Problems and Needs of Older & Disabled Adults


Changes in society, which can be found throughout the entire nation, have affected many of the older and disabled residents in our communities. With changing family structures, an increasing tendency for family members to live farther away from each other, and the decreasing availability of traditional family caregivers to provide help for their frail and struggling relatives, many older and disabled adults now find themselves without the support they need to get by at home. Even when support is made available through private or government assistance programs, many individuals do not qualify for this assistance, and those who do are often unable to access it. Nearly 15% of the older adults in Macomb, Oakland and St. Clair Counties have incomes that fall below or within 150% of the federal poverty level, many struggling to get by on under $10,000 a year. Thousands more earn just enough to hover above the poverty level, and because of this are ineligible for many of the support services which are available in the county. As life expectancy, and daily costs of living have increased, previously adequate retirement and savings plans are being rapidly depleted, and persons who are living just above the poverty line are finding themselves unable to pay for the help they need to remain at home. Many of these people often choose between medication and food, because they just cannot make ends meet. Hiring professional help, or even low-cost subsidized help, is often far out of their reach. Human service agencies, using private and government funds, are overburdened with demands and unable to meet all the needs of all the individuals requesting help. There are often long waiting lists to receive familiar services such as home delivered meals, chore assistance and subsidized personal care. Other services, while very important and helpful to many frail and disabled adults, do not begin to cover the needs. Hundreds of our neighbors fall through the “gaps" in services each year.


The transportation resources that exist often come with long waits for service and are not always well-suited for the needs of frail and disabled adults who need physical assistance and personal attention. Persons utilizing county vans must be able to board independently. Assistance is not generally available to persons using walkers and wheelchairs. Individuals accessing county-wide services must fall within low-income guidelines. Transportation is also limited to special purposes and within early daytime hours. Most van services offer limited routes within cities, and might not be able to accommodate medical appointments on days when a shopping route is scheduled. Special transportation is not available in the late afternoon, the evening or on weekends. Neither is transportation available for persons who must report to hospitals or clinics very early in the morning for outpatient surgeries and procedures. Persons who have any confusion or forgetfulness may miss rides or become lost during appointments. Those who are not feeling well may have long waits to return home.


Some county and city chore services provide grass-cutting and snow removal, and some other odd jobs, but are only available to a limited number of seniors. Those in need must register their request months in advance, and after the program is filled for that season, many people are turned away. Many seniors who cannot take care of their own yards anymore, and can't afford costly professional services, risk citations by local cities when their sidewalks are not shoveled or their grass grows too long. And simple tasks like changing light bulbs or fixing a leaky faucet can go undone for months and years. More substantial repairs such as plumbing or electrical repairs are typically not available through any subsidized programs, and are far too costly for most seniors to even consider. Persons who need help with bigger projects like cleaning out a cluttered basement after the death of a spouse have nowhere to turn for help.


There is no low-cost housekeeping service available in the area, except for persons who require medical care as well. This limited service is available only to persons who have very low incomes and who need the care of a home health aide, and the wait can be very long. This can be especially hard for someone who is managing fairly well at home, but just can't handle the strain of scrubbing bathtubs or doing other routine household chores.


Each year, more and more people in the community are struggling to help care for a loved one at home. Many people are living longer, but are burdened with physical ailments and dementia that may prevent them from being left alone for even short periods of time. Many families have come “to the end of their rope,” bending under the stress of full-time care. A large number of these family units consist of only one caregiver -- an elderly spouse or a single daughter or son, who have no ready options for an occasional break. Although there are a few Adult Day Care Centers in the area where an older adult can be dropped off for the day, many more are needed. And there are far fewer resources for persons who would not do well out of their own home. There are very few home-based respite services. As the need for respite care continues to grow in our society, we need to respond to such families with help that can allow them to keep caring for these older and disabled adults in their own homes, avoiding for as long a possible the need for institutional care, which often causes abrupt disruption of the family unit, and marked decline in the psycho-social well-being of those removed from their home.


Most older adults experience a great deal of loss that can leave them with great loneliness and depression. Once someone has retired from their job, grown too weak to pursue many of their former hobbies, and has lost their spouse and many of their friends, they can frequently become very isolated. Countless people in our community can go days, weeks and months without any substantial interaction with others, sitting alone in their homes for long periods of time. These individuals wait for the nurturing support that will abate their loneliness and ward off the isolation that often creates even greater physical, emotional and health-related burdens.


Many of the programs that are designed to help senior citizens, are not available at all to younger disabled adults who need the same kind of help to remain at home. These younger people, struggling with physical handicaps, terminal illnesses and degenerative diseases, often have no where to turn for help and do not even "qualify' for the limited services that are available to person over 60.


While many families do the best they can to help care for an aging loved one, they are often unable to do all that is needed. Family members indicate a wide variety of reasons that prevent them from providing all the help that they would like to offer to their loved ones. Typical examples include:

· Children who cannot take time off work 3 or 4 days each month to transport their parents to various medical appointments and tests without risk of losing their own jobs;

· Aged spouses who cannot drive long distances or in poor weather to get the partner for whom they are caring to necessary appointments;

· children with their own physical disabilities who cannot help their elderly parents with routine tasks such as shopping, housekeeping, yard work, etc.;

· Single daughters who are paying for several hours of companionship/aide services each week during working hours and cannot afford to pay for any additional hours of care so that they can run errands, do grocery shopping, go to their own doctor appointments, etc.;

· Spouses who ask for someone to watch their confused partner for just a few hours so that they can get an occasional stretch of uninterruped sleep;

· Family members who are going out of town for a few weeks and need someone to look in on their loved one every other day or so to take care of any needs that may arise;

· Family members who live out of state and cannot provide any of the various help that their loved ones may need on an occasional or regular basis;

· Low-income families and spouses that cannot afford any of the often expensive alternatives for care.