Gerontology Commons^™

Research Brief: "Military Service And Men’S Health Trajectories In Later Life", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the health and age-related changes of wartime male veterans during later years in life as compared to non-veterans and non-wartime veterans. In policy and practice, veterans reaching retirement age, with help from their families, should pay attention to their health in case any conditions arise, and health policies should look at early-life health in addition to later-life health. Suggestions for future research include performing studies over time on younger veterans as they age and clearing up biases within the sampling processes.

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

Nina Silverstein

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 …

Older Workers: An Essential Resource For Massachusetts, Peter B. Doeringer, Andrew Sum, David Terkla

David G. Terkla

The Massachusetts Jobs Council, the Governor’s principal advisory board on workforce development, established the Blue Ribbon Commission on Older Workers in 1997 to analyze the labor market for older workers in the Commonwealth and to recommend policies to improve the economic status of the older labor force. The Commission held numerous hearings, town meetings, and focus groups to solicit the views of older workers, employers, labor organizations, and training professionals, and it reviewed the findings of extensive research on older workers in Massachusetts.

Summary Of Mass State Pension Reform Law Chapter 176 Of The Acts Of 2011, Ellen A. Bruce

Pension Action Center Publications

Massachusetts passed significant changes to its public pension system meant to create cost savings for the state and to encourage employees to work longer. Most of the changes apply only to people hired after April 2, 2012. This summarizes the most important changes.

The Pension Factor: Assessing The Role Of Defined Benefit Plans In Reducing Elder Hardships, Frank Porell, Beth Almeida

Frank Porell

Traditional defined benefit (DB) pension plans have long been an important source of income for elder households seeking to maintain a middle-class standard of living after a lifetime of work. Under traditional DB plans, retirees receive a guaranteed, regular stream of income after retirement that continues until death. The monthly pension benefit is typically based on years of service to the employer, age, and salary history. Retirees also have the option to elect a joint-and-survivor benefit, to ensure that pension payments continue to a surviving spouse. DB plan participation rates among private sector American workers have sharply decreased from about …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Frank Porell

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Elizabeth Dugan

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Fun With Numbers: Disclosing Risk To Individual Investors, Christian A. Weller

Christian Weller

This paper discusses the need for better information on investment risks. The information should be relevant, concise, and accessible to individual investors. More and better information on factors that are likely to influence an investment’s performance and investors’ decisions should eventually lead to better investment decisions – more savings and higher retirement incomes. This paper presents a number of ways to disclose risk to individual investors. There are three numerical and three visual representations to risk. The discussion centers on the pros and cons of each risk representation. All risk descriptions show relevant information, are concise, and more or less …

States To The Rescue: Policy Options For State Government To Promote Private Sector Retirement Savings, Christian A. Weller, Amy Helburn

Christian Weller

We provide an overview of retirement plan proposals that could be implemented at the state level. All aim to increase participation in retirement savings, mainly by lowering the cost of doing so and possibly by offering some employer or government matches to employee contributions. The proposals vary widely on how much risk employees are exposed to. Some proposals leave most of the risks of saving for retirement – investment, market, and longevity risk – with the employee, while others try to eliminate them all. The tools of risk management range from well-diversified index funds and default investments to required offers …

Senior Transportation Abstracts: A Focus On Options, Helen Kerschner, Nina M. Silverstein

Nina Silverstein

This collection of abstracts represents a publication of importance for understanding the needs, challenges, solutions, and/or every day issues related to senior transportation services. While several of the abstracts include information about senior driver safety, the collection’s primary purpose is to present a holistic approach to transportation options for older adults. Such a collection is timely because, although the practice of providing transportation to older adults is not new, research and preparation of practical informational and technical materials related to older adult transportation service needs and service delivery are quite recent.

Assessing Stakeholder Opinions Of Medical Review Of Impaired Drivers And Fitness To Drive: Recommendations For Massachusetts, Nina Silverstein, Kelli Barton

Nina Silverstein

Driving is the main mode of travel for Americans age 65 and older, and although older adults are generally found to be safe drivers, aging often brings about functional limitations and an increase in medications that can impede safe driving and fitness to drive (Rosenbloom, 2003; Kissinger, 2008; Adler & Silverstein, 2008). Effective licensing policies and Medical Advisory Board practices are critical components in identifying medically at-risk drivers and may even have a role in the transition to alternative transportation options; yet, states vary greatly in their approach to licensing and renewal practices and in the utilization, composition, and function …

Primetimes Newsletter, Winter 2011, Office Of Lifespan Studies

PrimeTimes Newsletter

PrimeTimes is the newsletter of the Office of Lifespan Studies in the College of Science at Coastal Carolina University.

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 …

Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur

Nina Silverstein

By the year 2030, 70 million Americans will be 65 or older. Approximately 80 percent of this population will likely be driving themselves. And without appropriate and timely interventions, many are likely to be driving with Alzheimer’s disease (AD). Current estimates suggest that 2 percent of the population 65 to 74, 19 percent of the population 75 to 84, and 47 percent of the population 85 and older are likely to suffer from Alzheimer’s disease or a related disorder. By the year 2050, the number of Americans with Alzheimer’s disease could range from 11.3 million to 16 million. This significant …

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Nina Silverstein

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. 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, …

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

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments 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.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

A Primer For 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. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

The Frank J. Manning Certificate In Gerontology Alumni Survey: 21 Years Of Service To Elders, Nina M. Silverstein, Jenai Murtha, Donna Sullivan, May Jawad

Nina Silverstein

The Certificate Program in Gerontology at the University of Massachusetts Boston, a large urban university, was established in 1979 as part of an Administration on Aging (AoA) grant to develop and expand services to the elderly citizens of the Commonwealth of Massachusetts. In 1984, a line item was added to the state budget by the legislature and governor establishing the Gerontology Institute at the University of Massachusetts Boston and ensuring the continuation of training, research, and policy and advocacy work on behalf of and with Massachusetts’ elders (O’Brien, 1996). Upon Frank J. Manning’s death in 1986, the program was renamed …

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Nina Silverstein

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Nina Silverstein

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.

Promoting Safe Mobility Among Elders By Increasing Awareness Of Vehicle Modifications (Executive Summary), Elizabeth Van Ranst, Nina M. Silverstein, Alison S. Gottlieb

Nina Silverstein

This research project looks at one strategy to address the safety of older drivers, vehicular modifications. Specifically, a video demonstrating low-tech, low-cost features that may alleviate some driving challenges was produced to determine whether viewing the video would increase awareness of and motivation to use those features. Prochaska and DiClemente’s Transtheoretical Model of intentional behavioral change provides the theoretical framework for this study. This model posits five stages of change, a continuum over which the individual becomes more receptive to taking action.

Seniors Count Follow-Up Study, Nina M. Silverstein, Heather Connors, May Jawad

Nina Silverstein

Seniors Count is an ongoing outreach initiative under the direction of Boston Mayor Thomas M. Menino with the leadership and support of Joyce Williams, Boston's Commissioner on Affairs of the Elderly. The program's purpose is to "identify and reach out to those members of the city's elderly population who live in private housing arrangements and help provide them with the information and services they [may] need" (Boston Commission on Affairs of the Elderly, 2002). Since the program's inception in 1999, it has reached over 5,500 community-dwelling elders in the City of Boston (Boston Commission on Affairs of the Elderly, 2002). …

“Growing Pains And Challenges”: Grandfamilies House Four-Year Follow-Up Evaluation, Alison S. Gottlieb, Nina M. Silverstein

Nina Silverstein

During the past decade, there has been increased awareness of issues facing grandparent caregiver families on the part of policymakers and service providers. This awareness has prompted efforts to document the numbers of children being raised by grandparents, to identify challenges faced by grandparents raising grandchildren, and to provide services to meet the needs of these families. National estimates suggest that the numbers of grandparent caregiver families are increasing. Recent estimates suggest that 1.4 million (2%) of all children under 18 live in “skipped generation” families in the United States; similarly, 29,000 (nearly 2%) of all children in Massachusetts live …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Nina Silverstein

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …

Life At Grandfamilies House: The First Six Months, Alison Gottlieb, Nina Silverstein, Laney Bruner-Canhoto, Susan Montgomery

Nina Silverstein

Recent reports cite estimates of more than two million children in the United States who are currently living in kinship care arrangements; 10% or approximately 200,000 of these relationships are children in foster care. Much kinship care is done by midlife and older persons who are finding themselves assuming new responsibilities associated with parenting their grandchildren, typically for a period of two years or more. This is a social phenomenon that cuts across all socioeconomic, racial, and ethnic groups. There are many challenges facing these nontraditional families including healthcare, income security, education, social support, and housing. Public and private partnerships …

Driving In Massachusetts: When To Stop And Who Should Decide?, Nina M. Silverstein, Jenai Murtha

Nina Silverstein

The purpose of this exploratory research was to assess three stakeholders’ perceptions of the locus of responsibility for driving cessation and identify the criteria that should be included in that decision. The stakeholder groups studied were law enforcement officers, physicians, and the general public age 50 years and older. Defining areas of agreement and disagreement across stakeholders will be valuable for informing policy makers who may be considering statewide or national initiatives. Findings will also be useful for public information and training.

Senior Transportation Abstracts: A Focus On Options, Helen Kerschner, Nina M. Silverstein

Gerontology Institute Publications

This collection of abstracts represents a publication of importance for understanding the needs, challenges, solutions, and/or every day issues related to senior transportation services. While several of the abstracts include information about senior driver safety, the collection’s primary purpose is to present a holistic approach to transportation options for older adults. Such a collection is timely because, although the practice of providing transportation to older adults is not new, research and preparation of practical informational and technical materials related to older adult transportation service needs and service delivery are quite recent.

Gerontology Newsletter, September 2011, University Of Northern Iowa. Gerontology Program.

Gerontology Newsletter

Inside this issue:

-- Rural Aging Conference
-- Congratulations Graduates
-- Webiner
-- New Website
-- Recent Cuts to the State Budget

Net Worth Accumulation By Different Quintiles Of Older Adults Approaching Retirement Age And 10 Years Later, Martha N. Ozawa, Yeong H. Yeo

The Journal of Sociology & Social Welfare

The shift in responsibility for income security from the government to individuals makes the accumulation of net worth a vital issue. We investigated the rate of net worth accumulation for people aged 51 to 61 in 1991 (N=7,544) and 61 to 71 in 2001 (N=5,711) using the RAND Health and Retirement Study. We found that the rate of net worth accumulation by the fifth (top) quintile was extremely high in 1991, and the distribution of net worth became more skewed in favor of the wealthy in 2001. Older adults in the first and second quintiles are unable to face the …

Massachusetts Senior Legal Assistance Project Needs Evaluation: Current Demand For Legal Services, Alison Gottlieb, Lauren A. Martin, Ellen A. Bruce

Gerontology Institute Publications

The Gerontology Institute at the University of Massachusetts Boston was contracted to conduct a statewide needs assessment for the MSLAP. As agreed upon by the MSLAP Advisory Board, the focus of this assessment was to analyze the demand for services Massachusetts legal service providers have experienced recently as a means to understanding the legal needs of Massachusetts elders (age 60 and older). A second needs assessment was conducted by the Massachusetts Executive Office of Elder Affairs. That needs assessment surveyed home care workers and other elder agency personnel to gauge their assessment of elders’ legal needs in Massachusetts. Read together, …