Care Needs of Older Broome County Residents: A Survey of Elders Receiving Care Through the Continuum

Abstract

The majority of elderly persons in Broome County, 75% to 80%, live in urban cities-Binghamton, Johnson City, Endicott, and Vestal-while the remaining 20% to 25% live in rural Broome County. In October of 1997, the care community in Binghamton, New York and the surrounding county of Broome conducted a survey of persons over the age of 60 in receipt of longterm care. The U.S. Census Bureau reports that there were 38,781 persons over the age of 60 living in Broome County. In 1997 it was estimated that those ages 60 and over comprised 17.3% of the population. Broome County's population concentration of elders ranks 17th among the 63 counties of the state, including New York City. In October of 1997 there were approximately 4,500 persons over the age of 60 in receipt of some type of formal care service. Broome County has significantly fewer minorities (1.2%) than the New York State average (17.5%) and has a larger percentage (58%) of persons who rely on Social Security as their main source of income than the national average (37%). Social Security Administration studies have shown that the poverty rate is higher for those persons who rely heavily on Social Security, especially as they grow older. Mrs. Johnson is an 82-year-old widow who lives alone. She needs assistance with bathing, dressing and household chores due to arthritis and eye/vision problems. Mrs. Johnson resides in the house where she raised her three children. One daughter, Anne, lives locally and assists Mrs. Johnson in maintaining her home. However, Anne holds down a full-time job and is a single parent raising two teenagers. Mrs. Johnson is on Medicaid and receives seven hours per week of personal care services. Mrs. Johnson could benefit from any number of care settings but prefers to stay at home. Mrs. Johnson could be one of thousands of low-income elderly widowed women countrywide who receive care. Fortunately for Mrs. Johnson she resides in New York State. New York State is a service-rich state, which includes a generous Medicaid home care entitlement. New York State also has developed a number of care options, both institutional and noninstitutional. To access care at any level, there is generally an assessment process. Each county home care program, licensed agency, certified home health agency or nursing facility has either developed its own assessment tools or uses state-prescribed tools to ensure that the applicant is eligible for care in that program. The myriad of programs offered in New York State are often referred to as the long-term care system. The word system implies that there are some synergies between the programs, even if they are not affiliated by the same organizational structure. The goal of this implied interdependence is that persons in need of care are cared for at the most appropriate level. In October of 1997 the care community in Broome County, NY set out to examine whether or not the system of care was indeed operating as such. Providers considered whether Mrs. Johnson is typically representative of elderly females in Broome County who receive personal care services. What are the characteristics of others who receive services in the county? In other words, what are the demographic and functional profiles of the persons who receive community care, home care, adult home and nursing home care in the county? Broome County care providers wanted to develop descriptive profiles of care recipients. They accomplished this by undertaking a care community-wide survey. The purpose of the survey was to provide data that described the situation of elders within the medical and non-medical care service system at one point in time, in this case in October, 1997. The survey addressed the following specific questions: * What are the similarities and differences of persons who are served by different care settings? …