Iycee Charles de Gaulle Summary Housing and Living Arrangements of Community-Based Elderly in Tennessee Essay

Housing and Living Arrangements of Community-Based Elderly in Tennessee Essay

Housing and Living Arrangements of Community-Based Elderly in Tennessee

Introduction

            All living things may it be animals, trees and human it will grow, develop and mature and finally die. But before the living things especially human being come to and end they undergo changes from strong and youthful body to a mature and become elderly weak. Being old and weak they cannot provide to prepare foods for their own consumption and even taking a bath. As an old they need to have someone to take care and most specially they need their own privacy which they can freely move without giving hassle to their own children who do not have time to take care of them.

            As children we have to look up the olds as an important person in our life because the elderly persons can be rich source of positive values. With the elderly usually left behind while children go to work and some live in other country, they continue to keep the bonds that tie families together. The elderly bring unity and peace. Whenever there is misunderstanding in a family, they can resolve issues because of their presence. They have given many contributions in the society. They encourage us to continue telling long-time storytelling that incorporates values to our children. Without them helping us preparing our own family, culture and values will not be learned by the younger generation.

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            Robert Schafer as a Senior Research Fellow and Director of Housing Studies at the Joint Center for Housing Studies at Harvard University, believed “America’s elderly population is expected to grow from about thirteen percent of the population today to approximately 20 percent of the population in 2030, an increase of about 25 million persons. The growth is spurred by the aging of the 1942-64 baby boomers and the increased longevity of the elderly due to improved medical care and services. Housing market implications of this phenomenal growth depend on our understanding of the factors that bear on the living arrangements that elderly households select.”

            The next paragraph will explore the life of elderly in Tennessee with regards to their housing condition, living arrangement in community how the community deal with the elders especially with regards to race, gender, economic and marital status.

The community of Tennessee offers different housing programs to suit the needs of every resident. The house varies depending on the income of each citizen.

Five types of Living Arrangements

Assisted Community

            Three percent of the elderly households reside in assisted communities. Assisted living is more likely than board and care to emphasize apartment settings shared by choice of the residents. Yet other states describe “assisted living as a specific model that has a consumer centered philosophy, apartment settings, residential environment, and a broad array of services which support aging in place.” (Barton, 1997)  However, this type of community “allows shared rooms, toilet facilities, and bathing facilities are the rule among states with board-and care regulations. Board-and-care rules generally allow bedrooms shared by 2-4 residents and bathrooms shared by 6-10 residents. The privacy here is not strictly observed because of the sharing in all facilities.”(Ruth Gulyas, 1996).

            Within the assisted communities, approximately one-third of them provide on-site nursing assistance, one quarter provide off-site nursing assistance and the remainder provide other services without any arrangements for nursing assistance. (Schafer, 1999). He further shows that assisted communities are strongly favored by renters and households with “other” tenure situations.

Unassisted 60 plus Communities

            Another 6.6 percent of these elderly households live in age-restricted elderly communities which do not provide assisted living. This type of community has their own free will if they wanted assistant or not. They only call if it is really needed.

            Assets and Health Dynamics Among the Oldest-Old (AHEAD), two other types of living arrangements are discernible from the AHEAD responses. They will be referred to as the “shared living” and the “supported housing arrangements.” (Herzog, 1997)

            Generally, this type of community is favored by healthy persons. They are found more commonly in metropolitan areas, and in the South Atlantic, Mountain and Pacific census divisions. They are also favored by white non-Hispanic households.

Shared Housing

            Ten percent live in shared housing situations which were established for the specific purpose of the non-elderly member(s) of the household assisting the elderly member(s). A shared

living arrangement is defined to exist in either of two situations (Jaffe, 1989) :

a) When a non-elderly person who is at least 18 years old moves in with an elderly person    for the purpose of assisting the elderly person or

b) When an elderly person moves in with a non-elderly person who is at least 18 years old for the purpose of receiving assistance from the non-elderly person.

Schafer admits that Shared housing is favored by households who have difficulties with instrumental activities of daily living or with activities of daily living and by households without any nonresident children.

Supported Housing

            Five percent reside in supported housing which involves the provision of support services by non-family members from outside of the home. A supportive housing environment is defined to occur when the elderly person is receiving supportive help in their home from an organization or from an individual who is not a family member. Supportive housing is less popular with about five percent of all elderly households residing in these situations.

            This is favored by households having difficulties with daily activities living or with instrumental activities of daily living. Households with greater cognition tend to favor supported housing. Divorced/separated and widowed households also favor supported housing while the likelihood of selecting this alternative decreases as the number of non-resident children increases. Households without an elderly driver also turn to this alternative as a solution

to their lack of mobility.

Conventional Housing.

Approximately three-quarters or 25% of the elderly households reside in conventional housing. Many prepare on this type of arrangement only asking support from the members of the family and they also avail the privilege of the helper to assist them which is paid by their children.

These mostly is preferred by households that are younger, married with spouse present and have children living nearby or resident children. It also tends to be owner-occupied and is more prevalent in non-metropolitan areas. ( Douglas, 1994)

            Aside from housing the Community offers also long term care for elderly. Tim Wheat writes that the elderly must be care not isolated for he believed that living in a nursing home may isolate the elders from community activities. He added that every state that receives Medical funding is required to offer nursing home care. Home- and community-based programs that would provide the same care are optional. This resulted in bias for the programs instead of supporting individuals it become a Medicaid money funding institutions. He reveals that in Tennessee there are 94% of long-term care funding is doled out to institutions. Administrators and their governing boards are the financial care-takers of the nursing home “beds.” They determine what services are necessary, and how services are to be delivered to their charges.

Race

            The community of Tennessee has practice for Fair Housing and Equal Opportunity (FHEO). The office of FHEO administers and enforces the federal laws and establishes policies to ensure that all citizens are given equal choice in selecting their houses. They also help colored people to access without housing discrimination.

            Schafer admit that “Non-Hispanic blacks and Hispanics are much less likely to select unassisted 60 plus communities than are non-Hispanic whites with relative probabilities of 26 and 34 percent of the chances of non-Hispanic whites, respectively.”

Gender

            The selection of living arrangement is not affected by the sex of the oldest elderly

household member with the different consideration pointed out by Schafer.

Economic

            According to U.S. department of Housing and Urban Development, Section 3, Act of 1968 that “promotes local economic development neighborhood economic improvement, and individual self-sufficiency.”  This section gives financial assistance to very-low income citizens and even they offer training for them to land in good job.

            Another writer John Pitkin (1990) described the “Financial constraints limit the choices of elderly households. The various housing types have widely different cost profiles; assisted communities in the AHEAD sample had an average out of pocket cost of $1,461 per month compared to an average out of pocket cost of $351 per month for conventional housing.” The choices of housing would be based on the income stipulated by Schafer.

            An elderly with age 60 plus that attain more than college degree less selected as unassisted housing. “Income is also determine in the selection with an annual income reaching to $77,800 are favored for the selection however as it increase the selection percentage also decrease.” (Easterlin, Schaeffer and  Macunovich  1993)

Marital Status

            The Community Development Department gives financial assistance to families who don’t have shelter.  But marital status is also expected to affect the selection of living arrangement. Definitely, widowed persons and married persons who reported their spouse to be absent are more likely to select assisted communities (6.7 and 3.0 times, respectively, as likely as the married spouse present elderly households), a statistically significant result. (Costa,

                Schafer presented that they prepared to select in a shared housing the divorced/separated, widowed and never been married elderly than the married spouse presently elderly households. However, with the absent of spouse living with someone else household are likely to be selected as shared housing. Furthermore, Schafer added married spouse absent living with the divorce/separated and widowed household relative to married spouse are also selected. They will be favored to get 3 to 10 times selected as supported housing that married with spouse.

Conclusion

            Below is the summarization of the percentage availed and favored by different communities in different living arrangement.

Multinomial Logic Model of the Choice of Living Arrangements

Estimated from the AHEAD Data Collected in 1993 reveal by Fitzgerald, David, Douglas, Freedman, and Wolinsky (1993).

Variable

Assisted

Community

Unassisted

Living in a 60

Plus Community

Shared Housing

Supported

Housing

Race of Oldest

(relative to White non-

Hispanic)

Black Non-Hispanic

-0.4138

-1.3480a

0.4494a

0.2104

Other Non-Hispanic

-0.9027

-0.7239

0.7043

-0.0135

Hispanic

-0.3906

-0.3906

0.0276

0.2913

Sex of Oldest

(relative to Male)

Female

0.3538

0.2647

0.2647

0.0025

Marital Status

(relative to Married

Spouse Present)

Married Spouse Absent

2.0166a

0.5466

2.0304a

2.4717a

Living with Someone

-30.4294

0.4463

2.1008a

1.4618c

Divorced/Separated

-0.2154

-0.2937

2.9609a

1.3099a

Widowed

1.1894a

-0.1283

2.3952a

1.5107a

Never Married

0.8892

0.0502

3.2017a

0.4303

Economic Status

Income

1.2e-5

5.58e-8

5.58e-8

-5.17e-6

a = one percent confidence level

b = five percent confidence level

c = ten percent confidence level

            To facilitate use of this housing and services model for people who can no longer live in their own home or apartment, states need to address both their payment rates and the training of case managers and other staff who serve older people through home and community-based service programs. State policy makers may need to work with housing finance agencies and providers to understand the room-and-board costs that cannot be covered under Medicaid as well as the service costs that can be covered. To be able to move into assisted living residences, frail older people with low incomes will need to retain sufficient income to pay for the room and board costs.

References

Barton, Linda J., (1997) “ A Shoulder To Lean On: Assisted Living in the U. S.,” American

Demographics , pp. 45-51. Access January 4, 2007

Costa, Dora L., (1997).  “A House of Her Own: Old Age Assistance and Living Arrangements of Older Non-married Women,” NBER Working Paper No. 6217. January 4, 2007

Easterlin, Richard A., Christine M. Schaeffer and Diane J. Macunovich ( 1993) “Will the Baby Boomers Be Less Well Off Than Their Parents? Income, Wealth and Family Circumstances Over the Life Cycle in the United States,” Population and Development Review , vol. 19(3), pp. 497-521.

Fitzgerald, J., David, S, Douglas, M., Freedman, and Wolinsky, F. (1993).  “Replication of the Multidimensionality of Activities of Daily Living,” Journal of Gerontology: Social Sciences , Vol. 48(1), pp. S28-S31.

Gulyas, Ruth (1996). “An Overview of the Assisted Living Industry: 1996.” The Assisted Living Federation of America and Coopers and Lybrand. Washington, DC. 1996.

Herzog, A. Regula, and Robert B. Wallace, “Measures of Cognitive Functioning in the AHEAD

Study,” Journal of Gerontology: Psychology and Social Sciences, 1997, vol. 52B (Special

Issue), pp. 37-48.

Jaffe, Dale J.,(1989). Shared Housing for the Elderly . New York: Greenwood Press, January 4, 2007.

“Multi-Family Housing Programs” ( 2006). USDA. January 4, 2007, from http://www.rurdev.usda.gov/tn/multifamilyhousing.htm

Pitkin, John R.,  (1990 )“Housing Consumption of the Elderly: A Cohort Economic Model” in Dowell Myers, ed. Housing Demography: Linking Demographic Structures and Housing

Markets. Madison: University of Wisconsin Press, Pp. 174-199.

Schafer, Robert, “Housing America’s Elderly Population,” Working Paper No. 99-4 , Harvard

University Joint Center for Housing Studies (1999b).

Wheat, Tom. ( n/d). Tennessee needs Flexibility in Long-term Care. ADAPT . January 4, 2007,from http://www.mcil.org/mcil/adapt/squeaky3.htm#op-ed

Wolf, Douglas A., “The Elderly and their Kin: Patterns of Availability and Access,” in Linda G.

Martin and Samuel H. Preston, eds. Demography of Aging. Washington, D. C.: National

Academy Press, 1994, Pp. 146-194.