Older adults' perspectives on driving cessation

Relinquishing the privilege to drive is a difficult issue for older adults. To better understand factors that influence driving decisions and to identify approaches that could help ease the transition to a non-driving status, we conducted focus groups with elders who had recently stopped driving. Results demonstrate that the decision to stop driving is reluctantly made by elders on their own or after prompting from others. While all have other means of transportation, a sense of loss of independence remains. Participants urged policy makers to address older driver issues and were proponents of developing procedures to identify at-risk drivers. They also stressed the importance of making plans for retirement from driving. Findings suggest that while there is “life after driving,” efforts are needed to help older drivers, and their families develop a plan for driving cessation that includes identifying the appropriate time to stop and acceptable transportation alternatives to driving.     

Preventing economic hardship among Chinese elderly in Hong Kong

Over the next 20 years, Hong Kong will face a rapidly aging population as the number of older adults aged 65 or above increases to approximately 1.4 million by 2021, that is, 17% of the total population. In 2001, there were 1.2 million adults aged 45-59. To assess the differences between these middle-aged adults and the current cohort of older adults, we identified the challenges that Hong Kong society will face in meeting the financial needs of older adults in the coming two decades. In this paper, we examine the retirement economic status of three groups of older adults: those who are financially independent, those who are financially supported by their adult children or children-in-law, and those who are receiving welfare assistance. We describe the current situations of these groups, prevailing social policy, future trends, and recommend policies for tackling problem areas.     

Preventing Economic Hardship Among Chinese Elderly in Hong Kong

Abstract

Over the next 20 years, Hong Kong will face a rapidly aging population as the number of older adults aged 65 or above increases to approximately 1.4 million by 2021, that is, 17% of the total population. In 2001, there were 1.2 million adults aged 45-59. To assess the differences between these middle-aged adults and the current cohort of older adults, we identified the challenges that Hong Kong society will face in meeting the financial needs of older adults in the coming two decades. In this paper, we examine the retirement economic status of three groups of older adults: those who are financially independent, those who are financially supported by their adult children or children-in-law, and those who are receiving welfare assistance. We describe the current situations of these groups, prevailing social policy, future trends, and recommend policies for tackling problem areas.     

The potential role of physical activity on driving performance and safety among older adults

The elderly represent the fastest growing driving population. Older drivers have a high crash rate per distance traveled, a high risk of injury or death in traffic accidents, and are commonly found to be ‘at fault’ in crashes. This reality has focused more interest on issues associated with the fitness to drive and the safety of older drivers. Many older adults depend greatly on their personal vehicle for transportation and suffer a marked loss of quality of life when, as a consequence of no longer being able or permitted to drive, their mobility becomes significantly restricted. The reasons for the deterioration of driving performance that occur during the aging process are multi-factorial and a great deal of research has focused on the identification of those factors. Nevertheless, some studies incorporating training programs have tried, with some success, to improve the driving-related abilities of older drivers. It has been demonstrated that physical activity can promote several skills that are associated with driving performance in older drivers. Few studies, though, have conducted exercise interventions among older drivers intended to enhance their driving-related abilities and promote road safety. In this context, the purpose of this work consists of examining the perceptual, cognitive, health, and physical factors related to fitness to drive in older adults and identifying possible strategies that can enhance their driving-related abilities. Moreover, potential mechanisms underlying the relationship among physical activity, driving ability, and road safety are discussed.     

Changes in Self-Rated Health During the Transition to Retiring Living Among Medicare Managed-Care Recipients

ABSTRACT

Moving into a retirement community may be precipitated by or bring about changes in health status. We hypothesized that moving into a retirement community would be associated with a decline in self-rated health (SRH), but that health-related factors would mitigate this association. We analyzed data from 58,272 participants in Cohort 3 of the Medicare Health Outcome Survey. Individuals answered questions regarding living status in 2000 and 2002. Those who moved into a retirement community were compared with those who did not. The primary outcome was change in SRH. We created adjusted and unadjusted models. A total of 2,520 participants (4.4%) moved into retirement communities between 2000 and 2002. There were no substantial differences in the mean change in SRH between those who moved and those who did not. In adjusted and unadjusted models, moving was not significantly associated with changes in SRH. In an analysis stratified by SRH, only those with the best SRH had a significant decline in SRH during the move. SRH mainly remained stable for most people regardless of moving into a retirement community. These findings argue against environmental context being a main determinant of self-perceived health status among older adults.     

A Qualitative Exploration of Self-Regulation Behaviors Among Older Drivers

While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.     

Foreign retirement income among new older immigrants in the United States

Older adults make up an increasing share of new legal immigrants to the United States. These immigrants are often financially dependent on family since they are often barred from receiving several US support programmes and are less likely to receive US retirement benefits than natives. However, little information exists as to whether they receive retirement income from abroad. Using the New Immigrant Survey (N=2,150), we find that only 8.1 per cent of older recent immigrants report receiving foreign retirement income. In logistic modelling, older immigrants from Asia and Latin America were less likely to receive retirement income from abroad than those from Europe (Odds ratio = 0.50, p<0.05; Odds ratio = 0.22, p<0.001, respectively). Results suggest that newly admitted older immigrants from Asia and Latin America face an additional economic disadvantage compared with older Europeans that cannot be attributed to their demographic and migration characteristics.     

Resource Accessibility and Walkability Among Older Adults in Extended-Stay Hotels

Older adults represent a large and growing population group in the United States. This population cohort is projected to grow to 72.1 million, or 19% of the total population, by 2030, up from 40 million in 2010 (Administration on Aging, 2011; Federal Interagency Forum on Aging-Related Statistics, 2012). Despite reported decreases in the proportion of older adults living in poverty in recent years, inequities prevail. Approximately 40% of older American households reported housing cost burdens¹Cost burdens are expenditures on housing and utilities that exceed 30% of household income. (Federal Interagency Forum on Aging-Related Statistics, 2012). Many of these low-income older adults live in socially and economically marginalized positions, and housing them remains a major challenge complicated by (a) limited affordable housing options and (b) chronic health conditions that seriously undermine long-term health and mobility. In a study on the impacts of public housing transformation in Atlanta, Oakley, Reid, & Ruel (2011) reported that 26% of seniors entered public housing because of a health condition or disability. According to Smith (2006), seniors in public housing are in worse health than other older Americans, even other poor older Americans suffering from such chronic health conditions as hypertension, diabetes, arthritis, and asthma. Despite these realities, Ball (2012) has noted that older adults receive little attention in comprehensive development planning beyond specialized age-segregated retirement and care communities. Salkin (2009) echoes similar concerns about the tendency toward housing initiatives and designs for more affluent older adults. She commented that most states have focused attention on programs that are best suited for seniors who do not have the same income limitations as those who are truly on fixed incomes and living close to the poverty level (Salkin, 2009). While public housing remains the predominant affordable housing option for low-income older adults, such housing is out of reach for many low-income older adults who find themselves displaced and homeless. As a result, some of these adults move into extended-stay hotels to remain sheltered.     

Economic Trends,Politics, and Employment Policy for Older Workers

The rising interest among policymakers in developing employment policies for older persons can be traced to several sources. Two of these-concerns about the financing of retirement benefits and fears about possible future labor shortages-are shaping employment policies in ways that have undesirable consequences for older workers who are in poor health and who lack the economic resources to be able to afford retirement. In contrast, employment policies that operate by providing work incentives, rather than retirement disincentives, do not have discriminatory impacts on these subgroups of the older population.     

Expenditure patterns of older Americans, 2001-2009

PRE- AND POSTRETIREMENT EXPENSES: Before retirement, people pay FICA taxes, incur work-related expenses, and set aside money for retirement. But after retirement, most people have different financial obligations, and, as a result, retirees may still be able to maintain their level of preretirement well-being with very different income levels. Studying income, expenditures, and wealth-holding patterns together provides a more complete idea of how people are doing in terms of being able to afford retirement than arbitrary estimates such as income replacement ratios. UNIQUE DATA: This Issue Brief examines the expenditure patterns of the older section of the population. It uses data from the Consumption and Activities Mail Survey (CAMS), a supplement to the Health and Retirement Study (HRS), conducted by the Institute for Social Research at the University of Michigan, contains detailed expenditure data on 32 categories, and follows the same group of individuals over eight years In addition, the income and wealth data available in the HRS are used to establish the financial standing of older households. DECLINING EXPENSES: Household expenses steadily decline with age. With the age 65 expenditure as a benchmark, household expenditure falls by 19 percent by age 75, 34 percent by age 85, and 52 percent by age 95. HOME EXPENSES: Home and home-related expenses remain the single largest spending category for older Americans. On average, those over age 50 spend around 40-45 percent of their budget on home and home-related items. RISING HEALTH CARE EXPENSES: Health-related expenses are the second-largest component in the budget of older Americans. It is the only component which steadily increases with age. Health care expenses capture around 10 percent of the budget for those between 50-64, but increase to about 20 percent for those age 85 and over. DEMOGRAPHIC GROUPS: Singles, blacks, and high school dropouts do not have a sound financial standing in retirement. Their expenditures exceed their income and they hold very little financial wealth. The bottom income quartile, which includes mostly these demographic groups, has the weakest financial standing in retirement. LONG-TERM CARE and PRIVATE HEALTH INSURANCE: Long-term care and some form of private health insurance coverage have a significant effect on increased spending by older households.     

The Evolution of Housing Typologies for Older Adults in The Netherlands From 1945 to 2016: An Analysis in the Context of Policy,Societal, and Technological Developments

This study aims to examine housing typologies for older adults in the light of three qualitatively examined exogenous factors: policy, societal developments, and technology. The developments in inpatient and assisted ambulatory housing facilities for older adults have been mapped from 1945 to 2016 using quantitative data. Using these data, five transition periods can be distinguished. Within the first transition periods, policy factors were tremendously important, while within the later ones, societal influence empowered by technological change became the primarily driving factor. This research shows that the classification of inpatient, assisted ambulatory housing, and outpatient housing may no longer be applicable in its current form.     

Cross-border retirement migration plan in Hong Kong middle-aged adults

The purpose of this study was to determine factors affecting cross-border retirement migration plans in Hong Kong using a life-course model as the framework. Data were based on a representative random sample of 1867 adults aged between 45 and 59, who were interviewed in person in 2001. About 6.7% of these respondents planned to migrate to Mainland China after retirement or when they become older. Those who planned to migrate to Mainland China (n=126) were more likely to be male, to be employed in white-collar occupations, to have attained higher levels of education, and to possess non-self-occupied properties, but less likely to live with adult children than those who did not plan to migrate at all (n=1699). The Government must examine and anticipate the socio-economic impact of this future retirement migration on Hong Kong and formulate measures to effectively reduce its negative consequences.     

The retirement system in transition: the 2007 Retirement Confidence Survey

WORKERS SLOW TO SEE OR ADAPT TO A CHANGING U.S. RETIREMENT SYSTEM: The 17th annual wave of the Retirement Confidence Survey (RCS) suggests that American workers may be slow to recognize how the U.S. retirement system is changing, and those who are aware of these changes may not be adapting to them in ways that are likely to secure them a comfortable retirement. HALF OF WORKERS LESS CONFIDENT ABOUT PENSION BENEFITS: The RCS finds pension-plan changes by employers have left nearly half of workers less confident about the benefits they will receive from a traditional pension plan, but that those experiencing a decline in retirement benefits often fail to react constructively. Moreover, although Americans will rely increasingly on 401(k) retirement savings plans and other personal savings and investments to fund their retirement security, data suggest that many may not follow professional investment advice when it is offered to them. MANY WORKERS COUNTING ON BENEFITS THAT WON'T BE THERE: Many workers are counting on employer-provided benefits in retirement that are increasingly unavailable. Only 41 percent of workers indicate they or their spouse currently have a defined benefit pension plan, yet 62 percent say they are expecting to receive income from such a plan in retirement. Likewise, workers are as likely to expect as retirees are to receive retiree health insurance through an employer, even though the number of employers offering this benefit to future retirees is declining. MANY WORKERS UNLIKELY TO HEED INVESTMENT ADVICE EVEN IF THEY GET IT: More than half of workers indicate they would be likely to take advantage of professional investment advice offered by companies that manage employer-sponsored retirement plans. However, two-thirds of these workers say they would probably implement only some of the recommendations they receive and 1 in 10 think they would implement none of them. AMERICANS OVERESTIMATE LONG-TERM CARE COVERAGE: One-quarter of workers and more than one-third of retirees report they have long-term care insurance (separate from health insurance, Medicare, and Medicaid) to help pay for care they might need in a nursing home, assisted living facility, or at home. But only 10 percent of Americans age 65 and older are estimated to have had private long-term care insurance in 2002, suggesting that many are counting on coverage they do not actually have. MOST SAVINGS LEVELS ARE MODEST: Almost half of workers saving for retirement report total savings and investments (not including the value of their primary residence or any defined benefit plans) of less than $25,000. The majority of workers who have not put money aside for retirement have little in savings at all: Seven in 10 of these workers say their assets total less than $10,000. CONTINUED IGNORANCE ABOUT SOCIAL SECURITY COVERAGE: Despite the longstanding increase in the eligibility age for Social Security, only a small minority of workers are aware of the age at which they can receive full retirement benefits from Social Security without a reduction for early retirement.     

Mandatory Testing of Drivers on the Basis of Age and Degenerative Diseases: Stakeholder Opinions

Concerns about the driving competence of older drivers have led to policy discussions about mandatory aged-based and disorder-based assessments. This study explored the attitudes, beliefs, and preferences of older adults, law enforcement officers, and licensing authorities toward reexamination of driving skills for persons with Alzheimer's disease (AD) and Parkinson's disease (PD) and at varying ages. With few exceptions, participants across all groups supported retesting drivers with AD. Moderate support was given for further evaluation of 90-year-olds and those with PD. Least endorsement was given for reassessment of 70-year-old drivers. Findings have implications for legislative changes to address drivers with AD and PD and at older ages.     

The Influence of Self-Selection on Older Adults' Active Living in a Naturally Occurring Retirement Community

A cross-sectional, single-case study of older adults (N = 197) in a Midwestern rural naturally occurring retirement community compared the active living behavior and salience of socio-physical characteristics for three subsets of older residents: (1) in-migrants who moved based on recreational opportunities; (2) in-migrants who moved for other reasons; and (3) long-time residents. Some older adults with preferences for outdoor recreation self-selected into the naturally occurring retirement community due to opportunities for water-based activities. Self-selectors engaged in light recreation activities more frequently and for longer durations, received more frequent spousal encouragement to be active, and identified more types of activity companions than in-migrants who had moved for other reasons.     

Lessons on social and health disparities from older lesbians with alcoholism and the role of interventions to promote culturally competent services

ABSTRACT

Older adults who are lesbian, gay, bisexual, or transgender (LGBT) face greater health risks and possibly more costly care because of their reluctance to seek out health and long-term care services because of limited cultural sensitivity of service providers. This is particularly evident in older lesbians who face substantial risk of health problems associated with alcoholism and are less likely to be open with health care providers because of stigma combined with feelings of alienation, stress, and depression. An estimated 4.4 million older adults are predicted to have problems with alcohol by 2020, and the rates of alcohol-related hospitalizations are similar to those for heart attacks, creating exorbitant medical costs. More culturally competent health and long-term care may reduce health care costs by effectively addressing the dynamics of alcoholism, aging, and lesbian culture. Training initiatives such as those developed by the National Resource Center on LGBT Aging have begun to address the need of a more culturally competent aging services network. This article provides exemplars from empirical data on older lesbians with alcoholism to highlight some of the health, economic, and social disparities experienced in the aging LGBT community. Current interventions in the form of cultural competence training for service providers are presented as a potential step toward addressing health disparities among LGBT older adults.     

Transnational habitus at the time of retirement

ABSTRACT

International mobility requires the shifting of bodies across places, through life courses and stages, creating individual and collective experiences that become taken for granted. They are habitus, which is the durable deployment of an individual’s body in the world, as well as a scheme of perception, thought and action that is present throughout life, including retirement. This study asks what kind of transnational habitus is visible in the narratives of interviewed older adults at the time of retirement. The answer is sought by analysing life stories of mobility from older adults who live or have lived abroad for several years. The multilocal transnational habitus of interviewees rests on their desire to maintain their mobility when retired. However, both their physical and mental international mobility are at risk when faced with an ailing body and mind, and policies allow and restrict the transferability of benefits and accessibility to services.     

Counseling to Promote Retirement Adjustment

Older adults, who represent an increasing proportion of the population, face a major challenge in the adjustment to retirement. Nearly one third of older adults experience difficulty in making this adjustment (Atchley, 1975). Atehley's (1975) theory of adjustment to retirement and relevant empirical data are examined. It is argued that reactions to retirement are diverse and multifaceted. Specific counseling interventions and barriers to counseling older adults are suggested.     

Geographic distance and intergenerational relationships in Chinese migrant families

ABSTRACT

This study examines the effect of adult Chinese migrants’ geographic distance from home on their intergenerational relationships with parents who remain behind. We compared monetary and family care support as well as emotional relationships among four parent-child groups: older adults and international migrant children, older adults and internal migrant children (who migrated to other cities in China), older adults and coresiding children, and older adults and local children (living in the same city as their parents). Data were derived from 332 older adults in Beijing, China, with at least one child who migrated to another country or city. Results from chi-square tests, anaylsis of variance (ANOVA) tests, and regression analyses indicate that international and internal migrant children maintain similar intergenerational relationships with their parents, and that both of those groups are less likely than coresiding and local children to have family care exchanges and emotionally close relationships with their parents. The results may help professionals develop supportive services and policies for older adults in migrant families.     

Religion, social support, and health among the Japanese elderly

We address three issues in this paper: (1) Is religion related to self-rated health, (2) do these salubrious effects arise because religion encourages people to provide help to significant others, and (3) is the relationship between religion and helping others more evident among older men than elderly women? We analyze the relationships among religion, support giving, and health with data provided by a national probability sample of 2,153 older people in Japan who were interviewed face-to-face in 1996. Greater involvement in religion is associated with providing help to others more often, but these effects emerge for older men only. Regardless of gender, elders who provide assistance to others more often rate their health more favorably than older adults who are less involved in helping others. These results confirm that religion is related to health, and that helping others may explain at least part of the reason for this relationship.