ‡ Not planning to modify No modifications needed 87% One or more modification needed 13% Planning to modify 83% Unweighted N=300 Weighted N=106,028 Unweighted N=41 Weighted N=14,272 *People were asked whether their current residence needs any significant repairs, modifications, or changes to improve their ability to live there over the next five years. *People who said that their homes need modification were asked if they plan to make the change over the next five years. Note: Percentages may not add up to 100% due to rounding and/or missing information. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  20. Figure 3.2, Indiana-Area 3§ Type of modification needed Cosmetic/minor repairs Structural changes/ major repairs ‡ Bathroom modification Better heating in the winter ‡ Better cooling in the summer ‡ Accommodations for disabilities ‡ Fix problem with insects/rodents ‡ Medical emergency response system ‡ Unweighted N=300 Weighted N=106,028 ‡ Other ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  21. Figure 6.1, Indiana-Area 3§ Percentage of people age 60+ who are satisfied with the neighborhood as a place to live* DK/RF <1% Not Very Satisfied** 16% ‡ Very Satisfied 84% Unweighted N=300 Weighted N=106,028 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked how satisfied they are with their neighborhood as a place to live. **The category “Not very satisfied” includes those who said they were somewhat satisfied, somewhat dissatisfied, or very dissatisfied with their neighborhood. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  22. Figure 6.2, Indiana-Area 3§ Percentage of people age 60+ who are satisfied with the neighborhood as a place to live,* by demographics Total ‡ Age 60-64 ‡ Age 65-74 ‡ Age 75+ Women Men Note: Percentages may not add up to 100% due to rounding and/or missing information. Unweighted N= 300 Weighted N= 106,028 *People were asked how satisfied they are with their neighborhood as a place to live. **The category “Not very satisfied” includes those who said they were somewhat satisfied, somewhat dissatisfied, or very dissatisfied with their neighborhood. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  23. Figure 4.1, Indiana-Area 3§ Percentage of people age 60+ who feel safe/unsafe in their neighborhood* Safety-Fair/Poor Safety- Good 18% DK/RF <1% ‡ 6% ‡ Safety- Excellent/Very Good 76% Unweighted N=300 Weighted N=106,028 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked whether safety in their neighborhood is excellent, very good, good, fair, or poor. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  24. Figure 5.1, Indiana-Area 3§ Prevalence of Perceived Neighborhood Problems Crime People don’t get involved Traffic Public transportation Streets need repair Not enough arts/culture Lack of affordable housing Noise Streets too dark Rundown buildings Distance from parks Poor public service Distance from shopping Unweighted N= 300 Weighted N= 106,028 Traffic lights too few/too fast *People were read a list of fifteen neighborhood problems and were asked to indicate whether each item posed a big problem, small problem, or no problem in their neighborhood. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  25. Figure 8.1, Indiana-Area 3§ Percentage of people age 60+ who do not know whom to call if they need information about services in their community* Other 2% ‡ Family/ Neighbors Internet/Phone Book/ Other Media Do Not Know Whom to Call 21% ‡ 3% 9% City/County/ Office of Aging/ Social Services/ Other Agency 34% Senior Center 13% ‡ Medical Center/Health Professional 14% 4% Unweighted N=300 Weighted N=106,028 Church/Synagogue Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked to indicate the best resource, such as a person or an organization, in their city, town, or county to get information on various services. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  26. Figure 8.2, Indiana-Area 3§ Percentage of people age 60+ who do not know whom to call if they need information about services in their community,* by demographics Total ‡ Age 60-64 Age 65-74 Age 75+ Women Men Unweighted N= 300 Weighted N= 106,028 *People were asked to indicate the best resource, such as a person or an organization, in their city, town, or county to get information on various services. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  27. Figure 8.3, Indiana-Area 3§ Percentage of people age 60+ who do not know whom to call if they need information about services in their community,* by demographics (cont’d) Total ‡ Education >HS Education <HS Ex/vg/good health ‡ Fair/poor health Live w/others Live alone Unweighted N= 300 Weighted N= 106,028 *People were asked to indicate the best resource, such as a person or an organization, in their city, town, or county to get information on various services. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  28. Figure 9.1, Indiana-Area 3§ Percentage of people age 60+ who are aware/unaware of selected services in their community* ‡ ‡ ‡ ‡ Home Health Aide Home- maker Service Senior Center Visiting Nurse Meals- on- wheels Special Trans- portation Congregate Meals Respite Home Repair Service Hospice Note: Percentages may not add up to 100% due to rounding and/or missing information. Unweighted N=300 Weighted N=106,028 *Respondents were asked whether these 10 services are available in their area. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  29. Figure 10.1, Indiana-Area 3§ Percentage of people age 60+ with adequate assistance* in ADL and/or IADL activities One or More Unmet Need 59% No Limitations 85% One or More ADL/IADL 15% All Needs Are Met 41% ‡ Unweighted N=43 Weighted N=15,592 Unweighted N=300 Weighted N=106,028 *People were asked whether they need assistance with the following activities: ADLs- taking a bath or a shower, dressing, eating, getting in/out of bed/chair, using/getting to a toilet, getting around inside the home and IADLs-going outside the home, doing light housework, preparing meals, driving a car/using public transportation, taking the right amount of prescribed medication, keeping track of money and bills. *People who answered “yes” were asked whether they get enough assistance with these activities. Unmet need was defined as not getting help or not getting enough help for one or more ADLs and/or IADLs for which assistance was needed. Note: Percentages may not add up to 100% due to rounding and/or missing information. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  30. Figure 10.2, Indiana-Area 3§ Percentage of people age 60+ who have one or more limitations with ADL and/or IADL activities,* by demographics Total Age 60-64 ‡ Age 65-74 ‡ ‡ Age 75+ Women ‡ Men *People were asked whether they need assistance with the following activities: ADLs- taking a bath or a shower, dressing, eating, getting in/out of bed/chair, using/getting to a toilet, getting around inside the home and IADLs-going outside the home, doing light housework, preparing meals, driving a car/using public transportation, taking the right amount of prescribed medication, keeping track of money and bills. Unweighted N=300 Weighted N=106,028 ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  31. Figure 10.3, Indiana-Area 3§ Percentage of people age 60+ who have one or more limitations with ADL and/or IADL activities,* by demographics (cont’d) Total ‡ Education >HS Education <HS Ex/vg/good health Fair/poor health Live w/others ‡ Live alone *People were asked whether they need assistance with the following activities: ADLs- taking a bath or a shower, dressing, eating, getting in/out of bed/chair, using/getting to a toilet, getting around inside the home and IADLs-going outside the home, doing light housework, preparing meals, driving a car/using public transportation, taking the right amount of prescribed medication, keeping track of money and bills. Unweighted N=300 Weighted N=106,028 ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  32. Figure 12.1, Indiana-Area 3§ Percentage of people age 60+ who thought they needed the help of a health care professional because they felt depressed or anxious and have not seen one (for those symptoms)* Has not seen a health professional 26% Needed professional help ‡ Did not need professional help 95% ‡ 4% Has seen a health professional 74% DK/RF 1% ‡ ‡ Unweighted N=12 Weighted N=4,275 Unweighted N=300 Weighted N=106,028 *People were asked whether in the past year, there was a time when they thought they needed the help of a health professional or a counselor because they felt depressed or anxious. *People who answered “yes” were asked whether they obtained the professional help or counseling they thought they needed. Note: Percentages may not add up to 100% due to rounding and/or missing information. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  33. Figure 14.1, Indiana-Area 3§ Percentage of people age 60+ who report being in good to excellent health* DK/RF 1% ‡ Fair/poor** 21% Excellent/very good/good 79% Unweighted N=300 Weighted N=106,028 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked: “Would you say that, in general, your health is Excellent, Very good, Good, Fair, Poor, or Very poor?” **Includes people who said their health was Fair, Poor, or Very poor. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  34. Figure 14.2, Indiana-Area 3§ Percentage of people age 60+ who report being in good to excellent health,* by demographics Total ‡ Age 60-64 Age 65-74 Age 75+ Women Men Note: Percentages may not add up to 100% due to rounding and/or missing information. Unweighted N= 300 Weighted N= 106,028 *People were asked: “Would you say that, in general, your health is Excellent, Very good, Good, Fair, Poor, or Very poor?” **Includes people who said their health was Fair, Poor, or Very poor. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  35. Figure 16.1, Indiana-Area 3§ Percentage of people age 60+ with a usual source of care* No usual source of care Have a usual source of care 95% ‡ 5% DK/RF <1% ‡ Unweighted N=300 Weighted N=106,028 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked whether there is a place that they usually go when they are sick or need advice about their health. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  36. Figure 17.1, Indiana-Area 3§ Percentage of people age 60+ who failed to obtain needed medical care* Did not obtain care 4% ‡ Did not need medical care 56% Needed medical are 44% Obtained care 96% DK/RF 1% ‡ Unweighted N=300 Weighted N=106,028 Unweighted N=131 Weighted N=46,249 *People were asked whether in the past year there was a time when they thought they needed medical care because they felt sick. *People who answered “yes” were asked whether they saw a medical professional when they felt sick. Note: Percentages may not add up to 100% due to rounding and/or missing information. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  37. Figure 18.1, Indiana-Area 3§ Percentage of people age 60+ who had problems paying for medical care* DK/RF <1% ‡ No problem paying for medical care 96% Problem paying for medical care ‡ 4% Unweighted N=300 Weighted N=106,028 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked whether there was a time in the past 12 months when they did not have enough money to follow up on tests or treatment recommended by a doctor. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  38. Figure 25.1, Indiana-Area 3§ Percentage of people age 60+ who provide help to the frail or disabled* DK/RF <1% ‡ Provide care 21% Do not provide care 79% Unweighted N=300 Weighted N=106,028 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People were asked whether they provide help or care, or arrange for help or care, for a relative or friend who is unable to do some things for him/herself due to illness or disability. ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  39. Figure 25.4, Indiana-Area 3§ Relationship between caregivers age 60+ and care recipients* Non-relative friend ‡ Parent or in-law Spouse/partner ‡ ‡ Another relative ‡ Child Other 0% Unweighted N=62 Weighted N=22,172 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People who said they provide care were asked “What is this person’s relationship to you?” ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

  40. Figure 25.6, Indiana-Area 3§ Number of hours per week spent on caregiving among people age 60+ who provide help to the frail or disabled* More than 10 hours 21% ‡ Don’t Know 12% 4-10 hours 24% ‡ ‡ 1-3 hours 43% Unweighted N=62 Weighted N=22,172 Note: Percentages may not add up to 100% due to rounding and/or missing information. *People who said they provide care were asked “On average how many hours per week are you caring for … ” ‡ This percentage is based on fewer than 20 respondents (Unweighted N<20) and should be interpreted with caution. § Area 3 includes Adams, Allen, De Kalb, Huntington, Lagrange, Noble, Steuben, Wells, & Whitley Counties. Source: AdvantAge Initiative Community Survey in Indiana 2008

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