Mississippi Administrative Code › Title 18 - HUMAN SERVICES › Part 2 - Division of Aging and Adult Services › Chapter 1 - State Plan on Aging › Section 18-2-1-IX - Attachments › Attachment 18-2-1-IX-M - MISSISSIPPI STATEWIDE NEEDS ASSESSMENT

Current through June 25, 2024
GENERAL BACKGROUND
POPULATION CHARACTERISTICS
Mississippi, and the country as a whole, is aging, and this
					 will bring new challenges for those who serve the older population. The needs
					 of older adults are often interrelated, so it is important to understand who
					 makes up the aging population and how a state's aging population compares to
					 the nation as a whole.
In Mississippi, the characteristics of the general
					 55-and-older population tend to mirror those in the nation as a whole. Even
					 when trends in Mississippi are more pronounced, they follow essentially the
					 same path as the nation. In fact, historical population trends at the state
					 level show that Mississippi's older adult population has similar growth
					 patterns to those of the nation. According to U.S. Census figures, between 1900
					 and 2000 the number of adults aged 65 and older in Mississippi increased by
					 more than 600 percent from 45,000 to more than 343,000 individuals.
					 Mississippians aged 65 and older grew from less than 3 percent of the state's
					 population in 1900 to nearly 13 percent of the state's population today (see
					 Figure 1).
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Current census projections indicate that the number of
					 Americans aged 65 and older will more than double between 2010 and 2050. If
					 this projection holds true, older adults will account for approximately 20
					 percent of the country's population by as early as 2030 (Vincent and Velkoff
					 2010). These same estimates project the number of Mississippians aged 65 and
					 older to increase from approximately 343,000 in 2000 to over 499,000 in 2020.
					 This is an increase of over 45 percent in twenty years (U.S. Census 2005). Also
					 by 2020, Mississippians aged 85 and older are projected to increase from
					 approximately 43,000 in 2000 to nearly 60,000, an increase of over 39 percent
					 (U.S. Census 2005). Table 2 displays the projected growth of each age cohort 55
					 and over based on 2009 population estimates and 2020 projections for
					 Mississippi.
TABLE 2.
PROJECTIONS FOR
					 MISSISSIPPI'S 55 AND OLDER POPULATION, 2009-2020.
AGE COHORT
POPULATION 2009
PCT. OF POPULATION
POPULATION 2020
PERCENT CHANGE
55 TO 59
176,904
6.0
210,908
19.2%
60 TO 64
148,519
5.0
204,445
37.7%
65 TO 69
113,242
3.8
170,187
50.3%
70 TO 74
89,706
3.0
131,955
47.1%
75 TO 79
70,066
2.4
84,058
20.0%
80 TO 84
53,882
1.8
54,360
0.9%
85 AND OLDER
50,019
1.7
58,630
17.2%
TOTALS
702,338
23.7%
914,543
30.2%
Sources: U.S. Census Bureau, Population Estimates
					 2009.
U.S. Census Bureau, Interim State Projections,
					 2005.
Workforce participation is another important characteristic
					 of the aging population. Employment data from the Bureau of Labor Statistics
					 provide information on the employment situation for older adults in
					 Mississippi. In 2010 those between the ages of 55-64 recorded a workforce
					 participation rate of 55.5 percent compared to 13.6 percent for those 65 and
					 older. Both rates are lower than the national rate, as adults between the ages
					 of 55 to 64 reported a workforce participation rate of nearly 65 percent, while
					 those 65 and older reported a rate of over 17 percent.
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The figure below displays CPS data on the prevalence of
					 full-time workers in the 55 and older age group. Data for the most recent three
					 year averages show that the prevalence of full-time workers in Mississippi for
					 this age group is consistent with the nation and that Mississippi generally
					 records a higher rate of full-time workers than the national average for this
					 age group.
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Regarding unemployment, Mississippians 55 to 64 had an
					 unemployment rate of 5 percent compared to 7 percent for the nation in 2010.
					 Mississippians aged 65 and older had an unemployment rate of 4 percent compared
					 to nearly 7 percent for the nation. The chart below displays the unemployment
					 rates for these age groups from 1999 to 2010.
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Poverty can have tremendous impacts on a variety factors,
					 including health, well-being, and demand for services. Current Population
					 Survey data show that poverty among older adults in Mississippi has been
					 consistently higher than that of the nation, which follows historical trends
					 for overall poverty. Most recent averages from 2008-2010 indicates a poverty
					 rate of 17 percent for those adults aged 55 and older compared to 12.6 percent
					 for the nation.
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HEALTH
While the general population trends in the state and the
					 nation mirror one another, so do the trends in health for the aging population.
					 In terms of self-reported health status of older adults, Figures xxx and xxx
					 show that Mississippians are more likely than the rest of the nation to
					 classify their health status as either Fair' or Poor.' Estimates from the
					 Behavioral Risk Factor Surveillance Survey (2009) show that over 31 percent of
					 55 to 64-year-olds and nearly 40 percent of those aged 65 and older rated their
					 health as Fair' or Poor' compared to 20 percent and 26.1 percent for the
					 nation. Results from the GNAS show that over 15 percent of respondents rated
					 their health as Fair' or Poor.' By comparison, nearly 40 percent of WLNAS
					 respondents rated their health as Fair' or Poor.'
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Source: Centers for Disease Control and Prevention,
					 Behavioral Risk Factor Surveillance Survey, 1995-2009
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Source: Centers for Disease Control and Prevention,
					 Behavioral Risk Factor Surveillance Survey, 1995-2009
Data related to other major health indicators show that
					 older adults in Mississippi tend to fair worse than the nation as a whole.
					 Disability rates from the Current Population Survey show that over 29 percent
					 of older Mississippians reported living with a disability in 2010 compared to
					 24 percent of older adults nationwide.
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Source: U.S. Census Bureau, Current Population
					 Survey March Supplement, 1992-2010.
Obesity and diabetes are two major future health concerns
					 facing the aging population. Historic data trends show that obesity is already
					 a concern in Mississippi, as state-level rates consistently exceed those of the
					 nation. Figures 11 and 12 show that over 37 percent of Mississippians aged 55
					 to 64 and nearly 28 percent of Mississippians aged 65 and older are classified
					 as obese compared to national rates of 32 percent and 24 percent,
					 respectively.
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Source: Centers for Disease Control and
					 Prevention, Behavioral Risk Factor Surveillance Survey,
					 1995-2009.
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Source: Centers for Disease Control and Prevention,
					 Behavioral Risk Factor Surveillance Survey, 1995-2009
High rates of obesity in Mississippi have been accompanied
					 by high rates of diabetes. As Figure 13 shows, over 21 percent of 55 to 64 year
					 olds and over 24 percent of adults aged 65 and over reported being diagnosed
					 with diabetes.
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Source: Centers for Disease Control and Prevention,
					 Behavioral Risk Factor Surveillance Survey, 2004-2009
SERVICE
Population estimates for 2009 report that there were over
					 525,000 Mississippians aged 60 and older, which comprised nearly 18 percent of
					 the state's population (U.S. Census 2010). The Administration on Aging's Aging
					 Integrated Database (AGID) show that MDHS's Division of Aging and Adult
					 Services has served over 26,000 clients in 2009 (Administration on Aging 2011),
					 which is approximately six percent of the state's 60 and older population.
					 Assuming six percent represents the most needy elderly Mississippians, DAAS can
					 expect an increase of 14,000 clients by 2020.
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Source: Administration on Aging, Aging Integrated
					 Database, 2011.
A review of the specific services provided shows that the
					 most used service of AAA is Home Delivered Meals (HDM). Between 2000 and 2009,
					 approximately three percent of Mississippians over 60 received HDM. Assuming
					 these conditions persist, DAAS can expect to see an increase of 7,000 clients
					 seeking Home Delivered Meals by 2020.
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Source: Administration on Aging, Aging Integrated
					 Database, 2011.
Homemaker Services is the second-most accessed service
					 provided by AAA. Between 2000 and 2009, approximately one percent of
					 Mississippians over 60 received Homemaker Services. Assuming these conditions
					 persist, DAAS can expect to see an increase in demand for Homemaker Services of
					 close to 2,300 by 2020.
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Source: Administration on Aging, Aging Integrated
					 Database, 2011.
Though trending down, Congregate Meals is the third-most
					 popularly received service provided by AAA. Between 2000 and 2009, just under
					 one percent of Mississippians over 60 received Congregate Meals. Assuming these
					 conditions persist, DAAS can expect to see an increase in demand for Congregate
					 Meals of just over 2,000 by 2020.
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Source: Administration on Aging, Aging Integrated
					 Database, 2011.
2011 MISSISSIPPI OLDER ADULTS NEEDS ASSESSMENT
					 RESULTS
The 2011 Mississippi Older Adults Needs Assessment surveyed
					 adults aged 55 and older on a variety of topics, including service awareness,
					 everyday activities, health status, living arrangements, quality of life, and
					 future concerns. In order to gain greater perspective into the everyday lives
					 and unmet needs of older Mississippians, two telephone surveys of adults aged
					 55 and older were conducted.
The first was a random sample survey of the state's older
					 adult population (GNAS), and the second was a survey of individuals who are
					 currently on waiting lists for DAAS services (WLNAS). The minimum age was set
					 at 55 so that the needs and concerns of this age group could be documented to
					 help agencies prepare not only for those who are currently eligible for
					 services but for those who will become eligible for services in the next five
					 years.
A general set of questions was developed for both surveys
					 and were asked of the GNAS and WLNAS respondents. WLNAS respondents were,
					 however, asked additional questions specific to how long they have been waiting
					 for services, their level of urgency for receiving services, and how they were
					 coping with the lack of service. Results for the two surveys and the focus
					 group session are provided below.
2011 MISSISSIPPI OLDER ADULTS NEEDS ASSESSMENT
					 RESULTS
The 2011 Mississippi Older Adults Needs Assessment surveyed
					 adults aged 55 and older on a variety of topics, including service awareness,
					 everyday activities, health status, living arrangements, quality of life, and
					 future concerns. In order to gain greater perspective into the everyday lives
					 and unmet needs of older Mississippians, two telephone surveys of adults aged
					 55 and older were conducted. The first was a random sample survey of the
					 state's older adult population (GNAS), and the second was a survey of
					 individuals who are currently on waiting lists for DAAS services (WLNAS). The
					 minimum age was set at 55 so that the needs and concerns of this age group
					 could be documented to help agencies prepare not only for those who are
					 currently eligible for services but for those who will become eligible for
					 services in the next five years.
A general set of questions was developed for both surveys
					 and were asked of the GNAS and WLNAS respondents. WLNAS respondents were,
					 however, asked additional questions specific to how long they have been waiting
					 for services, their level of urgency for receiving services, and how they were
					 coping with the lack of service. Results for the two surveys and the focus
					 group session are provided below.
ASSESSMENT SURVEYS
Overall, the results of the GNAS show that Mississippi's
					 older adult population report high scores on quality of life and health status.
					 Specifically, 94 percent of respondents ranked their quality of life as "good"
					 or better with 76 percent ranking their quality of life as very good or
					 excellent. In general these respondents were less dependent on alternative
					 sources of transportation, had lower levels of food insecurity, and were less
					 concerned with being able to meet their basic needs.
Concerns arise, however, with the examination of the WLNAS
					 results, which show striking differences between the two survey populations.
					 These results encapsulate the major issues that face the state's aging
					 population. WLNAS respondents faired much worse on self-reported quality of
					 life and health assessment scores, and they also reported higher levels of
					 dependence on transportation and much higher levels of food insecurity than
					 those from the GNAS.
With the projected increase of older adults in Mississippi,
					 the state can expect an increase in the number of older adults who have
					 difficulty meeting basic needs without assistance. As the results of these two
					 surveys demonstrate, this is especially true for older adults living on low
					 incomes and those who reside in rural areas. Special attention should also be
					 paid to older adults who provide care for others, as an increase in older
					 adults could also result in an increase in caregivers who may be in need of
					 some type of relief.
Ultimately, potential clients will need to know what
					 services are available and how and where these services can be accessed. The
					 DAAS currently serves a small share of the state's aging population. An
					 increase in awareness, especially among low-income and rural individuals, could
					 result in more people receiving the services and assistance they need.
* QUALITY OF LIFE AND LIFESTYLE
GNAS
* Seventy-six percent of respondents reported their Quality
					 of Life as being Very Good or Excellent.
* Physical health was the most pressing quality of life
					 concern among GNAS respondents, as over 46 percent of respondents reported a
					 high level of concern for this indicator.
* Other major concerns included Financial Problems (26.6
					 percent), Access to Adequate Healthcare (21.3 percent), Affordable Medications
					 (20.3 percent), and Depression (18.2 percent).
* Physical Health was a major quality of life concern for
					 Low Income Respondents (60.2 percent). In contrast, only 23 percent of High
					 Income Respondents saw their current Physical Health as a major concern.
WLNAS
* In contrast to the GNAS results, only 40 percent of
					 respondents reported their Quality of Life as being Very Good or
					 Excellent.
* Physical Health (79.5 percent) and Financial Problems
					 (50.2 percent) were the most pressing quality of life concerns for WLNAS
					 respondents.
* WLNAS respondents were more concerned with issues related
					 to Loneliness and Isolation, the Ability to Perform Everyday Activities like
					 bathing or preparing meals, and Accessing Transportation than those who
					 participated in the GNAS.
FAMILY AND SOCIAL SUPPORT
GNAS
* Ninety-eight percent of respondents believed that they
					 had a reliable contact in the case of an emergency.
* Over 11 percent of respondents reported having no family
					 members living within 25 miles of their residence.
WLNAS
* Ninety-one percent of respondents believed that they had
					 a reliable contact in the case of an emergency.
* Almost 12 percent of respondents reported having no
					 family members living within 25 miles of their residence.
CAREGIVING
GNAS
* Over 33 percent of respondents reported that they provide
					 care for a family member or friend on a regular basis.
* Seventy-four percent of caregiving respondents were
					 female.
* About 30 percent of respondents spent more than 20 hours
					 per week providing care for others.
* Eight percent of caregivers reported a high need for
					 respite care.
* Twenty-three percent of caregivers reported that their
					 future ability to care for others was a major concern.
WLNAS
* Twenty-two percent of respondents reported that they
					 provide care for a family member or friend on a regular basis.
* Eighty-three percent of caregiving respondents were
					 female.
* Over 37 percent of caregivers spent more than 20 hours
					 per week providing care for others.
* Over 33 percent of caregivers reported that their future
					 ability to care for others was a major concern.
LIVING ARRANGEMENTS
GNAS
* Nearly 73 percent of respondents reported they were Very
					 Satisfied with their current living arrangements.
* Over 24 percent of respondents reported that the ability
					 to continue living independently was a major concern for them as they continue
					 to age over the next five or more years.
* Eighty-nine percent of High Income Respondents (those
					 with Household Incomes of $75,000 or greater) were Very Satisfied with their
					 Living Arrangements, compared to less than 63 percent of Low Income Respondents
					 (those with Household Incomes of $20,000 or less).
WLNAS
* Over 44 percent of respondents reported they were Very
					 Satisfied with their current living arrangements.
* Nearly 47 percent of respondents reported that the
					 ability to continue living independently was a major concern for them as they
					 continue to age over the next five or more years.
DIET AND FOOD SECURITY
GNAS
* Nearly 12 percent of the sample reported that there had
					 been times over the last year when they were unable to afford enough food to
					 eat.
* The inability to afford food was a major issue for
					 low-income groups. Over 38 percent of respondents with household incomes below
					 $10,000 reported that the inability to afford enough food to eat had been a
					 problem for them over the last year.
* Over 24 percent of respondents were unable to afford the
					 kinds of foods they wanted to eat at one time or another over the last 12
					 months, and for 6 percent of respondents this was a frequent occurrence.
* Over 20 percent of respondents were unable to afford to
					 eat healthier meals over the last 12 months. This was a frequent problem for
					 nearly 6 percent of respondents.
* The ability to afford basic needs like food and rent was
					 a major future concern for nearly 23 percent of respondents.
* Nearly 15 percent of respondents reported a high level of
					 need for Food Stamps.
* Nearly 23 percent of African-American Respondents claimed
					 that there had been times over the last year when they were unable to afford
					 enough food. This was a problem for only 8.3 percent of White
					 Respondents.
WLNAS
* Over 49 percent of the sample reported that there had
					 been times over the last year when they were unable to afford enough food to
					 eat.
* Over 66 percent of respondents were unable to afford the
					 kinds of foods they wanted to eat at one time or another over the last 12
					 months.
* Over 63 percent of respondents were unable to afford to
					 eat healthier meals over the last 12 months.
* The ability to afford basic needs like food and rent was
					 a major future concern for 46 percent of respondents.
TRANSPORTATION
GNAS
* Approximately 15 percent of respondents reported that
					 they did not use their own vehicle as a primary means of transportation for
					 most local trips.
* Of those respondents who did not use their own vehicle as
					 a primary means of transportation:
* Over 47 percent reported that a lack of transportation
					 was a problem for them over the last year.
* Nearly 49 percent resided in rural areas.
* Over 53 percent reported household incomes of less than
					 $10,000 in 2010.
* Nine percent of respondents reported a high level of need
					 for transportation services.
* Twenty-three percent of respondents reported a high level
					 of future concern with their ability to drive on their own.
* Sixteen percent of respondents had high levels of concern
					 with the availability of adequate transportation over the next five or more
					 years.
WLNAS
* Nearly 53 percent of the sample reported that they did
					 not use their own vehicle as a primary means of transportation for most local
					 trips.
* Over 74 percent of respondents reported that a lack of
					 transportation was a problem for them over the last year.
* Over 28 percent of respondents reported a high level of
					 future concern with their ability to drive on their own.
* Nearly 37 percent of respondents had high levels of
					 concern with the availability of adequate transportation over the next five or
					 more years.
HEALTH STATUS
GNAS
* Over 54 percent of respondents reported being in Very
					 Good or Excellent health.
* Over 40 percent of respondents reported that their
					 physical health did not interfere with their ability to perform basic daily
					 activities.
* High Blood Pressure was the most common health condition,
					 as nearly 64 percent of respondents reported they had been diagnosed with this
					 condition within the last two years.
* Some of the other major health concerns included
					 Arthritis (58 percent), Vision Problems (38.8 percent), Back Pain (36.4
					 percent), and other Joint Problems (32.0 percent).
* 13 percent of the sample reported there had been times
					 when they needed medical attention but elected not to seek it.
* Of those who decided not to seek medical attention, over
					 54 percent reported cost issues, over 27 percent decided to treat themselves,
					 and nearly 16 percent reported other reasons for not seeking medical attention,
					 such as nursing experience and not being able to miss work.
* Over 75 percent of High Income Respondents reported their
					 overall health as being Very Good or Excellent. In contrast, slightly over 43
					 percent of Low Income Respondents reported their overall health as being Very
					 Good or Excellent.
* Over 76 percent of African-American Respondents reported
					 being diagnosed with High Blood Pressure, and nearly 32 percent had been
					 diagnosed with diabetes. These percentages were at 64 percent and 25 percent
					 for the GNAS as a whole, respectively.
WLNAS
* Nearly 23 percent of respondents reported being in Very
					 Good or Excellent health.
* Nearly 63 percent of respondents reported that their
					 physical health made it difficult to perform basic daily activities like
					 bathing or preparing meals.
* High Blood Pressure was the most common health condition,
					 as nearly 79 percent of respondents reported they had been diagnosed with this
					 condition within the last two years.
* Some of the other major health concerns among respondents
					 included Arthritis (77.4 percent), Back Pain (61.1 percent), Vision Problems
					 (58.0 percent), and other Joint Problems (54.1 percent).
* 24 percent of the sample reported there had been times
					 when they needed medical attention but elected not to seek it.
* Of those who decided not to seek medical attention, over
					 44 percent reported cost issues, over 23 percent claimed they had no means of
					 transportation, and over 19 percent decided to treat themselves.
SERVICE NEED AND AWARENESS
GNAS
* Nearly 68 percent of respondents claimed to be unaware of
					 the services provided and facilitated through the Area Agencies on
					 Aging.
* Of those respondents who were aware of the Area Agencies
					 on Aging, nearly 34 percent did not know how to get in contact with local Area
					 Agency on Aging representatives.
* Senior Discount Programs were found to be the greatest
					 need among respondents, as over 31 percent reported a high level of need for
					 this service.
* Other services that scored high on the list were Repair
					 Services (22.4 percent), Physical Fitness and Exercise Programs (18.5 percent),
					 Tax Preparation (15.9 percent), and Information and Referral Services (15
					 percent).
* Over 77 percent of Low Income Respondents were unaware of
					 the services provided by DAAS, compared to 44 percent of High Income
					 Respondents claiming to be unaware.
* Senior Discount Programs (44.8 percent) and Food Stamps
					 (34.4 percent) were the greatest service needs among Low Income Respondents. In
					 contrast, the greatest service needs of High Income Respondents were Exercise
					 Programs (17.6 percent) and Repair Services (17.6 percent).
WLNAS
* Over 64 percent of respondents were on waiting lists for
					 Home Delivered Meals.
* Other services for which respondents were waiting for
					 included Homemaker Services (27.6 percent), Home Healthcare (17.3 percent),
					 Congregate Meals (8.1 percent), and Repair Services (7.8 percent).
* Repair Services (63.6 percent) was reported as the most
					 urgent need among WLNAS respondents.
* Help from family was the most consistent coping mechanism
					 used among respondents waiting for services.
* Many respondents reported there were times they were
					 forced to do without a service when alternative sources of support were not
					 available.
FUTURE CONCERNS
GNAS
* Physical health (58.5 percent) was reported as the
					 greatest future concern.
* Affording Healthcare (31.3 percent), Affording
					 Medications (29.5 percent), Mental Health (28.5 percent), and the Ability to
					 Care for Others (25.2 percent) were among the other major concerns.
* Declining Physical Health was the most pressing concern
					 for the entire sample (58.5 percent); this was especially true for Low Income
					 (66.3 percent) and Female Respondents (61 percent).
WLNAS
* Physical health (68.2 percent) was reported as the
					 greatest future concern.
* Affording Healthcare (46.9 percent), the Ability to Live
					 Independently (46.7 percent), Affording Basic Needs, and Affording Medications
					 (44.9 percent) were among the other major concerns.
SERVICE PROVIDER FOCUS GROUP
A computer-assisted focus group consisting of 25 service
					 providers from the 10 AAAs was conducted in order to gain insight on the
					 strengths and weaknesses of the current service delivery method and what the
					 state needed to do to prepare for the increase in the aging population.
Participants were made up of directors of AAAs, directors
					 of non-profits, and a variety of field specialists. The focus group used
					 innovative web-based technology that gathers information in a way that gives
					 everyone a voice in the process while still getting the benefits of sharing
					 ideas in a group setting. Focus group materials are available in Appendix
					 V.
Current and Future Needs Assessment
Overall results from the focus group and the surveys
					 indicate that service providers and elderly Mississippians share the same
					 vision of current and future needs. Both agree that home repair services are
					 the biggest need for today's clients. Both agree that preventative services for
					 health and finances are the greatest needs of tomorrow's clients. Both agree
					 that Mississippians need more awareness of available services. Both agree that
					 caregiving is very difficult.
Participants were asked about the greatest unmet needs of
					 their community. Service providers see keeping individuals in their homes as
					 the biggest priority in improving the lives of older Mississippians. In order
					 to do this, service providers are in agreement that currently general home
					 repairs is the greatest unmet need of seniors. Specific home repairs stated
					 included roofs and wheel chair ramps.
Participants were asked about the effect of the retirement
					 of the Baby Boom on services. Service providers agree that Baby Boomers are
					 more active, independent, and more educated than previous elderly generations.
					 Thus, there will be a need for preventative services, including exercise
					 opportunities and nutrition, and financial education on home-delivered meals,
					 homemaking services, and transportation.
Service providers also agree that Mississippians need more
					 training on how to get informed about the services that are available to
					 elders, including AAA services. GNAS results show that almost 70 percent of
					 Mississippians were not aware of AAA services. Service providers had many ideas
					 on how to reach clients effectively. The channels of trusted information most
					 cited were, in order, churches, wellness centers, doctors, and family members.
					 Targeting adult children was mentioned as a strategy as well as pharmacists,
					 senior centers, mass media, pamphlets, community meetings, health fairs, places
					 of employment, and utility companies.
Service providers agree that Mississippians of all ages
					 need an education campaign for all Mississippians that serves to prepare people
					 for the stages of the aging process. Service providers think that many people
					 are in denial about the aging process. There was general agreement that being
					 able to communicate about aging, death, dying, the stages of grief, and costs
					 of long-term and hospice care would help people to make choices that better
					 prepare themselves for retirement. The educational campaign would focus on good
					 health and financial practices throughout life so that people reach retirement
					 more physically and financially fit. Service providers were united in the
					 thought that successful aging starts early in life.
Service providers agreed that providing training to
					 caregivers is a top priority. Caregivers will have an expanded role as the Baby
					 Boomer population ages, increasing the need for caregiver training. Research on
					 care giving shows the detrimental impacts on the caregiver. Participants
					 overwhelmingly said that in order to prevent burn-outs, caregivers need to
					 learn coping skills and the importance of self-care. Coping skills include
					 stress and anger management and sensitivity to elders in terms of understanding
					 what it feels like to be dependent on someone else. Self-care includes
					 understanding one's limits and how to get help or find support groups. In
					 addition to training on how to physically care for loved ones, caregivers also
					 need training on how to make decisions that are in the best interests of the
					 family as a whole.
Service Delivery Method and Increasing
					 Capacity
AAA directors report that though the majority of their
					 staffs are not trained in geriatrics, their staffs work well as a team. AAA
					 personnel value shaping the process of improving service delivery through
					 collaboration, are loyal to the needs of Mississippi's aging population, and
					 enjoy interacting with the seniors they serve. The service providers at the
					 focus group are willing to learn and desire to be active in shaping the process
					 of improving lives of the elderly in Mississippi. Most participants in the
					 focus group know they need more training and welcomed training opportunities.
					 Service providers would like to see and know that DAAS personnel is personally
					 involved and understands the plight of some of their most needy clients,
					 especially rural individuals.
Service providers agreed that more and better communication
					 was needed from DAAS both within and between districts. There was a strong
					 desire for more regular meetings and for a significant increase in
					 communication from DAAS that is timely and well-thought out. Currently,
					 information is centralized with the directors and may not be consistent or
					 consistently disseminated.
Service providers overwhelmingly report a "figure it out
					 myself" approach to accomplishing their job duties. Lessons learned are not
					 shared which maximizes the work effort. Service providers agreed that more
					 training for all levels of personnel was a top priority. As Baby Boomer AAA
					 directors retire, an important window of opportunity for reshaping the culture
					 of each AAA will open. DAAS needs to be ready for the exodus of
					 expertise.
Service providers agree that current service provision is
					 done in "silos" with no resources spent to increase awareness of services
					 because they have no capacity to increase services. Service providers view
					 churches, wellness centers, doctors, and family members as trusted channels of
					 information that would be good partners.
There was also a consensus among service providers that
					 budgetary flexibility would increase capacity to serve more elderly
					 Mississippians. For example, being able to switch funds from Congregate Meals
					 to Home Delivered Meals would enable local providers to match the funds more in
					 line with local needs.