A study in the Journal of Clinical Psychiatry.
You are here
Desire versus outcome -- you can't always get what you want
I have been struck lately by disconnects between desire and reality -- what boomers and seniors want to happen and what may actually happen. In each one of these, planning is skipped in favor of dealing later with misery.
Boomers want to stay home versus want to move. AARP's September, 2008 Baby Boomers and Housing Plans survey asked baby boomers whether they agreed with the statement "What I'd really like to do is stay in my current residence for as long as possible." So, no surprise, 80% of those age 55-64 agree, and 88% believe that it is likely that they can. But 75% of responders age 55-64 believe some aspect of their home will challenge their ability to do so (stairs being the winner with 24%). AARP should do a survey of the same population in 5 years to see if they addressed these challenges -- or will these people become the seniors described below?
Boomers believe tech could help their parents stay home, but don't look for any. This one is from the Clarity 2007 survey of seniors and caregivers. It's one of my favorite survey stats to reinforce the need for promoting greater visibility of aging in place technology. 51% of boomers believe there is technology to help their parents, but only 14% have looked for any. This could be interpreted as 'not caring' but I doubt that about those willing to take this survey. Rather, this technology market (like PERS, home monitoring, med reminders, etc., etc.) is not 'in their face' as obviously available and therefore should be pursued.
Seniors fear nursing homes more than death, but get PERS devices only after incident. Fifty-three percent of seniors in the Clarity study were concerned about their ability (despite their desire) to remain in their own homes. They cited concerns about health, memory, ability to drive, but when asked about fears, seniors ranked loss of independence the highest (26%)moving into a nursing home (13%) and both higher than fear of death (3%). But I also talked to folks from Philips Lifeline about their PERS business in North America, which is north of 700,000 subscribers -- typically an 80-84 year old woman who lives alone and doesn't get around too much -- and heard that this is primarily an incident-driven business, that is this customer acquires the device, often recommended by a health care professional, after experiencing an incident (like a fall), not before.
Governments want nursing home residents to move versus never be admitted. 'Money follows the person' is a state and federal initiative to move seniors from nursing homes out to the community where there is an presumably an adequate level of care for them. Even if the federally funded program did not focus on Medicaid recipients who have been in nursing homes more than 6 months, it would still be an upside down program -- targeting the end of a cycle, rather than the beginning. What about applying the funding to ensure that hospital discharge planners, geriatric care managers, and rehab facilities have an adequate toolkit and resources to help people go and stay home before they ever see a nursing home?
Flash forward in the lives of the boomers with stairs who want to stay home. Flash backward from PERS-wearing mid-80's women who have already fallen or to the nursing home seniors who perhaps shouldn't be there. What's wrong with those pictures? How can these inevitabilities be averted?
Thoughts welcome as always.