#### Planning Along the Lifespan 

#### 

#### 

#### NUMBER: PC 1

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#### TITLE: Increased Retirement Savings 

#### 

Retirement savings is an effective strategy for ensuring that many baby
boomers and seniors are ready to meet their needs over their lifespan.
Savings can provide seniors greater ability to exercise their
preferences in how their needs are satisfied. What can be achieved
through savings varies depending on individual\'s earning power and
their proximity to retirement. Current laws both encourage and
discourage such savings. Stronger incentives for saving early in one's
life have potential for satisfying future needs. Coordinated reforms in
savings-related policies can have far reaching benefits, including
advantages for seniors, future workers, and government programs.
Simultaneously, taking account of the needs of those unable to
accumulate adequate savings, such as unprepared Baby Boomers nearing
retirement, is essential.

**RESOLUTION:**

**Provide Financial and Other Economic Incentives and Policy Changes to
Encourage and Facilitate Increased Retirement Savings.**

**NUMBER: PC 2**

**TITLE: Disclosure on Pension Plans**

The structure of pensions has shifted from employer-only defined benefit
plans to plans based on contributions by the employee only or the
employee and employer together. An alternative or supplemental
retirement savings mechanism is individual retirement accounts. All of
these structures have tax favored status, which is an incentive for
employers and employees to set aside earnings for retirement. Where
defined benefit plans are still in use, several are at risk of
insolvency because of corporate bankruptcies. The change in structures
and the risks of insolvency lead to a need for greater disclosure to
participants as to their options and risk.

**RESOLUTION:**

**Improve Disclosure and Education Regarding Participants' Pension Plans
For Enabling Effective Retirement Savings.**

**NUMBER: PC 3**

**TITLE: Policies on Pension Plans**

Where employers have been able to change the process of defined
contribution pension plans, participation has increased. These changes
include automatic enrollment into plans, automatic increases in the
contributions, and easy rollovers to an individual retirement account or
another employer's plan at the end of employment. Barriers to these
changes exist where the rules are too complicated or where there is
insufficient incentive for some employers. A simplification of the rules
and improvement in tax incentives could increase retirement savings.

**RESOLUTION:**

**Change Policies Regarding Defined Contribution Pension Plans to
Increase Retirement Savings.**

**NUMBER: PC 4**

**TITLE: Principles of Social Security**

The Social Security program provides economic security for workers and
their families upon the retirement, death or disability of the worker.
From its beginning, Social Security has been a pay-as-you-go program in
which current benefits are supported by current payroll taxes. It is not
an investment program. Payroll taxes are 12.4 percent of wages or
self-employment income up to a taxable maximum of \$90,000 in 2005. When
there is a surplus of income over outgo, those excess funds are credited
to the Social Security trust funds in the form of U.S. government
securities. The proceeds to the federal government from the purchase of
these securities by the trust fund are used to finance other government
programs.

Americans are living longer and having fewer children than previous
generations. These demographic changes present a long-run financing
challenge for Social Security because the number of beneficiaries is
growing faster than the number of workers paying payroll taxes that fund
each year's benefits.

All agree that the Social Security program faces a long-term funding
shortfall. The annual cash flow of the program is projected to peak in
2008 and then decline as the baby boom generation begins to retire.
Social Security benefits will first exceed tax receipts in 2017, when
repayment of the debt which the government owes itself will begin to
become due. Repayment options include increasing the rate of return on
assets, raising taxes, reducing other government spending, or additional
government borrowing. By 2041, the trust fund will be exhausted and
Social Security tax revenues will be able to pay about 70 percent of
benefits, declining to approximately two-thirds of benefits by 2079.
Social Security faces a long-term solvency challenge

that needs to be addressed through development of a full range of
principles in order to assure that it will be a reliable source of
retirement, survivor, and disability income for generations to come.

**RESOLUTION:**

**Establish Principles to Strengthen Social Security.**

**NUMBER: PC 5**

**TITLE: Long-Term Care Financing**

The American population is aging and, as a result, demand for healthcare
and long-term care services is increasing. Public funds and institutions
are not sufficient to meet these needs. Although options are expanding,
few Americans (only 6%) purchase insurance to protect themselves from
the high cost of potential long-term care needs. Although states are
encouraged to find more innovative methods for funding healthcare,
especially in the Medicaid program, they have not been encouraged to
develop changes in how they provide long-term care or prolonged care due
to disabilities. Currently, the structure for long-term care lacks
options and incentives for individuals and families to pursue long-term
care financing, contracts, or other arrangements; either for themselves
or in cooperation with state systems. In addition, few Americans are
pursuing disability insurance to protect them from unexpected risks of
injury or illness. Both government programs and consumers can benefit
from opportunities to pursue innovative products and contracts.

**RESOLUTION:**

**Foster Innovations in Financing Long Term Care To Increase Options
Available To Consumers.**

**NUMBER: PC 6**

**TITLE: Prevention of Financial Crimes**

Consumer fraud, scams, financial exploitation and other crimes present a
growing challenge to the economic security and independence of older
citizens. In 2000, a national survey of state Adult protective Services
(APS) reported 39,000 allegations of financial exploitation by people
close to vulnerable adults. In addition, the Federal Trade Commission
reported 38,000 cases of consumer fraud perpetrated against seniors
(over the age of 60) in 2004. During the same year, older Americans paid
approximately \$68 million into domestic and cross-border fraud schemes.

Many challenges exist in responding to older victims of financial crimes
due to the complexity of the cases, the relationships between victims
and perpetrators, issues of diminished capacity, privacy and other
factors. For example, given that complicated cases of financial
exploitation may take years to reach trial, an older persons' cognitive
or physical health may decline to the point they are unable to testify
in court.

In recent years, the federal government has achieved a high level of
success in combating financial fraud through prevention, prosecution and
multidisciplinary collaborations at the federal, state and local level.
However, formidable barriers still remain in addressing financial fraud
originating across borders and overseas. APS and law enforcement at the
state and local level continue to face challenges in the identification,
investigation and prosecution of financial exploitation by people known
and trusted by their victims.

**RESOLUTION:**

**Coordinate Prevention of Financial Crimes Against Seniors.**

**NUMBER: PC 7**

**TITLE: Prosecution of Financial Crimes**

To effectively resolve cases of financial crimes against seniors, a
variety of interdisciplinary expertise from the public and private
sector (e.g., social, medical, legal, financial) must be brought
together for collaboration. During the time it takes for a complicated
case to reach trial, a victim's cognitive or physical heath may decline
to the point that they are unable to testify. Successful outcomes in
these cases often require close cooperation across traditional
jurisdictions and professional boundaries. Law enforcement at the state
and local level continues to face challenges in the identification,
investigation, and prosecution of financial exploitation by persons
known and trusted by their victims. Various studies have attempted to
quantify estimates of financial exploitation, but have suffered from
methodological challenges including non-uniform definitions of financial
exploitation across state jurisdictions, and the lack of a standardized
national reporting system.

**RESOLUTION:**

**Strengthen Law Enforcement Efforts at the Federal, State, and Local
Level to Investigate and Prosecute Cases of Elder Financial Crime.**

**NUMBER: PC 8**

**TITLE: Financial Literacy Along the Lifespan**

There is growing evidence that large numbers of Americans lack basic
knowledge about personal economics and financial planning. A lack of
financial literacy affects consumers' current well-being and security in
a variety of ways. Poor money management and financial decision making
can lower a family's standard of living and interfere with crucial
long-term goals, such as financing retirement. The shift from defined
benefit to defined contribution pension plans means that Americans need
to take personal responsibility for their retirement security.

Currently, about 20 different federal agencies operate about 30
different programs related to financial literacy. In 2003, Congress
created the Financial Literacy and Education Commission, made up of 20
federal agencies and charged to develop a national strategy to promote
financial literacy and education for all Americans. The national
strategy is scheduled to be issued in the near future.

**RESOLUTION:**

**Promote Financial Literacy Throughout the Lifespan.**

**NUMBER: PC 9**

**TITLE: Supplemental Security Income**

The Supplemental Security Income (SSI) program provides basic safety net
protection for 7 million low-income aged, blind, and disabled adults and
children with few resources. The eligibility requirements have not been
updated for several years, making it less effective in alleviating
poverty. The federal benefit rate for an individual in 2005 is \$579,
which is 27.4 percent below the official poverty level and the general
income exclusion of \$20 per month and the earned income exclusion of
\$65 per month have not increased since 1972 and the resource limits
have not been updated since 1989. Approximately 54 percent of SSI
beneficiaries have no other source of income besides their SSI benefits.
Administration of the program is complex and needs simplification and
increased outreach. .

**RESOLUTION:**

**Modernize the Supplemental Security Income (SSI) Program.**

**NUMBER: PC 10**

**TITLE: Social Security Disability Insurance**

The Social Security Disability Insurance (SSDI) program provides
benefits to disabled workers and their families based on previous
employment covered by Social Security, and primarily is financed through
Social Security payroll taxes. As of August 2005, more than eight
million disabled workers and their families received \$6.3 billion in
monthly benefits. Current trends make clear that more and more baby
boomers may need to rely on this program. The Social Security Trustees,
who oversee the financial operations of the Social Security Trust Funds,
estimate that the number of disabled workers and their families
receiving benefits will increase by 50 percent by 2030, primarily due to
the aging of the baby boom generation. The Social Security
Administration has been making significant strides in the modernization
of the SSDI program and operations. However, the scheduled increases in
the normal Social Security retirement age, morbidity, and factors
leading more and more Americans to work later into their lives, add to
the challenges facing the SSDI program. The efficiency of this program
and its solvency will be important to the economic security and
well-being of millions of Americans over the course of their life spans.

**RESOLUTION:**

**Strengthen the Social Security Disability Insurance Program.**

**II. Workplace of the Future**

**NUMBER: PC 11**

**TITLE: Retention of Older Workers**

An aging population in combination with a falling fertility rate
diminishes the size of the national workforce. The impending retirement
of the Baby Boom generation can have compounding effects, which
destabilize the overall strength of the economy. Employers will lose
many experienced workers, and likely face skill gaps in their workforce.
Meanwhile, pressures on the Social Security and Medicare programs will
increase while tax funds for the programs will decrease. Currently,
federal laws are barriers to keeping older workers in the workforce
because they discourage employers from using flexible employment
arrangements that encourage older workers to stay employed.

Furthermore, workplace discrimination involving Americans of older age
and persons with physical, sensory, and neurological impairments related
to chronic illness and disability is increasing according to published
scientific research studies. Strategies to prevent age discrimination
from affecting opportunities for older workers are needed. While the
Americans with Disabilities Act outlaws discrimination in employment on
the basis of disability, the labor force participation rate continues
around 32% for people with disabilities and 81% for those without
disabilities.

**RESOLUTION:**

**Remove Barriers to the Retention and Hiring of Older Workers,
Including Age Discrimination.**

**NUMBER: PC 12**

**TITLE: Incentives for Older Workers**

Available evidence suggests older workers receive less employment
training than younger workers. While there have been successful programs
targeted at older workers, more can be done to help workers remain in
the workforce, particularly low-wage workers. Studies show that older
workers with more updated computer skills may be less likely to retire
and more likely to stay in the workforce. In addition, there are a
number of economic, legal and institutional barriers to providing
incentives to older workers to stay in the workforce. Some of these
barriers could be overcome by including more flexible employment
arrangements like phased retirement. To expand the reach of programs
like phased retirement, traditional thinking about older workers needs
to change and laws that regulate retirement and employee benefits should
be reexamined.

Older workers are valuable additions to the workforce. In the role of
mentor to younger workers, and as invaluable sources of knowledge, older
workers contribute significantly to a successful workplace. Employers
need to be made aware of the value of older workers through education
campaigns. They should also be educated about the impact of a declining
pool of labor that can lead to prospective skill shortages.

.

**RESOLUTION:**

**Promote Incentives for Older Workers to Continue Working and Improve
Employment Training and Retraining Programs to Better Serve Older
Workers.**

**NUMBER: PC 13**

**TITLE: Assistive Technology for Workers**

The national workforce is projected to decrease. The retirement of the
Baby Boom generation can have compounding effects, destabilizing the
overall strength of the economy and future of the nation. Employers will
lose many experienced workers, and likely face skill gaps in their
workforce. The American economy and workplaces will benefit from the
expertise and skills of older workers with the implementation of
assistive technologies to meet their workplace needs. For some older
workers, assistive technologies are necessary support. Assistive
technologies such as larger print copies, larger computer screens, and
padded seating allow older workers to remain in the workforce as
productive members of society despite limitations and impairments.

**RESOLUTION:**

**Promote Assistive Technology in the Workplace to Help Older Workers
Remain in the Workforce.**

**III. Our Community**

**NUMBER: PC 14**

**TITLE: Innovative Housing Designs**

American seniors are demanding innovative housing designs to accommodate
their changing lifestyle, mobility needs, and desire for remaining
active in their communities. Across the United States, developers and
local governments have experimented with housing options that range from
home modification to large campus integrated services. Each design
reflects regional differences in attitudes, demand, opportunities, and
familiarity with emerging innovations. The most common design element is
for safety, but the preferences of older Americans are much broader.
They include individual choice in interior designs; convenient access to
entertainment, family, and services; and opportunities for pursuing
physical and mental vitality.

**RESOLUTION:**

**Expand Opportunities for Developing Innovative Housing Designs for
Seniors' Needs.**

**NUMBER: PC 15**

**TITLE: Designs of Senior Centers**

An estimated 10 million Americans access an array of services and
opportunities through senior centers. These Americans represent a
diverse mix of people, by mobility, education, culture, and economics.
However, the appeal of senior centers may not be broad enough to attract
the next wave of aged Americans or the participation of the communities
at-large. One of the main purposes of senior centers is to provide
seniors with access to the community in a fashion that enables dignified
and supportive engagement. If senior centers are to continue this
function, they need to be redesigned for broader appeal and multiple
uses. Furthermore, their management needs to evolve, to better engage
the entire community and be even more responsive to those they serve now
and in the future.

**RESOLUTION:**

**Encourage Redesign of Senior Centers for Broad Appeal and Community
Participation.**

**NUMBER: PC 16**

**TITLE: Intergenerational Strategies**

Current and future older adult populations offer an opportunity to
advance intergenerational efforts for the welfare of the community as a
whole. The vast expertise and wisdom of the older adult population can
be brought to bear on community and individual needs. The older adult
population is a major human resource for the community.
Intergenerational strategies can emphasize the opportunity for
mentoring, community based education and literacy programs. Mentoring
programs bring together persons of all ages to break down the myths and
stereotypes resulting from age differences. Mentoring can allow an older
American to continue being involved in the community by giving time and
knowledge in exchange for the personal satisfaction that comes with
participation. Also, the inclusion of older adults as planners and
facilitators in community projects can create a collaborative
environment that will benefit both seniors and the community.

**RESOLUTION:**

**Encourage the Advancement of Intergenerational Strategies.**

**NUMBER: PC 17**

**TITLE: Older Americans Act**

The Older American Act was signed into law on July 14, 1965 and is due
for reauthorization in 2005. At the federal level, the Administration on
Aging (AOA) administers OAA programs designed to allow persons age 60
and older to remain in their homes by offering them an array of
supportive services. The OAA currently funds supportive services for
over 7 million Older Americans and their caregivers.

OAA services are provided through a National Aging Services Network
comprised of State Units on Aging, Area Agencies on Aging (AAA), and
other local service providers. Each state unit on aging is allocated
funds by the AOA based on the number of older persons in each state.
Most states are divided into Planning and Service Areas (PSAs) so the
local needs of particular areas are considered. The state Units on Aging
in turn provide grant funding to AAAs responsible for delivering senior
services at the local level. The AAAs may also contract with public and
private groups to deliver services locally. In total, the National Aging
Services Network includes 56 State Units on Aging, 665 AAAs, 243 tribal
organizations, over 29,000 local community service organizations,
500,000 volunteers and a variety of national organizations.

OAA programs provided 143 million home-delivered meals, 105 million
congregate meals, 19 million hours of personal care and homemaker
services and 38 million rides in 2004. These programs target low-income
minority seniors, those in greatest social and economic need, and those
in rural areas. Other programs include caregiver support, demonstration
and training programs related to older Americans, employment and
training opportunities for low-income adults, services addressing the

needs of older Native Americans, elder rights programs, and elder abuse
prevention efforts.

**RESOLUTION:**

**Reauthorize the Older Americans Act Within the First Six Months
Following the 2005 White House Conference on Aging.**

**NUMBER: PC 18**

**TITLE: Designs for Livable Communities**

The current and future housing demands of older Americans may require a
review of the sustainability of current home and community building
practices, as well as support for innovation in the home building
industry, especially for new models of housing that integrate and
provide for the needs of older Americans. Most new housing in the United
States is not designed for populations who have or will have functional
limitations. One place best practices in senior friendly design have
been identified is through the National Endowment for the Arts'
universal design initiatives. Residential design elements that can
enable older people to remain in their homes include easy access to
entries, bathrooms and doorways that can accommodate walkers or
wheelchairs, and pathways that are safe for limited mobility.
Modifications to homes after they are built can be too expensive for
seniors to stay in their homes. Incorporating universal design into new
home construction is estimated to be 2-4 percent of the total cost, as
compared to 20-27 percent of the total cost of retrofitting an existing
home. In many case, aging Americans may not be aware of the possibility
for home modification during construction. Likewise, developers may be
unaware of the rising need for such modifications in new homes.

**RESOLUTION:**

**Encourage Community Designs to Promote Livable Communities that Enable
Aging in Place.**

**NUMBER: PC 19**

**TITLE: Protection from Abuse and Neglect**

A recent study by the National Research Council estimated there to be
between one and two million cases of elder abuse in the U.S. The Senate
Special Committee on Aging estimates there may be as many as 4 times as
many cases of elder abuse that go unreported. Data collection is impeded
by non-uniform definitions and monitoring. Family members are the most
common perpetrators of elder abuse. Due to the challenges presented in
the identification, prevention, and prosecution of elder abuse,
effective strategies are needed at all levels of government and across
public and private sectors. Many states have an inadequate supply of
Adult Protective Services (APS) case managers to receive and investigate
reports on elder abuse. As a result, caseloads far exceed the number
recommended by the National APS Administrators Association. This leads
to APS clients receiving very few direct service hours. Some states do
not consider Adult Protective Services to be a priority issue.
Generally, there is a lack of coordination, support, standards, and
training for programs to protect seniors from abuse and neglect.

**RESOLUTION:**

**Create a National Strategy for Promoting Elder Justice Through the
Prevention and Prosecution of Elder Abuse.**

**NUMBER: PC 20**

**TITLE: Accountability of Guardianship System**

Guardianships manage "incapacitated" elderly adults' personal affairs
and property. When used correctly, guardianships can be an important
tool in securing the physical and financial safety of a vulnerable
elder. Guardianship can also divest an elderly person of all the
freedoms we consider important as citizens. When a full guardianship is
imposed, the elder no longer has the right to get married, vote in
elections, enter into contracts, make medical decisions, manage
finances, or buy and sell property. All these rights rest with the
guardian. Without adequate oversight and accountability, guardianship
may result in the loss of liberty and property for the very persons
these arrangements are intended to protect. Also, guardians administer
substantial sums of federal money including Social Security and SSI
payments, disability and survivor benefits, federal pensions, and
welfare benefits. Accountability of state guardianship systems must be
given closer consideration as the baby boomers age.

**RESOLUTION:**

**Encourage More Effective Oversight and Accountability at the State and
Local Level of Court Appointed Guardians and Conservators.**

**NUMBER: PC 21**

**TITLE: Capacity for Safe Driving**

Senior-friendly road and vehicle design, older driver screening,
assessment, and rehabilitation, and a greater focus on maintaining the
"driving health" of seniors is essential to enable Americans to continue
driving safely for as long as possible. The ability to drive allows
Americans to live, work, and travel virtually anywhere they choose.
Drivers over age 70 are about 19 million today, up from about 13 million
a decade ago. In 1980, there were nearly 9 million drivers, age 70 and
over; by 2000, there were almost 19 million. This is a 111 percent
increase in older drivers since 1980. Although each person is affected
by aging differently, older drivers may have physical and cognitive
changes that will affect their ability to drive safely. Since older
Americans rely on their car for 90% of their trips (followed by walking
at 8%), functional limitations that affect their ability to drive safely
are a major challenge to their independence. In addition, drivers over
65 are more likely to die in crashes than drivers under 64, because of
the inability to withstand injuries, so prevention is important.
Improvements that help seniors drive safely longer benefit drivers of
all ages.

**RESOLUTION:**

**Support Older Drivers to Retain Mobility and Independence Through
Strategies to Continue Safe Driving.**

**NUMBER: PC 22**

**TITLE: Transportation Options**

As Americans grow older, they need transportation options that allow
them to remain independent. While more and better public transportation
programs will help to address this need, within a few years the number
of transit dependent individuals will increase rapidly, and public
transportation and public resources alone will not be sufficient to meet
the need. The average American household spends almost 20 percent of
family income on transportation, second only to expenditures for
housing. If baby boomers are to plan for the transportation future, and
if we are to care for the mobility needs of today's seniors, private as
well as public resources will be needed. Better coordination among
publicly funded transit programs and among public and private programs
through the use of information technology will help, as will attention
to land use planning that prevents sprawl and promotes better pedestrian
access. No single transportation solution will be able to address all of
the needs of the aging population. Rather, a family of transportation
alternatives will be necessary---rail, fixed route bus, paratransit,
taxi, and volunteers. Most older people who stop driving outlive their
decision by more than a decade. It will take many transit options, both
public and private, to adequately meet the mobility needs of the aging
population.

**RESOLUTION:**

**Ensure That Older Americans Have Transportation Options to Retain
Their Mobility and Independence.**

**NUMBER: PC 23**

**TITLE: Available Housing**

For the older adult, housing is a major determinant of their ability to
continue to age in place in the community as opposed to being
institutionalized in a long-term facility. Low-income, frail seniors,
people living alone, and those living in rural areas are the most likely
to have unmet housing needs. Although seniors would like to remain in
their homes, homes require modifications and assistive technologies if
the individual with chronic illnesses and disabling conditions is to
remain living independently in the community. Changes in housing design
and community planning need to reflect the limitations in mobility of
current and future seniors.

**RESOLUTION:**

**Enhance the Availability of Housing for Older Americans.**

**NUMBER: PC 24**

**TITLE: Affordable Housing**

For the older adult, housing is a major determining factor supporting
their ability to continue to age in place in the community as opposed to
being institutionalized in a long-term facility. Home ownership provides
a significant cost saving alternative to a nursing home. Eighty percent
of seniors own their own homes. Almost 2 million older adults, mostly
low-income single women live in federally-assisted multi-unit rental
housing, more than the number that live in nursing homes.
Government-subsidized programs (e.g., Section 202 and Section 8) support
low-income elderly; however, in 1999, there were nine applicants for
each available Section 202 unit. However, many seniors are still faced
with high housing costs and structurally deficient homes or apartments.
In 1999, 7.8 million older families lived in unaffordable (paying more
than 30 percent of their income on housing) or poor quality dwellings.

**RESOLUTION:**

**Enhance the Affordability of Housing for Older Americans.**

**NUMBER: PC 25**

**TITLE: Emergency Response or Disaster Plan**

Our nation must develop and implement reliable communication,
coordination, and control of services across government agencies, the
aging network, and care provider systems at the private, non-profit and
public levels as the base of our emergency plans. The Department of
Health and Human Services, the Administration on Aging, and the Office
of the Assistant Secretary for Health and Emergency Preparedness should
assist state and local governments and assure that emergency
preparedness and disaster planning is coordinated at federal, state, and
local levels and is sensitive to the unique needs and resources of
seniors. Some seniors will have increased physical, mental and emotional
needs during emergencies, requiring assistance to initiate protective
actions. Those in institutions and with limited mobility may require
extensive transportation efforts and assistance. Still other, actively
involved seniors can serve as useful resources supporting the emergency
response as they bring years of expertise to bear on the situations.

**RESOLUTION:**

**Encourage the Development of a Coordinated Federal, State, and Local
Emergency Response Plan for Seniors in the Event of Public Health
Emergencies or Disasters.**

**NUMBER: PC 26**

**TITLE: Older Adult Caregivers of Children**

In the U.S., there are more than 2.4 million grandparents who are
primarily responsible for meeting the needs of more than four and a half
million grandchildren under age 18. They are the primary caregivers
because the children' parents are unable to care for them. The number of
grandparent-maintained households without either parent present
increased by 30 percent between 1990 and 2000. The demands of caring for
young children may lead to increased physical, emotional and financial
challenges for grandparents. Because care of children by grandparents
and other relatives prevents children from going into the formal foster
care system, conservative estimates show these arrangements save
taxpayers more than \$6.5 billion dollars each year. These caregivers
take on this role often at great personal sacrifice and face a range of
challenges related to securing basic services and provisions for the
children in their care, including difficulty accessing medical care and
coverage, securing mental health services for the children, obtaining
legal services, enrolling children in school and securing special
education services, and securing appropriate housing. Supportive
services are needed to help these caregivers to continue to provide safe
and nurturing homes for these children without compromising their own
health and financial security.

**RESOLUTION:**

**Support Older Adult Caregivers Raising Their Relatives' Children.**

**NUMBER: PC 27**

**TITLE: Expand Integrated Aging and Disability Resource Centers**

Rising numbers of aging baby boomers will bring an attendant increase in
the need and demand for a "one stop" source of information as well as a
single entry point for home and community based services. We need to
change the way that we view the very services that support the
independence of current and future seniors and persons with
disabilities. What is needed is a coordinated approach to services for
long term living, whether those services lie within the private sector,
through Medicaid, or other sources. Individuals with disabilities,
whether age-onset or life-long, need information on and access to basic
supportive services that will enable them to become and remain as active
as possible and to be engaged and contributing members of their local
communities. Over the last 30 years, aging network partners have
developed the infrastructure that coordinates a host of programs that
provide information on, access to, and choices for individuals who seek
such services. As part of this new systems approach, AoA and CMS have
supported Aging and Disability Resource Centers in 43 states and
localities.

**RESOLUTION:**

**Expand Integrated Aging and Disability Resource Centers Nationwide.**

**NUMBER: PC 28**

**TITLE: Rural Economic Development**

Approximately 25 percent of the nation's older persons live in rural
America, or some 9.2 million. The total rural population is aging more
rapidly due to more elderly aging in place, younger persons leaving for
metropolitan areas, and elderly returning home as they age. Major
challenges include access and delivery of care to rural seniors,
transportation limitations, and poor economic development. Also, rural
seniors are among the oldest old and frail, as evidenced by the fact
that nearly 40 percent of elderly receiving nursing home care are
rurally located.

**RESOLUTION:**

**Promote Economic Development Policies that Respond to the Unique Needs
of Rural Seniors.**

**IV. Health and Long Term Living**

**NUMBER: PC 29**

**TITLE: Prescription Drug Improvements**

Beginning in 2006, the Medicare Prescription Drug, Improvement and
Modernization Act (MMA) will offer pharmacy benefits to 42 million
Medicare beneficiaries. All seniors, regardless of income, health
status, or prescription drug usage, will have access to this
prescription drug coverage. In a 2003 national survey of Medicare
beneficiaries age 65 and older, more than one-quarter reported no
prescription coverage, and nearly half of low-income seniors in some
states lacked coverage.

Because this new benefit will help seniors live healthier lives and save
money, it is important that all Medicare beneficiaries and those who
care for them understand the benefits of this MMA coverage. Innovative
strategies to encourage enrollment and streamline implementation will be
important to the aging population.

**RESOLUTION:**

**Promote Enrollment of Seniors Into the Medicare Prescription Drug
Program With Particular Emphasis on the Limited- Income Subsidy.**

**NUMBER: PC 30**

**TITLE: Coordinated Long Term Care Strategy**

Long- term care encompasses a broad range of help with daily activities
that chronically frail and disabled individuals need for a prolonged
period of time. The demand for long-term care services is projected to
rise almost two-fold by 2020. The result of this increased demand will
be a significant rise in long-term care expenditures for older adults,
from a projected \$123 billion in 2000 to \$207 billion by 2020, and
this expenditure will continue to increase with the aging of the Baby
Boom generation. Private financing such as long-term care insurance and
personal savings may become more important funding sources over the next
decade and beyond for older Americans who require long-term care
services.

The service delivery system is very fragmented, with the acute and
chronic health care and supportive services, in public and privately
funded silos. Older people do not necessarily have the choice of living
in the least restrictive setting. The majority of people providing
long-term care are family and friends, but there will be fewer family
members in the future to act as caregivers. In addition, the paid
workforce is shrinking. Both these groups lack training and support to
do their job of providing long-term care.

**RESOLUTION:**

**Develop a Coordinated, Comprehensive Long-Term Care Strategy by
Supporting Public and Private Sector Initiatives that Address Financing,
Choice, Quality, Service Delivery, and the Paid and Unpaid Workforce.**

**NUMBER: PC 31**

**TITLE: Evidence-Based Long-Term Care**

High quality healthcare and social services originates from systematic
evidence showing its effectiveness. Evidence-based practices face both
technical and financial barriers to adoption by hospitals, physicians
and other service providers. Some new interventions and treatments are
too slowly adopted, while others are diffused too quickly with
insufficient evidence that they are useful. Studies show that few
guidelines lead to consistent changes in provider behavior. It is
important to weigh the benefits of evidence-based care for the
individual with the costs and preferences of the older adult and their
caregivers.

**RESOLUTION:**

**Apply Evidence Based Research to the Delivery of Health and Social
Services Where Appropriate.**

**NUMBER: PC 32**

**TITLE: Geriatric Healthcare Continuum**

Medicare and the private sector are exploring various ways to better
coordinate care for seniors with multiple conditions across the
continuum of care. For example, the care of patients with complex
conditions is being studied under a new Medicare demonstration to see if
costs and patient outcomes can be improved. In addition, geriatric
healthcare must meet the special needs of a broad array of services for
the elderly with continuity across the continuum of care. Incentives
that encourage Medicare service providers to serve recipients with
complex needs in a high quality, cost-effective manner will become
increasingly important as the baby boomers age.

**RESOLUTION:**

**Evaluate Payment and Coordination Policies in the Geriatric Healthcare
Continuum to Ensure Continuity of Care.**

**NUMBER: PC 33**

**TITLE: Healthy Nutrition**

Good nutrition can sometimes be difficult for seniors, especially if
they have not already developed healthy habits. One important message
for seniors is that it is never too late to benefit from healthy
nutrition practices. Another important message is that physical changes
that take place during aging can result in different nutritional needs.
These changes can contribute to decreased food intake, unintentional
weight loss, malnutrition, and/ or obesity.

The federal government has taken a lead role in promoting health and
nutrition initiatives for older Americans. The 2005 Dietary Guidelines
for Americans provide evidence-based information to promote health and
reduce risks for major chronic diseases through diet and physical
activity. Major causes of morbidity and mortality are related to poor
diet and a sedentary lifestyle. Cardiovascular disease, type 2 diabetes,
hypertension and other diseases have been linked to poor diet and
physical inactivity. Poor diet and physical inactivity contribute to the
increase in overweight and obesity in this country.

As the largest generation in American history the aging of the baby
boomers will have significant repercussions on health and healthy
living. If trends continue unabated, the next few years may see
significant increases in the numbers of new cases of diabetes, heart
disease, and other chronic diseases that could be addressed by a healthy
diet and exercise.

**RESOLUTION:**

**Promote the Importance of Nutrition in Health Promotion and Disease
Prevention and Management.**

**NUMBER: PC 34**

**TITLE: Disease Management Programs**

Life expectancy is increasing and a growing number of Americans are
living with multiple chronic conditions. Seniors require a 21^st^
century health system that includes programs focused on managing chronic
diseases. Chronic care and disease management coordination programs
share similar objectives. The best programs include primary, secondary
and tertiary prevention and use evidence-based practice guidelines to
help patients take responsibility for their own care, under the
supervision of medical professionals. Current Medicare disease
management demonstration and pilot projects focus on promising areas for
clinical and cost effectiveness. Successful implementation of these
projects may provide a road map for improving clinically effective and
cost effective programs for Medicare beneficiaries with chronic illness.

**RESOLUTION:**

**Improve the Health and Quality of Life of Older Americans Through
Disease Management and Chronic Care Coordination.**

**NUMBER: PC 35**

**TITLE: Alcohol and Substance Abuse Treatment**

An estimated 8 million older Americans experience addictive diseases.
One third of these 8 million experience a late onset of addiction, which
may be associated with problems in life transitions, declining health
status, clinical depression, boredom or financial problems. Because
alcohol problems are often mistaken for other conditions, alcohol abuse
and alcoholism may go undiagnosed, untreated, or treated
inappropriately. Furthermore, medical complications, cognitive
impairments, major depression, sensory deficits, and lack of mobility
can complicate a diagnosis or lead to an emphasis on another issue
besides the addiction. Substance abuse treatment is different from other
types of healthcare because of the stigma often associated with the
disease. The stigma leads individuals to deny problems or refuse seeking
treatment.

**RESOLUTION:**

**Enhance Provider and Consumer Education About Alcohol and Substance
Abuse and Appropriate Treatment.**

**NUMBER: PC 36**

**TITLE: Responsive to Mental Illness**

Though older Americans report lower rates of mental health problems than
younger Americans, they too are likely to experience mental illnesses,
such as major depression. Some older persons believe that mental health
disorders and treatment are shameful, represent personal failure, or
will lead to a loss of autonomy. As a result, they may deny having
problems or refuse to seek treatment. Because mental disorders are often
mistaken for other conditions in older adults, they may go undiagnosed
and untreated or be treated inappropriately. According to the American
Association of Geriatric Psychiatry, 15 percent of adults over 65 will
experience depression, but if referrals for treatment are not timely,
the condition can exacerbate other illness conditions through poor
self-care, or lead to high-risk behaviors, such as substance abuse. In
general, the psychology of older Americans is under examined, yet it is
well understood that the mind-body relationship has significant effects
on disease risk, physical fitness, and capacity for self-care.

**RESOLUTION:**

**Improve Recognition, Assessment, and Treatment of Mental Illness and
Depression Among Older Americans.**

**NUMBER: PC 37**

**TITLE: Provider Education on Consumer Healthcare**

Consumer health education has a major role in facilitating seniors'
capacity for self-care. Effective training is needed for health care
workers to provide proper self-care and disease management guidance. The
federal government has initiated a number of programs encouraging
seniors to maintain healthier lifestyles and prevent disease, including
the President's Council on Physical Fitness, the Center for Disease
Control and Prevention's (CDC) Senior Wellness Lifetime Fitness Program,
and the CDC's People with Arthritis Can Exercise Program. Providers and
other care professionals need to be aware of these programs and other
developments that support consumer driven health care, self-care, and
family-care.

**RESOLUTION:**

**Prevent Disease and Promote Healthier Lifestyles Through Educating
Providers and Consumers on Consumer Healthcare.**

**NUMBER: PC 38**

**TITLE: Cognitive Health**

Cognitive health includes changes in cognitive function as one ages. The
nature of the changes, timing when changes become apparent, and the
magnitude and rate of change vary depending upon the cognitive function
in question. The five major areas of cognitive function are (a) learning
and memory, (b) executive function abilities (e.g. concept formation and
abstract thought), (c) language, (d) visual-spatial abilities, and (e)
sustained attention. Older adults may be able to maintain optimal brain
function through the adoption or maintenance of a healthy lifestyle.
This may include behavior that stimulates the brain, such as regular
mental activities (e.g., reading, writing, cross word puzzles), social
engagement, physical activity, and a nutritious brain-healthy diet. A
study by investigators at the New York University School of Medicine
suggests that diet can play a part in brain defenses against cognitive
deficits with age and Alzheimer's disease. Healthy lifestyles may allow
for extended periods of independence and a higher quality of life for
older Americans.

**RESOLUTION:**

**Increase Awareness of the Benefits of an Active Mind on Resultant
Quality of Life.**

**NUMBER: PC 39**

**TITLE: Consumer Driven Health Education and Health Literacy**

Active participation and involvement in the community and integration in
the population requires access to information. Many Americans have
difficulty obtaining and understanding information needed to make
appropriate decisions regarding their health. If patients cannot
comprehend health information, attempts to improve quality of care and
reduce healthcare costs and disparities may fail. Health literacy
includes reading, writing, listening, speaking, arithmetic and
conceptual knowledge. Another important barrier to information among the
older adult population is limited English proficiency. Expectations of
patients, and patient self-determination and preference needs continue
to increase, making health literacy important in a patient's ability to
access care. Health care providers have a duty to provide information
that patients can access quickly, understand, and use effectively.

**RESOLUTION:**

**Improve Health Decision Making through Promotion of Health Education,
Health Literacy, and Cultural Competency.**

**NUMBER: PC 40**

**TITLE: Capacity of the Geriatric Workforce**

The demand is increasing for healthcare professionals formally trained
in the care of geriatric populations. People age 65 and older use 23
percent of U.S. ambulatory care visits, 48 percent of hospital days, and
69 percent of home health services. It is estimated that the U.S. will
fall 25,000 short of the 36,000 geriatricians that healthcare experts
say the nation will need by 2030. In addition, recruitment and retention
of paraprofessionals in nursing homes and home-based care is a growing
challenge because of unfavorable job features, including low wages and
benefits, lack of career advancement, high potential for injury,
exposure to emotional stress, and inadequate training. In addition to
the increasing demand, the population needing services is increasingly
more diverse. Studies have found direct links between cultural
competency and healthcare improvement, thus appropriately trained
providers are critical for the geriatric workforce. Cultural competency
is the ability to provide care to persons with diverse values, beliefs,
behaviors, and needs including tailoring delivery to meet patients'
social, cultural and linguistic needs. Today, few professionals are
offered training for such work.

**RESOLUTION:**

**Attain Adequate Numbers of Healthcare Personnel in All Professions Who
are Skilled, Culturally Competent, and Specialized in Geriatrics.**

**NUMBER: PC 41**

**TITLE: Prepared Healthcare Workforce**

Many health care professionals and direct care workers are not
specifically trained to provide health care for the aging population as
specialists in geriatrics. The current shortage of geriatricians is
expected to worsen. There is also a shortage of advanced practice
graduate level nurses certified in geriatrics. Social workers have no
national certification for geriatric social work. Registered dieticians
and dietetic technicians have no formal program in geriatric nutrition.
As the baby boomers age, it will be important that care by qualified
geriatric workers be available across the health care continuum in
ambulatory, acute, home and community-based services, assisted living,
and long-term care settings.

**RESOLUTION:**

**Support Geriatric Education and Training for All Healthcare
Professionals, Paraprofessionals, Health Profession Students, and Direct
Care Workers.**

**NUMBER: PC 42**

**TITLE: Non-Institutional Long Term Care**

Older Americans want to age in place. Care of chronic disease presents
an increasing challenge to a health care system that emphasizes care for
acute illness. Eighty-three percent of Medicare beneficiaries have at
least one chronic condition. Nearly one-quarter have five or more
chronic conditions. Among Americans over age 65, more than one-third
will spend some time in a nursing home and half of these will spend over
a year in a nursing home. At any given time, five percent of persons
over age 65 are in nursing homes, and ten percent living in the
community need some form of long-term care. Innovative models of care
have demonstrated that an appropriate and timely array of
non-institutional long-term care services can be a favorable and less
costly alternative to nursing home care for selected individuals with
chronic disease and disability. For example, the "Cash and Counseling"
model sponsored by Robert Wood Johnson Foundation, the U.S. Department
of Health and Human Services and the Administration on Aging combines
elements of financial support with direct services such as information
and counseling, to help consumers make informed choices about their
care.

**RESOLUTION:**

**Promote Innovative Models of Non-Institutional Long-Term Care**

**NUMBER PC 43**

**TITLE: Care for Seniors With Disabilities**

The American health care system is increasingly challenged to meet the
community-based health care needs of the expanding population who are
aging with or aging into disability. The lack of a seamless system of
health care services and appropriately trained health care providers
(including geriatricians, gero-pharmacists, and rehabilitation
specialists) who understand the special health care needs of middle-aged
and older adults with disabilities can all too often result in serious
medical conditions and premature deaths due to incorrect diagnoses,
inappropriate drug therapy, and inadequate management of secondary
conditions resulting from a disability that could have been prevented.
By providing early prevention and wellness services along with a
seamless system of health services that ensures access to needed health
care, the special needs of older adults with disabilities can be
addressed effectively. The result can be a more effective, efficient
system of health care that helps individuals with disabilities reside in
the community, potentially prevents clinically unnecessary
hospitalizations and nursing home placements, and potentially eliminates
excessive health care costs.

**RESOLUTION:**

**Ensure Appropriate Care for Seniors with Disabilities**

**NUMBER: PC 44**

**TITLE: Awareness of Disparities**

Minorities suffer disproportionately from cancer, HIV, diabetes, heart
disease and other life threatening illnesses compared to non-minority
counterparts. These disparities require improvements in the delivery of
health care to meet the needs of African Americans, Hispanic Americans,
American Indians, Alaska Natives, Asian Americans, and Pacific
Islanders. Factors contributing to disparities include lack of access to
care and transportation and difficulty navigating a complex healthcare
system. Low-income elders with linguistic and cultural barriers often
seek help too late, if at all. Even if they seek help, they are less
likely to properly follow prescribed treatments because of
miscommunication. These differences may explain higher rates of
morbidity and mortality in minority populations, as compared to others.
Examples of health disparities include prostate cancer rates 2 times
higher in African American men under 65 compared to like White men,
highest rates of tuberculosis among Asian Americans and Pacific
Islanders, and diabetes nearly 3 times higher in American Indians/Alaska
Natives than others.

**RESOLUTION:**

**Reduce Healthcare Disparities Among Minorities by Developing
Strategies to Prevent Disease, Promote Health, and Deliver Appropriate
Care and Wellness.**

**NUMBER: PC 45**

**TITLE: Informed Consumer Choice**

The nation is shifting toward more consumer choice in healthcare
decision-making, as seen in the enactment of health savings accounts and
the adoption by many employers of a variety of consumer directed health
plans. This emerging trend is designed to give patients more control,
active involvement, and responsibility for healthcare. This approach
could lead to better-informed consumers, more self-determination in
healthcare decisions and lower costs. For example, scientific studies
demonstrate that personal management in health has positive effects on
resiliency, pain control, utilization efficiency, drug effectiveness,
and health outcomes. To take more control of their dollars and
responsibility for numerous healthcare decisions, seniors will need
information programs to help them choose wisely. For example, healthcare
services could be priced separately to promote publicly visible prices
for and access to curative and supportive services. The price and
quality information consumers will need to make informed choices about
the trade-offs among costs, quality, and accessibility of care are still
lacking for the most part, making the idea of consumer-driven healthcare
a long-term strategy.

**RESOLUTION:**

**Promote Informed Healthcare Consumers and Consumer Choice.**

**NUMBER: PC 46**

**TITLE: Innovations in Aging Research**

In the last half of the 20^th^ century, investment in research to
improve health provided dramatic returns in prevention, treatment and
cures for disease and disability, consequently lengthening life
expectancy and enhancing U.S. productivity. Although U.S. health care
spending per capita is the highest globally, it does not currently
produce the highest quality of health for all its citizens. Substantial
growth in the older population drives policy changes at national state
and local levels. To inform the decision-making and demonstrate the
relative value of various solutions, objective data are needed about the
changing health characteristics of Americans. In response to the first
wave of baby boomers turning 60 in 2006, we must make a national
commitment to significantly increase our investment in research to
prevent disease, disability, and injury. A cross-sector research agenda
that improves dissemination of health outcomes research, increases the
capacity for private-public research partnerships, and removes barriers
to cooperation between researchers and health practitioners is
important. This stimulation of new ideas and innovative solutions is a
means to provide all Americans an optimal quality of life, as free from
disease and dependence as possible.

**RESOLUTION:**

**Promote Innovative Evidence- Based and Practice- Based Medical and
Aging Research.**

**NUMBER: PC 47**

**TITLE: Shared Health Information**

Agencies are exploring ways to share health information to support
individual and population healthcare and referral needs. Ideally,
healthcare providers would share information easily through a single
gateway system. An electronic health record would allow providers in
different locations to review a history of the patient's medical
condition, current medications, and other records of care. Seniors with
access to their electronic healthcare record could easily share copies
of their histories with new healthcare providers or treatment facilities
as needed. A one- stop gateway system would facilitate information and
referral for elderly patients and their families during critical
transitions in care. At the population level, exchange of health
information is crucial if systems are to detect and respond to outbreaks
of disease and public health emergencies. Health and social support
networks, however, have been slow to support and adopt electronic
exchange of information.

**RESOLUTION:**

**Encourage Appropriate Sharing of Healthcare Information Across
Multiple Systems.**

**NUMBER: PC 48**

**TITLE: Veterans Healthcare**

One fourth of all Americans over age 65 are veterans. Ensuring that
veterans who are eligible and entitled to benefits and services,
particularly healthcare, are recognized in all settings is a national
priority. Ensuring that veterans are recognized in all healthcare
settings is a national priority, both to ensure that they are informed
of benefits available to them through the Department of Veterans Affairs
(VA) and to allow appropriate honor and recognition for their service to
our country. Benefits and services are delivered through a nationwide
network of Department of Veterans Affairs (VA) benefit offices, veteran
centers, outpatient clinics, medical centers, and nursing homes. Each
State has a Director of State Veterans Affairs that works with VA to
facilitate the delivery of these benefits and services as well as
benefits and services that are offered to veterans by the state. This
network includes over 3,000 veteran service representatives employed by
county governments. Veterans are also being treated and provided
services by public and private providers who are unaware that they are
serving a veteran who may be eligible and entitled to benefits and
services through the VA. These public and private providers are often
unaware they are serving a veteran of the United States military.
Additionally, veterans who seek benefits and services outside VA may not
be aware of their eligibility and entitlement. It is imperative that
steps be taken to improve the coordination of veteran eligibility and
entitlement to benefits and services at all levels and then to provide
the most efficient and cost effective delivery of those benefits and
services.

**RESOLUTION:**

**Ensure Appropriate Recognition and Care for Veterans Across All
Healthcare Settings.**

**NUMBER: PC 49**

**TITLE: Maintaining Sensory Capacities as One Ages**

Sensory impairments often jeopardize one's ability to live independently
in the community and can present challenges in many aspects of daily
life. Seniors with impairments in the five senses (vision, hearing,
touch, smell and taste) run the risk of being isolated from social
contacts, being deprived of needed services and information, and
experiencing declines in overall health. Personal safety can also be
compromised when a senior experiences sight and hearing impairment and
becomes desensitized to touch. As the baby boomers age, it will be
important to help seniors, and those who care for them, better
understand how to prevent and/or live with these physical challenges and
encourage them to seek preventive care such as annual eye and hearing
exams, and to maintain oral health practices.

**RESOLUTION:**

**Increase Awareness of Prevention and Treatment Strategies to Maintain
Sensory Capacities as One Ages.**

**NUMBER: PC 50**

**TITLE: Medicaid Program for Seniors**

Medicaid, which is jointly financed by the federal government and the
states is the largest payor of health and long-term care in the U.S.
Operating within broad federal guidelines, states largely administer it.
Therefore, the program varies across states depending on how states
choose to structure their programs in terms of eligibility and coverage.
Eligibility is complex and varies based on a range of factors, including
income, assets, categorical group (i.e., children and families, the
elderly, people with disabilities) and functional status. The scope of
what Medicaid covers is broad and diverse ranging from long-term care
for people in nursing homes and in the community, to premium assistance
for Medicare beneficiaries, to payments to hospitals providing a
disproportionate amount of uncompensated care.

Over five million of the oldest, lowest income, most vulnerable seniors
in our nation receive some form of assistance from the Medicaid program.
This assistance provides an essential safety net that meets critical
health and long-term care needs not covered under Medicare. In 2001,
Medicaid spent an estimated \$64 billion on the elderly. Approximately
9% of Medicaid enrollees are elderly, while about 26% of Medicaid
dollars are spent on seniors. Medicaid is the largest public source of
funding for long-term care. Medicaid in its current form suffers from a
serious institutional bias. According to the Urban Institute, only 16%
of Medicaid's long-term care expenditures for the elderly are spent on
home and community services. We need to build a framework for a Medicaid
long-term care program that provides better choices and control,
improves quality, and better supports families.

Medicaid costs are high and growing, but there are no easy answers to
reducing the cost of providing care to the Americans who now depend on
Medicaid for health and long-term care assistance. It is critical to
maintain optimal coverage for our most vulnerable citizens, while
reviewing and balancing the responsibilities for coverage and financing
between the federal and state governments.

**RESOLUTION:**

**Strengthen and Improve the Medicaid Program for Seniors.**

**NUMBER: PC 51**

**TITLE: Medicare Reform for the Future**

When Medicare was enacted in 1965, only about half of all older persons
had any form of health insurance. Today, Medicare provides healthcare to
more than 40 million older and disabled Americans. Medicare faces
multiple fiscal and coverage challenges as it prepares for the
retirement of the soon-to-be eligible baby boomers while strengthening
the program to address chronic care needs. Chronic illness is America's
highest cost and fastest growing healthcare problem.

**RESOLUTION:**

**Strengthen and Improve the Medicare Program.**

**NUMBER: PC 52**

**TITLE: Issues Surrounding the End of Life**

Issues of importance at the end of life include medical, legal and
ethical choices and decision making as well as cultural considerations.
Respect for different cultures and individual older adults requires
addressing the unique mix of patient and family needs to relieve
suffering, promote autonomy, and maintain independence at the end of
life. Palliative care and hospice services are provided to prevent and
relieve suffering and to support the best possible quality of life for
patients and their families. The legal aspects of end of life decisions
are intricate and confusing to the majority of the population, and laws
affecting decisions vary across government jurisdictions. The major
decisions about wills, medical treatment, and decision-making authority
are difficult to resolve when one is facing family crises or diminishing
capacity. Additionally, the unexpected costs involved in end-of-life
situations can quickly deteriorate a family's finances. While many
services are available to seniors with very low incomes or who are
financially well-off, middle income seniors may be financially
ineligible for certain forms of assistance, and at the same time, are
unable to pay for the services outright.

**RESOLUTION:**

**Educate Americans on End of Life Issues.**

**NUMBER: PC 53**

**TITLE: Care in Rural Areas**

Approximately 25% of the nation's older persons live in rural America.
Preventive medical care is often inaccessible to consumers in rural
areas, as they do not have readily available transportation, often
resulting in a crisis medical situation and much higher medical costs.
Older adults in rural areas often struggle with poverty, a limited
number of health care professionals in their area and minimal services.
With the projected increase in the aging population over the next
decade, it is expected that rural areas will face an increased demand
for services. For example, the 2000 Census shows that five of the eight
counties in one rural Appalachia district do not have a hospital or
emergency care facility. Four of eight counties in the same area have 5
or fewer physicians and there are no critical access hospitals.
Cost-effective service delivery options are needed to study and develop
in order to address the health and long-term living issues in rural
areas.

**RESOLUTION:**

**Improve Access to Care for Older Adults Living in Rural Areas.**

**NUMBER: PC 54**

**TITLE: Medication Management**

Medication-related problems, including underutilization of medications,
polypharmacy, adverse drug events and inappropriate prescribing, would
represent the fifth leading cause of death in the U.S. if classified as
a disease. Medication therapy management targets those with multiple
chronic diseases. Additionally, frail older adults with multiple
co-morbidities are often sub-optimally treated for chronic conditions
around which clear therapeutic guidelines exist. If followed, these
guidelines would reduce morbidity and cost. Patient injury and
unnecessary costs to the health care system may be avoided when
prescribers adhere to evidence-based treatment guidelines.

**RESOLUTION:**

**Optimize Medication Management Programs.**

**NUMBER: PC 55**

**TITLE: Patient Advocacy**

When one is not feeling well, navigating our health care systems without
assistance can be challenging and at times intimidating. The frail
elderly, those with cognitive impairments, persons with complex medical
conditions or mental illness, adults with disabilities, and people at
the end of life often need assistance in order to receive the care they
want or need. Many older people, minorities, immigrants, and those with
low incomes are disproportionately more likely to have trouble reading
and understanding written information and may not know how to get
assistance, resulting in poorer care and higher health care costs. At
least 4.5 million elderly Americans have dementia caused by Alzheimer's
disease, vascular disease and other conditions. More than half of people
with serious chronic conditions see three or more different physicians
and many see other health and social service providers. Twenty-three
percent of Medicare beneficiaries have five or more chronic conditions;
on average they have nearly 15 physician visits and fill over 50
prescriptions each year. Health care can be very complicated, confusing
and needed most by those who can least advocate for themselves.

**RESOLUTION:**

**Improve Patient Advocacy to Assist Patients in and Across All Care
Settings.**

**V. Civic and Social Engagement**

**NUMBER: PC 56**

**TITLE: National Strategy for Volunteering**

Faith-based, civic and family volunteerism is a cornerstone of American
society. As tomorrow's baby boomers join today's large force of senior
volunteers, the nation needs a strategy for fully utilizing this
significant number of talented and available people. The 2002 Health and
Retirement Study indicated high rates of volunteerism after retirement,
including formal volunteering, informal volunteering and caregiving for
family and friends. Today, almost 23 percent of Americans ages 65 and
older volunteer. Forty-five percent of volunteers donate time to
religious organizations and almost 18 percent support social or civic
organizations. Many volunteers are still in the workforce while they
find opportunities to volunteer and support their communities. This
makes coordination between corporate, community, and individual
volunteerism goals an important requirement for future America. The
advantages of late-life stability, experience and talent, and more
disposable time make the senior population a valuable resource in
faith-based and civic activities. Not only does volunteerism provide a
valuable resource to communities, it also helps support the social
engagement and active lifestyle that enhances older adults.

**RESOLUTION:**

**Develop a National Strategy for Promoting New and Meaningful Volunteer
Activities and Civic Engagements for Current and Future Seniors.**

**NUMBER: PC 57**

**TITLE: Higher Education and e-Training**

According to a new study from the University of Toronto, higher
education seems to provide a protective buffer from cognitive declines
as people age. Brain imaging showed that in seniors taking memory tests,
more years of education were associated with more active frontal lobes.
Education strengthens the ability to "call in the reserves" of mental
prowess found in that part of the brain. Studies also demonstrate that
involvement in computer activities, such as email and chat rooms, can
help people remain engaged and less depressed. Lifelong learning and
computer literacy should be encouraged among the general population,
including current and future seniors. Community support for the
cognitive health of its population is provided in the form of
information on higher learning, continuing education, and training
opportunities available for all adults, including information on
multiple modes of learning such as in classroom, televised, and
web-based instruction. Additional sources of community-based education
include senior centers, Area Agencies on Aging and public libraries.

**RESOLUTION:**

**Promote Lifelong Learning and e-Literacy for Older Adults.**

**NUMBER: PC 58**

**TITLE: Arts Participation**

Research suggests that active participation in the arts and learning
promotes physical health, enhances a sense of well-being among older
Americans, improves quality of life for those who are ill, and reduce
the risk factors that lead to the need for long-term care. Even though
there is an interest and participation in the arts by many older
Americans, there is a general lack of awareness in the public,
healthcare, and social services communities about the positive physical
and psychological impacts of arts participation. However, there is a
valuable untapped resource of older artists who could be teachers or
mentors in expanded arts programs for seniors. Older Americans may be
encouraged to participate in dance, music, and visual arts activities
and may choose to expand their horizons though art appreciation
programs. Participation in arts activities may lead to intergenerational
exchange of values and knowledge. For example, seniors may work together
and with younger populations to preserve the value of older adults'
memories and life experiences by recording their experiences and life
histories in various mediums.

**RESOLUTION:**

**Increase Awareness of the Positive Physical and Psychological Impact
That Arts Participation Can Have on Older Americans.**

**NUMBER: PC 59**

**TITLE: National and Community Service Act**

Over 27.7 million persons age 55 and over render some form of volunteer
service on an average of 3.3 hours per week (4.8 billion hours per year)
for an estimated \$71.2 billion value. Older adults have consistently
volunteered at much higher rates than younger age groups in roles that
support health, education, civic, religious, community and public
information goals. Baby boomers approaching retirement age expect and
desire expanded opportunities to make positive contributions to the
nation and their communities as a means of remaining vital, healthy and
independent, and to avoid becoming dependent on public services and
resources. There are thousands of national and community service and
membership organizations dedicated to the full spectrum of human, civic
and community development goals through both public and private
partnerships. The National and Community Service Act provides the most
comprehensive network of integrated volunteer service opportunities for
older persons in the nation through the Corporation for National and
Community Service (CNCS). Older volunteers provide, through private and
membership organizations, valuable assistance in financial education,
literacy and money management, community service job skills development,
tax preparation, basic education tutoring and mentoring, assistance to
residents of nursing homes, and driver safety.

**RESOLUTION:**

**Reauthorize the National and Community Service Act to Expand
Opportunities for Volunteer and Civic Engagement Activities.**

**NUMBER: PC 60**

**TITLE: Public Libraries**

As the population ages and we move into the 21^st^ century it is time
for the library system to reinvent itself as the resource center of the
community. The library system is a vital learning and community center
for all population age groups in the community. Modernization and
revitalization of the system requires exploration of new and expanded
ways to serve the population as a national community support network.
Greater collaboration and coordination with community partners and
resource centers will provide the needed support for the changing
demographics of the community. Public libraries need to be prepared to
provide a wide variety of services to the older adult population,
including adaptive technology and access to computer-based electronic
and digital information systems, and staff who are aware of the older
adult population's needs. Collaborations with community partners are
needed in order to extend the public library's resources. Libraries of
the 21^st^ century will be elder-friendly environments, community
clearinghouses for civic engagement of all kinds, including paid
employment, volunteer positions, education, the arts, and leisure
activities.

**RESOLUTION:**

**Develop Programs and Services Promoting Use of Public Libraries Among
the Older Adult and Baby Boomer Population.**

**VI. Technology and Innovation**

**in the Marketplace**

**NUMBER: PC 61**

**TITLE: Coordinated Health and Aging Networks**

Healthcare demanded by older Americans is complicated because it can
require a mix of services, including supportive elements. In order to
meet these needs, consumers need access to coordinated communication
systems that provide comprehensive information and help integrate the
array of services that are appropriate for changing needs. Aging
networks have helped improve how seniors and their families get
information, make decisions, and manage contacts as their needs and
interests change. However, these information and communication systems
have not been integrated well with acute medical care, long-term health
services, and health funding sources. The lack of effective
communication has made management of care confusing, tiring, and even
wasteful for seniors. Effective integration of health communication into
aging networks would improve health and information referral, assist
caregivers, and enhance individual decision-making. Furthermore,
coordinated information can also assist local governments with planning
public investments to fill gaps between seniors' needs and available
services.

**RESOLUTION:**

**Promote the Integration of Health and Aging Services to Improve Access
and Quality of Care for Older Americans.**

**NUMBER: PC 62**

**TITLE: Health Information Technology**

There are at least five promising areas for changes in aging services
technologies: 1) prevention, 2) early disease detection, 3) compliance
assistance, 4) independent living, and 5) caregiver support.
Technologies addressing home health, disease management, tele-health,
and independent living will be important in preparing for the
demographic changes facing our nation. Health IT can encourage more
informed consumers, caregivers, and providers. Given the high number of
medications seniors take, it is critical that they have access to their
personal health records. Although health networks have been slow to
adopt electronic exchange of information, due to privacy and cost
concerns, the federal government is leading a move to expand the use of
information technology in healthcare through the U.S. Defense Department
and Veterans Administration. For example, evidence-based,
outcomes-oriented demonstration projects are being supported to evaluate
the effectiveness of telemedicine programs for selected physical and
mental health conditions. Management information systems and
standardized patient health information databases are used in large
national healthcare systems to coordinate, manage, and evaluate a broad
range of services provided across the continuum of care. Creative
approaches to healthcare delivery such as tele-health self-management
techniques, assessment across programs and electronic records, and the
use of telemedicine are being tested and used in national clinical care
systems.

**RESOLUTION:**

**Develop Incentives to Encourage the Expansion of Appropriate Use of
Health Information Technology.**

**NUMBER: PC 63**

**TITLE: Technology Innovation**

As the American population ages, information and assistive technologies
become even more vital components in active, productive, and healthy
lifestyles. Technological innovations will change how Americans manage
and plan their self-healthcare, long term care, communications,
transportation and housing needs, participation in workforce and civic
activities and financial planning. Private and public sector economies
will develop innovative products and services to meet the diverse needs
of the aging population of consumers. These same factors will motivate
entirely new areas of innovation and the development of goods and
services to better serve consumers of all ages. These factors will
challenge public and private organizations and agencies to encourage
research and development of technologies that maintain independence and
reduce dependence on long term care, and speed approval of new eldercare
technologies, drugs, tele-health monitoring and treatment and assistive
devices that support older Americans, while improving their safety
profiles. Of particular importance will be development of products and
technologies that are affordable to all older Americans, including
low-income seniors.

**RESOLUTION:**

**Assure that Technology Policies Stimulate Innovation and Investment to
Support Current and Future Seniors.**

**NUMBER: PC 64**

**TITLE: Innovations for Baby Boomers**

Baby Boomers represent a significant change in population demographics
and an important opportunity for businesses. To compete, companies will
need to adapt products and services to better meet the diverse needs of
the aging consumer. The aging of this generation provides incentives for
the development of goods and services that will ultimately improve
service to consumers of all ages. In the past, businesses considered
older consumers a niche rather than a significant market for their
products, so most existing services and goods were not designed for
them. In 2000, 35 million Americans were over age 65; by 2010 that
figure will climb to 40 million and by 2030 to 71 million seniors. As
the baby boomers age, businesses will change their marketing strategies
to respond to the changing needs of the population. Product innovations
and new technologies will be developed for an aging consumer base with
an intense interest in staying healthy, active, and independent for as
long as possible. Many of these older adults will be suffering with
chronic illnesses and disabilities as they strive to remain in their
homes and age in place.

**RESOLUTION:**

**Promote Marketplace Innovations to Address the Changing Tastes and
Preferences of Aging Baby Boomers.**

**NUMBER: PC 65**

**TITLE: Incentives for Assistive Technologies**

Many older persons will need assistive (AT) or universally designed (UD)
technologies and environmental accommodations to support health,
productivity, and community living. This is particularly true for
Americans who are aging with and aging into disability. To meet this
need, all technology, products, services, systems and physical
environments should be accessible to the approximately 50 million adults
living with disabilities. Accessibility is central to fulfilling the
promise of the President's New Freedom Initiative. Creating an
accessible nation will provide significant, measurable economic benefits
to businesses and the American public through access to larger markets,
to more diverse talent, and to the productive potential of all in our
society. Significant barriers remain that prevent AT and UD technologies
and environments from being developed, deployed, and used by people with
disabilities and their families, caregivers, employers, and communities.
Barriers include insufficient coordination and investment in research
and development, lack of support for prototype development, poor market
data on needs, costs and questions of reimbursement which hinder
commercialization, legislative barriers and lack of coordination among
public and private programs, and lack of awareness among consumers,
providers, policymakers and businesses.

**RESOLUTION:**

**Promote an Accessible Nation by Expanding the Availability and
Utilization of Assistive and Universally Designed Technologies through
Private-Public Incentives.**

> **\* Cross Cutting**

**NUMBER: PC 66**

**TITLE: Accommodating Changes in the Demographic Future**

The Baby Boomer generation is likely to transform notions of old age.
Not only will this generation have dramatic effects on markets and
public programs, it will also promote an attitude about aging that is
unique to its own background. While this generation is impacting public
and private sectors as aged Americans, it will also affect the
age-related options and experiences of the previous generation. Baby
boomers have displayed a level of social, cultural, and economic
vitality that is unique, and this will likely carry over into their
lifestyles as older Americans, their desire to embark on new careers and
other meaningful experience, and their demands for suitable public
policies. Furthermore, the ethnic and language mix is likely to change
in the population of older Americans. Across the United States, policies
need to be examined as to their readiness for the demographic future.
This policy readiness includes the ability to meet changing needs; the
removal of barriers to innovation and consumer responsiveness; support
for dramatic changes in housing, work, and healthcare; and coordination
of these changes into future lifestyles and interests of the aged.

**RESOLUTION:**

**Promote Broad Policy Readiness and Engagement for the Demographic
Future.**

**NUMBER: PC 67**

**TITLE: Strategy for Informal Caregivers**

Family members, neighbors, friends, and other unpaid informal caregivers
are the primary source of labor in the U.S. long-term care system.
Approximately 80 percent of all care to older Americans is by an unpaid
family member or friend. It is estimated that there are 44.4 million
informal caregivers in the U.S. Family caregivers face challenges in
providing care to seniors, including access to home and community based
services, availability and access to resource information, and promoting
consumer choice in delivery of home care. In the case of caregivers who
work, many face challenges balancing work, caregiving, and family
responsibilities. Despite significant efforts to assist family
caregivers, challenges still remain in assessing caregiver needs,
receiving education and training, coordinating local services, accessing
coordinated information, planning long-term options, and creating
incentives for families to continue informal non-institutional care.
Emerging technologies may help the older adult and the caregiver; they
range from low tech gadgets such as mechanical lifting devices to more
complicated electronic monitoring.

**RESOLUTION:**

**Develop a National Strategy for Supporting Informal Caregivers of
Seniors to Enable Adequate Quality and Supply of Services.**

**NUMBER: PC 68**

**TITLE: Global Aging Insights**

Most other industrial countries are aging as rapidly as America; some
are aging much faster. Countries like Japan and Germany are experiencing
increasing numbers of elderly and a shrinking labor force. As a result,
both countries have recently reduced public pension benefits for
existing and future retirees. France recently extended the number of
years that civil servants needed to work before being able to collect a
full pension. Other countries such as Italy, Spain, and Greece are
facing fiscal pressures caused by aging and may take similar steps. The
approaches used by these and other countries in addressing the
challenges presented by global aging may provide useful insights, best
practices, and solutions to the United States in its efforts to address
the challenges of an aging population.

**RESOLUTION:**

**Identify Best Practices Derived from the Experiences of Other
Industrial Countries Facing an Aging Population.**

**NUMBER: PC 69**

**TITLE: Accountability for Implementation of 2005 WHCOA
Recommendations**

Historically, the statutory authority calling for the WHCoA has not
included a mechanism to provide on-going visibility and accountability
for implementation of WHCOA recommendations after the Conference and
submission of the WHCOA Implementation report to the Congress and the
Executive Branch. As a result, there has been limited focus on long-term
implementation of WHCOA recommendations. There is a clear need to
establish public or private mechanisms to facilitate follow up.

**RESOLUTION:**

**Implement a Strategy and Plan for Accountability to Sustain the
Momentum, Public Visibility, and Oversight of the Implementation of 2005
WHCOA Resolutions.**

**NUMBER: PC 70**

**TITLE: Response to Prevalent Disabilities**

While disability can arise at any age, the likelihood of acquiring a
disability increases as a person ages. As an aging population increases
the prevalence of disabilities, it requires effective responses to
social, economic, physical, and emotional well-being. Successful reforms
in policies and practices will result in the development of communities
in which everyone can live, work, and participate fully, consistent with
individual choice and direction, free of labeling, stigma or
discrimination. The substantive issues that support these potential
changes range from individual rights to national systems for standards
and coordination. However, there are few oversight mechanisms for
ensuring the community's response to age-based disability policy is
appropriate for the reinforcement of autonomy, self-determination, and
self-care. The American's with Disabilities Act charges all Federal
institutions to examine and modify their programs so as to protect and
reinforce autonomy and self-determination in Americans with
disabilities. Helping individuals with disabilities reside in the
community prevents clinically unnecessary hospitalizations and nursing
home placements and eliminates excessive health care costs.

**RESOLUTION:**

**Promote a National Strategy for Responding to the Higher Prevalence of
Disabilities in an Aging Population.**

**NUMBER: PC 71**

**TITLE: Coordination of Aging-in-Place**

Failure to coordinate senior services is the most significant obstacle
to aging in place in one's own home. While assisted living residences
and continuing care retirement communities integrate housing and care
services, they won't necessarily meet the needs of current and future
seniors. Implementation of a culture of consumer-focused services has
demonstrated dramatic improvements in quality care services for older
adults aging-in-place. Barriers to achieving quality of care and quality
of life include the use of non-standardized assessment protocols,
duplicated paperwork and processes, multiple medical records,
ineffective triage, and professionals who lack the training in
geriatric-related conditions. Coordination for aging-in-place is also
affected by a general shortage in affordable homes for low-income
seniors, and transportation infrastructure that is not designed to be
elder-friendly. For example, older adult populations need transportation
coverage by public transit systems and senior-friendly designs of road
signs, signals, and lighting. A broad systems approach to coordination
of multiple services begins with application of successful strategies
from managed healthcare to transportation and housing models. The degree
to which the nation's governmental, non-profit, and for -profit agencies
are coordinated, aligned, well consolidated, and accountable will
greatly determine the ability of older Americans to access quality
services in the 21^st^ century.

**RESOLUTION:**

**Improve State and Local Based Integrated Delivery Systems to Meet
21^st^ Century Needs of Seniors.**

**NUMBER: PC 72**

**TITLE: Program Alignment and Performance**

In order to provide effective and efficient program service delivery to
older Americans in areas of government funded health care, social
services, transportation, and housing programs, it is important that
these programs and services are consolidated and aligned within and
between federal agencies. Departmental sub-divisions within federal
agencies, and programs housed in separate federal agencies, often
overlap are duplicative, and may fail to coordinate services. For
example, there are 75 federal transportation programs, multiple housing
programs with conflicting selection criteria and myriad prevention
programs. Yet, in 2001 the Administration created the President's
Management Agenda of which one component was the use of performance
budgeting to guide agency budgets. The Office of Management and Budget
introduced an instrument to measure program efficiency within federal
agencies, the Program Assessment Rating Tool. The aging of the U.S.
population is expected to increase demand for a broad array of health
care and social support services, transportation, and housing programs.
The degree to which the nation's federal agencies are coordinated,
aligned, well consolidated, and accountable will greatly determine the
ability of older Americans to access quality services in the 21^st^
century.

**RESOLUTION:**

**Review Alignment of Government Programs That Deliver Services to Older
Americans**

**NUMBER: PC 73**

**TITLE: Limited English Proficient Access**

Little attention has been given to the growth of America's minority
senior populations. While the population aged 65 and older will grow
100% in the next 50 years, the diversity of the senior population will
also change drastically. During that same time period the number of API
and Hispanic elders will each grow by around 700%. Nearly 60% of Asian
Pacific Islanders (API) and Hispanic elders do not speak English well
and over 30% of the elders who are API or Hispanic have no one in the
household who speaks English. Elders who have linguistic and cultural
barriers tend to have difficulty accessing the system of aging and
health programs and services. Providing access to the continuum of
programs and services for all elders requires a commitment to an ongoing
effort of outreach and education as well as expansion of the aging
network and service provider's ability to provide linguistically and
culturally appropriate services. Community based organizations (CBOs)
that provide services or support in communities of unserved and
underserved populations play a crucial role in the lives of elders who
have limited English proficiency. CBOs that serve these communities can
provide an infrastructure of relevant information and assistance.

**RESOLUTION:**

**Assist Limited English Proficient Elders to Ensure That They Are Well
Informed About Programs and Services and Can Be Served Throughout the
Aging and Health Network.**