The well-documented national increase in the number and percent of older adults (US Census Bureau, 2010) is reflected in Illinois, having grown from 1.9 million to 2.2 million in the past decade, currently representing 17.7% of the state population. It is estimated that by 2030 the older adult population will increase to 3.6 million and represent 24% of Illinois’ population. The population age 85 and older is currently the fastest growing segment of the older population. The population of older adults is also more diverse both culturally and linguistically as the number of minorities age 60 and older living in Illinois increased by 39% between 2000 and 2010 (US Bureau of the Census, 2010). Approximately 8% of older adults in Illinois live in poverty (US Bureau of the Census, 2009). Without Social Security, an additional 36% of older Illinoisans will fall into poverty (AARP Public Policy Institute, 2012).

While an increasing proportion of the U.S. population resides in urban areas, a substantial proportion of the population continues residing in rural areas. Many of these rural areas are designated physician shortage areas (HRSA, 2003). Approximately 17% of the US population and 20% of Illinoisans live in counties classified as rural or nonmetropolitan (CDC, 2014). The age of the population increases as “rurality” increases (Rural Health Reform Policy Research Center, 2014). Adults over age 65 account for 17% of the total population in rural areas, compared to 13% in urbanized areas. Rural areas are likely to see the greatest surge in this age group (Cromartie et al., 2009).

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Life Plan for the Life Span

Multiple Chronic Conditions (MCC)

Chronic conditions such as diabetes, arthritis and hypertension are common, expensive, and increasing (Mokdad, 2000).The number of people suffering from MCC (two or more chronic conditions) is increasing nation-wide and especially prevalent in adults over the age of 65. Approximately 62% of older adults nationally suffer from multiple chronic conditions (Anderson et al., 2004). This rate increased by 8% from 2000-2010 (CDC, 2012). In Illinois, the rates are considerably higher, with 77.5% of older adults reporting two or more chronic conditions (Amerson et al, 2015). Data from the Illinois Cook County Health System indicates that rate of MCC is rising by 1-2% per year. (Cook County Health and Hospitals System, unpublished data).

In the context of MCC, geriatric syndromes (falls, malnutrition, disability, frailty, and increased dependence), are common and lead to considerable personal suffering (CMS, 2012; Fried et al., 2001; USDHHS, 2010). MCC are associated with more rapid health decline and both decreased quality of life and psychological well-being (Fortin et al., 2006). MCC also negatively affect the health care system due to associations with increased emergency room visits, hospital stays, and post-operative complications, as well as fragmented or disorganized care (Fortin et al., 2007). In all, MCC explain 84% of national health care spending (Yoon et al., 2014; USDHHS, 2010).

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• My Medicine Record: This record will help you keep track of your medicines and dietary supplements: http://www.fda.gov/drugs/resourcesforyou/ucm079489.htm
• UpToDate Patient Handout: Patient education: Taking medicines when you're older (The Basics): http://www.uptodate.com/contents/taking-medicines-when-youre-older-the-basics?source=see_link

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• Elder Health in Rural America
  An overview and analysis of the current status of rural communities and rural elder health, including policy, and practice. Suggests recommendations for future policy based on a systems approach which incorporates sustainability, best practice, quality, efficiency, and effectiveness.
  Author(s): Rebecca M. Hartman, Florence M. Weierbach
  Sponsoring organization: National Rural Health Association
  Date: 02/2013
• Integrated Care for Older Adults in Rural Communities (Policy Brief)
  Assesses four types of organizational models for delivering integrated physical, behavioral health services, and long term services and supports to rural older adults. Each model has different strengths and drawbacks, weighing for and against implementation in rural areas. Reports that introducing an integrated care model in a rural community requires an investment in building relationships with local providers and adapting to local culture and services.
  Author(s): Eileen Griffin, Andrew Coburn
  Sponsoring organization: Maine Rural Health Research Center
  Date: 05/2014

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Family Caregiving

By the year 2030, more than 20 percent of the U.S. population will be 65 years or older (Administration on Aging, 2014.)  As the American population ages, growing numbers of people are serving as caregivers for family members affected by dementia, multiple chronic conditions, and other types of functional impairment.  Dementia alone is present in 1 of 9 individuals older than 65 years and as many as 80 percent of these persons are being cared for in their homes by family members. (Alzheimer’s Association, 2016.)  In this role, caregivers have meaningful and fulfilling experiences while providing care to a family or friend.  At the same time, it’s important to recognize the impact that providing care for a loved one can have on one’s own health and relationships.

A 2007 study by the non-profit EverCare reported that providing care for a loved one can take a significant toll on the health of the caregiver.  The report found that:

• 66% reporting increased anxiety/stress, and over 50% reported difficulty sleeping
• 50% reported having to use vacation or sick days at work to provide care, with 37% having to cut back on work hours or quit work entirely
• 26% reported that they had experienced new or worsening of their own health problems as a result of caregiving.

While it’s easy to see how caregivers can struggle with the responsibility of caring for a loved one, there are a number of resources and opportunities for supporting caregivers (e.g. homemaker services, respite care, support groups, etc.)  There is no formula when it caring for a loved one.  Each family situation is unique and there are many ways to care for a loved one.  Please see below for more information and resources.

Alzheimer's Association Caregiver Center

Caregiver Action Network
Carers Canada
CareCentral
CareGiver: For, About and By Caregivers 
Caregiver's Home Companion
Caregivng Resources from AARP
Care Giving Help
CarePages
CareSearch: Palliative Care Knowledge Network
CaringBridge
Caring.com
Caring From a Distance: Dedicated to the Needs of Long-Distance Caregivers
Family Caregiver Alliance
Family Caregivers Network Society MediCare: Caregiver Resource Kit
Medicare Rights Center: a National, Nonprofit Consumer Service Organization
National Alliance for Caregiving
National Association of Professional Geriatric Care Managers
Strength for Caring: A Place for Caregivers

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