HomeMy WebLinkAboutAgenda - 04-24-2003-3ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: April 24, 2003
Action Agenda„
Item No.
SUBJECT: Informational Report on the Proposed Development Process for Orange
County's New Senior Centers
DEPARTMENT: Aging
Central Services/Purchasing
County Manager's Office
ATTACHMENT(S):
Proposed Stages of the Development
Process
Senior Centers Development Time Line
Community Input Survey/Forum Dates
County-UNC Partnership Proposal:
A Campus for Senior Wellness and
Longevity
PUBLIC HEARING: (Y/N)
INFORMATION CONTACT:
Jerry Passmore ext. 2009
Florence Soltys -962-4541
Pam Jones ext. 2652
Gwen Harvey ext. 2307
TELEPHONE NUMBERS:
Hillsborough
Chapel Hill
Durham
Mebane
732-8181
968-4501
688-7331
336-227-2031
No
PURPOSE: To receive as information the proposed development process for the Southern and
Central/Northern Orange Senior Centers.
BACKGROUND: In November 2001, a county bond package was approved by the citizens for
$4 million to construct two new multipurpose senior centers: a Southern Orange Senior Center
to replace the Chapel Hill Senior Center, currently located in leased space on Elliott Road,
Chapel Hill, and the Central Orange Senior Center, also leasing space in Hillsborough at the
Meadowlands. Also, indications were to secure an additional $2 million loan in order to
construct a minimum of 25,000 ft. facility in Southern Orange serving two-thirds of the county's
older population and a minimum of 15,000 sq. ft facility in Central Orange serving the remaining
older population. Senior Center rental facilities are currently leased through June 30, 2006,and
would require an extension should additional development time be required.
During May-June, the County Commissioners should formalize a planning process
(Attachments- Process Development Phases and Time Line) that would include identifying
senior citizen representatives and agencies to work with county staff on the program needs and
the selection of an architect to design each new senior center. The Development Process
includes four Phases: (1) Community Based Input (April -June, 2003-- community input
(attachments-survey and forum dates) on programs, functions and design preferences, (2)
Preliminary Design Plan (July-Sept, 2003)- review all input and develop a preliminary plan for
both senior centers for the County Commissioners' consideration, (3) Formal Development
Phase (October.2003-Nov., 2004)- BOCC appoint Senior Center Development Steering
Committees for each senior center and the hiring of the architect to work with staff (October-
Dec.,2003) and begin work on finalizing the design and site location (January-Nov. 2004), and
(4) Construction Phase (March,2005 -June, 2007) -the construction timeline of the two
facilities would overlap with the Southern Orange Senior Center completed by June, 2006 and
the Central/Northern Orange Senior Center completed by June, 2007.
Since 1998 the County and the University of North Carolina have worked on collaborative
planning for establishing a campus setting for the Southern Orange Senior Center on the
County's Homestead property and the University's adjoining Horace Williams Property (now
referred to as Carolina North). The principal County interest has been in the designation of
approximately 2 acres by the University to allow sufficient space for the County to provide
additional parking and enable the construction of the Senior Center as proposed. Additionally,
the Department on Aging has developed and the Advisory Board on Aging has approved a
vision for greater synergy between programs and services, based on future use by the
University of its own land, as contained in the report, "A Campus on Senior Wellness and
Longevity: `Preparing for the Future Age Wave', APublic-Private Partnership Proposal"
(Attachment)
A formal meeting was held with the Chancellor's Office and other possible partners on April 8
to discuss the acreage for parking and the larger vision for the Senior Wellness Campus, and a
timeframe for reaching a formal agreement. While there was favorable reception to the
proposal, in concept, a final decision on participation by the University will not be reached until
after June 2003. The UNC Board of Trustees must first formally approve the criteria for
including any projects at Carolina North. The University was also advised that the BOCC has
not yet acted officially on the Senior Wellness Campus report. Thus, afollow-up meeting
between the County and the University is proposed for July to consider different levels of
partnership which may be desired and achievable.
FINANCIAL IMPACT: The new Senior Centers will be financed from $4 million in bond funds
and $2 million from private placement funds. The Board may also wish to consider authorizing
additional community fund raising that could be applied towards furnishing the new senior
centers.
RECOMMENDATION(S): The Manager recommends that the Board receive this update as
information only.
FN:AB030424-worksession-New Senior Centers Planning Process
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WHAT DO YOU WANT IN A
NEW SENIOR CENTER?
WE WANT YOUR INPUT!
We are planning for Orange County's 21St Century Senior Centers -one in Southern and one in
Central Orange. How do you think they should look? What programs and services should
they offer? Your input is important and will be helpful in the design of our new senior centers.
What are Senior Centers? They are community focal points for services and programs, as
well as opportunities for older adults over their life span. They are designed to enhance senior
adults' quality of life and well being, and to enhance their longevity and independence.
Please rank the suggested senior center services and functions listed according to their importance.
In the space below, please share your most important and creative ideas on programs,
functions and design of the centers or you may complete this form on the County Website
at: www.co.oran~e.nc.us/a i~ng/hottopics/survey.htm
Thank you for your input.
It will be included in a report this summer to the County Commissioners.
Sincerely,
The Orange County Dept. on Aging £~ Aging Advisory Board
Friends of the Senior Centers-Chapel Hill £~t Central Orange
Deposit Your Completed Input Survey by June 30th in the Suggestion Box at the Senior Centers or return to:
The Orange County Deparhnent on Aging P.O Box 8181 Hillsborough, N. C. 27278
Programs/ Services:
Functions/Design:
All information you give is confidential and will be reported only as a group. Check (~) All that apply:
1. ~h- age group: 49 and under 70-~y 60-69 ~
- ~.?-79 ~or ~0+-_-
2. I~1~° .ender: ?dale ~ Female- -- ~ ~I
. '~lv race: White I>la~k _
His anic_ Asian Other
4. My living arrangements: Live alone- With someone- Apartment- Home_ Senior
Housin _
5. ?~~1v participation level ir1
enter pro rams is: Daily ~tieekly I~~Ionti~l~~ I Yearle None____
6. My senior center
participation is generally
in: Chapel Hill- Central Orange/
Hillsborough- Northside_ Community
Center in
Efland_ Community
Center in
Cedar
Grove
7. I reside in: Chapel Hill, I-'illshorou~;h ~ Carrboro ?~'Iebane Pural Orailbe_
8. My Zip Code is:
If you would like to be more involved in this process or be informed of future meetings, complete the
spaces below.
Name
Address
Telephone
City Zip
(Turn Over)
SUGGESTED SERVICES AND FUNCTIONS AT THE NEW SENIOR CENTERS?
The following is a list of suggestions for the new senior centers. Do you agree or disagree?
Please rank the programs/functions listed below by checking the appropriate box as:
"Essential", "Important", "No Opinion", "Not Important" or "Not Needed" in the new Senior Centers.
CHECK ONLY ONE ACROSS EACH ROW ALSO, PLEASE WRITE IN ADDITIONAL ONES.
Programs/Functions Essential Important No Opinion Not Important Not Needed
rmation S.. Assistance
1.
In o i
~
(
7
consultation on a~inff issues
tele phone & office
l I b b ) ~
~
~
~
_
2. Interest groups/Clubs and Support Groups ._ _.
_._
__ -- --
_
{ _
_ _ _
3. Conversation lounge _ ~___
_
4. Food Service/Cooking Program
(kitchen serving meals/ snack bar, classes) ~ __ ____
5. Visual Arts Center I
(gallery, space fox painting, ceramic, crafts, eic.) ~-
6. Fitness/Wellness Center
(therapy & class space, exercise equipment, etc.)
-
--- -
-
- ---
7. Computer Learning ~ ~ ~ ~
(PC learning and use- SeniorNet, etc.) _ __ '
8. Volunteer Service Center -RSVP
(info, recruit, refer, train, recognize, special prog.) _ __
9. Eldercare Services -for Special Needs ~
(assessments,counseling~care planning,services) ~,' j I __ _
10. Financial Planning/ Management Assistance
(taxes-VITA, health insurance-SHIIP, planning) _
11. Adult Day Services ',
(seniors w/special needs-rehab., monitored) ~ ____
_
__
12. Cards~T'able Games Area
(drop-in area for all kinds of table games)
13. Education Center -for Life Long Learning
1 _
(classes, workshops, seminars, special events) ~ _ _
14. Multi-purpose Area
(large area with dividers for Special events)
T
15. Employment Center
(job postings, training, placenie,nt,fmrs, etc. ~ ~ _
16. Performing Arts.- dance, music, drama, video, ___
(stage for productions and classes, etc.)
_
17. Game Room area
(table tennis, billiards, putting green, etc.)
18. Reading area/ Library
19. Agency Services Center.
(drop-in space for agencies to serve seniors) j
20. Health/Wellness Center _
(Info, personal assessments, clinical services)
21. Outdoor Leisure Area
(croquet, horseshoes, walking trails, gardens)
22. Emergency Shelter
(Disaster conditions-ice storm, hurricane, etc.)
_3. Trans ortation Assistance
~ __
(arra wing transport to centers and sen~ices) ~ ~
24. Other: ~ F.__ ___
25.Other:
SCFM/3/2003/JP
By Item Number above, list the top 5 programs for the new senior centers
SUGGESTED SERVICES AND FUNCTIONS AT THE NEW SENIOR CENTERS?
The following is a list of suggestions for the new senior centers. Do you agree or disagree?
Please rank the programs/functions listed below by checking the appropriate box as:
"Essential", "Important", "No Opinion", "Not Important" or "Not Needed" in the new Senior Centers.
CHECK ONLY ONE ACROSS EACH ROW ALSO, PLEASE WRITE IN ADDITIONAL ONES.
Programs/Functions Essential Important No Opinion Not Important Not Needed
~ 1. Information & Assistance - ~~
(telephone &'office consultation on wing issues)
2. Interest groups/Clubs and Support Groups I
3. Conversation loun e _
l
4. Food Service/Cooking Program _ _
kitchen servin meals/ snack bar, classes)
-
5. Visual Arts Center
~ Salle
s ace for painting, ceramic, crafts, etc:)
~__
6. Fitness/Wellness Center
(theca y & class space, exercise ecLuipment, etc.) _
7. Computer Learning
PC learning and use- SeniorNet, etc.
8. Volunteer Service Center -RSVP
info, recruit, refer, train, reco e, s ecial ro .)
9. Eldercare Services -for Special Needs
(assessments,eounselina care plannin ,sere-ices)
10. Financial Planning/Management Assistance
(taxes-VITA, health insurance-SHIIP, lannin )
-
11. Adult Day Services ~ ~i
(seniors w/ s ecial needs-rehab., monitored) ~
12. Cards/Table Games Area
(dro -in area for all kinds of table games)
13. Education Center -for Life Long Learning
i i
classes, worksho s, seminars, s ecial events ,
14. Multi-purpose Area __
lac a area with dividers for S ecial events
15. EmpIoymenf Center _ - -. - _
(job postings, training, placement, fairs; etc.) ' ~
16. Performing Arts.- dance, music, drama, video, _ _ _
(stage for productions and classes, etc.)
17. Game Roonl area __ _
table tennis, billiards, uttin green,-etc. - ~~~
18. Reading area/ Library
19. Agency Services Center
(drop-in space for agencies fo serve seniors)
20. Health/Wellness Center
(Info, ersonal assessments, clinical services)
21. Outdoor Leisure Area ''
(croquet, horseshoes, walkin trails, ardens ~ 1
22. Emergency Shelter
Disaster conditions-ice storm, hurricane, etc.)
~, 23. Transportation Assistance -
(arran in transport to centers and services) _
24. Other: __
25. Other:
SCFM/3/2003/JP
By Item Number above, list the top 5 programs for the new senior centers
SENIOR CENTER COMMUNITY FORUMS
March 21 Chapel Hill Senior Center 11:45 a.m.
Apri129 Central Orange Senior Center 2:00 p.m.
May 13 Central Orange Senior Center 1:00 p.m.
May 14 Northside Senior Center 10:30 a.m.
Chapel Hill Senior Center 3:15 p.m.
June 2 Carrboro Century Center 10:00 a.m.
June 4 Chapel Hill Senior Center 6:30 p.m.
June 5 Cedar Grove Community Center 10:30 a.m.
Central Orange Senior Center 6:30 p.m.
June 11 Efland Community Center 10:30 a.m.
Other Important-Dates
May 15 Friends of the Chapel Hill Senior Center Annual Meeting 2:00 p.m.
May 16 Friends of the Senior Center for Central Orange Annual Meeting 10 a.m.
A Campus on Senior Wellness and Longevity
"Preparing for the Future Age Wave"
A Public-Private Partnership Proposal
Prepared By
Jerry M. Passmore, Director
Orange County Department on Aging
For
The Orange County Advisory Board on Aging
Florence Soltys, Chair
Approved August 9, 2002
Introduction
Over the centuries both society and individuals have continued to raise the same
age old, but fascinating questions - Why do I grow old? How can I stop, slow down
or reverse the aging process? What impact do environment, lifestyle and genes play
in successful aging? How can I live a longer life?
Perhaps the most important question to us is: How can I stay healthy, well and
functionally independent as long as possible up to the time of death? Simply
stated -How can I improve both the quality and quantity of my life to the very end?
As we enter the 21St Century, we as a society will be forced to consider this ancient
question as never before. We are living at a critical point in history in which five
demographic conditions never before seen will force us to make critical decisions
concerning massive societal changes.
1. Never before in history have we lived chronologically longer lives.
The U.S. Administration on Aging states, "Globally, we are witnessing one of
society's greatest achievements-an extension of human longevity more
dramatic than in the preceding 4,500 years. Advancements in medicine,
public health and technology will make it even more commonplace for people
to live 80, 90, or 100 or more years." (AoA, Ref #1) According to the U.S.
Census, the number of people aged 100 or above, "centenarians," increased
dramatically from 37,306 in 1990 to 50,545 in 2000, a 35% increase over the
last decade. (AoA, Ref #2) In Orange County the projected growth between
the year 2000 and 2020 is most dramatic for the 95+ population with an
increase of 234%.
Life expectancy in the United States in 1900 was only 49 years as compared
to 76.9 years in 2000. In 2000, a person who was 65 had an average life
expectancy of 17.9 years (19.2 years for females and 16.3 years for males).
In North Carolina the life expectancy is 75.6 years and a person who was 65
had an average life expectancy of 17.1 years, a little less than the national
figure.
2. Never before in history have we seen such an explosion in the sheer
numbers of older persons.
The older population is the fastest growing segment in the United States
today and in the foreseeable future. According to the United Nations
Population Division, "The number of persons age 60 or older (world wide) is
estimated to be nearly 600 million in 1999, and is projected to grow to
almost 2 billion by 2050, at which time the population of older persons will be
larger than the population of children (0-14) for the first time in human
history." (UN,1999, Ref #15) This population shift will have an impact on the
caregiving of tomorrow, especially on women who have been the primary
caregivers. Women today and in the future can count on caring for older
Page 1 of 18
family members for longer period of time than they will care for their own
children (under 18 years of age)! This will be exacerbated as the Baby
Boomers age to due fewer family caregivers with responsibility for more
elderly adults.
In the United States, comparing the turn of the century year 1900 to 2000:
• The 65+ age group is 3 times larger.
• The 65-74 age group (18.4 million) is eight times larger,
• The 75-84 age group (12.4 million) is 16 times larger, and
• The 85+ age group is 34 times larger. (AoA, Ref #2)
As illustrated in Table 1, in the year 2000 the older population (65+) now
numbers 35 million. By the year 2030, the older population will more than
double to about 70 million. The 85+ population will see an even more
dramatic increase from 4.2 million in 2000 to 8.9 million in 2030. (AoA, Ref
#3)
Table 1 also demonstrates how the "age wave" will be at high tide in the
year 2030 when all Baby Boomers (born between 1946 and 1964) will reach
65 years of age. The 65+ population in 2030 will represent 20% of the U.S.
population compared to 12.4% in 2000. The ratio of older adults to the rest of
the population will increase from 1 to 8 to 1 to 5. (AoA, Ref #4) By 2030 the
state of North Carolina will have nearly 18% of its population over age 65,
which is a higher percentage than the state of Florida's current 17.6% 65+
population. (AoA, Ref #4)
In 2000 the state of North Carolina had almost one million (969,048) older
persons 65+, representing 12% of the total population. The state's 65+
population showed a dramatic increase of 20.5% between 1990 and the
2000 Census (Table 1). Thirteen other states also had increases of 20% or
more for the decade. (AoA, Ref #5)
The growth in numbers of older adults in Orange County is expected to
outpace similar growth for the nation as a whole, as well as that of North
Carolina. Orange County's 65+ population is expected to grow from 10,744
persons in the year 2000 to 23,840 by 2020 (Table 1). This is an increase of
122% over the 2000 total, versus an anticipated total county population
increase of only 40.5% for the same period.
Page 2 of 18
Table 1: Percent of Persons Age 65 Years and Older
Year Orange County North Carolina United States
1990 8,136 (8.7%) 804,341 (12.1 %) 31,241,831 (12.6%)
2000 9,931 (8.4%)
(22.1 % change from
1990) 969,048 (12.0%)
(20.5% change from
1990) 34,991,753 (12.4%)
(12.0% change from
1990)
2010 14,825 (10.4%) 1,306,942 (13.8%) 39,715,000 (13.5%)
2020 23,840 (14.2%) 1,831,699 (16.8%) 53,733,000 (16.5%)
2030 30,757 (17.0%) 2,221,470 (17.8%) 70,319,000 (20.1%)
Source: U.S. Census Bureau, NC State Demographics
3. Never before in history have we seen so many people living more of
their advanced years in declining health and limited function before
death.
As we age we have more illnesses, disabilities and chronic conditions that
limit our independence and ability to perform ordinary tasks. In the United
States, most older Americans (65+) have at least one or more chronic
conditions. In 1996 (AoA, Ref #6) the "most frequently occurring conditions
per 100 elderly were: arthritis (49), hypertension (36), hearing impairments
(30), heart disease (27), cataracts (17), orthopedic impairments (18), sinusitis
(12), and diabetes (10)."
According to a U.S. Administration on Aging (AoA, Ref #7) Report, "With a
current life expectancy of 75 years, newborns today (2000) can expect to
experience an average of 13 years with an activity limitation. Because the 85
plus group is the fastest growing segment of the population, many Americans
may live with activity limitations for 20 years or more." In North Carolina the
average years of healthy life remaining at birth (based on perceived health
status) is 63.0. "This means that 12.6 of the 75.6 years of life expectancy will
be spent in a state where health status is perceived to be fair or poor." (N.C.
Center for Health Statistics, Jan. 2002, Ref #13)
The fact that the 85+ population (the" Oldest-Old") is the fastest growing
population segment and has the highest per capita disability rate creates
social and economic implications for our society now and dramatically more
so in the future. Two social situations that best illustrate this are:
(1) Increase in Nursing Home Placements with Age. In 2000, only 4.5% of
the nation's 65+ population (1.56 million) lived in a nursing home.
Page 3 of 18
However, as illustrated in Figure 1, that percentage increased dramatically
as age increased, with a low of 1.1 % for the 65-74 age group, 4.7% for the
75-84 age group and a staggering 18.2% for the 85+ age group. (AoA, Ref
#8)
Figure 1: Nursing Home Occupancy by Age Group, 2000
^ Percent in
2000
(2) Increase in Alzheimer's Disease with Age. Alzheimer's Disease (AD)
affects 6-8% of all people over age 65, but the prevalence of the disease
doubles every 5 years after age 60. Therefore, estimates suggest that
almost 30% of the 85+ population has AD. When you look at dementia in
the 85+ category (Figure 2), the numbers are estimated to be over 40%.
From diagnosis to death, the range of care needed for those with AD is
from 3 to 20 years. The financial and emotional impact on caregivers can
be devastating, especially since many AD patients do not qualify for skilled
care. (Many AD patients have few medical problems, thus making them
eligible for assisted living level of care.)
Figure 2: Percent with AD or Dementia by Age Group
50
40
30
20
10
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Page 4 of 18
65-74 75-84 85 and older
65+ with AD 85+ with AD 85+ with dementia
Medical advances have enabled us to live longer, but have not improved the
delivery of chronic care services. According to Chronic Care in America: A
21St Century Challenge, a report from the Robert Wood Johnson Foundation:
"There is no effective system to care for those with chronic conditions in the
United States. As a result, much of the care that is available is fragmented,
inappropriate, and difficult to obtain." Furthermore, the report states, "In
1995, one in six Americans-41 million people - had a chronic condition that
inhibited their lives to some degree." Some of the chronic conditions listed
were arthritis, cancer, heart disease, diabetes, emphysema, Alzheimer's
disease, blindness, hearing impairments, mental retardation and mental
illness. (AoA, Ref #7)
In 1998, 28.8 % of those in the 65-74 age group reported limitations in their
daily activities because of a chronic condition. This percentage increased
with age to over half (50.6%) for those in the 75+ age group. The U.S.
Administration on Aging's A Profile of OlderAmericans: 2001 (AoA. Ref #6),
reported a 1997 study indicated that more than half (54.5%) of the older
Americans (65+) had a least one disability of some type (physical or
nonphysical). Furthermore, 37.7% of Older Americans had at least one
severe disability, 14.2% (4.5 million) had difficulty in carrying out activities of
daily living (ADCs), and 21.6% (6.9 million) had difficulty with instrumental
activities of daily living (IADLs) (Figure 3). ADCs are defined as basis self-
care activities such as bathing, dressing, eating, toileting and hygiene. IADLs
include tasks related to independent living, such as telephoning, shopping,
preparing meals, doing housework, taking medication properly and handling
money or managing finances.
Figure 3: Percent 65 Years and Older with Disabilities, 1997
Page 5 of 18
At least one At least one Difficulty with Difficulty with
disability severe disability ADCs IADLs
As the older population grows in age and magnitude, the percentage of
disabilities and chronic conditions will increase sharply for both the United
States and North Carolina. For the 80+ age group In the United States,
almost three-fourths (73.6%) reported at least one disability, over half (57.6%)
indicated one or more severe disabilities, and over one-third (34.9%) needed
assistance as a result of disability (Figure 4). (AoA, Ref #6)
Figure 4: Percent 80 years and Older with Disabilities
e„ ~~ s~i
disability disabilities due to disability
The economic costs and social impact of this phenomenon on the health care
system and society will be catastrophic unless society focuses on chronic
diseases through prevention, home health and rehabilitative services rather
than merely reimbursing short-term acute care needs. While most older
people only see their doctor for a chronic condition, doctors are limited in what
they can prescribe for the chronically ill.
In 1999, the Administration on Aging reported older Americans (65+) as
compared to the under age 65 group, had four times the number of days of
hospitalization (1.6 days vs. 0.4 days) and averaged more doctor contacts (6.8
contacts vs. 3.5 contacts). Out--0f-pocket health care expenses for older
Americans increased to an average of $3,019 in 1999, a rise of more than one
third since 1990. As illustrated in Figure 5, these health care costs add up to
an average of $1554 (51 %) for insurance, $706 (23%) for medications, $601
(20%) for medical services, and $158 (6%) for medical supplies. Older
Americans spend twice as much on total health care (11 % vs 5%) as the rest of
the population. (AoA, Ref #6)
Page 6 of 18
At least one One or more severe Assistance needed
Figure 5: Out of Pocket Expenses for Older Adults, 1999
~ Insurance-51%
®Medications-23%
^ Medical Services-20%
Medical Supplies-6%
4. Never before in history have we seen so many multiple generations
living at one time, and scattered throughout the United States.
Thus, we are seeing more "Long Distance" caregiving of older persons
by relatives, as well as older persons having to rely more on community
resources and government assistance in later years. While over half
(55%) of older Americans (65+) lived with their spouse in 2000, a large
and growing segment of older adults are "Older Persons Living Alone" or
(OLA). In 2000 about 30% (9.7 million) of all Older Americans (65+) lived
alone. Nearly 17% of older men (65+) lived alone while as many as 40% of
older women (65+) lived alone. For women in the 75+ age group, almost half
(49.4%) lived alone. In 2000, 28% of old North Carolinians lived alone
and 25 % lived alone in Orange County.
The percentage living alone increases with advanced age, again,
especially for women. For the period 1990 to 2020, the Older persons 85+
living alone group is projected to double in size. (AOA, Ref #9)
The negative societal implications for older adults increase as more and more
seniors live alone in advanced years:
(1) Little or no assistance with ADLs or IADLs within a household thereby
allowing a person to live independently.
(2) Higher rates of depression -especially among older men who live alone
and are more prone to suicidal behavior.
(3) Emergencies left undetected for long periods of time, such as falls,
myocardial infarctions, cerebral vascular accidents. Personal emergency
response systems (PERS) have developed to respond to this issue.
(4) Little or no socialization can lead to cognitive decline.
(5) No consistent person to assess changes in memory, mood, or behaviors.
(6) No consistent person to coordinate care, even if funds are available to
purchase this assistance.
Page7of18
The older person living alone (OLA) is more likely to need home and
community-based services. Compared to the older population in general,
research has shown that OLAs are more likely to:
(1) have inadequate diets and poor nutrition,
(2) rely on formal paid services for assistance,
(3) be more socially isolated and at greater risk of mental health problems,
(4) be functionally disabled,
(5) be at greater risk for nursing home admission, and
(6) be more reliant on public support for nursing home care, particularly from
the Medicaid program. (AOA, Ref #9)
5. Never before in history have we seen such a large and growing number
of retirees who are a major human resource.
The future Baby Boomers will likely place more demands on the health and
retirement systems between 2010 and 2030 when they have passed age 65.
They will also be a major human resource with skills and talents that can be
utilized by society.
In 2030, approximately 1.5 million Boomers will be living in North Carolina.
Compared to North Carolina's older persons today, aging N.C. Baby Boomers
are predicted to:
• Be a larger and more diverse population;
• Be better-educated;
• Have had higher incomes,
• Be the largest group of consumers,
• Be less likely to exercise vigorously and regularly,
• Experience lower rates of illness and impairment in their later years,
• Be likely to do volunteer work and give to charities,
• Remain in the work force for a longer period of time.
(NCDOA, 1997, Ref #12)
Issues and problem areas that will become exacerbated with the future Baby
Boomers are listed below:
1. Inadeauate health care work force to meet today's and tomorrow's
demands, even though older adults may have the resources to pay for
them.
• Turnover rates for Certified Nurses Aides (CNA) in Adult Care Homes
& Nursing Homes in N.C. (Currently,140% average annual turnover
rate in Adult Care Homes and 100% average annual turnover rate in
Nursing Homes.)
Staffing problems for home care agencies.
Low numbers of nursing students.
Page8of18
• Low numbers of Masters in Social Work students with specialization in
aging.
• Few board certified geriatricians.
2. Continued Geographic relocation of older persons that lead to the further
creation of age-segregated societies in the form of Continuing Care
Retirement Communities (CCRCs), Assisted Living, and other retirement
communities. This trend creates artificial boundaries between the generations
and between socio-economic classes of seniors who have resources. Some
have referred to this situation as the development of "golden ghettos" for the old,
rich and talented.
3. Continued overuse of the medical system occurs because older adults
do not know where to turn for help especially when treatments and
medications are non-reimbursable. This situation is driven, in part, by the
media and mass advertisement.
4. Growing trend among older adults toward alternative or holistic
medicine, natural healing remedies or therapies such as massage,
acupuncture, reflexology, meditation, hydrotherapy, herbs, vitamins, diet and
exercise, to name a few. Many of these approaches require out-of pocket
expenditures and lack scientific research on their effectiveness.
Page 9 of 18
Proposal
The unprecedented number of older persons with longer life spans, but with more
years with disabilities or poor health, will create challenges never before seen in
public policy that will impact every institution in society. More demands will likely be
placed on the health and retirement systems and other community resources.
Therefore, society and especially its governmental and educational
institutions, must find new and better ways to support, as well as utilize, the
skills of a growing older population.
While it seems that health problems and increased costs are inevitable in later life
due to disability, mounting evidence (AoA, Ref #10) indicates that one can
improve health and delay disability by at least seven years if he/she stops smoking,
stays physically active and maintains weight appropriate to height. A 1996 U.S.
Surgeon General report found that many diseases and chronic conditions in later
life could be prevented, controlled or forestalled by adopting a healthy active
lifestyle, specifically moderate exercise done on a regular basis. Yet, it is
difficult to convince older persons of the importance of physical activity or get their
participation in fitness programs. (AoA, Ref #11)
It is imperative that we now begin "Longevity Planning" that focuses on
prevention (research, education and services), rather than reaction to these
demographic conditions with increases in our current services.
How should we respond to these historic age-related trends in our society? How do
we prepare for a society of Longevity?
First, citizens must receive encouragement and assistance to plan now for a long
life. They must begin "Personal Longevity Planning" (Passmore, 2002, Ref #14)
or what others refer to as "life course planning." The time is now to begin developing
programs and services for future older persons that promote personal responsibility
for their health and well-being utilizing their skills and talents. The so-called
"retirement planning" concept of the past is no longer appropriate for the future,
since many older persons will not choose or be able to retire from work. The
opportunity to live a long life carries with it the new responsibility to make healthy
lifestyle choices. Society must assist in implementing Personal Longevity Planning
that includes health promotion, senior employment and community volunteer
options. Collectively, this generation and future ones have the power to
increase their own longevity and improve their quality of life until the end of
life.
Second, the State of North Carolina has an obligation and a responsibility to begin
"Societal or Community Longevity Planning" (Passmore, 2002). We must take
the lead both locally and statewide through governmental entities and educational
systems to identify, promote and offer healthy active life choices for older
North Carolinians. Innovative partnerships between academic and community
Page 10 of 18
programs can create models that address the quality of life issues faced by older
persons with chronic disabilities.
In response to this challenge, we propose the establishment of a Campus on
Senior Wellness and Longevity at the University of North Carolina at Chapel
Hill that brings together research, education, training and service from an
interdisciplinary perspective. (See Chart: Campus on Senior Wellness and
Longevity, page 12)
The Campus's mission would be "to improve the independence, functionality,
quality of life and well-being of older persons as long as possible through research,
education and service." In addition, the Campus's mission should address positive
interdependence between diverse generations such as the roles of seniors as
mentors and contributors, rather than merely as those who require assistance.
The Campus must include the following key characteristics:
1. A public and private partnership. All sectors including government, private
non-profit and private enterprise have a part to play in the campus's mission.
2. Interdisciplinary in scope. The campus should include all schools,
departments and institutes. UNC-Chapel Hill is especially blessed by being
one of only 16 universities in the U.S. with all Health Sciences and its School
of Social Work on campus.
3. Involve the business community including pharmacies, housing providers
and health care providers who already market goods and services to seniors.
4. A centrally located and easily accessible campus for senior citizens,
students, faculty, employees and public transportation services. The
University's Horace Williams Property, adjoining the County's Homestead
property, would be an ideal location if appropriate access can be achieved.
5. A Enough acreage to accommodate research, education and training
facilities, a central Senior Wellness-Longevity Service Center, and several
research models for senior living and service delivery such as housing, health
care (nursing) center, an adult day and rehabilitation program and a geriatric
assessment center.
6. Easy access to other campus facilities.
7. Adequate parking and drop-off design features to accommodate disabled
persons and public transit/private bus service.
Page 11 of 18
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Local Resources and Aging Initiatives
Several nationally recognized local resources have been established over the years,
and many current initiatives are taking place that make Chapel Hill an excellent
location to establish a Campus on Senior Wellness and Longevity.
Local Resources:
• The Orange County/Chapel Hill community has one of the highest
concentrations of older persons in the state, and has been a creative
force for change.
• More than 20 years ago, Orange County established one of the first public
departments on aging and community advisory boards on aging to help
plan, advocate and offer services in cooperation with other organizations.
• More than 10 years ago, the Friends of the Chapel Hill Senor Center
organization was formed to provide leadership, funding and community
involvement in the operation of the Chapel Hill Senior Center.
• More than 25 years ago, the Town of Chapel Hill established the Council on
Aging and the Retired Senior Volunteer Program. These programs
eventually merged with the County Department on Aging, but the Town still
supports senior services.
• Carol Woods Retirement Community, a continuing care retirement
community, has provided funds and staff for community aging projects and
serves as a training center for UNC students.
Current Apinp Initiatives: Orange County has supported and practiced the
development of community partnerships, both public and private, over the years.
Several initiatives exist on the University of North Carolina-Chapel Hill campus, in
the community and within Orange County government that would support a Campus
on Senior Wellness and Longevity.
Interdisciplinary Aging activities on UNC campus:
A. Program on Aging -Geriatric Assessment Clinic that works with
Gero-psychiatry, Nursing, Physical Therapy, Occupational Therapy,
Social Work and Pharmacy as a training center that sees frail elderly
with multiple health problems and their families. The Departments of
Speech and Language Pathology and Nutrition are called upon when
needed.
B. Institute on Aging -providing research opportunities and educational
opportunities for students from social work and allied health with a
Certificate in Aging.
C. School of Social Work- Geriatric Specialization offering
interdisciplinary classes on aging that involve students in clinical
services or in community planning such as the Master Aging Plan, and
specific services such as Adult Day Care and Eldercare Programs.
D. Hubbard Project- An interdisciplinary program consisting of senior
residents in Medicine, Pharmacy, Allied Health and Social Work who
make home visits to frail seniors. Referrals are made from the Dept.
Page 13 of 18
on Aging, Geriatric Evaluation Clinic and community providers. Care
Plans are sent to the care provider. The students learn to look
holistically at the patient and family and appreciate the contribution of
each discipline. Appropriate patients are then referred to the new
home visiting of Student Health Action Center (SHAG) who will visit
monthly to monitor.
E. The Pharmacy School -Under the direction of faculty, doctoral
students make home visits to assist with medication monitoring.
Referrals are made from the County Dept. on Aging and Geriatric
Evaluation Clinic.
2. University and Community Partnership on Aging:
A. In Praise of Age Weekly. The television show is produced by
seniors for seniors on topics of aging, and features University faculty
and programs. Co-sponsored by the Orange County Department on
Aging, Carol Woods Retirement Community and the Friends of the
Senior Centers in Chapel Hill and Central Orange.
B. Coalition on Continuity of Care. University faculty and community
agencies have come together to inform each other on community
needs and to advocate legislative and community change.
C. Senior Wellness Program. UNC Health Care co-sponsors and assists
in funding this Orange County program. It provides direct services such
as immunizations, foot care, blood pressure checks and community
education. Students and faculty from various disciplines have been
involved with these services and serve on the Wellness Advisory Board.
D. Elder Mistreatment Coalition. Along with community agencies, the
Coalition educates the community on abuse, neglect and mistreatment
of older persons.
E. UNC and Department on Aging. Over the years the Department on
Aging has been a training and research center for University students
from the schools of: nursing, pharmacy, public health, social work, and
rehabilitation counseling. The Department on Aging (DOA) has offered
internships in its various divisions such as Eldercare, Senior Centers,
Wellness, Transportation, Administration, and Volunteerism, as well as
special planning projects. Currently, the School of pharmacy and
Eldercare are partnering on a grant to provide Pharmacy
services/education in the homes of DoA community clients.
Interdisciplinary students from the Health Service Schools and Social
Work have worked in teams on the development of the new Day Health
Care Program initiative in central Orange.
3. Orange County Government Initiatives in Aging:
A. Orange County has developed, adopted and begun the implementation
over a five year period (2001-2005) of one of the state's first
comprehensive Master Aging Plans (MAP) that focuses on older
adults over their life span. Sensitive to the functional diversity within the
senior population, the MAP addresses the needs of the well elderly, the
moderately impaired elderly living in the community, and the frail
elderly both at home and in institutions. The emphasis on prevention,
Page 14 of 18
maximizing functionality, and enhancing quality of life, is in some
cases directly related to quality of care.
B. The Orange County Board of Commissioners placed on the ballot a
Senior Centers Bond that was approved by the voters in November,
2001. The Bond will help construct two large multipurpose Senior
Centers -one in southern Orange and the other in central Orange. The
Senior Centers are hubs for healthy living and exercise, disease
prevention, socialization, recreation, information, counseling, and
services for seniors and their families.
C. The Chapel Hill Senior Center, operated by the Department on
Aging, is recognized as a state-wide model for the coordination of
and access to, community services and opportunities. It has a proven
track record for consistently providing high quality services to all
segments of the older adult population. Over the past 20 years the
Department on Aging has been awarded seven Achievement Awards
by the National Association of Counties (NACo). Most of the awards
were associated with senior center operations such as Coordinated
Leisure Programming, Saturday School for Seniors, Volunteer Income
Tax Assistance, Coordinated Agency Transportation, and the Senior
Times Newspaper: APublic-Private Partnership to promote aging
services.
D. For over 20 years, Orange County Nursing Home and Adult Care
Home Advisory Committees have been grassroots ombudsmen that visit
local long-term care facilities quarterly and act as advocates for residents.
They are appointed by the County Commissioners, staffed by the
Department on Aging and receive training and technical assistance from
the Regional Ombudsman Program through Triangle J Area Agency on
Aging.
Page 15 of 18
Impact and Benefits
The impact and benefits from the research, training and service generated by a
Campus for Senior Wellness and Longevity will be enormous. Here is a brief listing:
1. Improve the quality of life and longevity for older persons in Orange
County, North Carolina.
2. Improve the quality of education and training of professionals in
gerontology within a community setting. The gerontological education and
training would focus on the older person and the aging process holistically-
from a "mind, body and spiritual perspective." This would include
partnerships with the faith community.
3. Reduce the workforce shortage of health professionals needed in
geriatrics.
4. Establish UNC as a national and international leader in geriatrics and
gerontology.
5. Attract research and development funds from federal sources, private
foundations and the business community.
6. Develop effective and efficient service delivery models that can be
replicated in North Carolina, as well as nationally and internationally.
7. Develop research, education and training models that can be replicated
on other UNC campuses.
8. Develop a university and community partnership to reduce
fragmentation of service delivery, which can be replicated across NC on a
university campus with allied health programs.
9. Expand the traditional medical model to reflect an inter-disciplinary
approach, which addresses the unmet needs of chronically ill patients,
resulting in lower Medicare/Medicaid costs and greater patient satisfaction.
Such a program could be a pilot project to replace the state Community
Alternatives Program (CAP).
10. Research, evaluate and develop holistic medical models that use
natural healing remedies and therapies to which older adults and the
general population are turning for relief of chronic conditions.
Page 16 of 18
11. Develop innovative, intergenerational housing models that meet
the needs for affordable housing of seniors, students, paraprofessionals in the
aging workforce and lower income UNC employees both active and retired.
This addresses the issue of geographically distant nuclear families in many
communities, and creates a setting within which multiple generations can
teach each other and help each other.
12. Develop a training partnership between the UNC system, the state
Division of Aging and the Area Agencies on Aging which would enable
local front line workers in the field of aging to develop their knowledge base
and enhance their skills in working with individual seniors and in developing
successful programming.
13. Identify and address cultural, political, policy and socio-economic
norms that undermine wellness among certain groups of older adults (rural,
minorities) or impede their access to information, services and resources that
facilitate wellness and longevity.
14. Develop nursing home, adult day care and rehabilitation service models
that can address the chronic conditions of older adults from amulti-dimensional
wellness perspective.
This is an opportune time to establish a Campus for Senior Wellness and
Longevity that provides leadership and meets the age-related challenges now
facing our county, state, nation, and world.
Page 17 of 18
References
(1) Administration on Aging (AoA), Fact Sheet: Life Course Planning, May, 2000
(2) Administration on Aging (AoA), A Profile of Older Americans: 2001, The Older
Population, December, 2001
(3) Administration on Aging (AoA), A Profile of Older Americans:2001, Highlights,
December, 2001
(4) Administration on Aging (AoA), A Profile of Older Americans:2001, Future
Growth, December, 2001
(5) Administration on Aging (AoA), A Profile of Older Americans:2001, Geographic
Distribution, December, 2001
(6) Administration on Aging (AoA), A Profile of Older Americans:2001, Health,
Health Care and Disability, December, 2001
(7) Administration on Aging (AoA), Fact Sheet: Older and Younger People with
Disabilities: Improving Chronic Care Throughout the Life Span, May, 2000
(8 Administration on Aging (AoA), A Profile of OlderAmericans:2001, Living
Arrangements, December, 2001
(9) Administration on Aging (AoA), Fact Sheet: The Many Faces of Aging, Older
People Living Alone, May, 2001
(10) Administration on Aging (AoA), Fact Sheet: The Future is Aging, Good
Nutrition !Essential for Health, May, 2000.
(11) Administration on Aging (AoA), Fact Sheet: Older Americans Month, Health
Promotion Programs for Older Americans, November, 1998.
(12) N.C. Division on Aging (NCDOA), The Future of Aging in North Carolina,
July, 1997.
(13) N.C. Center for Health Statistics, January, 2002.
(14) N.C. State Demographics, Population Projections, retrieved from
http://demoa.state.nc.us/ on June 6, 2002.
(15) Passmore, Jerry M., A Campus on Senior Wellness and Longevity, May,
2002.
(16) United Nations (UN), Population Division, Dept. of Economic and Social Affairs,
1999
(17) United States Census Bureau. Population Projections. January 13, 2001.
FN:H/Proposals/Proposal Senior Wellness Campus020809-approved
Page 18 of 18