Educating Older Persons

This week you will learn about political, educational, and religious aspects of aging. You’ll learn about elderly involvement in the political system. We’ll cover the educational needs of older adults, and the programs and services that fulfill those needs. We’ll also discuss the religious beliefs and involvement of the elderly. You’ll have access to some great resources that outline program benefits and eligibility requirements. Review all of the information from this class before taking the second exam.

Learning Outcomes

· Recall the goals and resources provided by the organizations discussed: AARP, Silver Haired Legislation, Elderhostel

· Describe voting trends for elderly, addressing both cross-sectional and longitudinal data

· Describe education participation rates among elderly in relation to personal and practical barriers

· Relate trends in religious participation among the elderly to historical trends among all groups and the study conducted by your professor

· Describe the difference between legislation and implementation in elder care in the U.S.

· In regard to major U.S. federal programs to assist the elderly mentioned in the lecture, recall sources of administration and funding, services provided, and the target population

· Week 7: Lecture

· Political Aspects of Aging
· Comprising approximately 14 percent of the total U.S. population, older persons could be a major factor in determining the outcomes of local, state, and national elections. However, gerontologists for nearly a half century have reported the same observation: Rarely do older persons vote as a bloc in any election. Older adults tend to maintain their party affiliation, whether Republican or Democrat. The political clout of older persons tends to manifest itself in ways other than regular elections, including participation in national organizations like the American Association of Retired Persons (AARP) and involvement in state lobbying and legislative efforts.

· AARP is comprised of more than 40 million members aged 50 (yes 50!!) and over. The organization regularly supports and /or conducts research aimed at improving the lives of individuals roughly 50 and over. Publications that are free or very low cost are made available; services (e.g., various forms of insurance) are offered; and policy positions related to older adulthood are advocated regarding issues and legislation affecting that age group. AARP also has state affiliates who are kept abreast of national AARP advocacy. I urge you to visit the AARP website (Links to an external site.) and learn more about the extensive offerings of this organization. It is likely that several gerontology courses could be taught beneficially just relying on AARP resources alone!

· Another example of older adult participation in the political process relates to a program that began in Missouri in 1972 (see the Silver Haired Legislature handout

· Actions

· ). Missouri started a Silver Haired Legislature in 1972 to provide an opportunity for older persons to actively advocate for legislation primarily for older adults in that state. Older adult delegates are elected through area agencies on aging (agencies that will be addressed in Class Eight of this course). The delegates are expected to become familiar with some of the major interests of their constituents and then to convene each year in the state capitol to actually develop mock legislation. At the end of the legislative session, delegates prioritize five bills that they would like to see enacted into law. As you can see in the attachment, many of the bills prioritized by the Silver Haired Legislature have been made into laws in Missouri.

· The discussion above is significant in part because most states reportedly have developed their own versions of a silver-haired legislature. This has resulted in older persons exercising an active and direct role in the political process.

· In the 2008 presidential and congressional campaigns the state of the U.S. economy and concerns related to the wars in both Iraq and Afghanistan likely resulted in older adult issues being pushed far into the background of political priorities. And, major funding challenges remain in regard to Social Security, Medicare, Medicaid, and other programs that greatly impact the older adult population.

Week 7: Lecture

Education and Aging

Few gerontologists have found ways to attract older persons to participate in regular educational offerings. In 1974, a study supported by the National Council on Aging reported that only 2 percent of the U.S. population 65 and over were participating in organized and systematic educational programs at that time. By 1981 the participation level had grown to 5 percent, but the comparison is fallacious because the questions about participation had changed (from “current participation” to “participation during the past year”). “Lack of interest” was the major reason for not participating, but it was followed by the rationale of “…I’m too old…” to participate. Even in the presence of very low cost and free educational programs for older persons at many different venues (churches, adult educational programs, colleges and universities, senior centers, hospitals, etc.), a relatively small percentage of older eligibles participate.

As early as 1971, Howard McClusky asserted at the White House Conference on Aging that older persons needed not only practical information (e.g., Social Security and Medicare benefits, how to access programs and services, financial guidance, healthcare updates, etc.) but also education aimed at personal growth and development. Harris (Sociology of Aging, 2007) describes the five categories of McClusky’s hierarchical needs theory and their meanings:

1. Coping Needs

2. Expressive Needs

3. Contributive Needs

4. Influence Needs

5. The Need for Transcendence

Harris provides a rationale regarding the importance of lifelong learning. Clearly, each stage of life confronts individuals with new challenges related to adjustment to that stage and to living a rich and full life in general. Much more could be done to attract older persons to potentially beneficial programs aimed at problem-solving, adult development, and life enrichment.

One of the most successful educational programs for people 55 and over, from the standpoint of percentage increase in participation in recent years, is the Road Scholar program (formerly Elderhostel program). Started in 1975 as the Elderhostel program, the program has provided educational offerings in more than 90 countries. Go to the Elderhostel web site (Links to an external site.) and review the nuts and bolts of this approach to educating older persons. If you have any interest in this topic, I urge you to get on the Road Scholar mailing list to review the extensive sessions available each quarter of the year.

View the video below on services that were provided by Elderhostel. Many of these same programs are provided by Road Scholar.

Is there a difference between the way one should attempt to educate adults as opposed to teaching youth? Malcolm Knowles, a prolific writer on adult education, points out some major differences. Keep in mind his emphasis is on adults, not necessarily older adults.

Knowles differentiates pedagogy (methodology for teaching children) from andragogy (methodology for teaching adult learners). He says there are three major differences.

1. Adults have a “crystallized self-concept,” which indicates that less “discovery of self” focus is needed.

2. Adults tend to be more “problem-centered,” as opposed to “subject-centered”; practical information tends to be more valued.

3. Adult learners have “broad experiences” from which they can draw to enrich a learning situation.

I urge you to at least reflect on Knowles observations as you present information to your peers in this class. Especially emphasizing practical information and sharing your rich experiences with one another are important.

Again, it should be emphasized that older persons have abundant opportunities for free or very low cost education. One very significant example that underscores this point is the opportunities available in Missouri. The Missouri legislature enacted a “Senior Citizens’ Tuition Exemption” law that permits a resident of that state who is at least sixty-five years of age or older to be awarded a scholarship to most public post-secondary educational institutions in Missouri. Individuals age 65 and older may attend classes free on a space available, non-credit basis. See the handout titled “ Senior Citizens’ Tuition Exemption

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Week 7: Lecture

Religion and Aging
Harris (Sociology of Aging, 2007) quotes sociologist Johnstone’s (1988) definition of religion as “a system of beliefs and practices by which a group of people interprets and responds to what they feel is sacred and usually supernatural as well…” Harris adds that “… studying and measuring religiosity – interest and involvement in religious activities – are difficult to do scientifically.” Also, the ideological and ritualistic dimensions of religion may not be closely related, as Harris notes.

You may recall the item on religiosity on the “Facts on Aging Quiz” that you took as a part of Session One. Gerontologists regularly have refuted the commonsense notion that people become more religious as they age. Review the tables below and the accompanying narrative on religious trends and aging in your text. You likely would draw the same conclusion. Do you see how research methodology might be a major factor contributing to the belief in one’s becoming more religious as s/he ages? According to the research reported in these tables, a higher percentage of older persons compared to adults under age 65 report a belief in God and more frequent church attendance. However, these data are primarily from cross-sectional data; older persons today grew up in a period when organized religion was more highly emphasized; often, they have been more religious throughout their lives.

(Both tables from: Harris, Diana K., The Sociology of Aging (Third Edition). Lanham, Maryland: Rowman and Littlefield, 2007. Tables 11.3 and 11.4) Notice the section on “Religion and Personal Well Being” in your text (p. 54). A consistent finding in the literature on aging is that religiosity tends to contribute to a sense of well-being. Your instructor did a study on group counseling and aging as a part of his doctoral thesis. One of the six counseling groups in the study were retired Catholic sisters at St. Mary of the Woods College in Terre Haute, Indiana. Interestingly, the sisters had higher mean scores on life satisfaction and adjustment scales than any of the other five groups who participated.

Belief in God, 1998

Ages

Believe and have no doubts

Believe but have doubts

18 – 24

54%

17%

45 – 54

62%

1%

65 and older

71%

9%

Source: National Opinion Research Center (1998)

Attendance at Religious Services, 1998

Ages

At least weekly

At least monthly

Less than once a year or never

18 – 24

16%

19%

39%

45 – 54

35%

16%

28%

65 and older

50%

13%

25%

Source: National Opinion Research Center (1998)

(Both tables from: Harris, Diana K., The Sociology of Aging (Third Edition). Lanham, Maryland: Rowman and Littlefield, 2007. Tables 11.3 and 11.4)

A consistent finding in the literature on aging is that religiosity TENDS to contribute to a sense of well-being.

Week 7: Lecture

Social Policy
According to Wikipedia, The Malcolm Wiener Center for Social Policy at Harvard University describes social policy as “public policy and practice” in the areas of health care, human services, criminal justice, inequality, education, and labor. If one accepts Wikipedia’s definition of “policy” as a “deliberate plan of action to guide decisions and achieve rational outcome(s),” one might conclude social policy as it relates to aging is murky at best. If one focuses on federal laws (e.g., Social Security Act, Medicare, and Medicaid) and the stated objectives of the Older Americans Act, one likely would conclude that older adults are a top priority of the U.S. government and the people of this country. If one focuses on the implementation of programs, including funding levels, one may question whether older persons are a priority. Nonetheless, older persons in the U.S. have made significant progress in their health and welfare since 1935.

Week 7: Lecture

Programs and Services

The twentieth century in the United States might someday be viewed as a golden age of aging in this country. Supportive legislation for older persons, especially at the federal level, and expanded services characterized the last two-thirds of the century. Virtually everyone would agree that the passage of the Social Security Act of 1935 was the most important legislation in U.S. history towards the improvement of older adult lives. In Class Six, we noted the significance of Social Security in providing the major source of income for older persons.

The Great Society programs of the 1960’s also greatly benefited older persons in this country. Three laws in particular helped older persons:

1. Medicare

2. Medicaid

3. The Older Americans Act.

Medicare has provided basic health care coverage for most people aged 65 and over. Review the material on Medicare in your text, as well as the section on healthcare in the Profiles of the Administration on Aging (AOA).

It is Medicaid, rather than Medicare, that is a primary funding source for nursing home care. However, Medicaid is a “mean-tested” program, meaning that eligibility is determined by some combination of income and/or assets. To qualify for Medicaid funded nursing home care, older persons must “spend down” most of their assets and have a limited income. Learning the basic Medicaid provisions in your state can enhance your value as a resource working in the field of aging.

A third major program for older persons that was launched in the 1960’s stemmed from the Older Americans Act (OAA) of 1965. The significance of that law does not relate so much to its funding level but rather to its mission. The major charge of the OAA is to develop a system of coordinated services for older adults at the federal, state, and local levels. At the federal level the Administration on Aging (AOA) oversees the OAA program. To obtain OAA funding, each state is required to develop a plan under AOA guidelines to utilize the funds. In each state further subdivisions, called Area Agencies on Aging, devise plans to use OAA funds. The diagram below, titled “The Formal Aging Network,” depicts the organization of the OAA.

Area Agencies on Aging were created for the purpose of coordinating aging services in their geographical region and providing information on older persons. The Area Agencies on Aging sometimes provide direct services to older persons but more often develop contracts with various local providers of services such as meals, transportation, and social programs. The single most important item of information that I would like for you to remember from this course is this: The information and referral component of Area Agencies on Aging may be the most important resource available to you. There are more than 600 such agencies in the country that service almost every geographical area in the U.S. See the ” Active Aging Resource Guide

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” published by the Mid-East Area Agency on Aging for examples of services provided.

Go to the United States Code, Title 42, Chapter 35 (Links to an external site.) (The Public Health and Welfare: Programs for Older Americans) for more information on federal provisions for the elderly.

Another important program for the poor elderly is the Supplemental Security Income (SSI) program. The program is means tested and targets the blind, disabled, and/or aged. See the attachment titled “ Social Security, Supplemental Security Income, and Medicare

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,” which was prepared in 2007 by Bill Hunot, a former Public Affairs Specialist for the Social Security Administration.

Week 7: Lecture

Program Provisions
The following are basic provisions of the Social Security, SSI, Medicare, and Medicaid programs that you are responsible for remembering:

Social Security:
· Administered at the federal level by the Social Security Administration

· Funded primarily by OADSI payroll taxes

· Targeted primarily to retired individuals with at least 40 quarters of relevant work and who are at least 62 years old (Note: After “regular” or “full” retirement age between ages 65-67, one no longer has to be retired to receive benefits.)

Supplemental Security Income
· Administered by the Social Security Administration

· Funded primarily by general revenue (taxes)

· Targeted (eligibles) to the aged, blind, and/or disabled who meet income and asset guidelines (means-tested)

Medicare
· Administered at the federal level by the Centers for Medicare and Medicaid Services; administered at the local level by contractors

· Part A funded by payroll taxes, general revenue, and other sources Part B funded by monthly premiums and other sources Other parts funded by a combination of premiums, co-pays, and general revenues.

· Targeted (eligibles) primarily to individuals 65 and over plus qualified disabled of any age

Medicaid
· Administered at the federal level by the Centers for Medicare and Medicaid Services; funded at the state level by state designated agency

· Funded by federal general revenue funds matched by state funds

· Targeted (eligibles) to the poor of all ages who meet income and asset guidelines

The programs reviewed above are fundamental to the health and welfare of the majority of older persons. Becoming familiar with the basics of the programs likely will enable you better to advocate for and/or provide assistance to older persons.