Missing a great opportunity
Older but not always wiser in the ways of a graying population
December 18, 1998
Pittsburghs not a bad place to grow old.
Lottery-funded programs provide low-cost transportation, medication and other services. Traditional communities with helpful neighbors and charitable churches have a strong history of helping the elderly. Hospitals, social service agencies and comprehensive senior centers can provide excellent support.
But this region, which has a 40 percent higher proportion of elderly people than the nation as a whole does, is no leader in recognizing the assets of seniors who are still active, or assisting those whose health is deteriorating.
The lack of new initiatives is a missed opportunity to put Pittsburgh on the map as a place to learn about older people and benefit from them, say advocates for the elderly.
These experts see vast potential in the concentration here of hospitals, universities, foundations and agencies connected to aging topics but regret that theyve produced no visionary strategy targeting the older population.
The region is "doing the standard stuff, and doing it pretty well, but we havent somehow really figured out all the things that should be done," said Dr. Beaufort B. Longest Jr., executive director of the University of Pittsburghs Health Policy Institute.
"If we were going to be a national model of how to take care of elderly people, we would have a more centralized effort, a way of pulling everything together," he said. "Theres a disjointed system of paying for everything, of providing everything."
Many aging-related professionals interviewed for this series see pockets of success: collaborations sparked by the United Way of Allegheny County and Southwestern Pennsylvania Partnership on Aging to create new programs for the elderly; adoption this year of some innovative concepts that found success in other states; progressive Alzheimers care facilities that have been emulated elsewhere.
But the conclusion of many is that the region has a long way to go if it wants to be ideal rather than average, and if it wants to be at the forefront of the trend to treat the elderly as a resource instead of just a drain on society.
While the percentage of elderly will actually drop in the Pittsburgh area over the next decade, theyre around 18 percent of the population now. It will take the rest of the country a quarter-century to reach that kind of age mix.
"We here in Allegheny County are truly the vanguard of aging. We are experiencing demographics that the rest of the country wont see for decades. We have a responsibility to the rest of America to figure this stuff out," stressed Dr. Fred Rubin, a UPMC Shadyside geriatrician.
The four basics
The lottery fund, senior citizen centers, Medicare and Medicaid have defined the care of older Pennsylvanians in recent decades.
The lottery, initiated in 1972 as the only one in the land dedicating its entire profits to the elderly, delivered nearly $417 million to aging services in 1997-98. That represented the bulk of the Pennsylvania Aging Departments budget.
More than half of that money subsidizes pharmaceutical purchases for low-to-moderate-income elderly people. Most remaining funds are funneled through 52 Area Agencies on Aging around the state to contract for services such as transportation, meals and in-home assistance.
Senior centers began flourishing in the 1970s, using funds primarily from the national Older Americans Act to establish central points of contact for socialization, meals, education and information.
Medicare is the federal governments health insurance plan for senior citizens, primarily to cover hospitalization. Most individuals are expected to purchase supplemental policies to pay for routine doctors visits and various other medical needs. The system has the same kind of long-term financing problems as Social Security, only more pressing, because the Medicare trust fund is projected to empty its reserves by 2008 unless its bolstered.
Medicaid, also known as Medical Assistance, is provided jointly by the federal and state governments to finance the cost of nursing home care, as well as health care for poor people
Aging experts say that the combination of these programs plus personal income derived from Social Security and other sources enables a large majority of older adults to manage their various medical and financial needs. They have greater health, wealth and potential to enjoy leisure time than any preceding generation in history.