Administered by the Admin. on Aging (AoA), Title III of the Older Americans Act (OAA) is intended to assist individuals age 60 and older by providing supportive services. Title III, Medicaid and Medicare, state, and other sources of funding provide for several types of services, including congregate and home-delivered meals, transportation, and support for caregivers. This testimony reports on ongoing work by the auditor in preparation for the reauthorization of the OAA. This report describes: (1) Title III services most requested by seniors and how state and local agencies reach those most in need; and (2) how agencies have coped with increasing requests in the current economic environment. Charts and tables.

OLDER AMERICANS ACT: Preliminary Observations on Services Requested by Seniors and Challenges in Providing Assistance

This report, one in a series on the uses of and accountability for Recovery Act (RA) funds in selected states and localities, comments on recipients' reports of the jobs created and retained. The RA provided $2.1 billion for Head Start and Early Head Start, primarily to expand services. This report addressed four questions: (1) How have Head Start and Early Head Start grantees used RA funds, including for expanding enrollment? (2) What challenges have grantees encountered in spending RA funds? (3) How has the Office of Head Start monitored the use of RA funds? (4) How has the quality of jobs data reported by RA recipients, particularly Head Start grantees, changed over time? Charts and tables. This is a print on demand publication.

Community Resources for Older Adults: Programs and Services in an Era of Change, Fourth Edition, by Robbyn Wacker and Karen Roberto, provides an in-depth review of policy and programs for the "aging network," answering such key questions as "How have programs for older adults evolved?" "Who uses these resources?" "How are they delivered?" and "What challenges do service providers face in meeting the needs of the aging baby-boom generation?" To give students the foundational knowledge they need to meet the needs of their older clients, the authors provide a theoretical framework for understanding the forces that shape older adults' likelihood to seek assistance, include in-depth reviews of the current body of empirical literature in each program area, and discuss the challenges programs and services will face in the future.

As women moved into the formal labor force in large numbers over the last forty years, care work – traditionally provided primarily by women – has increasingly shifted from the family arena to the market. Child care, elder care, care for the disabled, and home care now account for a growing segment of low-wage work in the United States, and demand for such work will only increase as the baby boom generation ages. But the expanding market provision of care has created new economic anxieties and raised pointed questions: Why do women continue to do most care work, both paid and unpaid? Why does care work remain low paid when the quality of care is so highly valued? How effective and equitable are public policies toward dependents in the United States? In For Love and Money, an interdisciplinary team of experts explores the theoretical dilemmas of care provision and provides an unprecedented empirical overview of the looming problems for the care sector in the United States. Drawing on diverse disciplines and areas of expertise, For Love and Money develops an innovative framework to analyze existing care policies and suggest potential directions for care policy and future research. Contributors Paula England, Nancy Folbre, and Carrie Leana explore the range of motivations for caregiving, such as familial responsibility or limited job prospects, and why both love and money can be efficient motivators. They also examine why women tend to specialize in the provision of care, citing factors like job discrimination, social pressure, or the personal motivation to provide care reported by many women. Suzanne Bianchi, Nancy Folbre, and Douglas Wolf estimate how much unpaid care is being provided in the United States and show that low-income families rely more on unpaid family members for their child and for elder care than do affluent families. With low wages and little savings, these families often find it difficult to provide care and earn enough money to stay afloat. Candace Howes, Carrie Leana and Kristin Smith investigate the dynamics within the paid care sector and find problematic wages and working conditions, including high turnover, inadequate training and a “pay penalty” for workers who enter care jobs. These conditions have consequences: poor job quality in child care and adult care also leads to poor care quality. In their chapters, Janet Gornick, Candace Howes and Laura Braslow provide a systematic inventory of public policies that directly shape the provision of care for children or for adults who need personal assistance, such as family leave, child care tax credits and Medicaid-funded long-term care. They conclude that income and variations in states’ policies are the greatest factors determining how well, and for whom, the current system works. Despite the demand for care work, very little public policy attention has been devoted to it. Only three states, for example, have enacted paid family leave programs. Paid or unpaid, care costs those who provide it. At the heart of For Love and Money is the understanding that the quality of care work in the United States matters not only for those who receive care but also for society at large, which benefits from the nurturance and maintenance of human capabilities. As care work gravitates from the family to the formal economy, this volume clarifies the pressing need for America to fundamentally rethink its care policies and increase public investment in this increasingly crucial sector.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/