Experts, senior citizens and caregivers at the 2015 White House Conference on Aging this week discussed programs and practices that enable millions of Americans to live productive lives long after they retire, as well as the obstacles they face.
President Obama speaks about the progress of major social programs that assist the elderly, such as Medicare and Social Security, during the 2015 White House Conference on Aging.
AAFP President Robert Wergin, M.D., of Milford, Neb., attended the conference and later told AAFP News how some of those issues affect his older patients and their families.
Officials at the event, which is held every decade, reminded visitors that Medicare and Medicaid -- both approaching their 50th anniversaries at the end of this month -- as well as Social Security, underlie the ability of seniors to obtain health care and live well into their 80s.
"These three programs are truly symbolic about where we are as a country," said Valerie Jarrett, senior advisor and assistant for intergovernmental affairs and public engagement to President Obama. "We are our brother's keeper. We are our sister's keeper."
Obama opened the conference by noting that during the past century, the United States has achieved substantial progress in caring for senior citizens, largely by enacting legislation that provided baseline living standards.
"When Social Security was signed into law, far too many seniors were living in poverty," Obama said. "When Medicare was created, only a little more than half of all seniors had some form of insurance. Before Medicaid came along, families often had no help paying for nursing home costs.
- Senior citizens, caregivers and health experts, including AAFP President Robert Wergin, M.D., met at the White House to share knowledge about helping Americans live well long after retirement.
- President Obama cited Medicare, Medicaid and Social Security as bedrocks that have enabled seniors to continue living healthy lives.
- Family physicians are key to coordinating health care and other issues that senior citizens have to navigate, Wergin said.
"Today, the number of seniors in poverty has fallen dramatically. Every American over 65 has access to affordable health care."
A Look at Aging in America
Every month, 250,000 people in this country turn 65 years of age, and the average life expectancy is now 79 years.
Those demographics affect Department of Veterans Affairs (VA) hospitals, too, said VA Secretary Robert McDonald. In 1975, there were 2 million military veterans age 65 or older. In 2017, there will be 10 million in the same category, and the number of veterans with chronic illness will be twice as high as it is today.
"Medicare and Social Security are not in crisis," Obama said. "Both programs are facing challenges because of the demographic trends" he and others discussed during the conference.
After the president spoke, a series of discussions addressed topics such as assisting seniors with financial decisions, healthy living habits and staying active.
As an example of how one's greatest achievements can occur later in life, Diana Nyad shared with the audience how invigorated she felt after swimming from Cuba to Florida as a 64-year-old in 2013. Now she's preparing to walk from California to Washington, D.C., next year.
"I feel as if I am in the prime of my life," she said. "You are never too old to chase your dreams."
Panelists emphasized the need to maintain an exercise regimen such as walking -- albeit not necessarily at Nyad's level -- as a way to reduce obesity rates, diabetes and other diseases affected by inactivity.
U.S. Surgeon General Vivek Murthy, M.D., M.B.A., discusses the importance of nutrition and exercise to maintain seniors' health.
Surgeon General Vivek Murthy, M.D., M.B.A., called regular exercise, along with proper nutrition and mental health, the three pillars of health for seniors and the entire population. He said 75 percent of seniors report being in good health, but he added that figure could slip. Only 50 percent of adults and 25 percent of adolescents are getting the right amount of exercise. To encourage seniors to exercise, the Surgeon General's office is promoting an intergenerational initiative that will pair seniors with young people to gather for outdoors walks.
A Family Physician's Perspective
"For family physicians, many issues related to aging are issues we face every day," Wergin said after the conference. "The challenge we have is identifying what resources we can employ in our practice to keep people at home and make sure they live happy, productive lives."
Wergin recalled one of his patients, an elderly widow, who told him she had trouble turning off her oven because of failing eyesight. After discussions with her relatives, a family member added a bright yellow line to the appliance she could use to be sure the oven was off.
"The bigger issue is: This is the first step to determining whether she can live independently," he said. "What else does she have trouble seeing? Is it safe for her to cook meals?"
Family physicians are often called on to handle conversations about the effects of aging with patients and their relatives.
For example, the average senior citizen is taking four or five medications at a time, which requires careful attention -- and often assistance -- to manage all of them.
"During every visit, our nurse handles medication reconciliation, and then I get into a deeper discussion where I ask them if they are having any problems with their medications," Wergin said.
Harry Leider, M.D., M.B.A., chief medical officer for Walgreens, said that as a primary care physician, he would see his senior patients about every six months, but those patients might visit a pharmacy 20 times year. Communication between physicians and the pharmacy is now paramount, he said.
Caregiver Numbers Growing
Given the rapidly aging population, a new segment of the population has emerged: paid and volunteer caregivers. There are an estimated 50 million caregivers who are either professionals or providing unpaid care to a family member. By 2050, this number is expected to double. As important as this role is in the health care sector, the average caregiver is only paid $13,000 annually.
One conference participant, Britnee Fergins, talked about having to balance the demands of caring for her father and a young son as a single mother with a full-time job.
Fergins said she calls a lot of services, only to be referred to another hotline or wait an extended period on the phone. She said paid time off from work to assist her father would make it significantly easier to care for him with tasks such as picking up his medications and taking him to appointments.
That issue of transportation, which was not discussed in detail at the conference, is especially important for seniors who live in rural areas. Wergin said he has to address the problem with many of his patients. Someone who needs to go for radiation treatment and cannot drive, for example, might rely on a local minister or a fellow church member for a ride.
Another problem for many seniors is appropriate access to food. Nine million seniors are categorized as being food-insecure. But only 42 percent of seniors who are eligible for the Supplemental Nutrition Assistance Program receive its benefits, according to Secretary of Agriculture Tom Vilsack, who spoke during one session of the conference.
The availability of food is limited in rural areas because of a lack of large grocery stores and delivery services, Wergin said, leaving many seniors without necessary nutrition options. In his community, he added, volunteers collect food that stores and restaurants would have discarded. Every Friday from 4 to 7 p.m., low-income residents and seniors can visit the local fire station to receive a basket of food and often a turkey or fruit.
"In our practices, you need to understand what community resources you have and create your own if needed," Wergin said.
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