"The first baby boomers turned 60 last year. By 2030, the number of Kentuckians reaching their 60th birthday will double. Is government prepared to provide the services that will be demanded? Is business prepared to accommodate shifting consumer needs and interests?
Dr Graham Rowles is director of the University of Kentucky component of and principal investigator for the Kentucky Elder Readiness Initiative (KERI), an initiative of the Cabinet for Health and Family Services. Dr. Rowles has directed UK's contribution to a study that has produced a preliminary statewide report, as well as one focused on the Bluegrass. In a discussion with Business Lexington's Tom Martin, Dr. Rowles details findings that carry important implications for both the private and public sectors of the commonwealth. It was an extensive interview and appears here in an edited form to accommodate space. The entire conversation can he heard online as a BizCast at www.bizlex.com. The statewide and Bluegrass studies are available for download at /www.mc.uky.edu/gerontology/keri.htm
TM: What inspired this study?
GR: The last needs assessment for the elder population of Kentucky was conducted in 1985, believe it or not. And given the aging of the baby boom cohort, it was felt by the state and by the university that what we need to do is take a real look at what the implications are going to be of the aging of the baby boomers.
TM: Your investigation looked into many areas of concern — retirement, awareness, finances, employment, transportation, housing, health and safety, life quality, community involvement. Could you highlight the findings?
GR: In our pilot work — in our focus groups — we found a remarkable and alarming lack of awareness of this particular issue. People are not aware of the doubling of the population who will be 60 and over that's going to occur by 2030. There was surprise expressed throughout the focus groups. And so one of the (survey) questions asked was, "How aware are people throughout the state of this issue?" What we found out from the survey was very interesting in that there was a higher level of awareness than in the focus groups. So maybe the KERI projects are having some effects already. Sixty-six percent of the people considered that they were very much aware of this issue. On the other hand, equal numbers — 66 percent — felt that their community was not preparing adequately for the implications of this change. So perhaps there is increasing awareness in our commonwealth but also increasing awareness that we are not doing enough to prepare for the implications.
TM: Why do you suppose there is this disconnect?
GR: I think one of the things that came out of our initial work was a sense of denial. "It won't affect me" is a very common one, or "I'm prepared, it's not a problem for me." Well, the average savings of a baby boomer is about $35,000; that is not going to go very far. One I like is "the government will take care of me." That doesn't actually fill me with a great deal of confidence. And then there were also people who said, "Yes, I am aware I'm not preparing, but I really don't have the resources to put aside for my retirement. I'm trying to keep my head above water right now. I'm trying to raise my two children," and so on and so on. And so they said, "Yes, we would love to plan, but we haven't been able to from a fiscal point of view."
TM: For communities such as Lexington, which is in a transformational phase right now, are there any particular points that you think policy makers ought to pay attention to?
GR: Yes, not just for the Lexington area but for other areas, as well. We asked people what they thought was the most important thing on a list of 15 different alternative directions that the commonwealth should take and that local communities should take, because this project is very much oriented towards providing a stimulus to local communities to come up with their own solutions. We were surprised to find that in 13 out of the 15 regions, including the Bluegrass region, the number one priority that people had was actually providing support to children with disabilities who are being cared for by aging parents. For this population (of aging parents caring for disabled dependents), most estimates are somewhere in the range of 10,000 to 12,000, and that's a low estimate. There's a real concern that when those parents die, there are no resources available to support those children who have been so dependent on them. So that really surprised us, that this was the number one concern that people had.
Now interestingly enough, the second and third priorities in the state were, first of all, the issue of housing. We asked people where they thought they would be living when they were 75, and their response to that, not surprisingly, was that most people, about 80 percent, felt that they were going to be living in the home that they are in right now. They want to grow old in the home place, and that's very common. That's a nationwide phenomenon. But we also asked where people thought they would be living when they were 90. Approaching 25 percent of people felt that they would be living in an assisted living community when they were 90. Now, if you look around the commonwealth and you look at the different areas of the commonwealth, this is not the kind of housing we have in many areas. There's also a secondary problem, and that is that assisted living housing as it is right now is very expensive and is beyond the means of most people. And so between now and when these people move into their 80s and 90s, which isn't too long, we have to think about how we can respond to that express need.
The other thing with regards to where people thought they would be was that a large number of people, more than 20 percent, thought they would be in a nursing facility. What has happened in the last few years is actually the numbers of people in nursing homes has dropped. And it has dropped significantly in the last five years, because essentially, as a culture, we're trying to keep people out of nursing homes now and provide home care and other kinds of options. But many of the people in this survey considered that as their future, so this is sort of a disconnect between what people anticipate and what is actually going to be out there for them. And I think the business community needs to start thinking about how we are going to fulfill those needs.
Now, the third most important finding and the third priority that people had was again of great importance to the business community, and that is the whole issue of employment. A major concern out there in the commonwealth is employment opportunities for elders. When we looked at finances we discovered some rather interesting things. (There's) going to be much less reliance on retirement income coming from employers, much more reliance on 401Ks. The baby boom generation and this population in particular have very low rates of savings, and savings have been a source of income for some older folks. And there's a remarkably high degree of potential reliance on social security, which surprised us — more among the older population, that's people over 62, about 66 percent of those. But approaching 50 percent of baby boomers anticipate that social security is going to be a source of their income. Now, closely linked to that is the belief by many older people that they will or are working in their old age. And so basically, we found that about 75 percent of all the people considered that they are going to be working either full or part time in their retirement. Now it's interesting when you look at the baby boomers. Baby boomers view retirement as a reward for hard-earned income generation of their life. Only 35 percent of baby boomers anticipate working in their retirement. I have news for some of those baby boomers, because essentially if you look at their financial situation and you look at the realities, my guess is a lot of them will have to work. And so the baby boomers as well as others in this survey are pointing out that we really need to be looking at employment opportunities and options for elders.
TM: Okay, lets talk about something called "single point of entry." What is that about?
GR: This is a very important finding. We were pleased to discover that people of the commonwealth think this is important. "Single point of entry" is a notion that as our technological society develops, we shouldn't have to, every time we go to a different physician or practitioner, start that visit with being given a clipboard and please give us your entire life history — when you had your last tetanus shot and so on — which most of us frankly can't remember very well. The whole idea is to have a system that takes advantage of our technology without invading peoples' privacy. But basically, it is a single point of entry for all services and programs within the state. So if there is an older person and you need home care, you don't have an evaluation for home care and then go to a separate evaluation for some other kind of service that you might need, like Meals on Wheels. And the whole idea, which is a priority in the state, is to move toward a seamless system.
The best way to illustrate this is, let's for example assume that you fell at an airport and you couldn't remember as an older person what your medications were, and your daughter, who is with you, couldn't remember. Then basically, in our society, what we need to be doing is moving towards a system whereby access could be gotten as to what medications this person is on. What kind of health condition do they have? What is their health history? So that we can be much more responsive statewide to those needs, and we can also save people an awful lot of time who get really frustrated filling out the same form again and again and again.
TM: I see another priority here that is interesting, and it is the "rediscovery of the sense of community and community support that has been traditional in the past." We've lost that?
GR: Yeah, this was one of the surprises from the focus groups. People said, you know, when it comes down to it in the long run what we are talking about with elders is people helping people. And we really need to discover that sense of community in helping one another which is a part of our heritage — at least in our image. It may not have been a fact. And this was surprising, and so we included the question on this in the 15 questions on future priorities. And we were surprised to find that this came out as among the most important concerns of commonwealth residents — this rediscovery of a different way of interacting with each other, which to me is kind of reaffirming and
TM: Encouraging?
GR: It's encouraging and also consistent in what we believe our Kentucky philosophy is, what it is to be a Kentuckian. And that sense of caring also was reflected in the final one of the six (top issues) that I want to mention, which is the concern out there for the large number of grandparents who are raising their grandchildren. There are 35,000 Kentuckians right now who have sole responsibly for raising their grandchildren. And the estimates are that we are talking about a total of about 70,000 children being raised by grandparents. Now, those grandparents sometimes have needs of their own. They are moving into old age themselves. They may need some support as well. And they're taking a major responsibility in the care for those grandchildren. And there is awareness out there in the commonwealth that we need to be thinking about that issue as well.
TM: These are all very compelling findings that evoke a lot of thought and concern. What do you do with them now? Where do you go next?
GR: That's a very important question. As we decided to design this study, we decided that we didn't want to just go through the same-old-same-old, which is the notion that our elders are people in need and that we need to think about what services to provide them. We went about this whole study with a philosophy that had a more positive view of elders as resources as well as recipients of care. We also felt very strongly that this was an issue that related to all sectors of the population. This relates to everything from our elders to our businessmen through to our schools, our grade schools even — the way in which we are teaching about what an elder is, because basically the baby boom generation is a whole different type of person. One of the things that came out in the survey, for example, was that most people do not want to go to the current senior center. Basically, if they are like me, I want to go to a senior center when I am a little bit older, where I can go and basically start off by having a workout in the gym, and then I want to go and have my lattè in the cafè. And then I want to go to the computer room and do my e-mail and interact with my family on the other side of the world. And you may say that that sounds like science fiction; it's not. There are actually a couple of senior centers in Kentucky where this is already occurring. So we are going to need to transform our senior centers and, in fact, we're going to have to transform our entire culture.
Essentially, the notion is that KERI is not so much a study as a movement that we're trying to develop. And so the next phase in this process is that we, in the last three months, have been to all 15 area development districts, and we've made presentations to invited audiences, large audiences in many cases, well over a hundred people in each of these areas, where we have presented these findings. And that presentation has been the prelude of the formation in each of the area development districts of task forces. And those task forces will be looking into these findings — particularly the ones that apply to local areas like here in the Bluegrass for example, with the notion we don't just put the findings on a shelf, but we move forward with this.
The issue is so huge that this is not one of those things that we can expect to get the legislature to pass billions of dollars to support. That's not the way it's going to work. It's going to work at that level certainly for some things, maybe support for people who are raising children with disabilities. But it's also going to work on the regional level, and it's also going to work on the local level. I'm kind of proud of the fact that I am a resident of Georgetown, Kentucky, right now. Last summer, the city fathers and mothers in Georgetown decided to give $200 to a group of older men who wanted to run a program to teach children about gardening. You may say what's that got to do with KERI and the aging of the baby boomers? I would argue that it has everything to do with it, because those children are the people who'll be looking after some of those baby boomers as they grow older. And unless we can change people's attitude to what growing old is, we're going to have to deal with some problems we'd rather not have.
TM: Do you suppose this particular generation has a more pronounced trait for refusing to give up on its youth and that could be driving this sense that it's invincible, and that it's going to keep on working?
GR: This is a generation that's really in a state of denial. And it's helped by our media, which are reinforcing this. I mean, I can't think of the last time I was able to watch the television program without having an ad telling me how I can be a lot younger. Or how I can put some hair back on my head, or that I could get rid of wrinkles, and so I think denial is a major factor. It's also a very interesting generation. The baby boom generation in many senses is a "me" generation. It's not a giving generation. It's not a saving generation. It's a credit card generation. And I think we are going to have some rough adjustments to make. On the other hand, it's also a relatively healthy generation in comparison with previous ones. And it's also one that's going to have its facilities and its abilities to function better. There is a lot of research that shows that each generation is healthier than the one preceding it at the same age. And so I see the baby boomers not only as having this problem to overcome, but I see them also as having the potential to be part of the solution to the problem as well. I see people working longer. I think the baby boomers are going to have to. But I also see a transformation of our society as we change what it means to be old.
And if the business community is smart, it will realize that this is what is coming down the pike because this is not a small market segment. This is a huge market segment coming. We need the contractors who respond to building the appropriate housing, the retailers who response in terms of providing the services that this generation needs, not previous generations of elders; those are the people who are going to make it. I was speaking to a builder in Western Kentucky during my travels, and he was talking about how he used to build two-story homes and one-story homes, and he said to me that he will never build a two-story home again — never. "My two-story homes are not selling," he said. "My single-story homes are selling like hotcakes, because basically this generation of baby boomers is beginning to realize they are not going to be able to climb all those stairs."
TM: That's a perfect place to close. This has been fascinating. We really appreciate you taking the time.
GR: It's really been a pleasure being here.
Graham D. Rowles is a social geographer. He is a Fellow of the Gerontological Society of America and the Association for Gerontology in Higher Education, serves on the Editorial Board of the Journal of Gerontology: Social Sciences and is President Elect of the Southern Gerontological Society.
Methodology
The focus of the interview with Dr. Rowles was a 251 question statewide survey distributed in 2007 to 9,400 households in the Commonwealth of Kentucky.
The survey received a 33 percent response providing a margin of error of +/— 1.7 percent.