Category Archives: Events

Wine Around the World 2017: An Aging Population is Transforming Britain

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

An Aging Population is Transforming Britain

By 2040, nearly one in seven Britons will be over 75, according to a recent study, which also reveals that almost a third of people born today in the UK can expect to live to 100. In 2014, the average age in the UK exceeded 40 for the first time. As the baby boomer generation enters retirement, the UK will also reach a dramatic demographic turning point: 2017 will see the ratio of non-workers to workers start to rise for the first time since the early 1980s.

This vastly improved life expectancy, which is growing by five hours a day, was one of the great triumphs of the last century. It is now, however, the source of the greatest challenges – and opportunities – of this era, for the UK and many other countries around the world.

Demographic change of this scale requires a long-term perspective. This ageing population brings great opportunities – but also challenges. The tax burden associated with an aging society and higher dependency ratio – the ratio of non-workers to workers – will rise to £15billion a year by 2060.

How will Britain cope? Further increases in the state pension age, as the government is currently considering, will not be enough. The aging population will also need to pursue full employment to maintain the “effective” dependency ratio for many decades to come, and of course the main beneficiaries of this will be disabled and older workers who are struggling to return to the labour market.

In the absence of governmental long-term responses, aging baby boomers in the UK are seizing the reins for the second time. When they were teenagers, this generation transformed the morals and structure of the 1960s with their mantra of “I want.” Their new mantra is “I need” and, thanks to both low birth rates and high life expectancies, their voice is once again the dominant one.

Wine Around the World 2017: Austria Meeting the culturally diverse needs of aging migrants

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

Meeting the culturally diverse needs of aging migrants

Like most of Europe, Austria faces significant population aging. Its fertility and mortality rates are decreasing as its life expectancies increase. In Germany, the median age is almost 47; in Italy, 45; in Austria and Greece, 44. These trends pose a very serious challenge to European society. As Europe ages, the costs of healthcare and pensions will increase dramatically while tax revenues decrease. The savings rate will decrease too, since retirees have little incentive to save, which means investment will lessen, potentially slowing the economy further. The effect could be a fiscal catastrophe.

So, when millions of migrants, disproportionately young and male, came knocking on the borders of Western Europe years ago, many sensed an opportunity to integrate the migrants into Austrian society, boosting the country’s shrinking labor force, contributing taxes to help alleviate the country’s looming revenue problem, and increasing the nation’s savings rate. Largely, those goals were not realized.

In addition to the challenges of such migration, the health of older immigrants can have important consequences for needed social support and demands placed on health systems. In a recent study of 11 European countries, migrants generally have worse health than the native population. In these countries, there is a little evidence of the “healthy migrant” at ages 50 years and over. In general, it appears that growing numbers of immigrants may portend more health problems in the population in subsequent years.

Roughly 1.6 million inhabitants of Austria have a migration background, of which 10.2% are older than 65 years with a growing number expected for the near future as well. Yet in Austria, there has been little or no discussion of the need for culturally sensitive health care options. Elderly care for migrants is largely decoded as special needs care. Migrants’ special needs range from a language-based treatment (especially for patients with dementia) to the respect of cultural habits, tastes and religious backgrounds.

Austria now needs to focus on the impact of growing immigration on the health and social security needs of a growing and aging immigrant population. In general, growing numbers of immigrants may be linked to more health problems in the population in subsequent years, requiring new strategies in eldercare.

Wine Around the World 2017: Japan’s lessons from an elder-care approach gone wrong

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

Lessons from an elder-care approach gone wrong 

Japan is a country that combines the oldest population in the world with levels of public debt to match Zimbabwe. Their experience illustrates the consequences of retracting state support for eldercare too far and relying on individual and familial support.

Until 2000, publicly-funded social care was nonexistent in Japan; caring for the elderly was a family responsibility. There were two main consequences of this approach. First, there were many reports of neglect and abuse towards older people being looked after by family members. In a survey conducted by the Japanese government, a third of carers reported feeling “hatred” towards the person they looked after. Caring also restricted the employment options of a growing number of Japanese women.

A second issue was the development of a phenomenon known as “social hospitalisation.” Older people were being admitted to hospital for long periods–not for any medical reason, but simply because they could not be looked after anywhere else.

The response from the Japanese government was radical. They introduced long-term care insurance, offering social care to those aged 65+ on the basis of needs alone. The system is part-funded by compulsory premiums for all those over the age of 40, and part-funded by national and local taxation. Users are also expected to contribute a 10% co-payment towards the cost of the service. The costs are seen as affordable and the scheme is extremely popular.

The result is that older people in Japan can access a wide range of institutional and community-based services.

However, it would be a mistake to see this as a problem solved. The uptake of services has far outstripped expectations and the Japanese government is faced with spiralling costs. Their response has been to introduce higher co-payments for wealthier adults, but the challenges continue. Other countries would be well-served to study the long-term impact of Japan’s decisions in order to course correct.

Wine Around the World 2017: California recognizing the need to provide culturally competent care to seniors

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

Recognizing the need to provide culturally competent care to seniors

California’s senior population is entering a period of rapid growth. By 2030, as the Baby Boom generation reaches retirement age, the over-65 population will grow by four million people. It will also become much more racially and ethnically diverse, with the fastest growth among Latinos and Asians. Many more seniors are likely to be single and/or childless—suggesting an increased number of people living alone. All of these changes will have a significant impact on senior support services in California.

By 2030 the demand for nursing home care in California will begin to increase after decades of decline. California’s community college system will be critical in training workers to meet the state’s healthcare workforce needs for the growing and changing senior population.

The growing diversity of this aging population illustrates a growing need for culturally competent care—that is, care that respects the beliefs and responds to the linguistic needs of seniors from diverse backgrounds. Respect is at the heart of cultural competence–patients who feel their healthcare providers respect their beliefs, customs, values, language, and traditions are more likely to communicate freely and honestly, which can, in turn, reduce disparities in healthcare and improve patient outcomes.

Disparities in health-care and dissatisfaction are more pronounced among racial minorities. According to a report by the Agency for Healthcare Research and Quality (AHRQ), African Americans, Hispanics, and Asians received worse care and had worse access to care than their non-Hispanic White counterparts. The report also highlighted language barriers as a significant contributor to disparities in care. For example, patients who speak Spanish at home were more likely than patients who speak English at home to report poor communication with nurses.

When patients feel heard and understood by their healthcare providers, they are more likely to participate in preventive health care and less likely to miss health appointments. This can reduce medical errors and related legal costs for healthcare facilities, and it can improve health outcomes for patients. California, like other areas with increasing minority populations, will be well served to focus on creating culturally competent caregivers.

Wine Around the World 2017: Creating futuristic answers to aging issues in France

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

Creating futuristic answers to aging issues in France

Traditionally, it is considered natural among the French for senior relatives to be cared for by the family. In accordance with the law, children are required to provide for their aging parents.

This, in particular, explains why old people’s homes and retirement homes are less common in France than in other Western countries. However, this has begun to change.

A recent survey in France confirms that 90 percent of people aged 50 or older would prefer to live in their own homes as long as possible. A quarter of those over 85, though, are already in some form of assisted living, which amounts to around 450,000 people.

One company is creating a technological approach to meeting those increasing needs: A robot called Kompaï, from France-based Robosoft, features a touch-screen display on an easel and a bowling ball–sized head with a “face.” Although the face is currently just for emotional comfort, future versions will light up and show expressions.

The vision for Kompaï is as follows: Family members would call the robot via Skype. The robot would then use ultrasonic sensors to detect the location of the person being called and navigate to that person, who answers the Skype video conference call via Kompaï’s multitouch tablet PC and Webcam. Kompaï could likewise be used as an interface to Facebook or some other social network. Interactive speech recognition would be available to help elderly or otherwise dependent people access the Internet using a simple graphic and tactile interface.

Kompaï could also store a person’s daily schedule and shopping lists, and access online calendars or weather. Robosoft is now being tested in hospitals, geriatric centers, and homes in France, Hungary and Austria to see how the technology is accepted.

Robosoft is looking to partner with companies that make wireless physiological sensors worn by a robot’s owner that could communicate blood pressure, pulse, body temperature and other data via Bluetooth to the robot, which would then relay that information to the person’s doctor.

In this way, the needs of France’s aging population might be met more efficiently.

Wine Around the World 2017: Croatia Looks at Policy for Caring for the Aging

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

Creating National Policy on Caring for the Aging

In Croatia, a burgeoning elderly population and rapid socio-economic change have strained health services to the point where health care providers, policymakers, and citizens alike have begun to recognize an immediate need for alternative options for geriatric care–in a nation where geriatrics and gerontology have not yet evolved into recognized specialties.

There are not enough retirement homes, waiting lists are long, there are no hospices, there is no program to educate families in how to care for the elderly, there are no guidance centers. Home care is developing. Unfortunately, a major problem is an insolvent community that cannot contribute enough resources.

Croatia wants to address the issues of a growing aging population and the absence of a national policy on how to care for the aging. They want to look at alternative means of elder care: day care, assisted living, home care, and ways to move people out of hospitals.There are currently two options for residential elder care in Croatia: retirement homes, which provide assistance with activities of daily living and with administration of medications, and health and welfare institutes, which house those with chronic conditions. These facilities are funded through a combination of government welfare supplements and private pay; residents’ relatives are required to assist with payment when they are able to. The pressure to get into residential care facilities is intense. There are more than 10,000 people on waiting lists for these homes, and applicants often must wait up to three years for placement.

After visiting The Franciscan at St. Leonard in Centerville, Ohio, on an exchange recently, nursing home administrators conceived a plan to introduce adult day care to Croatia, resulting in the opening of a nursing home in Sibenik that provides three meals a day and a range of leisure activities–including painting, singing, dancing and playing cards–for elderly citizens.

Wine Around the World 2017: Aging in Greece

This series of blog posts by author Patti Digh will focus on aging in the countries whose wines we will taste at our Wine Around the World event on Thursday, October 12, 2017. Purchase tickets here! Wine Around the World 2017.

What can Greece teach us about aging well?

Greece is aging faster than any other nation in Europe, adding to the difficulties facing the country in resolving its massive economic problems.

Ikaria, a small Greek island, has been dubbed a “blue zone,” one of the few places in the world where people lead healthy, active lives past the age of 100. People on this island are living to 90 almost three times as often as Americans, and are far less likely to develop Alzheimer’s or depression. Their low-stress lifestyles, level of physical activity, and a few other habits unique to their culture could be the secret.

Here are four things the Greeks can teach us about aging well:

  1. They know how to take a break from the stresses of daily life. As with many countries with hot climates, people in Greece stop midday to take a quick, but restorative nap. Research has found that Greek men who napped just half an hour a day were much less likely to have heart attacks.
  2. They drink to their health. Boiled Greek coffee is a staple in Ikaria and it’s loaded with polyphenols and antioxidants that protect your body from aging and a variety of chronic diseases. Drinkers of this coffee were found to have improved endothelial function—which protects your blood vessels—compared to those who drank other types of coffee.
  3. Their diet is heart-healthy: the freshest olive oil, a rainbow of vegetables, tons of lentils and beans, while taking it easy on the meat. This diet has been linked with benefits ranging from a lower risk of heart disease and cancer, to even lessening the likelihood of developing Alzheimer’s.
  4. Family is everything. A welcoming sense of community and family ties are a major part of life in Greece. In Ikaria, a typical evening routine includes visiting neighbors. Studies have not only shown that older people tend to eat worse when they’re alone, but loneliness in later life can lead to poor health and earlier death.

Wine Around the World 2016: Oregon, USA

This series of blog posts by author Patti Digh will focus on issues of aging in the countries whose wines we will taste at our Wine Around the World event on October 6, 2016. This event is sold out. If you would like to be on our invite list for next year and hear about our other events, you can subscribe here at COA News.

OREGON LEADS THE WAY

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by Patti Digh

Oregon has long been known as an innovator in community-based care options for older people who need ongoing assistance with daily activities. The state was the first to receive a federal waiver to provide home and community-based services for adults with low incomes who would otherwise require nursing home placement. Assisted living facilities, now common across the U.S., began in Oregon. In 2009, AARP ranked Oregon first in use of home and community-based services for older persons and adults with disabilities and next to last in use of nursing facilities. Other states and countries have studied Oregon’s assisted living, home care, and adult foster care programs.

“Toward an Age-Friendly Portland” is a Portland State University Planning Workshop Project whose aim is to create an “Age-Friendly Action Plan” for the City of Portland. Planning for age friendliness is a collaborative partnership among the people of Portland, City bureaus, Multnomah County, Metro, and many non-profit organizations and those efforts are directed at creating choices and opportunities for older adults to live healthy, vibrant, happy lives.

In the coming decades, Portland (and Oregon as a whole) will see a substantial increase in the population of older adults both in size and as a percentage of the population. Properly supported, this generational shift can result in a more resilient Portland with stronger neighborhoods where people can grow up and grow old.

Many of Portland’s efforts to improve livability for its older citizens have made, and are likely to continue to make, Portland friendlier to people of all ages. The City’s approach to increasing quality of life, including the Portland Plan’s “healthy, connected neighborhoods” concept, generally supports a high quality of life for older adults. Walkable, bikeable, mixed-use places that feature parks and social gathering spaces, located near convenient, accessible transit improves the ability of older adults to access the goods, services, and social and recreational opportunities they desire for a healthy and satisfying life.

Portland is focused on improving the quality of life for older adults and people of all ages by focusing on three things: Age-Friendly Neighborhoods, Age-Friendly Housing Options, and An Age-Friendly Transportation System.

The vision of this Age-Friendly Portland project is compelling: “In an age-friendly Portland, the lives of older adults abound with choice and opportunity. Portlanders will embrace the transition into late adulthood. Since growing older is not associated with a diminished quality of life, older adults expect to enjoy active and satisfying lives throughout their golden years. Elders look forward to encore careers, fulfilling volunteer opportunities, pursuing their favorite activities, and new adventures. Older adults maintain their autonomy, health, security, and social connections. In an Age-Friendly Portland, intergenerational connections bolster interdependent vivacity across the age spectrum. A network of healthy, connected, and complete neighborhoods will intentionally cater to the needs of older adults. Vibrant, walkable neighborhoods cultivate an effortless sense of community amongst people of all ages. The everyday lives of all people will overlap through expanded and inclusive social networks.

Barriers to intergenerational interactions have been removed, and the isolation of older adults is a memory of the past. Easy access to social gathering spaces like parks, neighborhood plazas, community centers, restaurants, and cafes enable Portlanders to stay active, healthy, and involved as they age. A range of social, educational, and recreational activities fuel friendships, curiosity, and resilience among seniors. Diverse and inclusive neighborhoods support safety and security throughout the city. Older adults will thrive in affordable, attractive, well-constructed homes of their choice. A diverse range of housing types and arrangements provide the opportunity for elders of all incomes to age in place or age in community. Flexible, adaptable dwellings facilitate new possibilities.

Older Portlanders also have the option to move into housing that better suits their needs at different stages of aging, whether that is a smaller home that requires less maintenance, an apartment close to family, or a familiar home environment shared with peers that offers living and nursing assistance. A well-balanced transportation system will enable older adults to safely and conveniently access the things they need. Older adults feel comfortable moving about the city no matter how they choose to travel. A walkable and rollable network of smooth, barrier-free sidewalks, walking paths, and functional crosswalks benefit all users, including those using mobility aids. Off-street trails, neighborhood greenways, and protected on-street bikeways provide a pleasant, low-stress bicycling and strolling experience.”

It’s an inspiring vision for the future. Let’s learn from Oregon and work to create an age-friendly country!

Wine Around the World 2016: Italy

This series of blog posts by author Patti Digh will focus on issues of aging in the countries whose wines we will taste at our Wine Around the World event on October 6, 2016. There are a limited number of tickets left. Don’t miss this unforgettable event! Purchase online or stop by our office at 105 King Creek Blvd, Hendersonville, NC.

ITALY IS THE OLDEST COUNTRY IN EUROPE

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by Patti Digh

Italy is second only to Japan in its proportion of seniors in the general population, so the country is having to cope with growing demands for long-term care while managing issues related to the health, social exclusion, poverty, and technological needs of the aging population. In fact, Italy has the largest proportion of elderly population in Europe. Italy’s Genoa is the oldest city in Europe, with 33% of the population being over 60.

Similar to most European countries, this is linked to the fertility fluctuation that occurred during the second half of the 20th century: the baby boom cohort (born between 1945 and 1964) is progressively reaching the old age, and it will continue up to the 2030s, whereas the baby bust cohort (born between the early 1960s and 1975) now constitutes the bulk of the working age population. This circumstance will lead to a top-heavy age structure, and is expected to last about 30 years, after which the end of the baby bust generation will enter old age.

To accommodate the needs of this aging population, two systems have evolved: formal care provision, which provides in-kind home and residential services and cash-for-care financing to informal caregivers. The second is the informal network comprised of family, volunteers, friends, and neighbors. This second system is possible in part because so few women between the ages of 55-64 are in the formal workforce.

In Italy’s cash-for-care scheme, a dependent person receives a care allowance from the state and, in many municipalities, this is supplemented with a means tested additional 300-500 euros per month for those over the age of 65. This has encouraged hiring private help to assist with activities of daily living.

A large number of those hired are immigrants employed to supplement the family’s support or cohabitate with the client. The wage differential and reduced costs of living for resident home care workers also provides economic incentives for immigrants. However, this quasi-underground system raises several concerns. First is the inability to maintain standards of care, particularly when the workforce lacks accreditation. Second is the concern that families or senior clients may exploit immigrant home care workers. Third, these workers often work in isolation from their families and communities for prolonged periods of times, which raises concerns for their mental health.

To accommodate this migrant workforce, Italy has undertaken a series of legal and policy reforms to formalize the system. Illegal migrants now have the means to gain legitimate workers’ status. Fiscal incentives have been introduced to discourage households from employing undeclared workers. Starting in 2007, domestic workers now sign contracts to reduce the potential for employer abuse. Finally, training and accreditation programs for migrant workers have been developed by local municipalities to raise the workforce’s skillset. At the same time, stricter controls for access to cash-for-care allowances for seniors are now in place.

A recent survey found that high proportions of adults in Italy (70 percent) help their aging parents with basic tasks, such as running errands, housework or home repairs, compared with people in the United States (58 percent). But Americans were more likely to offer financial support to aging parents: 28 percent of U.S. adult children have given financial support to a parent who is 65 or older, compared with 20 percent in Italy. Italians were also much more likely to provide hands-on care. In Italy, 26 percent reported providing personal care, compared with 14 percent in the United States.
The study also found that in both the U.S and Italy, people said they were more likely to have helped an adult child financially in the preceding 12 months than an aging parent. In the United States, 61 percent of people with at least one adult child said they helped with financial support, compared with 60 percent in Italy. Among its other findings, the survey says that people in both Italy and the U.S. who are 65 or older preferred to grow older in their homes, a concept known as aging in place.

Wine Around the World 2016: France

This series of blog posts by author Patti Digh will focus on issues of aging in the countries whose wines we will taste at our Wine Around the World event on October 6, 2016. There are a limited number of tickets left. Don’t miss this unforgettable event! Purchase online or stop by our office at 105 King Creek Blvd, Hendersonville, NC.

TRAGEDY IN FRANCE SPURS NATIONAL REFORM FOR THE ELDERLY

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Connected homes, communities, and cities are essential to creating age-friendly environments; and adapting housing is a first step in a “prevention approach” that ensures the health and wellbeing of older people in their homes. In Europe, communities are looking at housing solutions that safeguard the needs of older adults and also provide housing and services in a new way.

In the region of Aquitaine, France, a local initiative finances home modifications for older people on lower incomes. In partnership with a housing organization, pension funds, and insurance companies, the initiative renovates existing housing to the meet the needs of older residents, at an average cost of 7,000 euros (9,100 dollars). In the city of Boé in that region, they are adapting residential parks for ease of mobility and access to urban transport systems.

These kinds of changes are necessary because the population aged 65 and older is rapidly growing in France. In the mid-2000s, about 16% of their population was 65 and older. The share of the French population 65 and older will reach about 25% in 2030 and nearly 30% in 2050. The sheer demographic weight of people aged 85 and older will rise even faster, increasing from about 1 million people in the mid-2000s to about 2.5 million in 2030. Finally, over the same period, the number of centennials will likely quadruple, rising from about 15,000 to 60,000.

One of the main factors in this aging trend is the decline in fertility. Like most other advanced industrial countries, from the mid-1960s to the mid-1970s, France witnessed a steep decline in the total fertility rate, though it has since stabilized. The long-standing French tradition of family-friendly public policy and, more recently, improvements to child care and family benefits that facilitate work–family balance are likely to explain this increase in fertility. Even so, France’s fertility rate still remains lower than the net reproduction rate and contributes to population aging in that country.

An increase in life expectancy is the other major factor in population aging. From 1800 to 1900 in France, the average life expectancy rose from 30 to about 45 years. In 2004, the average life expectancy reached 80 years. One key piece of demographic information that is missing concerns the growing ethnic diversity of the older population. This question is difficult in France, in part because French census questions do not refer to ethnicity or “race,” a situation related to a strong political opposition against “ethnic statistics,” as they are known in France, which derives from the universalistic, “color blind” political culture at the core of the French Republican model. But as many researchers know, aging is not a “color blind” experience, and knowledge about this reality can have direct policy implications.

A 2003 heat wave created a major political shock-wave in France, as it resulted in the death of 15,000 older persons. Limited access to air conditioning, as well as urban pollution, social isolation, and a lack of experience in handling such heat waves, led to dehydration and excessive sun exposure, which largely accounted for the high number of casualties. This traumatic episode helped push aging onto the policy agenda.

As a result, the French government launched an ambitious Aging and Solidarity Plan, granting massive investments for the construction or renovation of nursing homes as well as the development of new long-term care services. Other French policy initiatives included a national campaign against elder abuse and the “Bien Vieillir” (Age Well) National Plan, to promote healthy aging among people aged 55–75. A 5-year Alzheimer Plan was launched to support research, improve care, and both inform and mobilize citizens regarding this issue. Other public health initiatives launched that can directly affect older people, without necessarily targeting them directly. These initiatives include a plan against pain (Plan Douleur), a plan for palliative care, and a plan for suicide prevention.