Examining the needs of older Americans as we continue to live longer.

The aging process can be compared to snowflakes — unique, beautiful and different for each person. Factors such as genetics, lifestyle, geography, race, economics and diet make aging both stunning and complex. This wild mix sends researchers’ heads spinning as they try to untangle the elements that lead to the best possible aging process — one that brings the greatest well-being to older people.

Understanding the needs of older Americans as they age has become vastly important based on the sheer numbers. In 1900, only 100,000 Americans lived to be 85, but by 2010, that number had grown to 5.5 million. By 2050, the 85+ age group will reach 19 million or more. Numbers like that demand attention.

The questions we as a nation need to be asking are: What kinds of services will be needed throughout the spectrum of aging? How can we ensure a competent workforce to provide those services? What systems of care will need to be in place to ensure the well-being of this enormous wave of people?

Generational breakdown


60 is the new 40. Many people at this age today have bought into a lifestyle that has included healthy diet, exercise and strong social and family circles, finding themselves in better physical and mental fitness than those who hit 60 a generation ago. The majority of today’s 60-year-olds are valuable contributors to the workforce and their families. Those who are active, keep fit, go for regular checkups and tend to medical issues are rewarded by a youthful, healthy “young old.”

Contributing to the climb to older age is the significant decrease in acute conditions. Many people in earlier generations died of heart conditions, cancers and various other acute events. Cigarette smoking had a substantial impact. Between 1981 and 2009, the death rates for heart disease and stroke fell by more than 50 percent. These conditions did not disappear though; rather, people are now surviving and living with the chronic consequences of cardiovascular disease. So, although acute conditions decreased, a staggering 91 percent of older adults report dealing with chronic conditions such as diabetes, arthritis and hypertension. Caregiving issues and responsibilities with this age demographic are primarily about maintenance, maintaining a vigilance toward the disease while attempting to remain as independent as possible.


Caregiving for elders in their 70s begins to define itself around gender. It is reported that 11.3 million older adults live alone, with older women being twice as likely to live alone. The caregiving needs for this group revolve around services that provide ease and safety within the home. Food delivery, transportation, alert services, housekeeping and chore services factor prominently in helping the 70 strata live independently.

Innovative communities have arisen to support their aging in place. From trailer parks to upscale retirement communities, many older Americans have found support by unifying. Management companies help to service an area, providing all of the previously mentioned services along with home care services and healthcare navigation support.


As Americans age, we begin to see a remarkable number of women outpacing men. Two-thirds of Americans age 85+ are women. Caregiving for this age includes services that have a great deal to do with overall well-being. Within the community, all around us, are those who are seen in stores, at church, volunteering and using the midday hours for shopping and errands. They might accept the help of home service agencies to cover chores and other household needs. Illness, injuries or accidents can lead to the use of institutional care. The possibility of using a skilled nursing facility is high, but it can be temporary if the rehabilitation and healing are successful.

More and more Americans are able to live outside of institutions, but the possibility increases with age. Fifty percent of those over 95 live in nursing homes to support their care needs.

As you can imagine, ensuring for a robust, competent workforce is a dire need in America as the needs of this growing population expands. Creative solutions that meet the needs of communities have included community health workers, specialists who can support people with Alzheimer’s disease, physical therapists, recreational therapists, speech and occupational therapists, fitness trainers, retirement coaches, home modification specialists and patient advocates.

Technological devices such as telemedicine, smart homes and virtual communication are allowing longer-living Americans to stay in their own homes longer. Something as simple as a smartphone connected to a blood pressure cuff can transmit vital statistics to professionals. Home health services are able to track a wide array of data that is easily transmitted by phones and computers.

Individual needs will always be varied, but with the help of an adapting society and appropriate caretakers, our seniors can live longer, more versatile lives no matter the age.

Marguerite McLaughlin is Sr. Director of Quality Improvement at the American Health Care Association. She teaches and trains long-term care staff and is an active advocate for individualized care. She has supported and educated families and staff on using a holistic approach to care for those with Alzheimer’s and dementia. She also keeps an eye on her 90-year-old mother who lives independently.