Ala. Admin. Code r. 410-2-2-.03

Current through Register Vol. 43, No. 1, October 31, 2024

Section 410-2-2-.03 - Care Of The Elderly And Chronically Ill

(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.

(2) Recommendations

(a) The State should strengthen its existing support services for the elderly and chronically ill and, when appropriate, develop new services, beginning at the community level. These services should include, but not be limited to, the following:

1. Adult day care facilities to assist working families;

2. Assisted living facilities to provide housing for elderly and chronically ill who can no longer live alone;

3. Counseling services that deal with depression, alcohol and drug abuse, suicidal tendencies, mental health, nutrition, appropriate life styles, and self-care;

4. Geriatric training and education for caregivers;

5. Homemaker and chore services;

6. Home delivered meals;

7. Transportation services;

8. Emergency alert systems;

9. Dental care, including prosthodontics;

10. Audiology, including hearing aids;

11. Optometry services, including glasses;

12. Adaptive and assistive equipment;

13. Adequate housing for persons living below the poverty level.

14. Nursing Homes to provide housing and/or rehabilitative services for elderly and chronically ill patients who can no longer live alone and who require care at a level above and beyond that available in an assisted living environment.

(b) The success or the breakdown of these support services will determine to a considerable extent the demands made on health care services by the elderly and chronically ill. However, with the success of such support services, the need for more costly health care for our elderly and chronically ill will drastically diminish.

Ala. Admin. Code r. 410-2-2-.03

Amended by Alabama Administrative Monthly Volume XXXIII, Issue No. 03, December 31, 2014, eff. 1/6/2015.

Amended by Alabama Administrative Monthly Volume XXXVIII, Issue No. 06, March 31, 2020, eff. 5/15/2020.

Adopted by Alabama Administrative Monthly Volume XLII, Issue No. 07, April 30, 2024, eff. 6/14/2024.

Author: Statewide Health Coordinating Council (SHCC)

Statutory Authority:Code of Ala. 1975, § 22-21-260(4).