What’s measured The study spotlights the percentage of individuals age 65 or older who require assistance in performing Activities of Daily Living (ADL). Data by county were available for the year 2000 from North Carolina Division of Aging and Adult Services and South Carolina Mature Adult Count. Activities of Daily Living include eating, dressing, bathing, personal hygiene-related tasks, transfers (the ability to get in and out of a bed or chair), ambulation and communication. The percent of individuals aged 65 and older who need ADL assistance is available for each county in the region and for the two states. In the absence of the appropriate weighting factors for the county data, the regional indicator is calculated as an un-weighted average of the county data. Why it’s measured. An individual’s ability to perform Activities of Daily Living is important to individual quality of life and autonomy, but also helps in determining types of long-term care (i.e. home care or nursing home) and coverage of individual needs (i.e. Medicaid, Medicare). While ADL assistance may be provided by family members, these services may also be provided by local, state and private agencies. This indicator can help those agencies gauge the level of demand for such services. Also, as Baby Boomers embark on retirement, the number of people needing ADL assistance will likely increase. Indicator results The regional county average for 2000 of the percent of elderly residents who need ADL assistance was 46.4%. This is consistent with the North Carolina average of 45.7% and the South Carolina average of 45.8%. By county, residents needing ADL assistance ranged from a low in Mecklenburg at 40.9 % to a high in Gaston at 49.6 %. Evaluation Without further data and analysis, no clear pattern can be established to explain the relatively small differences among the counties’ results for this indicator. The region’s most rural counties, such as Anson and Chester, tended to have among the highest rates of elders needing ADL assistance in 2000, and Mecklenburg, the most urban county, had the lowest; however, the pattern is less clear for counties that are both urban and rural. The relatively low degree of variation by county, the potential impact of the aging Baby Boomer population and increasing life expectancies, suggest that services for those ages 65 or older will need to be carefully considered not only on a county level but on regional, state and national levels as well. The lack of trend data also hampers interpretation of this indicator. Is it changing or remaining stable? If it is changing, how fast is it changing? Many factors influence elders’ ability to manage Activities of Daily Living without assistance, including their health status, their age, and the state of medical science. To date, every generation in the U.S.’s recent history has entered retirement in better overall health and with longer life expectancy than the preceding generation. Will the Baby Boomers continue that trend, or diverge from it? Will advances in medical science enable more elders to care for themselves longer or will they extend lives but at the cost of additional ADL assistance needed? Given the size of the Baby Boom generation, the implications for provision of elder care could be significant, underscoring the importance of monitoring trends in this indicator. Connections There are obvious connections to demographics and health, in that the age and health status of individuals and medical science all play a role in determining the extent to which ADL assistance is needed. There are also connections to the economy, in that “Health care and social assistance” is among the region’s fastest growing employment sectors.
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