Social and Behavioral Sciences Commons^™

Aging In Boxford: Planning For An ‘Active And Involved’ Future, Nina Silverstein, Caitlin Coyle

Gerontology Institute Publications

This planning study was conducted to investigate current and anticipated needs, interests, preferences, and concerns of Boxford adults aged 45 and older. Special emphasis is placed on gauging future age-related services needed by residents, including those provided by the Boxford Council on Aging and its Senior Center (hereafter, COA), as well as the existing physical infrastructure of the COA relative to these service needs now and in the future. A primary focus of this study was whether Boxford is a town where lifelong residents will feel supported in later life.

The goals of the project were (1) to identify the …

The Alzheimer’S Association Dementia Care Coordination Program: A Process Evaluation, Executive Summary, Nina Silverstein, Frank Porell, Pamela Nadash

Gerontology Institute Publications

The Massachusetts/New Hampshire (MA/NH) Chapter of the Alzheimer's Association has long sought ways to systematically increase the number of families who utilize its services and support. According to the Alzheimer’s Association’s 2015 Alzheimer’s Disease Facts and Figures, there are 142,000 individuals living with Alzheimer’s disease in Massachusetts and New Hampshire, and the Alzheimer’s Association estimates that less than 30% of those individuals and their caregivers take advantage of its programs (Alzheimer’s Association, 2015). The MA/NH Chapter recognized that one major barrier to accessing services is a model that relies on families taking the initiative to seek out assistance.

In …

Assessing Current And Future Needs Of Residents Aging In The Town Of Andover, Bernard A. Steinman, Ceara R. Somerville, Maryam Khaniyan, Hayley Gleason, Mai See Yang, Jan E. Mutchler

Gerontology Institute Publications

This report describes the collaborative efforts undertaken by the Town of Andover Division of Elder Services and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston. Beginning in Fall 2014, these organizations joined to conduct a needs assessment to investigate the needs, interests, preferences and opinions of the Town’s older resident population, with respect to aging in Andover. The focus of this report is on two cohorts of Andover residents—those who are age 50 to 59 (referred to as “Boomers”) and the cohort of individuals who are currently age …

Aging In Place In Marion: A Community Endeavor, Bernard A. Steinman, Hayley Gleason, Maryam Khaniyan, Ceara Somerville, Jan Mutchler

Gerontology Institute Publications

This report describes collaborative efforts undertaken by the Friends of the Marion Council on Aging (FMCOA) and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston (UMass Boston). Beginning in Fall 2014, these organizations partnered to conduct a study to investigate the needs, interests, preferences, and opinions of the Town’s older resident population, and the priorities of other stakeholders in the Town, with respect to living and aging in Marion.

In the earliest phase of the project, we met several times with members of the FMCOA to discuss and …

Effects Of Video Enhancement In A Stated-Choice Experiment On Medical Decision Making, Susanne Hoffmann, Joachim Winter, Francis G. Caro, Alison Gottlieb

Gerontology Institute Publications

Background. The internet can be useful in administering stated-choice experiments to understand medical decision making and refine the content of patient decision aids. In internet-based stated-choice experiments, video and audio files can be used to provide information to respondents. Quality of data may or may not be affected.

Objectives. In a methodological experiment concerned with administration of a stated-choice experiment on the internet concerned with knee-replacement surgery, we compared the data quality obtained with video-enhanced and conventional text formats.

Methods. Members of the RAND Corporation’s American Life Panel and 50 years of age or older (n=1616) were randomly assigned to …

Aging In West County Communities: Coming Together To Age In Place, Bernard A. Steinman, Hayley Gleason, Ceara Somerville, Maryam Khaniyan, Jan Mutchler

Gerontology Institute Publications

This report describes collaborative efforts undertaken by the Towns of Ashfield, Buckland, and Shelburne Consortium of Councils on Aging (hereafter, The Consortium) and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston (hereafter, UMass Boston). Beginning in Fall 2014, these organizations partnered to conduct a study to investigate the needs, interests, preferences, and opinions of older residents in communities in West Franklin County (hereafter, West County), and priorities of stakeholders who interact with older adults in various capacities.

Early in the project, researchers from UMass Boston communicated with stakeholders …

Fact Sheet: Cohort Differences In Parental Survival, Maximiliane E. Szinovacz

Gerontology Institute Publications

Increases in longevity and especially increased survival into very old age have implications not only for individuals’ own life course but also for that of their families. For example, if parents survive into very old age they will have more opportunities not only to become grandparents but also great-grandparents and to experience these family roles for a longer time period (the so-called “beanpole family”). From their adult children’s perspective, longer survival of parents also can mean that needs for companionship arising from one parent’s widow(er)hood will be postponed into their adult children’s later years, possibly after the child’s retirement. Similarly, …

Fact Sheet: Cohort Differences In Parents’ Illness And Nursing Home Use, Maximiliane E. Szinovacz

Gerontology Institute Publications

Surviving parents of the war baby and baby boom cohorts are now reaching very old age. Given their increased longevity and postponement of morbidity into very old age (see Fact Sheets on parental mortality and care needs), it is essential to estimate whether and to what extent these parents will require informal or formal care. Such care is typically most burdensome and costly if it involves long-lasting illness prior to death. Furthermore, Medicare and especially Medicaid expenditures will depend on whether or not these parents require nursing home care. To obtain some estimates of the prevalence of long-lasting illness and …

Fact Sheet: Cohort Differences In Parental Care Needs, Maximiliane E. Szinovacz, Linda C. Lieber

Gerontology Institute Publications

There has been considerable concern about the availability of informal and especially family care when the baby boom cohorts reach old age (Ryan and Smith et al., 2012). However, as care needs typically arise in late old age (age 70 or later), a more immediate issue is the care burden faced by the baby boomer cohorts themselves as their parents now reach late old age. To assess the potential care burden faced by baby boom adult children one first needs to assess their parents’ care needs. Such assessment is also essential as research shows that parental care needs do not …

Living And Aging In Newton: Now And In The Future, Bernard A. Steinman, Hayley Gleason, Ceara Somerville, Jan E. Mutchler, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

This report describes collaborative efforts undertaken by the City of Newton Department of Senior Services, the Newton Council on Aging, The Senior Citizens Fund of Newton, Inc., and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston. Beginning in Fall 2013, these organizations partnered to conduct a needs assessment study to investigate the needs, interests, preferences, and opinions of the City’s older resident population, with respect to living and aging in Newton. The focus of this report is on two cohorts of Newton residents—those aged 50 to 59 (referred …

Social Networks, Decision Aids, And Patient Decisions Regarding Knee-Replacement Surgery, Francis G. Caro, Susanne Hoffmann, Alison Gottlieb, Iris Kesternich, Joachim Winter

Gerontology Institute Publications

Objective: Examine how information from social networks is associated with patient decisions in the presence of information from multiple professional sources including decision aids.

Methods: We conducted a stated-choice experiment in which respondents made recommendations for hypothetical patients about whether full knee-replacement surgery should be performed to treat knee osteoarthritis. In addition, we administered a background questionnaire in which we explicitly asked respondents about the experience of people in their social network with knee osteoarthritis and possible treatment options. We examined the manner in which respondents’ recommendations for vignette persons were associated with the experiences of members of …

Aging In Boston: Preparing Today For A Growing Tomorrow, Jan E. Mutchler, Bernard A. Steinman, Caitlin Coyle, Hayley Gleason, Jiyoung Lyu, Ceara Somerville

Gerontology Institute Publications

Boston’s population is becoming older than ever before. The oldest Baby Boomer is approaching 70 and reinventing what it means to be a “senior citizen.” Waves of Boomers will forge a new path into later life, creating a population of seniors that is larger and more long-lived than previous cohorts, and diverse in new ways. In 2010, more than 14% of Boston’s residents were 60 years or older, representing 88,000 older people. By 2030, projected increases in the older population will result in as many as 130,000 seniors residing in Boston. How will Boston accommodate its growing older population? What …

Healthy Eating And Savvy Saving: An Evaluation Of Action For Boston Community Development’S Food Dollars Program For Low-Income Elders, Ann Bookman, Susan M. Phillips

Gerontology Institute Publications

This report is an evaluation of an innovative community-based intervention – the Food Dollars Program. Funded by the AARP Foundation, this program was designed and delivered by Action for Boston Community Development (ABCD) and their Elder Services staff in order to promote healthy eating and reduce food and economic insecurity among low-income elders in Boston. The impetus for creating this program arose from the challenges many low-income individuals face in purchasing and consuming healthy foods from the five food groups as recommended by the US Department of Agriculture (USDA) in their ChooseMyPlate model of healthy eating. The Food Dollars curriculum …

Evaluation Of The Jewish Community Housing For The Elderly Memory Support Initiative, Joan Hyde

Gerontology Institute Publications

Jewish Community Housing for the Elderly (JCHE) is a large, multi-campus organization that houses and serves 1,500 residents (80 market rate and 1,420 low income). The average age is 80 years old, with one-third of residents 85 and older. Three quarters of the residents are not native English speakers. Through HUD and other funding, JCHE offers a range of supports to these residents, including translators, interpreters and staff with language and cultural competence, meals, transportation and, through their Service Coordinators, facilitation of resident access to government benefits, home care and other services.

According to the Alzheimer’s Association’s 2012 special report …

Putting Retirement At Risk: Has Financial Risk Exposure Grown More Quickly For Older Households Than Younger Ones?, Christian Weller, Sara Bernardo

Gerontology Institute Publications

Financial markets have been characterized by boom and bust cycles since the 1980s, while the responsibility for managing retirement wealth has increasingly shifted onto individual households at the same time. Policymakers and experts have expressed concern over rising risk exposure among older households, who appear to be increasingly exposed to the growing financial risks just as they near retirement. We consider household data from the Federal Reserve’s Survey of Consumer Finances from 1989 to 2010 to analyze the correlation between age and risk exposure. We test if older households’ risk exposure has indeed grown over time, if it has increased …

Massachusetts Healthy Aging Data Report: Community Profiles, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Stacey Mann

Gerontology Institute Publications

The Massachusetts Healthy Aging Data Report: Community Profiles was created by researchers at the Gerontology Institute of the John W. McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston and commissioned by the Tufts Health Plan Foundation.

In this report, we have created a custom profile of nearly 100 healthy aging indicators for every city and town in Massachusetts including the 16 neighborhoods of Boston (367 Community Profiles). Each Community Profile is designed to help community residents, agencies, providers, and governments understand the older adults who live in their cities and towns – their ages, …

Fact Sheet: What Influences Plans To Work After Ages 62 And 65?, Maximiliane E. Szinovacz, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

Timing of retirement and, implicitly, plans to work in later life have great policy relevance. They affect Social Security expenditures, employers’ pension expenditures, as well as labor force supply and demand. In light of the recent recession, it is particularly important to explore whether economic downturns and workers’ financial status influence their later-life work plans. To answer this question, we analyzed data from the nationally representative Health and Retirement Study (HRS), which included questions about expectations to work full-time after age 62 and age 65.

Gender And Marital Status Differences In Retirement Planning, Maximiliane E. Szinovacz, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

During the past decades, women have increasingly joined the labor force and worked in their later years. Yet women, especially married women, often have shorter work histories than their male counterparts due to taking time off for child care or care for ailing relatives. Are they also different in their retirement expectations? To answer this question, we explore gender and marital status differences in retirement plans.

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Block Granting Medicaid And Other Retrenchment, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

On January 16, 2009, the Federal government approved Rhode Island’s application for a Global Consumer Choice Compact Medicaid Waiver whereby the state became the first granted permission to operate its entire Medicaid program under the state plan and a single 1115 “research and demonstration” waiver. The Global Waiver has been implemented in the context of Republican proposals to turn Medicaid into a block grant which would give states substantially more flexibility administering the program in exchange for receiving an upfront allotment from the Federal government. Proponents have held up the Global Waiver as a successful example of what might be …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Rebalancing Long-Term Care Under The Affordable Care Act, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Federal approval of Rhode Island’s Global Consumer Choice Compact Global Waiver in 2009 provided Rhode Island with greater flexibility to modify its Medicaid program. Because 96% of long-term care expenditures in Rhode Island were directed toward institutional settings, a primary goal was to facilitate the state’s efforts to shift the locus of long-term care to non-institutional settings. This study draws lessons from Rhode Island’s experience with the Global Waiver for the long-term care rebalancing provisions of the Patient Protection and Affordable Care Act of 2010. Data derive from 325 archival sources and 26 semi-structured interviews. Results suggest that prospectively documenting …

Implications Of Rhode Island’S Global Consumer Choice Compact Medicaid Waiver For Designing And Implementing State Health Reform, Edward Alan Miller, Divya Samuel, Susan Allen, Amal Trivedi, Vincent Mor

Gerontology Institute Publications

Provisions in the Medicaid statute permit states to apply for waivers from traditional program requirements. On January 16, 2009, the federal government approved Rhode Island's Global Consumer Choice Compact Waiver. In exchange for a cap on combined federal and state spending of $12.075 billion through 2013, Rhode Island received greater flexibility to adopt certain Medicaid program changes. This study analyzes the design and implementation of the Global Waiver to draw general lessons for health reform at the state-level, a key concern given ongoing state discretion to improve their health care systems under the Patient Protection and Affordable Care Act. Data …

Aging In Hingham: A Community Affair, Jan Mutchler, Caitlin Coyle, Hayley Gravette

Gerontology Institute Publications

The purpose of this needs assessment is to investigate the needs, interests, and opinions of mature residents of Hingham, Massachusetts, relating to their aging experiences and needs for age-related services. This assessment was undertaken by the Gerontology Institute of the McCormack Graduate School at UMass Boston on behalf of the Town of Hingham Department of Elder Services (hereinafter referred to as the Department of Elder Services). The focus of this report is on Hingham residents aged 60+ (referred to here as “Seniors”) and residents aged 45-59 (referred to here as “Boomers”). Information about these two age groups was obtained both …

The National Elder Economic Security Standard Index, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

The Elder Economic Security Standard Index (Elder Index) is a new tool for use by policy makers, older adults, family caregivers, service providers, aging advocates, and the public at large. Developed by the Gerontology Institute at the University of Massachusetts Boston and Wider Opportunities for Women (WOW), the Elder Index is a measure of income that older adults require to maintain their independence in the community and meet their daily costs of living, including affordable and appropriate housing and health care. The development and use of the Elder Index promotes a measure of income that respects the autonomy goals of …

Town Of Cohasset Senior Center Study, Jan Mutchler, Hayley Gravette, Caitlin Coyle

Gerontology Institute Publications

The Town of Cohasset is considering the construction of a new Senior Center that will provide the opportunity for expanded programming within a dedicated building. In support of planning efforts by the Town of Cohasset, a study was conducted by the Gerontology Institute of the McCormack Graduate School at UMass Boston. The study addresses the need for, and probable utilization of, a new Senior Center, and includes consideration of the recreational, educational and health-related programs that are likely to be offered through the new Center. Results of the study presented in this report respond to three questions: First, what are …

Evaluation Of Lift Up Your Voice! Advocacy Training For Older Adults And Their Caregivers: Executive Summary, Alison Gottlieb, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

The Lift Up Your Voice! (LUYV) training, a component of Community Catalyst’s effort to support the Campaign for Better Care (CBC), is designed to mobilize grassroots advocacy structures of vulnerable older adults by directly engaging and empowering older adults and their caregivers. The goal of the evaluation is to assess the effectiveness LUYV in recruiting potential advocates, educating them about the health care reform, empowering them via advocacy skills training, and engaging them in state-based CBC activities.

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Elder Economic Security Initiative™: The Elder Economic Security Standard™ Index For South Dakota, Gerontology Institute, University Of Massachusetts Boston, Wider Opportunities For Women

Gerontology Institute Publications

This report addresses income adequacy for South Dakota’s older adults using the national WOW-GI National Elder Economic Security Standard Index (Elder Index) methodology. The Elder Index benchmarks basic costs of living for elder households and illustrates how costs of living vary geographically and are based on the characteristics of elder households, including household size, home ownership or renter status and health status. The costs are based on market costs for basic needs of elder households and do not assume any public or private supports.

Elder Economic Security Initiative™: The Elder Economic Security Standard™ Index For North Carolina, Gerontology Institute, University Of Massachusetts Boston, Wider Opportunities For Women

Gerontology Institute Publications

This report addresses income adequacy for North Carolina’s older adults using the national WOW-GI National Elder Economic Security Standard Index (Elder Index) methodology. The Elder Index benchmarks basic costs of living for elder households and illustrates how costs of living vary geographically and are based on the characteristics of elder households, including household size, home ownership or renter status and health status. The costs are based on market costs for basic needs of elder households and do not assume any public or private supports.

The Massachusetts Elder Economic Security Index (2011), Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

The Elder Economic Security Standard^TM Index measures the income that Massachusetts’ seniors need to maintain independence and meet their basic living expenses in the community. The Elder Index uses an income measure that reflects the actual expenses for basic needs of older adults, and includes cost estimates for housing, food, medical care, transportation, and household essentials. Elder Index values are calculated for each state, on a county-by-county basis, providing policy makers and individuals a benchmark for determining what income or governmental supports are needed in their communities.

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …