REPORT ON BABY BOOMERS and OLDER ADULTS: Information and Service Needs
Survey Conducted by Virginia Polytechnic Institute and State University for The National Association of Area Agencies on Aging (n4a) Administrator of the Eldercare Locator
September 2010
T
he National Association of Area Agencies on Aging (n4a) is the leading voice on aging issues for Area Agencies on Aging across the country and a champion in our nation’s
capital for Title VI Native American aging programs. n4a is dedicated to enhancing the capacity of its members to: advocate on behalf of older adults, persons with disabilities and their caregivers; take action to ensure that communities are equipped to support and enhance the wellbeing of older adults, persons with disabilities and their caregivers; and serve as the focal point in their community for answers on aging. The Eldercare Locator is the first step to finding resources for older adults in any U.S. community. These services enable older persons to live independently in their communities and offer support to caregivers. Just one free phone call (1-800-677-1116) or website visit (www.eldercare.gov) instantly connects people to community resources. The Eldercare Locator is a free, national service of the U.S. Administration on Aging and is administered by n4a. The Center for Gerontology, and Center for Survey Research, at Virginia Polytechnic Institute and State University (Virginia Tech) conducted the survey and were responsible for survey design, analysis and development of key findings and charts. The report was prepared by n4a, in collaboration with Virginia Tech. Suggested Citation: Brossoie, Nancy, Karen A. Roberto, Susan Willis-Walton, and Sandra Reynolds (2010). Report on Baby Boomers and Older Adults: Information and Service Needs. Blacksburg, VA: Virginia Polytechnic Institute and State University, Center for Gerontology ______________________ This report was supported, in part, by a grant, No. 90AM2746, from the Administration on Aging, U.S. Department of Health and Human Services. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official Administration on Aging policy.
Report on Baby Boomers and Older Adults:
Information and Service Needs
As the size of the senior population increases, and people are living longer, the demand for information on how to navigate and cope with issues faced in later life (e.g., health care, housing, transportation, support services, caregiving, employment and volunteer opportunities) is expected to increase. The Eldercare Locator provides the public with information about resources on aging issues through its toll-free telephone number, website, and partnerships with other agencies. The Eldercare Locator is a free service of the U.S. Administration on Aging and is administered by the National Association of Area Agencies on Aging (n4a). In 2010, with a grant from the U.S. Administration on Aging, the Eldercare Locator partnered with the Center for Gerontology and the Center for Survey Research at Virginia Polytechnic and State University (Virginia Tech), to conduct a telephone survey with Baby Boomers (ages 45-64) and older adults (65+) to identify the type of aging-related information they are most interested in receiving, their concerns about aging, their interest in using long-term services and supports in the future, their likely contact for aging information and their preferred ways of getting information about aging topics.
Methodology The Virginia Tech Center for Survey Research (CSR) implemented a telephone survey of 1,052 Baby Boomers and older adults throughout the United States. Respondents represented four different age groups: 45-64, 65-74, 75-84, and 85+. Telephone calls for the survey were made by CSR staff members utilizing a Computer-Assisted Telephone Interviewing (CATI) system during June and July 2010. On average, the interviews took 15 minutes to complete. A profile of the nationally representative study sample is provided in Figure 1.
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Figure 1. Survey Respondent Profile (n = 1,052)* Women White Age 45-64 Age 65-74 Age 75-84 Age 85+ Health excellent/good Education beyond HS Lives alone Retired Income < $50,000 Unpaid caregivers
Number % of All Respondents 764 72.6% 932 89.2% 259 24.6% 250 23.7% 281 26.7% 268 24.9% 773 73.5% 618 58.7% 401 38.1% 726 69.0% 452 42.9% 353 33.6%
Respondents were asked a series of questions about (1) Aging Topics of Interest (2) Concerns about Aging, (3) Potential Service Usage in the Future, (4) Contact Preferences for Aging Information, and (5) Preferred Ways to Receive Aging Information. The following summarizes the findings for each of the five categories, and highlights responses to items that differ significantly by age group. Although responses of male and female respondents also were compared, no significant differences were found for any of the items. For more details about the study methodology and findings, contact the National Association of Area Agencies on Aging (n4a). ___________________________ *The survey sample used for the study was targeted by age in order to ensure over-representation (compared to the U.S. population) of individuals in higher age ranges of interest for the study. The resulting survey sample and respondent characteristics reflect the demographic characteristics present in the U.S. population for the age brackets selected for the study. Therefore, groups less likely to be prevalent in the highest age groups in the general population due to life expectancy (e.g., women have higher life expectancy than men, black males have the lowest life expectancy compared to women in general and white men) were also less likely to be included in the survey sample and among the survey respondents.
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Aging Topics of Interest Survey respondents were asked to identify their interest in receiving information on 30 age-related issues, spanning the topics of health, caregiving, home and community-based services (HCBS), finances, health insurance coverage, living arrangements, and health care reform.* Whereas the most desired topics focused on support and health-related topics (Figure 2), the areas in which respondents were least interested in receiving information focused on financial and employment topics: reverse mortgages (9%), household money management (16%), and employment or training opportunities (18%).
Figure 2. Top Information Needs 80 60
60
56
48
46
46
46
Medicare
Exercise and Fitness
Prevention of Falls
Geriatric Case Management
40 Percent 20 0 Impact of Healthcare Reform
HCBS
Comparisons Eighty-five percent of respondents indicated interest in receiving information about at least one aging issue. Among these individuals the following differences were noted:
1. As age increased, interest decreased.
â&#x20AC;˘ Baby Boomers expressed the most interest in receiving information on all topics, averaging interest for 16 of the 30 topic areas.
___________________________ *It should be noted that in March, 2010, only a few months before this survey was conducted, Congress passed the Affordable Care Act and the Health Care and Education Reconciliation Act, which both dealt with health care reform issues.
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• Persons aged 85+ had the lowest informational needs, averaging interests for 10 of the 30 topics.It may be that many in the 85+ group have already adjusted to many of the challenges of aging and, therefore, are no longer seeking aging information.
2. Some respondents in each age group were only interested in one or two topics. The topics of most interest of respondents who had few information needs (indicated interest in only one or two topics) differed by age group:
• Baby boomers and persons aged 65-74 preferred to receive information on health care reform and volunteer opportunities.
• Adults aged 75-84 were interested in home and community-based services (HCBS) and health care reform.
• Persons aged 85+ were interested in home and community-based services (HCBS) and home repair/ modifications.
Concerns about Aging It is not uncommon for persons, as they age, to be concerned about what the future will bring and whether or not they will be able to meet the challenges that lie ahead. The top three concerns about aging suggest that respondents were most concerned about maintaining their independence (see Figure 3).
Figure 3. Top 3 Concerns About Aging 80
61
56
54
Physically unable to care for myself
Unable to drive
60 40 Percent 20 0 Unable to do the things I want to do
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Comparisons The top three concerns about aging did not differ significantly by age groups; however, two differences were noted about other age-related concerns:
â&#x20AC;˘ More Baby Boomers expressed concerns about not having enough money to stay in their homes than the other age groups, perhaps thinking ahead about maintaining current life styles into later life.
â&#x20AC;˘ Fewer adults aged 85+ indicated concerns about being alone compared to the other age groups, perhaps because this age group is more likely than the other age groups to be living alone (64% of those 85+ reported living alone compared to 18% of Baby Boomers).
Potential Service Usage in the Future Identifying a personâ&#x20AC;&#x2122;s likelihood to access community services when the need arises is useful for predicting future service use and planning how to meet the needs of the aging population. Respondents evaluated the likelihood of future service use for three services, as shown in Figure 4. Almost 50% of the respondents indicated that they were likely to seek assistance in coordinating and obtaining appropriate services in the future.
Figure 4. Likelihood of Future Service Use 60
49
44
40
Assessment of Service Needs
Long-term Care Counseling
40 20 Percent 0 Help Coordinating Services
5
Comparisons Few differences were noted by age groups when considering future service use, except that:
â&#x20AC;˘ Baby Boomers were significantly more likely to indicate they would seek assistance (e.g. for service coordination, assessment, and counseling) in obtaining services than any other age group, perhaps reflecting this age groupâ&#x20AC;&#x2122;s interest in more aging topics in general.
â&#x20AC;˘ Respondents ages 85+ were significantly less likely to state they would use the identified services than any other age group, suggesting that, at this age, they have already identified services they might have needed in order to continue to live in their communities.
Likely Contacts for Aging Information Information about aging services and programs can be accessed through a number of community agencies, organizations, and people. Not surprisingly, the top resource for respondents were family and friends (89%) (Figure 5). Other popular sources of information named were health care providers (74%) and the local Area Agency on Aging (73%).
Figure 5. Top 3 Resources for Information 100
89 74
73
Healthcare Provider
Local Agency on Aging
80 60 40 Percent 20 0 Family Member or Friend
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Comparisons The list of top three resources for information was dominated by family and friends as main resources for information regardless of respondent’s age. When considering the other information options, the following differences were found among the age groups, supporting other study findings that Baby Boomers tend to seek out information more than older age groups:
• More Baby Boomers were likely to contact community resources (e.g., local Area Agency on Aging or Eldercare Locator) for information than persons in the other age groups. Alternately, adults aged 85+ were less likely to contact community resources for information than the younger age groups.
• More Baby Boomers and those aged 65-74 expressed interest in contacting the Eldercare Locator for information than persons in the older age groups.
• Fewer adults aged 75+ were interested in contacting their health care provider than younger respondents.
• Compared to younger age groups, fewer persons in the 75-84, and 85+ age groups were likely to contact government agencies (e.g., social services) for information.
Preferred Ways to Receive Aging Information Identifying respondents’ preferred method of receiving information is critical for planning how to address informational and service needs. Printed materials and television were the most common ways in which the respondents preferred to get information about agingrelated topics. Among those respondents who were likely to go to Internet websites for information, approximately one-third indicated they would also seek information from electronic social mediums (i.e., Facebook (36%), Twitter (26%), and YouTube (32%)). The respondents preferred formats are shown in order of preference in Figure 6.
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Figure 6. Preferred Information Formats Newspaper/ magazine articles
63
Brochures and pamphlets
61
Television
61
Community presentations
45
Internet websites
43
Health & wellness fairs
42
Radio
34
Telephone hotlines
30 0
10
20
30
40
50
60
70
Comparisons Preferences for information formats varied somewhat across age groups:
• More Baby Boomers were likely to identify the radio as a source of information than in the other age groups.
• More Baby Boomers and those aged 65-74 indicated that they would look for information from health and wellness fairs, telephone hotlines, and Internet websites than adults aged 75-84 and 85+.
• Regardless of presentation format, adults aged 85+ were less likely to seek information than persons in the other age groups.
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Conclusions Overall, the study findings point to both common interests as well as distinct needs for information among Baby Boomers and older adults. By far, the impact of health care reform on personal health care was of greatest interest for the majority of the study participants. Thus, service agencies need to be prepared to help educate individuals about health care access, coverage, and costs as these changes unfold. Because the â&#x20AC;&#x153;aging populationâ&#x20AC;? represents such a wide range of individuals, it behooves health care and aging service providers to identify their primary audiences and recognize differences in their interests and need for information about aging-related issues as well as how they are likely to access this information. During the course of the interviews, many respondents expressed interest and curiosity about services mentioned. Although the amount of interest fluctuated, this finding suggests that strategies to disseminate information need to be sensitive to population needs and preferences for information delivery formats within age groups and service areas.
1. Health care reform was of great interest to the majority of respondents.
2. Members of the Baby Boom generation were receptive to receiving information on a variety of aging issues. Their interest in learning more may be related to their involvement in the care of older family members and friends, or simply recognition of their own changing needs.
3. Adults in the age group 65-74 did not have significantly different informational needs, service needs, and concerns about aging than the other age groups. In fact, the responses of members of this group were generally polarized. That is, they either expressed no interest in or concerns about aging-related topics, or reported a great deal of interest. Their lack of interest may be because they have yet had to face health or resource challenges whereas their interest in aging is perhaps a function of their own experience with changing health needs or
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their experiences providing support or care to a family member or friend. This suggests that marketing information and services to the 65-74 year old age group requires two distinct approaches: basic introduction to aging issues related to healthy aging to interest those with fewer interests in service-related aging issues and information on service and care options for those with more concerns about service-related topics.
4. Those aged 75+ were not very interested in seeking information on aging issues. This may be a testament to their personal strengths and abilities to manage their lives and age in place as they see fit. When they needed information, they relied heavily on family and friends as resources. Thus, a two-pronged strategy may be most effective for disseminating information on aging topics: Approach older persons using marketing methods that address quality of life issues, and focus efforts on educating members of informal care networks that work with older persons on aging issues, services, and information resources.
5. As technology is becoming increasingly accessible by a greater number of individuals of all ages, it will be an important medium for sharing information. While Baby Boomers were more technologically savvy than persons in the other age groups, most would turn to traditional websites rather than search for aging information through social media sites (i.e. Facebook, YouTube, and Twitter).
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Informational Interests and Needs of Caregivers A 2009 study by the National Alliance for Caregiving in collaboration with AARP estimated that more than 43 million adults over the age of 18 in the United States serve as unpaid caregivers to people over the age of 50. The following summarizes the current study findings specific to caregivers of older adults, and highlights responses to items that differ significantly from non-caregivers as well as by age group and gender.
In this study, 353 respondents (one-third of the study sample) served as caregivers
for 1 to 10 older adults during the past year. Among those caregivers, 74% were women, 67% cared for 1 person and 20% cared for 2 people. A profile of caregiving respondents is provided in Figure 7.
Figure 7. Caregiver Respondent Profile (n = 353)
Women White Age 45-64 Age 65-74 Age 75-84 Age 85+ Health excellent/good Education beyond HS Lives alone Retired Income < $50,000
Number % of All Caregiver Respondents 260 73.7% 316 93.5% 116 32.9% 101 28.6% 82 23.2% 54 15.3% 264 74.8% 228 64.8% 106 30.0% 210 63.4% 132 55.5%
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Caregivers â&#x20AC;&#x201C; Aging Topics of Interest Caregivers routinely face challenges concerning the health and well-being of the people they care for, often to the detriment of their own physical health and emotional needs. Mirroring the responses of the overall study sample, the top information interests of caregivers were health care reform, HCBS, and caregiving (Figure 8). The topics that caregivers were least interested in receiving information on were reverse mortgages (11%), household money management (19%), and employment or training opportunities (22%).
Figure 8. Caregivers - Top Information Needs
100 90 80 70 60 50 40 Percent 30 20 10 0
69
Healthcare Reform
65
63
HCBS
Caregiving
56
56
Managing Caregiver Stress
Fall Prevention
Comparisons Ninety three percent of caregivers were interested in receiving information about agerelated topics. Among these respondents, the impact of health care reform was of most interest regardless of age or gender. However, a few other differences were noted:
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1. Caregivers were interested in receiving more information than non-caregivers.
• More caregivers were interested in receiving information related to caregiving issues, health and wellness, and service options than non-caregivers.
• The average number of areas of interest for caregivers was 15 compared to 12 for non-caregivers.
• Among caregivers interested in receiving information on only 1 or 2 topics, most preferred to receive information on HCBS and health care reform than any other topics.
2. The information interests of male and female caregivers were similar except for two areas, supporting other research findings that indicate male caregivers typically handle more financial issues than female caregivers.
• More male caregivers expressed interest in receiving financial information than female caregivers.
• More female caregivers reported interest in obtaining information about managing caregiver stress, geriatric case management, and transportation services than male caregivers.
3. With the following exceptions, caregivers in each age group did not differ in their informational needs.
• More caregivers who were Baby Boomers were likely to express interest in receiving information on caregiving, Medicaid, employment or training opportunities, home meal delivery or community meal sites, and volunteer opportunities than caregivers in the other age groups.
• Fewer caregivers aged 75-84 expressed interest on the impact of health care reform and employment and training opportunities than caregivers in other age groups.
• Fewer caregivers aged 85+ were interested in volunteer opportunities and legal issues such as wills, trusts, and power of attorney than caregivers in the other age groups.
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Caregivers - Concerns about Aging Caregivers see firsthand how poor health and lack of resources and support impact personal well-being and quality of life, thus, it is not surprising that their main concern about aging was being physically unable to care for themselves (see Figure 9).
Figure 9. Caregivers - Top 3 Concerns About Aging
64
63
59
Physically unable to care for myself
Unable to do the things I want to do
Unable to drive
70 60 50 40 30 20 Percent 10 0
Comparisons The top three concerns of caregivers and non-caregivers were the same categories; however, the caregiver group did differ in the following ways:
â&#x20AC;˘ More caregivers were concerned about not being able to physically care for themselves in later life than non-caregivers.
â&#x20AC;˘ Fewer caregivers aged 75-84 were concerned about being a burden on their families and not being able to do the things they like to do than caregivers in the other age groups.
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Caregivers – Potential Service Usage in the Future Identifying caregivers’ likelihood to access community services when the need arises can help agencies and organizations predict the future service needs of individuals and their caregivers. As shown in Figure 10, similar to the sample as a whole, caregivers would seek assistance in coordinating and obtaining appropriate services to meet their own or their care recipients’ care needs.
Figure 10. Caregivers - Likelihood of Future Service Use
58
60
52
46
40 20 Percent 0 Help Coordinating Services
Assessment for Service Needs
Long-term Care Counseling
Caregivers – Likely Contacts for Aging Information Information about aging services and programs can be accessed through a number of community agencies, organizations, and people. Family members and friends (93%), health care providers (84%), and the local Agency on Aging (77%) were identified as the top three resources for information among caregivers (Figure 11).
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Figure 11. Caregivers - Resources for Information
93
100 80 60 40 Percent 20 0
Family Member or Friend
84
77
Healthcare Provider
Local Agency on Aging
Comparisons Although caregivers reported relying heavily on family and friends for information, they also indicated that they would look to other people and organizations for guidance. When comparing the likelihood of accessing resources, the following differences were identified between caregiver and non-caregivers:
â&#x20AC;˘ More caregivers indicated they would look to a health care professional for information than non-caregivers.
â&#x20AC;˘ Almost twice as many caregivers reported that they would turn to the Eldercare Locator for information than non-caregivers.
Both of these findings may reflect the fact that caregivers have had more contact with health care professionals in general (either for themselves or for the older adults they are caring for), and, as caregivers, they would be inclined to talk with these professionals about older adult services.
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Caregivers â&#x20AC;&#x201C; Preferred Ways to Receive Information Knowing caregiversâ&#x20AC;&#x2122; preferred methods of receiving information is critical when planning for and addressing their informational and service needs. Like non-caregivers, printed materials and television were the most common ways in which caregivers preferred to get information about aging-related topics. Among those caregivers who were likely to go to Internet websites for information, approximately one-third indicated they would also seek information from electronic social mediums (i.e., Facebook (30%), Twitter (30%), and YouTube (35%)). The preferred formats of caregivers are shown in order of preference in Figure 12.
Figure 12. Caregivers - Preferred Information Formats
Brochures/pamphlets
71 68
Newspaper/magazine articles Television
63
Community presentations
45 43 42
Internet websites Health & wellness fairs Radio
34
Telephone hotlines
30 0
10
20
30
17
40
50
60
70
80
Comparisons With the following few exceptions, caregivers did not differ from non-caregivers nor did they differ among themselves in their preferences of information formats.
â&#x20AC;˘ More caregivers were likely to look for information presented in brochures and pamphlets, health and wellness fairs, and Internet websites than non-caregivers.
â&#x20AC;˘ More caregivers who were Baby Boomers were likely to look for information on Internet websites compared to caregivers from all other age groups.
â&#x20AC;˘ Few caregivers aged 75-84 and 85+ were likely to look for information on an Internet website.
Conclusions Overall, study findings suggest that caregivers are receptive to receiving information on a variety of aging issues, with a heightened interest in the topics of caregiving, health and wellness, and community service options. This is likely to be a function of their own experiences working in a caregiving capacity coupled with their familiarity with their own aging needs. When providing information and services for caregivers it is important to recognize that:
1. Caregivers viewed family and friends as key resources for information. For those caregivers involved with extensive daily caregiving activities, this reliance may be related to having limited time to seek out other resources. Thus, the dissemination of information to caregivers needs to be intentional and targeted towards activities or locations accessed by caregivers.
2. Traditional Internet websites were important sources of information for caregivers who were Baby Boomers. While this age group may be technologically savvy, however, they do not appear to rely on social media (i.e. Facebook, YouTube, and Twitter) as key resources for aging information.
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Recommendations The study findings point to both common interests as well as distinct needs for information among Baby Boomers and older adults. Because the â&#x20AC;&#x153;aging populationâ&#x20AC;? represents such a wide range of individuals, it behooves health care and aging service providers to identify their primary audiences and recognize differences in their interests and need for information about aging-related issues as well as how they are likely to access this information. Specific recommendations include:
1. Service agencies need to be prepared to help educate individuals about the range of home and community-based services available, health care access and costs as changes in health care reform unfold.
2. Marketing information and services to the 65-74 year old age group may require two distinct approaches to address the polarized responses of this age group: basic introduction to aging issues to appeal to those who may have not yet faced health or resource challenges (e.g., ways to enhance quality of life in the later years), as well as information on home and community-based services and care options.
3. When marketing to persons aged 75+, use marketing methods that address quality of life issues, as well as marketing methods that educate members of informal care networks that work with older adults on aging issues, home and community-based services, and information resources.
4. Strategies for disseminating information to caregivers need to be intentional and targeted towards activities or locations accessed by caregivers, including family and friends who are non-caregivers, as well as the Internet.
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notes
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