Alabama Administrative Code › Title 410 - STATE HEALTH PLANNING AND DEVELOPMENT AGENCY › Chapter 410-2-2 - HEALTH PRIORITIES › Section 410-2-2-.03 - Care Of The Elderly And Chronically Ill

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The Problem
(a) The elderly comprise one of the most
			 rapidly growing age groups in the United States. The same is true in Alabama.
			 Since 1900, the state's total population (approximately 4.4 million people) has
			 more than doubled and there are nearly ten times as many senior citizens. In
			 1900 persons 65 and older accounted for only 3% of the total population
			 compared to 16.8% in 2019. This age group is expected to increase to over 22%
			 by the year 2050.
(b) Improvements
			 in life style, changes in diet, and development of medical technology for
			 identification and treatment of diseases have resulted in increased life
			 expectancy. Because of this increase, a new phenomenon is occurring, aging of
			 the aged. More persons are living well into their 80s and even 90s. Within the
			 ten-(10) year period from 2013 to 2022, the 65 and older segment of the
			 population is expected to increase by fifteen percent (15%). The special needs
			 of these frail elderly will demand increased attention from service providers
			 in the years ahead. The number of people aged 65 and older in Alabama is
			 projected to be almost 900,000 by 2022.
(c) The male population age 65 plus increased
			 by 13.3% from 1990 to 2000 and the female population of the same age group
			 increased by 9.3%, while one-third of the noninstitutionalized elderly live
			 alone, 80% of these are women.
(d)
			 As age increases, the incidence of chronic disease and disability, particularly
			 at the lower levels of severity, increases. Another factor affecting the
			 increase of the chronically ill is the projection of an increase in the number
			 of AIDS cases in the state.
(e)
			 Many of our chronically ill live below the poverty level. The current census
			 reflects they do not always seek medical assistance because of out-of-pocket
			 costs. Often they cannot afford required medications. Some live in substandard
			 housing with inadequate plumbing and heating. They do not always practice
			 proper nutrition because of economic concerns and the inability to
			 shop.
(f) Depression, loneliness,
			 alcohol and drug abuse, suicide, and mental health conditions pose problems for
			 many elderly and chronically-ill citizens.
(g) Transportation is not available to all
			 elderly and chronically ill persons. Many who have lived alone in the past will
			 need to be placed in a facility where they can receive assistance. Families,
			 with both husband and wife working, need assistance with parents during work
			 hours and at other times for respite care.
(h) Dental care and audiology are not
			 available at affordable prices for all the elderly and chronically ill,
			 although many more dentists are accepting Medicaid patients.
(i) Recent statistics project an increase in
			 the need for care of the elderly and chronically ill within the next few years.
			 However, much of this care will be linked directly to functional limitations,
			 and only indirectly to illness.
(j)
			 The social, economic, and cultural environment will have important bearing on
			 how well our elderly maintain their overall health status. The support that was
			 once provided by relatives is less feasible in today's society because of
			 scattered families, divorce, single parents, childless couples, and two-income
			 families.
(k) The kind of care and
			 support needed to maintain the health of our elderly and chronically ill
			 population cannot be sustained within the state's current medical
			 framework.
(l) The availability of
			 health care services has increased. Medicaid increased the payment to dentists
			 and physicians in the last two years; the Medicaid drug formulary has been
			 expanded and payments have been increased to nursing homes.