Alabama Administrative Code
Title 410 - STATE HEALTH PLANNING AND DEVELOPMENT AGENCY
Chapter 410-2-2 - HEALTH PRIORITIES
Section 410-2-2-.03 - Care Of The Elderly And Chronically Ill
Universal Citation: AL Admin Code R 410-2-2-.03
Current through Register Vol. 43, No. 02, November 27, 2024
(1) The Problem
(a) The elderly comprise one of the most
rapidly growing age groups in the United States. The same is true in Alabama.
Since 1900, the state's total population (approximately 4.4 million people) has
more than doubled and there are nearly ten times as many senior citizens. In
1900 persons 65 and older accounted for only 3% of the total population
compared to 16.8% in 2019. This age group is expected to increase to over 22%
by the year 2050.
(b) Improvements
in life style, changes in diet, and development of medical technology for
identification and treatment of diseases have resulted in increased life
expectancy. Because of this increase, a new phenomenon is occurring, aging of
the aged. More persons are living well into their 80s and even 90s. Within the
ten-(10) year period from 2013 to 2022, the 65 and older segment of the
population is expected to increase by fifteen percent (15%). The special needs
of these frail elderly will demand increased attention from service providers
in the years ahead. The number of people aged 65 and older in Alabama is
projected to be almost 900,000 by 2022.
(c) The male population age 65 plus increased
by 13.3% from 1990 to 2000 and the female population of the same age group
increased by 9.3%, while one-third of the noninstitutionalized elderly live
alone, 80% of these are women.
(d)
As age increases, the incidence of chronic disease and disability, particularly
at the lower levels of severity, increases. Another factor affecting the
increase of the chronically ill is the projection of an increase in the number
of AIDS cases in the state.
(e)
Many of our chronically ill live below the poverty level. The current census
reflects they do not always seek medical assistance because of out-of-pocket
costs. Often they cannot afford required medications. Some live in substandard
housing with inadequate plumbing and heating. They do not always practice
proper nutrition because of economic concerns and the inability to
shop.
(f) Depression, loneliness,
alcohol and drug abuse, suicide, and mental health conditions pose problems for
many elderly and chronically-ill citizens.
(g) Transportation is not available to all
elderly and chronically ill persons. Many who have lived alone in the past will
need to be placed in a facility where they can receive assistance. Families,
with both husband and wife working, need assistance with parents during work
hours and at other times for respite care.
(h) Dental care and audiology are not
available at affordable prices for all the elderly and chronically ill,
although many more dentists are accepting Medicaid patients.
(i) Recent statistics project an increase in
the need for care of the elderly and chronically ill within the next few years.
However, much of this care will be linked directly to functional limitations,
and only indirectly to illness.
(j)
The social, economic, and cultural environment will have important bearing on
how well our elderly maintain their overall health status. The support that was
once provided by relatives is less feasible in today's society because of
scattered families, divorce, single parents, childless couples, and two-income
families.
(k) The kind of care and
support needed to maintain the health of our elderly and chronically ill
population cannot be sustained within the state's current medical
framework.
(l) The availability of
health care services has increased. Medicaid increased the payment to dentists
and physicians in the last two years; the Medicaid drug formulary has been
expanded and payments have been increased to nursing homes.
(2) Recommendations
(a) The State should strengthen its existing
support services for the elderly and chronically ill and, when appropriate,
develop new services, beginning at the community level. These services should
include, but not be limited to, the following:
1. Adult day care facilities to assist
working families;
2. Assisted
living facilities to provide housing for elderly and chronically ill who can no
longer live alone;
3. Counseling
services that deal with depression, alcohol and drug abuse, suicidal
tendencies, mental health, nutrition, appropriate life styles, and
self-care;
4. Geriatric training
and education for caregivers;
5.
Homemaker and chore services;
6.
Home delivered meals;
7.
Transportation services;
8.
Emergency alert systems;
9. Dental
care, including prosthodontics;
10.
Audiology, including hearing aids;
11. Optometry services, including
glasses;
12. Adaptive and assistive
equipment;
13. Adequate housing for
persons living below the poverty level.
14. Nursing Homes to provide housing and/or
rehabilitative services for elderly and chronically ill patients who can no
longer live alone and who require care at a level above and beyond that
available in an assisted living environment.
(b) The success or the breakdown of these
support services will determine to a considerable extent the demands made on
health care services by the elderly and chronically ill. However, with the
success of such support services, the need for more costly health care for our
elderly and chronically ill will drastically diminish.
Author: Statewide Health Coordinating Council (SHCC)
Statutory Authority: Code of Ala. 1975, § 22-21-260(4).
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