UAB Center for Aging · John Porter Lillis, BS Barbara Meek Smith, ... plementary survey of older...
Transcript of UAB Center for Aging · John Porter Lillis, BS Barbara Meek Smith, ... plementary survey of older...
STATE OF ALABAMA LONG TERM CARE NEEDS ASSESSMENT
Report Prepared Under the Direction of
Patricia Sawyer Baker, PhD Richard M. Allman, MD
UAB Center for Aging
AUGUST 2004
Charting the Course is a program to assist in planning for the long term healthcare needs of Alabama’s older citizens. A main component of Charting the Course is a survey of adults aged 55 and older, conducted by the Center for Aging at the University of Alabama at Birmingham (UAB). A sample of community-dwelling Alabama residents participated in face-to-face inter-views completed between May 2002 and August 2003. This report provides an analysis of data from these interviews.
This report was supported by an Interagency Agreement Between the Board of Trustees of the University of Alabama for the University of Alabama at Birmingham and Alabama Medicaid Agency.
Patricia Sawyer Baker, PhD Project Director
Richard M. Allman, MD
Project Co-Director
Other UAB Contributors to This Report Eric Bodner, BS Tara Kolstad, BA
John Porter Lillis, BS Barbara Meek Smith, MA
Teresa Tennyson Freddie M. Thomas
Richard Watt Beverly Williams, PhD
Long Term Care Task Force Contributors
Nick Sellers Task Force Member Frank Brown USA Healthcare Danny Cottrell, RPh Registered Pharmacist Robert Crowder Executive Director Southern Alabama Regional Council on Aging John Dunbar Unicare, Inc. Norman Estes President and Chief Executive Officer Northport Health Services, Inc. Rick Harris, JD Alabama Department of Public Health Mary Ann Holt Legislative Affairs Director Alabama Nursing Home Association Daniel Hughes Task Force Member Alva Lambert Executive Director State Health Planning and Development Agency Mike Lewis Alabama Medicaid Agency Miller Piggott Executive Director Alzheimer’s of Central Alabama Melissa Mauser Galvin, PhD, MPH Associate Dean, External Affairs Associate Professor, Department of Health Behavior UAB School of Public Health Marilyn Ferguson Director, Long Term Care Division Alabama Medicaid Agency
Lee Guyton Owner, Ross Rock Management Altoona Pines Nursing Home Ruth Harrell Task Force Member John Shuster, MD Research Physician VA Medical Center, Tuscaloosa W. Dale Walley Task Force Chairman Donald E. Williamson, MD State Health Officer Rebecca Wright President, Wright and Associates Lance Brown Task Force Member Mary Hayes Finch, JD, MBA Director, Office of Policy and Legislative Affairs Alabama Medicaid Agency Richard E. Powers, MD Associate Professor UAB, Division of Neuropathology Director, Bureau of Geriatric Psychiatry Alabama Department of Mental Health and Mental Retardation John Searcy, MD Medical Director Alabama Medicaid Agency Kathy Hall Deputy Commissioner, Program Administration Alabama Medicaid Agency ShaDel Williams Task Force Member
Project History and Overview
Goals: The State of Alabama Long Term Care Task Force presented a workgroup report in December 2000 which identified the need to evaluate the current and emerging medi-cal conditions and social needs of older Alabama residents. It was recommended that a representative survey of Alabama residents aged 55 and older be conducted, similar to the Statewide Survey of Alabama’s Elderly done in 1986-7. As part of this survey, knowl-edge of services would be assessed. Another recommendation was to compile a com-plementary survey of older adults in Alabama nursing homes. The UAB Center for Aging was consulted and awarded a contract to conduct the survey. The project consists of three components: I. Summary of the Minimum Data Set collected for Alabama Nursing Home Residents (report submitted April 2004) II. Charting the Course: Summary of data from community-dwelling older adults (this report) III. Charting the Course: Knowledge of Services (report submitted October 2003) The study is designed to compare older (65 years old and older) to younger (55 to 64 year olds) community-dwelling adults. The survey also is designed to compare the 65 years and older community-dwelling adults to nursing home residents aged 65 years and older (reported in the Minimum Data Set analyses). These comparisons will permit state leaders to predict future health and service needs. Questionnaire Development: The questionnaire content areas were identified by mem-bers of the Long Term Care Task Force. Specific areas covered include sociodemo-graphic factors, general health and medical conditions, health care utilization, family/social needs and resources, and retirement planning (see Appendix 1).
Organization of This Report Project goals and the development of the questionnaire used for in-home interviews are briefly discussed below. A description of the characteristics of older adults in Alabama follows. The descriptive information in “Aging in Alabama” is based on 2000 census data. A more detailed description of study methodology precedes the graphical summary of interview data. The presentation generally follows the format of the questionnaire, and is subdivided into sections. A guide to reading elements of the report is provided on page 1.
I. Introduction: Aging in Alabama ......................................................................... vi Map 1: Alabama Population, 2000 ............................................................... vii Map 2: Median Age by County .....................................................................viii Map 3: Percent 55 and Older by County ...................................................... ix Map 4: Percent 65 and Older by County ........................................................x Map 5: Percent 75 and Older by County ....................................................... xi Map 6: Number of Centenarians by County ................................................ xii II. Methods Questionnaire Design ....................................................................................xiii
Sampling Strategies and Recruitment Design .............................................. xvi Project Implementation .................................................................................. xx Statistical Procedures ...................................................................................xxii
III. Results Elements of the Report...................................................................................1 Section I: Background .................................................................................2 Section II: General Health ..........................................................................24 Section III: Activities/Mobility .......................................................................37 Section IV: Health Services Utilization.........................................................47 Section V: Medical History..........................................................................55 Section VI: Diet and Nutrition .....................................................................68 Section VII: Cognitive Functioning and Emotional Health............................75 Section VIII: Spirituality.................................................................................77 Section IX: Social Care...............................................................................82 Section X: Retirement Planning.................................................................88 Section XI: Long Term Planning.................................................................92
IV. References...................................................................................................105 V. Appendices A. Questionnaire B. Frequency Tables C. Other Documentation
Contents
The 2000 U.S. census confirmed the changing population profile of the United States and Alabama. Approximately one in eight persons was over the age of 65, unprecedented in the history of the United States. Between 1990 and 2000, the highest percentage of growth was among those 85 years and older. Additionally, the number of persons aged 45-64 (the “baby boomers”) increased by 34% during this period. At the same time, birth rates have decreased such that future projections will continue the trend of population aging and the percentage of older adults will continue to increase through 2030. Although our aging society reflects the success of many programs (government, economic, health), there will be many challenges to these programs in the future.
Alabama Aging Highlights from the 2000 Census Life-Expectancy for an Alabamian born in 2000 was 74 (U.S. 77) White Females: 78.7 (U.S. 80.1) White Males: 72.3 (U.S. 74.9) Black and other race Females: 72.3 (U.S. 75.2) Black and other race Males: 68.2 (U.S. 68.3) Life-Expectancy for an Alabamian who turned 65 in 2000 was 16.5 (U.S. 18.0) In 2000, approximately 35,000 Alabamians celebrated their 65th birthday. From 2000 to 2001 there was a net increase of 5,246 persons 65 and older. The median age (half older and half younger) was 36 (Map 2). % Persons over 55: 995,330 or 22% (Map 3) % Persons over 65: 579,798 or 13% (Map 4) % Persons over 75: 263,050 or 6% (Map 5) % Persons over 85: 67,301 or 1.5% In 2000, there were 897 centenarians in Alabama (Map 6).
Alabama ranks 25th in the nation for the percent of adults aged 65 and older.
Alabama ranks 9th in the nation for the percent of adults aged 65-74.
Alabama ranks 29th in the nation for the percent of adults aged 75 and older.
Alabama ranks 3rd in the highest rate of elders living in poverty (19%: U.S. = 13%)
Aging in Alabama
AGING IN ALABAMA PAGE vi
Baldwin
Calhoun
Etowah
Houston
Jefferson
Lauderdale
Lee
Madison
Marshall
Mobile
Montgomery
Morgan
Shelby Tuscaloosa
Autauga
Blount
Chilton
Coffee
Colbert
Cullman
Dale
Dallas
De Kalb
Elmore
Jackson Limestone
Russell
Saint Clair
Talladega
Tallapoosa
Walker
Bibb
Bullock Choctaw
Clay
Cleburne
Conecuh
Coosa
Crenshaw
Fayette
Greene
Hale
Henry
Lamar
Lowndes
Perry
Pickens
Sumter
Washington
Wilcox Barbour
Butler
Chambers
Cherokee
Clarke
Covington
Escambia
Franklin
Geneva
Lawrence
Macon
Marengo
Marion
Monroe
Pike
Randolph
Winston
SECTION 1: BACKGROUND ALABAMA AREA DEFINTIIONS
Map 1: Alabama Population 2000* 4,447,100
82,231 - 662,047 (Urban)
39,593 - 80,321 (Mid-Size)
21,399 - 38,440 (Rural)
9,974 - 20,949 (Rural)
County Distribution by Population Size
PAGE vii
Map 2: Median Age by County
AGING IN ALABMA
28Lee
32Macon
32Tuscaloosa
33Sumter
33Pike
34Perry
34Montgomery
34Wilcox
35Mobile
35Dale
35Hale
35Lowndes
35Bibb
35Bullock
35Washington
35Autauga
36Dallas
36Elmore
36Russell
36Monroe
36Shelby
36Clarke
36Madison
36Limestone
36Barbour
36Chilton
36Jefferson
36Greene
36Lawrence 37
De Kalb
37Blount
37Marengo
37Franklin
37Morgan
37Saint Clair
37Houston
37Marshall
37Talladega
37Escambia
37Pickens
37Calhoun
38Coffee
38Cullman
38Cleburne
38Jackson
38Lauderdale
38Randolph
38Butler
38Chambers
38Coosa
38Conecuh
38Winston
38Choctaw
38Etowah
39Walker 39
Lamar
39Colbert
39Clay
39Crenshaw
39Baldwin
39Fayette
39Marion
40Henry
40Geneva
40Tallapoosa
40Covington
40Cherokee
28Lee 28Lee
32Macon 32
Macon
32Tuscaloosa
32Tuscaloosa
33Sumter
33Sumter
33Pike 33Pike
34Perry 34
Perry
34Montgomery
34Montgomery
34Wilcox 34
Wilcox
35Mobile 35
Mobile
35Dale 35Dale
35Hale 35Hale
35Lowndes
35Lowndes
35Bibb 35Bibb
35Bullock
35Bullock
35Washington
35Washington
35Autauga
35Autauga
36Dallas 36
Dallas
36Elmore
36Elmore
36Russell
36Russell
36Monroe
36Monroe
36Shelby 36
Shelby
36Clarke 36
Clarke
36Madison
36Madison
36Limestone
36Limestone
36Barbour
36Barbour
36Chilton 36
Chilton
36Jefferson
36Jefferson
36Greene
36Greene
36Lawrence
36Lawrence 37
De Kalb 37
De Kalb
37Blount 37
Blount
37Marengo
37Marengo
37Franklin
37Franklin
37Morgan
37Morgan
37Saint Clair
37Saint Clair
37Houston
37Houston
37Marshall
37Marshall
37Talladega
37Talladega
37Escambia
37Escambia
37Pickens
37Pickens
37Calhoun
37Calhoun
38Coffee 38
Coffee
38Cullman
38Cullman
38Cleburne
38Cleburne
38Jackson
38Jackson
38Lauderdale
38Lauderdale
38Randolph
38Randolph
38Butler 38
Butler
38Chambers
38Chambers
38Coosa 38
Coosa
38Conecuh
38Conecuh
38Winston
38Winston
38Choctaw
38Choctaw
38Etowah
38Etowah
39Walker
39Walker 39
Lamar 39
Lamar
39Colbert
39Colbert
39Clay 39Clay
39Crenshaw
39Crenshaw
39Baldwin
39Baldwin
39Fayette
39Fayette
39Marion 39
Marion
40Henry 40
Henry
40Geneva
40Geneva
40Tallapoosa
40Tallapoosa
40Covington
40Covington
40Cherokee
40Cherokee
Median Age
27 to 30 years
30 to 33 years
33 to 36 years
36 to 39 years
39 to 41 years
PAGE viii
Map 3: Percent of Alabama Population 55 and Older by County
AGING IN ALABMA
15Lee
17Shelby
19Tuscaloosa
20Autauga
20Elmore
20Limestone 20
Madison
20Montgomery
21Barbour
21Dale
21Lowndes
21Mobile
22Bibb
22Bullock
22Hale
22Jefferson
22Lawrence 22
Morgan
22Pike
22Saint Clair
22Sumter
22Washington
23Blount
23Chilton
23Clarke
23Dallas
23Houston
23Macon
23Monroe
23Russell
23Talladega
23Wilcox
24Calhoun
24Coffee
24De Kalb
24Escambia
24Greene
24Marengo
24Perry
25Cleburne
25Coosa
25Cullman
25Franklin
25Jackson
25Lauderdale
25Marshall
26Baldwin
26Butler
26Chambers
26Choctaw
26Colbert
26Conecuh
26Etowah
26Pickens
26Randolph
26Walker
26Winston
27Crenshaw
27Fayette
27Henry
27Lamar
27Marion
27Tallapoosa
28Cherokee
28Clay
28Geneva
29Covington
15Lee 15Lee
17Shelby 17
Shelby
19Tuscaloosa
19Tuscaloosa
20Autauga
20Autauga
20Elmore 20
Elmore
20Limestone
20Limestone 20
Madison 20
Madison
20Montgomery
20Montgomery
21Barbour 21
Barbour
21Dale 21Dale
21Lowndes
21Lowndes
21Mobile 21
Mobile
22Bibb 22Bibb
22Bullock 22
Bullock
22Hale 22Hale
22Jefferson
22Jefferson
22Lawrence
22Lawrence 22
Morgan 22
Morgan
22Pike 22Pike
22Saint Clair
22Saint Clair
22Sumter 22
Sumter
22Washington
22Washington
23Blount 23Blount
23Chilton 23
Chilton
23Clarke 23
Clarke
23Dallas 23Dallas
23Houston
23Houston
23Macon 23
Macon
23Monroe
23Monroe
23Russell 23
Russell
23Talladega
23Talladega
23Wilcox 23
Wilcox
24Calhoun
24Calhoun
24Coffee 24
Coffee
24De Kalb
24De Kalb
24Escambia
24Escambia
24Greene 24
Greene
24Marengo
24Marengo
24Perry 24Perry
25Cleburne
25Cleburne
25Coosa 25Coosa
25Cullman
25Cullman
25Franklin
25Franklin
25Jackson
25Jackson
25Lauderdale
25Lauderdale
25Marshall
25Marshall
26Baldwin
26Baldwin
26Butler 26Butler
26Chambers
26Chambers
26Choctaw
26Choctaw
26Colbert 26
Colbert
26Conecuh
26Conecuh
26Etowah 26
Etowah
26Pickens
26Pickens
26Randolph
26Randolph
26Walker 26
Walker
26Winston
26Winston
27Crenshaw
27Crenshaw
27Fayette 27
Fayette
27Henry 27Henry
27Lamar 27Lamar
27Marion 27
Marion
27Tallapoosa
27Tallapoosa
28Cherokee
28Cherokee
28Clay 28Clay
28Geneva 28
Geneva
29Covington
29Covington
% 55 and Older
15 to 19
19 to 23
23 to 27
27 to 31
PAGE ix
9Lee
9Shelby
10Autauga
10Madison
11Elmore
11Limestone
11Montgomery
11Tuscaloosa
12Barbour
12Blount
12Chilton
12Dale
12Lawrence
12Mobile
12Morgan
12Saint Clair
12Talladega
12Washington
13Bullock
13Clarke
13Cleburne
13Jackson
13Lowndes
13Pike
13Russell
14Bibb
14Calhoun
14Dallas
14Escambia
14Hale
14Houston
14Jefferson
14Macon
14Monroe
14Sumter
14Wilcox
15Choctaw
15Coffee
15Colbert
15Coosa
15Cullman
15De Kalb
15Fayette
15Franklin
15Greene
15Lauderdale
15Marengo
15Marion
15Marshall
15Perry
15Randolph
15Walker
15Winston
16Baldwin
16Butler
16Chambers
16Cherokee
16Conecuh
16Etowah
16Geneva
16Lamar
16Pickens
17Clay
17Covington
17Crenshaw
17Henry
17Tallapoosa
9Lee 9Lee
9Shelby 9
Shelby
10Autauga
10Autauga
10Madison
10Madison
11Elmore 11
Elmore
11Limestone
11Limestone
11Montgomery
11Montgomery
11Tuscaloosa
11Tuscaloosa
12Barbour
12Barbour
12Blount 12Blount
12Chilton 12
Chilton
12Dale 12Dale
12Lawrence
12Lawrence
12Mobile 12
Mobile
12Morgan 12
Morgan
12Saint Clair
12Saint Clair
12Talladega
12Talladega
12Washington
12Washington
13Bullock 13
Bullock
13Clarke 13
Clarke
13Cleburne
13Cleburne
13Jackson
13Jackson
13Lowndes
13Lowndes
13Pike 13Pike
13Russell 13
Russell
14Bibb 14Bibb
14Calhoun
14Calhoun
14Dallas 14
Dallas
14Escambia
14Escambia
14Hale 14Hale
14Houston
14Houston
14Jefferson
14Jefferson
14Macon 14
Macon
14Monroe
14Monroe
14Sumter 14
Sumter
14Wilcox 14
Wilcox 15
Choctaw 15
Choctaw
15Coffee 15
Coffee
15Colbert 15
Colbert
15Coosa 15
Coosa
15Cullman
15Cullman
15De Kalb
15De Kalb
15Fayette 15
Fayette
15Franklin
15Franklin
15Greene 15
Greene
15Lauderdale
15Lauderdale
15Marengo
15Marengo
15Marion 15
Marion
15Marshall
15Marshall
15Perry 15Perry
15Randolph
15Randolph
15Walker 15
Walker
15Winston
15Winston
16Baldwin
16Baldwin
16Butler 16Butler
16Chambers
16Chambers
16Cherokee
16Cherokee
16Conecuh
16Conecuh
16Etowah 16
Etowah
16Geneva
16Geneva
16Lamar 16
Lamar
16Pickens
16Pickens
17Clay 17Clay
17Covington
17Covington
17Crenshaw
17Crenshaw
17Henry 17
Henry
17Tallapoosa
17Tallapoosa
Map 4: Percent of Alabama Population 65 and Older by County
AGING IN ALABMA
% 65 and Older 9 to 11
11 to 14
14 to 16
16 to 18
PAGE x
Map 5: Percent of Alabama Population 75 and Older by County
AGING IN ALABMA
3Shelby
4Autauga
4Lee
4Madison
5Barbour
5Dale
5Elmore
5Lawrence
5Limestone
5Lowndes
5Morgan
5Saint Clair
5Tuscaloosa
5Washington
6Bibb
6Blount
6Calhoun
6Chilton
6Clarke
6Cleburne
6Coffee
6Coosa
6De Kalb
6Escambia
6Houston
6Jackson
6Marshall
6Mobile
6Montgomery
6Pike
6Russell
6Talladega
6Winston
7Baldwin
7Bullock
7Cherokee
7Choctaw
7Colbert
7Conecuh
7Cullman
7Dallas
7Franklin
7Greene
7Hale
7Jefferson
7Lamar
7Lauderdale
7Macon
7Marengo
7Marion
7Monroe
7Perry
7Pickens
7Randolph
7Sumter
7Walker
7Wilcox
8Butler
8Chambers
8Clay
8Etowah
8Fayette
8Geneva
8Henry
8Tallapoosa
9Covington
9Crenshaw
3Shelby 3
Shelby
4Autauga
4Autauga
4Lee 4Lee
4Madison
4Madison
5Barbour
5Barbour
5Dale 5Dale
5Elmore
5Elmore
5Lawrence
5Lawrence
5Limestone
5Limestone
5Lowndes
5Lowndes
5Morgan
5Morgan
5Saint Clair
5Saint Clair
5Tuscaloosa
5Tuscaloosa
5Washington
5Washington
6Bibb 6Bibb
6Blount 6
Blount
6Calhoun
6Calhoun
6Chilton 6
Chilton
6Clarke 6
Clarke
6Cleburne
6Cleburne
6Coffee 6
Coffee
6Coosa 6
Coosa
6De Kalb
6De Kalb
6Escambia
6Escambia
6Houston
6Houston
6Jackson
6Jackson
6Marshall
6Marshall
6Mobile 6
Mobile
6Montgomery
6Montgomery
6Pike 6Pike
6Russell 6
Russell
6Talladega
6Talladega
6Winston
6Winston
7Baldwin
7Baldwin
7Bullock
7Bullock
7Cherokee
7Cherokee
7Choctaw
7Choctaw
7Colbert 7
Colbert
7Conecuh
7Conecuh
7Cullman
7Cullman
7Dallas 7
Dallas
7Franklin
7Franklin
7Greene
7Greene
7Hale 7Hale
7Jefferson
7Jefferson
7Lamar 7
Lamar
7Lauderdale
7Lauderdale
7Macon 7
Macon 7
Marengo 7
Marengo
7Marion 7
Marion
7Monroe
7Monroe
7Perry 7Perry
7Pickens
7Pickens
7Randolph
7Randolph
7Sumter 7
Sumter
7Walker 7
Walker
7Wilcox 7
Wilcox 8
Butler 8
Butler
8Chambers
8Chambers
8Clay 8Clay
8Etowah 8
Etowah
8Fayette
8Fayette
8Geneva
8Geneva
8Henry 8
Henry
8Tallapoosa
8Tallapoosa
9Covington
9Covington
9Crenshaw
9Crenshaw
8 to 10
3 to 5
5 to 6
6 to 7
7 to 8
% 75 and Older
PAGE xi
Map 6: Number of Centenarians by County
AGING IN ALABMA
0Fayette 1
Cleburne
1Lamar
1Randolph
2Bibb
2Henry
3Clay
3Conecuh
3Lawrence
3Sumter
4Barbour
4Cherokee
4Chilton
4Choctaw
4Coosa
4Franklin
4Lowndes
4Wilcox
5Crenshaw
5De Kalb
6Bullock
6Dale
6Geneva
6Greene
6Saint Clair
6Washington
7Covington
7Limestone
7Marengo
7Pike
8Autauga
8Hale 8
Perry
8Winston 9
Blount
9Butler
9Jackson
9Russell
10Clarke
10Colbert
10Macon
10Marion
10Monroe
10Morgan
11Escambia
11Talladega
11Tallapoosa
12Chambers
12Coffee
12Cullman
12Lauderdale
12Walker
13Elmore
13Pickens
15Etowah
15Lee
18Baldwin
19Houston
20Shelby
22Calhoun
22Marshall
23Dallas
33Madison
34Tuscaloosa
37Montgomery
74Mobile
193Jefferson
0Fayette
0Fayette 1
Cleburne 1
Cleburne
1Lamar 1
Lamar
1Randolph
1Randolph
2Bibb 2Bibb
2Henry 2
Henry
3Clay 3Clay
3Conecuh
3Conecuh
3Lawrence
3Lawrence
3Sumter 3
Sumter
4Barbour
4Barbour
4Cherokee
4Cherokee
4Chilton 4
Chilton
4Choctaw
4Choctaw
4Coosa 4
Coosa
4Franklin
4Franklin
4Lowndes
4Lowndes
4Wilcox 4
Wilcox
5Crenshaw
5Crenshaw
5De Kalb
5De Kalb
6Bullock
6Bullock
6Dale 6Dale
6Geneva
6Geneva
6Greene
6Greene
6Saint Clair
6Saint Clair
6Washington
6Washington
7Covington
7Covington
7Limestone
7Limestone
7Marengo
7Marengo
7Pike 7Pike
8Autauga
8Autauga
8Hale 8Hale 8
Perry 8Perry
8Winston
8Winston 9
Blount 9
Blount
9Butler 9
Butler
9Jackson
9Jackson
9Russell 9
Russell
10Clarke 10
Clarke
10Colbert 10
Colbert
10Macon 10
Macon
10Marion 10
Marion
10Monroe
10Monroe
10Morgan 10
Morgan
11Escambia
11Escambia
11Talladega
11Talladega
11Tallapoosa
11Tallapoosa
12Chambers
12Chambers
12Coffee 12
Coffee
12Cullman
12Cullman
12Lauderdale
12Lauderdale
12Walker 12
Walker
13Elmore 13
Elmore
13Pickens
13Pickens
15Etowah 15
Etowah
15Lee 15Lee
18Baldwin
18Baldwin
19Houston
19Houston
20Shelby 20
Shelby
22Calhoun
22Calhoun
22Marshall
22Marshall
23Dallas 23
Dallas
33Madison
33Madison
34Tuscaloosa
34Tuscaloosa
37Montgomery
37Montgomery
74Mobile 74
Mobile
193Jefferson
193Jefferson
PAGE xii
METHODS Questionnaire Design
METHODS: QUESTIONNAIRE
The State of Alabama Long Term Care Task Force reviewed the questionnaire used for the UAB Study of Aging, a prospective observational study of Medicare beneficiaries recruited from five counties of Central Alabama between 1999-2001 with funding from the National Institute on Aging. The initial two hour in-home assessment for that study included content areas of sociodemo-graphic variables, specific medical diseases as well as geriatric syndromes, assessments of neuropsychological status, health care utilization, medications, and physical activity. The Task Force decided to use the UAB Study of Aging questionnaire as a guide to develop a questionnaire for the Charting the Course survey.
The Task Force contracted the UAB Center for Aging to refine the questionnaire for this survey. They directed the addition of questions related to long term care planning. All data were to be col-lected in face-to-face interviews with participants. To ensure that the State of Alabama Long Term Care Needs Assessment interview would not exceed two hours, the Task Force suggested the de-letion of outside of their areas of interest. These recommendations were provided to the UAB Center for Aging who developed a questionnaire for the Task Force.
After several review sessions, a draft of the questionnaire was presented to the Committee for final approval in February 2001. For purposes of data entry, the questionnaire was formatted using Teleform, which produces a computer scannable form. (The questionnaire is presented in Appen-dix A.)
The State of Alabama Long Term Care Needs Assessment questionnaire contains the following content areas (presented in the order they are asked in the questionnaire):
INTRODUCTION Sex
Type of Housing Environmental Descriptions Address/Location
SECTION I: BACKGROUND
Number of Persons in Household
Family Military Service Education Employment Status Financial Information
Age Birth Date Ethnicity Marital Status Birth State Years in Alabama Property Owner Alabama Driver’s License Alabama Voting Status
PAGE xiii
SECTION II: GENERAL HEALTH Self Perceived Health
General Feelings/Anxiety
General Physical Symptoms
Pain
Hearing
Vision Oral Status/Dental
SECTION III: ACTIVITIES/MOBILITY
Social Activity
Physical Activity
Falls
Aids/Equipment
Instrumental Activities of Daily Living
Activities of Daily Living
Home Health Services Received
Transportation
SECTION IV: HEALTH SERVICES UTILIZATION
Health Insurance
Physician Information
Emergency Room/Hospital Prescription Drug Usage
SECTION V: MEDICAL HISTORY
Diseases
Conditions
Surgeries
Continence
Medications
METHODS: QUESTIONNAIRE PAGE xiv
SECTION VI: DIET AND NUTRITION Height/Weight
Eating Patterns/Meals
Tobacco Use
Alcohol Use
SECTION VII: COGNITIVE FUNCTIONING AND EMOTIONAL HEALTH
Cognitive status (MMSE)
Geriatric Depression Scale
SECTION VIII: SPIRITUALITY Church Attendance
Religious Activities
Spirituality
SECTION IX: SOCIAL SUPPORT Care Giving
Care Receiving
SECTION X: RETIREMENT PLANNING A. Employed
B. Retired
SECTION XI: LONG TERM PLANNING
Long Term Insurance
Planning for Death
Planning for Serious/Terminal Illness
Advanced Directives
HEALTH SERVICES QUESTIONNAIRE
(Reported submitted to Alabama Medicaid, October 2003)
METHODS: QUESTIONNAIRE PAGE xv
Methods Sampling Strategy and Recruitment Design
The State of Alabama Long Term Care Task Force goal was to recruit a sample that was representative of the State of Alabama. To achieve this goal, the first criteria was to select counties based on size of the county and geographic distribution. Counties of Alabama were categorized by the population size of the county (Census 2000 and the University of Alabama Center for Business and Economic Research, 2001, see Map 1). Following these designations, we describe counties with 82,231-662,047 persons as urban counties; counties with 39,593-80,321 persons as mid-size counties; counties with 21,399-38,440 persons as rural counties; and counties with 9,974-20,949 persons as most rural counties. Combining these designa-tions with north/south geographic region (Alabama Rural Health Association), the popula-tion of Alabama is described below.
North Population % of State Population
Urban 1,743,914 39% Mid-Size 664,389 15% Rural 205,034 5% Most Rural 116,753 3% South Population % of State Population Urban 967,647 22% Mid-Size 298,410 7% Rural 280,712 6% Most Rural 170,271 4%
State Total 4,447,100
METHODS: IMPLEMENTATION PAGE xvi
METHODS: IMPLEMENTATION v
The second criteria for selection from each category was based on the % of the county classified as urban (Census 2000) and adjacency to urban counties. Urban counties were eligible if they were classified as being 65% urban. Mid-size counties were eligible if they were less than 50% urban and adjacent to a
urban county included in the study and a Rank 3 or Rank 4 county. Rural counties were eligible if they were less than 35% urban and not adjacent to
either a Rank 1 or Rank 2 county. Most rural counties were eligible if they were less than 30% urban and not adjacent
to either a Rank 1 or Rank 2 county.
Additional criteria were established to select only one urban county from each MSA(Metropolitan Statistical Area*) and to select only counties in which at least 20% of the county population was aged 55 years or older.
The following counties were selected: North Urban: Jefferson and Madison Counties Mid-size: Limestone and Walker Counties Rural: Randolph County Most Rural: Lamar County South Urban: Houston, Mobile, and Montgomery Counties Mid-size: Dale and Houston Counties Rural: Monroe Most Rural: Conecuh
*The general concept of a metropolitan area is that of a large population nucleus, together with adjacent communities having a high degree of social and economic integration with that core. Metropolitan areas generally comprise one or more entire counties.
PAGE xvii
Statisticians determined that a sample size of 1200 would give adequate power to detect differences by age, race, sex, and area of residence. A stratified random sampling design was established to ensure that the proportion of study subjects would represent the state population over the age of 55. Recruitment was designed to reflect the state population. 1. Population 60% of the sample would be recruited from Rank 1 counties. 22% would be recruited from Rank 2 counties. 11% would be recruited from Rank 3 counties. 7% would be recruited from Rank 4 counties.
2. After the counties for the study were identified, a target recruitment num-ber for each county was determined. This number was proportionate to the population of all counties identified in that ranking.
For example, for the Rank 1 counties (which comprise 60% of the state population and 60% of the sample) the included counties were Houston, Jefferson, Madison, Mobile, and Montgomery. Of these five counties, Jefferson county has a population that is 40% of the total. Thus 40% of the Rank 1 participants were recruited from Jefferson County
3. Within counties, target goals for white/non-white recruitment were set to reflect the composition of selected counties within a Rank category
4. Within counties, target goals were set to reflect the age and gender com-position of the state population aged 55 and older. Of this population, per-sons aged 55-64 represent 42% of the total and persons aged 65 and older represented 58% of the population. The percent of females over the age of 55 was 57% and the percent of males was 43%.
5. To assure that there would be statistical power for comparisons, the number of subjects derived for target goals were rounded to include non-whites over whites. This resulted in a slight over-sampling of non-whites.
METHODS: IMPLEMENTATION PAGE xviii
A list of 13,000 names and phone numbers of a random selection of Alabama residents in proportionate numbers to recruitments goals by county, age group, and sex was pur-chased. These names were drawn from 31 different sources and were representative of the state in terms of household income. These names were entered into databases by county, age group (55-64 and 65 and older), and sex. A computer program was used to put the names in random order. Re-cruitment began by contacting the first name in each group and continued until the re-cruitment goal for that group was complete. Recruitment: 1. A letter was sent to the resident’s address describing the study. A toll free
number was provided so that potential participants could inquire about the study or ask to have their names withdrawn from consideration.
2. A screening call was made to determine eligibility. Persons had to be living in
the community and over the age of 55. Participants had to be able to commu-nicate with the interviewers and be willing to be interviewed. As recruitment goals within counties were met for age, race, and sex criteria, recruitment was closed for that specific group. If the person who was contacted was ineligible or did not wish to participant, we asked if anyone else in the household was eligible. Only one person from a household could participate.
3. Interview appointments were made by trained interviewers who went to partici-
pants’ homes to conduct the interview. After the informed consent was signed, the interview was conducted. Completed interviews were returned to the UAB Center for Aging.
4. Within one to two weeks after interviews were completed, a staff person from
the UAB Center for Aging contacted the participant to thank them for their participation. This call served as a quality control to determine that the inter-view was done accurately and professionally. Most participants reported that they enjoyed the opportunity to be interviewed for Charting the Course.
METHODS: IMPLEMENTATION PAGE xix
METHODS: IMPLEMENTATION
Methods Project Implementation
December 2000 State of Alabama Long Term Care Task Force workgroup report identified the need to
evaluate the current and emerging medical conditions and social needs of older Alabama residents.
Preliminary Plans Consultation with the UAB Center for Aging related to the feasibility of conducting a
survey similar to the Statewide Survey of Alabama’s Elderly, 1986-7
Presentations about the UAB Study of Aging made by the Center for Aging to the Task Force
Negotiation related to a contract for the UAB Center for Aging
October 2001 Interagency Agreement between the University of Alabama and Alabama Medicaid
Agency finalized
November 2001 Preliminary plans for sample design presented to the State of Alabama Long Term Care
Task Force
January 2002 Sampling design finalized
Recruitment protocol determined
Completed test version of the questionnaire
Reviewed and tested for cultural sensitivity
UAB Institutional Review Board submission
February 2002 Questionnaire reviewed and approved by State of Alabama Long Term Care Task Force
Databases designed to track recruitment
Plan analyses reviewed for the Minimum Data Set
Interviewer guidelines established, began to recruit interviewers
PAGE xx
March 2002 IRB approval for revised questionnaire
Charting the Course logo approved by Task Force
Test data entry system for questionnaire
Print materials
Prepare mailing procedures
Set-up system for delivering and receiving interviews
April 2002 Interviewer training Initial set of letters mailed in North Alabama
May 2002 Interviewing begun Interview goal schedule:
400 interviews completed by Sept. 1, 2002
600 interviews completed by Dec. 31, 2002
900 interviews completed by May 1, 2003
1200 interviews completed by Aug. 1, 2003 August 2003-August 2004 Data entry, data preparation, verification, and analyses for reports
October 2003 Minimum Data Set obtained
Knowledge of Services Report submitted
April 2004 Minimum Data Set report submitted
August 2004 Charting the Course final report submitted
METHODS: IMPLEMENTATION PAGE xxi
1. Completed questionnaires were returned to the UAB Center for Aging and a visual inspection made to assure that data were entered correctly. Forms were then scanned and a database was created. SPSS, a statistical software package developed for use in the social sciences, was used for all analyses.
2. Descriptive statistics were examined for each variable in the survey. (See Frequency Table, Appendix B.) The frequency, mean, and range of values were noted to detect potential errors. If there were discrepancies, such as out-of-range values, or missing information, the original form was examined to clarify the values. Pie charts and bar graphs showing the distribution of a characteristic for the total sample were generated from these data. Note that due to rounding, subtotals may not sum to 100%.
3. For this report, we examined data by counties based on population. Counties with populations above 82,000 were classified as urban; counties with populations between 22,000 and 82,000 were classified as midsize; counties with less than 22,000 population were classified as rural.
4. To examine differences within age groups, between blacks and whites, between males and females, and among residents of urban, mid-size, and rural counties, we utilized the Chi Square test of significance. This test compares the observed and expected frequen-cies for each response to assess whether categories contain the expected number of responses. If the test determines that the observed responses differ from the expected responses and that the difference is likely to occur in the population, it is considered to be statistically significant. The parameters of the test were set to show significance at the 0.05 level. This means that 95% of the time or 95 times out of 100, detected differ-ences reflect true population differences.
5. Results of the Chi-square test were used to determine the information presented in this report. When comparing age groups, males to females, blacks to whites, and areas of residence, we report results only if they differ from the findings for the total sample.
6. Persons were included in the analyses if they were African-American or white. In the course of recruitment, 7 participants (0.6% of the sample) were enrolled who were neither African-American nor white. The number of persons from these groups did not represent a sufficient size to generalize to the population, and thus were not used in the statistical analyses. By county, there were four persons in Mobile (2 female American Indian/Alaskan natives; 1 male Asian/Pacific Islander; 1 male Hispanic); one person each in Jefferson, Madision, and Monroe counties (a female American Indian/Alaskan native, a male Hispanic, and a female American Indian/Alaskan native, respectively).
Statistical Analysis
METHODS: IMPLEMENTATION PAGE xxii
Page number
PAGE 3 SECTION 1 : BACKGROUND
One35%
Two 49%
Three 10%
Four or More6%
Number of persons living in household [10]
49% of participants live with their spouse.
1% live with a parent.
17% live with a child.
8% live with a grandchild.
4% live with some other relative.
2% live with an unrelated person.
HOUSEHOLD MEMBERS
LIVES ALONE BY AGE AND SEX
Sex
51% of females
13% of males
Age
27% of 55-64 year olds
35% of 65-74 year olds
Questionnaire Section and Topic
Question number from
survey
Question
Breakdown of response categories to show differences within age groups; between blacks and whites; between males and females; and among residents of urban, mid-size, and rural counties.
Additional information related to the question topic. Unless other-wise noted, percentages repre-sent the proportion of the entire sample, N = 1204.
Elements of the Report
Graph showing breakdown of responses for all participants.
Only results significantly different from the whole sample are noted. In this example, only Age and Sex dif-fered from responses indicated in the pie graph.
PAGE 1
PAGE 2 SECTION 1: BACKGROUND
Rural - North 12%
Midsize - South 10%
Midsize - North 12%
Urban - South 25%
Urban - North32%
Rural - South 9%
Region within Alabama
Age 75 +27%
Age 55-6441%
Age 64-7432%
Male43%
Female57%
Black27%
White73%
Sex
Charting The Course Sample Description
Race/Ethnicity
Age distribution
PAGE 3 SECTION 1: BACKGROUND
Region within Alabama
Sex Race/Ethnicity
Age distribution
Region Number Urban-North 411 Midsize-North 147 Rural-North 105 Urban-South 309 Midsize-South 122 Rural-South 110 Total 1204
Age Group Number
55-64 494 64-74 382 75 + 328 Total 1204
Race/Ethnicity Number
Whites 876 Blacks 328 Total 1204
Sex Number
Females 690 Males 514 Total 1204
Charting The Course Numerical Sample Description
PAGE 4 SECTION 1: BACKGROUND
Marital status [4]
WIDOWED BY AGE AND SEX
Age 18% of 55-64 year olds
35% of 65-74 year olds
52% of 75 years and older
Sex 51% of females
8% of males
Separated1%
Divorced13%
Widow ed33%
Married49%
Never Married4%
MARRIED BY AGE, RACE, AND SEX
Age 58% of 55-64 year olds
49% of 65-74 year olds
38% of 75 years and older
Race 52% of whites
42% of blacks
Sex 26% of females
82% of males
PAGE 5 SECTION 1: BACKGROUND
One35%
Two 49%
Three 10%
Four or More6%
Number of persons living in household [10]
LIVING ALONE BY AGE AND SEX
HOUSEHOLD MEMBERS
Sex 51% of females
13% of males
Age 27% of 55-64 year olds
35% of 65-74 year olds
46% of 75 years and older
49% of participants lived with their spouse.
17% lived with a child.
8% lived with a grandchild.
4% lived with some other relative.
2% lived with an unrelated person.
1% lived with a parent.
PAGE 6
Other 10%
Single-family Home90%
SECTION 1: BACKGROUND
Type of housing [Intro. 3]
SINGLE FAMILY HOME BY SEX
8% of participants lived in a multi-family home.
2% lived in an apartment building.
Less than 1% of participants lived in:
A house with one or more apartments.
Housing especially for the elderly.
Some other type of housing.
OTHER HOUSING
Sex 86% of females
95% of males
PAGE 7 SECTION 1: BACKGROUND
Amenities in the home [Intro. 4]
58
33
8
0
50
100
Outside StairsLeading Into
Home
Stairs InsideHome
Ramp
Perc
ent o
f Sam
ple
4638
20
50
100
Computer InternetAccess
Special PhoneService
Perc
ent o
f Sam
ple
100 100 98 93
0
50
100
Electricity Heat Available AirConditioning
Fans Available
Perc
ent o
f Sam
ple
PAGE 8
Yes87%
No13%
SECTION 1: BACKGROUND
Property ownership [7]
Number of years lived in Alabama [6]
PROPERTY OWNERSHIP BY RACE AND SEX Race
88% of whites
83% of blacks
Sex 81% of females
94% of males
More Than 20 Years93%
11-20 Years 4%
6-10 Years 2% 5 Years or Less
1%
PAGE 9
Other Southern 15%
Other US11%
Other Country1%
Alabama 73%
SECTION 1: BACKGROUND
Place of birth [5]
Possession of valid Alabama driver’s license [8]
ALABAMA BORN BY RACE AND COUNTY SIZE
No8%
Yes92%
NO ALABAMA DRIVER’S LICENSE Age
3% of 55-64 year olds
7% of 65-74 year olds
16% of 75 years and older
Race 4% of whites
19% of blacks
Sex 12% of females
3% of males
Race 67% of whites
87% of blacks
Residence 69% of urban residents
71% of mid-size county residents
83% of rural residents
Sex 74% of females 70% of males
PAGE 10
Yes94%
No6%
SECTION 1: BACKGROUND
Registered Alabama voters [9]
Residence 95% of urban residents
90% of mid-size county residents
96% of rural residents
REGISTERED VOTER BY RESIDENCE
5% of participants rarely voted.
9% sometimes voted.
81% voted regularly.
PREVALENCE OF VOTING
91% of participants voted in national elections.
90% voted in state elections.
90% voted in local elections.
TYPES OF ELECTION IN WHICH PARTICIPANTS VOTED
PAGE 11 SECTION 1: BACKGROUND
NO LIVING CHILDREN BY SEX
Sex 10% of females
6% of males Two 28%
Three 21%
Four or More 28%
No Children 10%
One 13%
Number of living children [11]
21% of participants had no children or no children living in Alabama.
26% had one child living in Alabama.
54% had two or more children living in Alabama.
NUMBER OF CHILDREN LIVING IN ALABAMA
26% of participants had no children or no children living within an hour drive.
30% had one child living within an hour drive.
45% had two or more children living within an hour drive.
NUMBER OF CHILDREN LIVING WITHIN AN HOUR DRIVE
11% of participants had no children or little or no contact with their children.
3% had contact ranging from four times per year to once a month.
12% had contact ranging from two times per month to once a week .
16% had contact ranging from two to four times per week.
58% had contact at least five times per week.
FREQUENCY OF CONTACT WITH CHILDREN
14% of participants provided care for their children.
PROVIDING CARE FOR CHILDREN
PAGE 12 SECTION 1: BACKGROUND
Yes83%
No17%
Participants with grandchildren [12]
FREQUENCY OF CONTACT WITH GRANDCHILDREN
21% of participants had no grandchildren or little or no contact with their grandchildren.
9% had contact ranging from four times per year to once a month.
18% had contact ranging from two times per month to once a week.
16% had contact ranging from two to four times per week.
36% had contact at least five times per week.
17% had no grandchildren.
14% of participants provided care for their grandchildren.
PROVIDING CARE FOR GRANDCHILDREN
5% of participants provided care for children and grandchildren.
PROVIDING CARE FOR BOTH CHILDREN AND GRANDCHILDREN
PAGE 13
No70%
Yes and Needs
Assistance12%
Yes and Does Not
Need Assistance
18%
PARENT REQUIRING ASSISTANCE BY AGE
Age 20% of 55-64 year olds
11% of 65-74 year olds
2% of 75 years and older
5% of participants had a parent living with family.
1% had a parent living in an assisted living facility.
1% had a parent with a live-in caretaker.
4% had a parent living in a nursing home.
2% had a parent that had another arrangement.
Less than 1% had a parent living in a board or care home.
LIVING ARRANGEMENTS OF PARENTS NEEDING ASSISTANCE
20% of participants reported parents living in Alabama.
17% reported a parent living within an hour drive.
RESIDENCE OF PARENT
2% of participants had little or no contact with any parent.
3% had contact ranging from four times per year to once a month.
7% had contact ranging from two times per month to once a week .
5% had contact ranging from two to four times per week.
10% had contact at least five times per week.
FREQUENCY OF CONTACT WITH PARENT
SECTION 1: BACKGROUND
Living parent [13]
LIVING PARENT BY AGE, SEX, AND RESIDENCE
Sex 25% of females
37% of males
Age 56% of 55-64 year olds
19% of 65-74 year olds
3% of 75 years and older
Residence 31% of urban residents
24% of mid-size county residents
33% of rural residents
PAGE 14 SECTION 1: BACKGROUND
One20%
Two 18%
Three 16%
Four or More 31%
None15%
NO SURVIVING SIBLINGS BY AGE, RACE, AND SEX
Number of living siblings [14-15]
64% of participants reported that they had living brothers.
68% reported that they had living sisters.
LIVING SIBLINGS
Age 9% of 55-64 year olds
15% of 65-74 year olds
25% of 75 years and older
Race 17% of whites
12% of blacks
Sex 17% of females
13% of males
PAGE 15
Age 65% of 55-64 year olds
64% of 65-74 year olds
54% of 75 years and older
Residence 58% of urban residents
63% of mid-size county residents
73% of rural residents
PARTICIPANTS WITH FIVE OR MORE FAMILY MEMBERS WITHIN AN HOUR DRIVE BY AGE AND RESIDENCE
SECTION 1: BACKGROUND
Number of family members within an hour drive [16]
Age 5% of 55-64 year olds
8% of 65-74 year olds
11% of 75 years and older
PARTICIPANTS WITH NO FAMILY MEMBERS WITHIN AN HOUR DRIVE
None8%
One to Two17%
More Than Five 61%
Three to Five 14%
PAGE 16
Yes28%
No72%
MILITARY SERVICE BY AGE, RACE, SEX, AND RESIDENCE
Age 23% of 55-64 year olds
29% of 65-74 year olds
33% of 75 years and older
Race 31% of whites
20% of blacks
Residence 29% of urban residents
30% of mid-size county residents
20% of rural residents
Sex 1% of females
64% of males
Number (Percent) Branch Average Time Served Minimum Time Maximum Time
182 (15%) United States Army 6 years 1 year 38 years
50 (4%) United States Navy 8 years 1 year 35 years
71 (6%) United States Air Force 10 years 1 year 41 years
3 (1%) United States Marines 8 years 2 years 32 years
2 (0.2%) United States Coast Guard 14 years 6 years 22 years
14 (1%) Other Military Service 7 years 1 year 36 years
TYPE AND LENGTH OF SERVICE BRANCH PARTICIPATION
SECTION 1: BACKGROUND
Military service [17]
PAGE 17
ELIGIBLITY FOR MILITARY BENEFITS THROUGH FAMILY BY RACE, SEX, AND RESIDENCE
Race 11% of whites
4% of blacks
Residence 7% of urban residents
12% of mid-size county residents
12% of rural residents
Sex 12% of females
4% of males
Eligibility for military benefits (through self or family member) [17-18]
SECTION 1: BACKGROUND
Family members with military service [18]
Spouse24%
Other family59%
None17%
Not Eligible76%
Family Only 6%
Self and Family
1%
Self Only 17%
PAGE 18 SECTION 1: BACKGROUND
Highest level of education [19]
DID NOT COMPLETE HIGH SCHOOL BY AGE, RACE, SEX, AND RESIDENCE
Age 7% of 55-64 year olds
24% of 65-74 year olds
41% of 75 years and older
Race 20% of whites
41% of blacks
Residence 22% of urban residents
29% of mid-size county residents
34% of rural residents
Sex 28% of females
22% of males
ADVANCED EDUCATION (POST HIGH SCHOOL) BY AGE, RACE, SEX, AND RESIDENCE
Age 52% of 55-64 year olds
44% of 65-74 year olds
32% of 75 years and older
Race 50% of whites
29% of blacks
Residence 51% of urban residents
36% of mid-size county residents
33% of rural residents
Sex 41% of females
48% of males
Some College/Assoc.
Degree23% High School
Graduate30%
9-11 years16%
1-8 years10%
College Graduate12%
Graduate/Professional
Degree10%
PAGE 19 SECTION 1: BACKGROUND
Less Than $12,000
22%
$12,000 or More 78%
Income* [23]
Sex
30% of females
10% of males
Residence 18% of urban residents
25% of mid-size county residents
30% of rural residents
Race 15% of whites
40% of blacks
Age 16% of 55-64 year olds
22% of 65-74 year olds
31% of 75 years and older
INCOME LESS THAN $12,000 BY AGE, RACE, SEX, AND RESIDENCE
*Responses indicating perceived income adequacy (“All things considered, would you say your in-come is not enough to make ends meet; gives you just enough to get by on; keeps you comfortable, but permits no luxuries; or allows you to do more or less what you want?”) were used to define an income category for persons with missing responses to reported income. These responses corre-sponded to income categories of $8,000 to $11,999, $12,000 to $15,999, $20,000 to $29,999, and $40,000 to $49,999, respectively.
PAGE 20
2
8
11
13
0
5
10
15
20
Less Than $5,000 $5,000-$7,999 $8,000-11,999 $12,000-15,999
Per
cent
of S
ampl
e
7
16
10
13
0
5
10
15
20
$16,000-$19,999 $20,000-$29,000 $30,000-$39,999 $40,000-$49,999
Per
cent
of S
ampl
e
SECTION 1: BACKGROUND
Income distribution* [23]
* See footnote on previous page.
9
53
2
0
5
10
15
20
$50,000-$75,000 $75,000-$99,999 $100,000-$149,000 $150,000 or More
Perc
ent o
f Sam
ple
PAGE 21 SECTION 1: BACKGROUND
Sex
20% of females
10% of males
Residence 12% of urban residents
18% of mid-size county residents
27% of rural residents
Race 12% of whites
27% of blacks
Race 8% of whites
24% of blacks
Sex
16% of females
6% of males
Somewhat Difficult
27%
Not Very Difficult
57%
Impossible1% Very Difficult
15%
Ability to afford basic expenses [21]
VERY DIFFICULT/IMPOSSIBLE TO PAY FOR BASICS BY RACE, AGE, AND SEX
Comfortable, No Luxuries
29%
Not Enough12%
Just Enough27%
Very Comfortable
32%
NOT ENOUGH INCOME BY RACE AND SEX
Income description related to standard of living [22]
PAGE 22 SECTION 1: BACKGROUND
RETIRED BY AGE, RACE, AND SEX
FULL-TIME EMPLOYMENT BY AGE, RACE, AND SEX
Sex
61% of females
68% of males
Race 66% of whites
60% of blacks
Age 36% of 55-64 year olds
81% of 65-74 year olds
87% of 75 years and older
Age 41% of 55-64 year olds
8% of 65-74 year olds
1% of 75 years and older
Race 21% of whites
16% of blacks
Sex
16% of females
25% of males
64
20
11 9
0
20
40
60
80
Retired Full-Time Disabled Part-Time
Per
cent
of S
ubje
cts
Employment (multiple responses possible) [20]
DISABLED BY AGE, RACE, AND RESIDENCE
Race 9% of whites
18% of blacks
Age 15% of 55-64 year olds
11% of 65-74 year olds
6% of 75 years and older
Residence 9% of urban residents
13% of mid-size county residents
18% of rural residents
PAGE 23 SECTION 1: BACKGROUND
EMPLOYMENT SUMMARY
773 participants were retired.
Of the retired participants,
12 worked full-time.
43 worked part-time.
31 did volunteer work.
3 reported being unemployed.
236 participants were employed full-time.
Of participants who were employed full-time,
12 were also retired.
6 also worked part-time.
1 did volunteer work.
107 participants were employed part-time.
Of the participants who were employed part-time,
43 were retired.
6 also had full-time employment.
4 were volunteers.
2 were disabled.
137 participants are disabled.
37 participants have never worked outside the home.
PAGE 24 SECTION 2: GENERAL HEALTH
Age 33% of 55-64 year olds
42% of 65-74 year olds
46% of 75 years and older
Race 34% of whites
53% of blacks
Residence 35% of urban residents
45% of mid-size county residents
45% of rural residents
Poor13%
Fair26%
Good31%
Very Good18%
Excellent12%
Self-perceived health [1]
FAIR/POOR HEALTH BY AGE, RACE, AND RESIDENCE
Worse 42%
Same 44%
Better14%
Health today compared to three years ago [2]
Residence 39% of urban residents
54% of mid-size county residents
41% of rural residents
HEALTH WORSE THAN THREE YEARS AGO BY AGE, RACE, AND RESIDENCE
Age 38% of 55-64 year olds
44% of 65-74 year olds
48% of 75 years and older
Sex 46% of females
37% of males
PAGE 25 SECTION 2: GENERAL HEALTH – SYMPTOMS
DEPRESSION BY SEX AND RESIDENCE Sex
19% of females
12% of males
Residence 15% of urban residents
21% of mid-size county residents
13% of rural residents
No84%
Yes16%
Depression* [3-4,15]
57% of participants said “yes” when asked if they had ever experienced sad spells or depression.
16% were currently taking medication for sadness or depression.
7% reported that sad spells or depression limited their activities.
HISTORY OF SAD SPELLS OR DEPRESSION
*Participants were classified as having depression if they answered “always” or “very often” when asked, “How much of the time during the past 4 weeks have you not taken interest or pleasure in doing things?” or if they answered “always” or “very often” when asked “How much of the time dur-ing the past 4 weeks have you felt downhearted or blue?”
PAGE 26 SECTION 2: GENERAL HEALTH – SYMPTOMS
No76%
Yes24%
Anxiety [5, 7,16 ]
ANXIETY BY RESIDENCE
Residence 21% of urban residents
29% of mid-size county residents
29% of rural residents
24% of participants said “yes” when asked if they had ever experienced anxiety or panic attacks.
9% were currently taking medication for anxiety or panic attacks.
2% reported that anxiety limited their activities.
HISTORY OF ANXIETY
*Participants were classified as having anxiety if they answered “always” or “very often” when asked, “How much of the time during the past 4 weeks have you felt tense or high-strung?” or if they answered “almost never” or “never” when asked “How much of the time during the past 4 weeks have you felt relaxed and free of tension?”
PAGE 27 SECTION 2: GENERAL HEALTH – SYMPTOMS
Sex 12% of females
7% of males
Residence 7% of urban residents
15% of mid-size county residents
13% of rural residents
No90%
Yes10%
Nervousness / Nerves [6, 17]
NERVOUSNESS BY AGE, SEX, AND RESIDENCE
HISTORY OF NERVOUS BREAKDOWN 6% of participants said “yes” when asked if they had ever had a nervous breakdown.
3% were currently taking medication for a nervous breakdown.
2% reported that a nervous breakdown limited their activities.
*Participants were classified as having problems with nervousness if they answered “always” or “very often” when asked, “How much of the time during the past 4 weeks have you been bothered by nervousness or your nerves?”
PAGE 28
Never or Almost Never
66%
Sometimes19%
Very Often or Always
15%
SECTION 2: GENERAL HEALTH – SYMPTOMS
Race 31% of whites
27% of blacks
Sex 34% of females
24% of males
Residence 27% of urban residents
36% of mid-size county residents
31% of rural residents
Never or Almost Never
39%
Sometimes 31%
Very Often or Always
30%
Fatigue [8]
FATIGUE (VERY OFTEN OR ALWAYS) BY RACE, SEX, AND RESIDENCE
Shortness of breath [9]
Race 16% of whites
13% of blacks
Residence 14% of urban residents
19% of mid-size county residents
15% of rural residents
SHORTNESS OF BREATH (VERY OFTEN OR ALWAYS) BY RACE AND RESIDENCE
PAGE 29 SECTION 2: GENERAL HEALTH – SYMPTOMS
Sex 3% of females
2% of males
Residence 3% of urban residents
4% of mid-size county residents
1% of rural residents
Very Often or Always
3%
Never or Almost Never
90%
Sometimes7%
Never or Almost Never
67%
Sometimes22%
Very Often or Always
11%
Nausea [10]
NAUSEA BY SEX AND RESIDENCE
Balance problems [11]
BALANCE BY AGE, RACE, AND RESIDENCE Age
8% of 55-64 year olds
12% of 65-74 year olds
13% of 75 years and older
Race 10% of whites
11% of blacks
Residence 10% of urban residents
15% of mid-size county residents
8% of rural residents
PAGE 30 SECTION 2: GENERAL HEALTH– SYMPTOMS
Fainting [12]
Less than 1% of participants reported fainting “very often” or “always.”
1% reported fainting “sometimes.”
PREVALENCE OF FAINTING
Frequency of pain [13]
12% of participants reported having agonizing pain.
7% reported dreadful pain.
27% reported uncomfortable pain.
20% reported annoying pain.
34% reported that they experienced no pain.
23% reported that pain interfered with their normal work “a little bit” or “moderately.”
20% reported that pain interfered with their normal work “quite a bit” or “extremely.”
DESCRIPTION OF PAIN
Sex 38% of females
28% of males
Residence 31% of urban residents
42% of mid-size county residents
32% of rural residents
PAIN (VERY OFTEN OR ALWAYS) BY SEX AND RESIDENCE
Never or
Almost Never40%
Sometimes26%
Very Often or Always
34%
PAGE 31 SECTION 2: GENERAL HEALTH– HEARING
Age 4% of 55-64 year olds
8% of 65-74 year olds
17% of 75 years and older
Race 10% of whites
5% of blacks
Sex 6% of females
12% of males
Good91%
Poor9%
Hearing: Interviewer’s evaluation [20]
POOR HEARING ABILITY (INTERVIEWER’S EVALUATION) BY AGE, RACE, AND SEX
No89%
Yes11%
Hearing aid usage [18]
45 of the 133 participants who reported using a hearing aid had hearing difficulty even when wearing the hearing aid.
HEARING AID EFFICACY
HEARING AID BY AGE, RACE, AND SEX
Age 7% of 55-64 year olds
11% of 65-74 year olds
18% of 75 years and older
Race 12% of whites
8% of blacks
Sex 8% of females
15% of males
PAGE 32 SECTION 2: GENERAL HEALTH– VISION
POOR VISION BY AGE, RACE, SEX, AND RESIDENCE Age
17% of 55-64 year olds
17% of 65-74 year olds
23% of 75 years and older
Race 16% of whites
24% of blacks
Sex 21% of females
16% of males
Residence 17% of urban residents
24% of mid-size county residents
15% of rural residents
No 82%
Yes18%
Poor vision* [26-29]
2% of participants were legally blind.
1% were blind.
BLINDNESS
8% had difficulty reading traffic signs, street signs, or store signs.
7% had difficulty seeing steps, stairs or curbs.
17% had difficulty reading a newspaper or book.
38% had difficulty reading small print.
VISION DIFFICULTY
*Poor vision was defined as having two of the following vision problems: reading traffic signs; seeing steps; reading a newspaper; or reading small print.
PAGE 33
Not Regular or Never22%
Every 1-2 Years78%
SECTION 2: GENERAL HEALTH– VISION
NOT REGULAR OR NEVER HAD EYE EXAMINATION BY AGE AND SEX
Frequency of eye examinations [22-23]
Age 26% of 55-64 year olds
19% of 65-74 year olds
20% of 75 years and older
Sex 19% of females
26% of males
58% of participants had their last eye examination within the past year.
35% had their last eye examination one to five years ago.
5% had their last eye examination more than five years ago.
1% did not know when their last eye examination had been.
72% were given a prescription for eye glasses.
68% obtained prescribed glasses.
2% said they could not obtain glasses because of cost.
LAST EYE EXAMINATION
PAGE 34
Yes32%
No63%
Doesn't know5%
Yes60%
No36%
Doesn't know4%
SECTION 2: GENERAL HEALTH– VISION
NO INSURANCE FOR EYE EXAMINATIONS BY AGE, SEX, AND RESIDENCE
Insurance coverage for eye glasses [25]
Insurance coverage for eye examinations [24]
Age 46% of 55-64 year olds
39% of 65-74 year olds
31% of 75 years and older
Sex 38% of females
42% of males
Residence 37% of urban residents
43% of mid-size county residents
48% of rural residents
NO INSURANCE FOR EYE GLASSES BY RACE AND RESIDENCE Race
70% of whites
62% of blacks
Residence 65% of urban residents
72% of mid-size county residents
73% of rural residents
PAGE 35
No51%
Yes49%
Eye disease [26]
EYE DISEASE BY AGE AND SEX Age
27% of 55-64 year olds
53% of 65-74 year olds
77% of 75 years and older
Sex 54% of females
43% of males
37% of participants currently had or had had cataracts.
23% had had cataract surgery.
9% had glaucoma.
7% had retinal eye disease.
CATARACTS AND EYE DISEASE
SECTION 2: GENERAL HEALTH– VISION
PAGE 36
More Than One Year
49%
Within Past Year 51%
DENTAL VISITS MORE THAN ONE YEAR AGO BY AGE, RACE, AND RESIDENCE
Frequency of dental examinations [30]
Age 45% of 55-64 year olds
51% of 65-74 year olds
54% of 75 years and older
Race 42% of whites
69% of blacks
Residence 45% of urban residents
53% of mid-size county residents
61% of rural residents
15% of participants had dentures and reported that they did not know, had never been, or had not been to a dentist in the past five years.
16% of participants needed dental care, but did not go. 11% did not go because of cost. 1% did not go because there was no time. 12% had changed eating habits because of dental problems.
DENTAL CARE ISSUES
Mouth rinse 60% used mouth rinse four or more times per week. 22% used mouth rinse sometimes. 19% never used mouth rinse. Flossing 34% flossed four or more times per week. 21% flossed sometimes. 23% never used dental floss. 23% have dentures.
DENTAL HYGIENE
SECTION 2: GENERAL HEALTH– DENTAL
PAGE 37
Active39%
Moderately active31%
Minimally active21%
Not active9%
Active49%
Moderately active28%
Minimally Active17%
Not active6%
SECTION 3: ACTIVITY/MOBILITY
Physical activity [3]
Social activity [1]
MINIMAL OR NO SOCIAL ACTIVITY BY RESIDENCE
Residence 19% of urban residents
27% of mid-size county residents
33% of rural residents
MINIMAL OR NO PHYSICAL ACTIVITY BY AGE, SEX, AND RESIDENCE
79% of participants reported being satisfied with their amount of social activity.
18% reported that they had too little social activity.
3% reported that they had much social activity.
SATISFACTION WITH SOCIAL ACTIVITY
Age 28% of 55-64 year olds
26% of 65-74 year olds
36% of 75 years and older
Sex 33% of females
25% of males
Residence 26% of urban residents
36% of mid-size county residents
35% of rural residents
Race 28% of whites
35% of blacks
PAGE 38 SECTION 3: ACTIVITY/MOBILITY
Types and frequency of activities [5]
41
21 17
4
0
20
40
60
Walking forExercise
GeneralExercise
Us ing ExerciseEquipm ent
Aerobics
Perc
ent o
f Sam
ple
4.3
(1,21)
Average Times per Week
(Minimum, Maximum)
4.3
(1,20)
3.7
(1,10)
3.4
(1,7)
3% of participants reported golfing.
3% reported dancing.
16% reported that they did not participate in any regular activity.
OTHER ACTIVITY AND INACTIVITY
53
42
30
0
20
40
60
Yardwork StrenuousHousework
Gardening
Perc
ent o
f Sam
ple
2.2
(1,7)
Average Times per Week
(Minimum, Maximum)
1.8
(1,21)
3.1
(1,7)
25% of participants reported difficulty walking.
18% were unable to walk 3-4 blocks or 1/4 mile; another 23% had difficulty walking 3-4 blocks or 1/4 mile.
33% reported difficulty going up/down stairs.
10% reported difficulty getting outside.
AMBULATION DIFFICULTY
PAGE 39 SECTION 3: ACTIVITY/MOBILITY
Falls within the past year [6]
FALLS BY AGE, RACE, AND SEX Race
28% of whites
23% of blacks
Sex 31% of females
21% of males
Age 23% of 55-64 year olds
26% of 65-74 year olds
32% of 75 years and older
13% of participants had fallen one time.
10% had two to four falls.
3% had five or more falls.
13% had fallen within the past three months.
12% suffered injurious falls.
8% obtained medical treatment because of their falls.
FREQUENCY AND CONSEQUENCES OF FALLS
Did Not Fall 73%
At Least One Fall27%
PAGE 40 SECTION 3: ACTIVITY/MOBILITY
4
7
1 1
0
3
6
9
Oxygen Toilet Bedpan Hospital Bed
Per
cent
of S
ampl
e
Less than 1% of participants used crutches, elevator chairs, ventilators, artificial legs, transfer lifts, roll-in showers or other walking equipment.
OTHER EQUIPMENT
1614
9
6
0
10
20
30
Cane Bathing Aids Walker Wheelchair
Perc
ent o
f Sam
ple
2 2 2 1
0
3
6
9
Orthopedic Shoes Lift Chair Scooter Brace
Perc
ent o
f Sam
ple
Mobility equipment currently used [7]
14% of participants had insurance coverage for equipment.
INSURANCE FOR EQUIPMENT
PAGE 41 SECTION 3: ACTIVITY/MOBILITY
Age 8% of 55-64 year olds
11% of 65-74 year olds
14% of 75 years and older
Race 8% of whites
17% of blacks
Sex 14% of females
6% of males
UNAFFORDABLE EQUIPMENT NEED BY AGE, RACE, AND SEX
Yes11%
No89%
Equipment needed, but unaffordable [9]
4% of participants reported needing scooters.
2% reported needing rails in the bathroom.
1% reported needing a cane or walker.
1% reported needing a wheelchair.
1% reported needing a lift chair.
1% reported needing special shoes.
1% reported needing other bathroom equipment.
1% reported needing some other unspecified equipment, but could not afford it.
TYPES OF UNAFFORDABLE EQUIPMENT NEEDED
PAGE 42
No Difficulty 63%
One18%
Three3%
Four 5%
Two9%
Five to Six 2%
SECTION 3: ACTIVITY/MOBILITY
ANY IADL DIFFICLTY BY AGE, RACE, SEX, AND RESIDENCE Age
28% of 55-64 year olds
34% of 65-74 year olds
54% of 75 years and older
Race 35% of whites
43% of blacks
Sex 45% of females
26% of males
Residence 34% of urban residents
41% of mid-size county residents
42% of rural residents
Instrumental Activities of Daily Living (IADL): Difficulties reported [IADL 1-6]
Number of IADL Difficulties
30
1610 8 6 5
0
20
40
60
DoingHeavy
Housework
Shopping Doing LightHousework
PreparingMeals
Using theTelephone
ManagingMoney
Per
cent
of S
ampl
e
PAGE 43 SECTION 3: ACTIVITY/MOBILITY
Activities of Daily Living (ADL): Difficulties reported [ADL3-6,9]
ANY ADL DIFFICULTY BY AGE, RACE, SEX, AND RESIDENCE Age
22% of 55-64 year olds
30% of 65-74 year olds
37% of 75 years and older
Race 26% of whites
35% of blacks
Sex 33% of females
23% of males
Residence 25% of urban residents
36% of mid-size county residents
31% of rural residents
No Difficulty 72%
Four 2% Five
1%
Three4%
Two6%
One15%
23
11 95 3
0
20
40
60
Transferring Bathing Dressing Toileting Eating
Per
cent
of S
ampl
e
Number of ADL Difficulties
PAGE 44
Yes5%
No95%
Age 3% of 55-64 year olds
5% of 65-74 year olds
9% of 75 years and older
HOME HEALTH CARE/HOSPICE NEED BY AGE, SEX, AND REGION
Sex 8% of females
2% of males
Residence 4% of urban residents
6% of mid-size county residents
9% of rural residents
3% of participants reported needing home health care or hospice, but were not receiving it.
HOME HEALTH CARE/HOSPICE NEED BUT NOT RECEIVED
SECTION 3: ACTIVITY/MOBILITY
Home health care or hospice need [11]
Of the 2% of participants who received services at home, 11 participants reported that Medicare paid for home health services. 9 participants reported that Medicaid paid for the services. 6 participants paid themselves or had help from family. 1 person had health insurance.
SOURCES OF PAYMENT
Of the 3% of participants who needed, but did not receive services at home, 17 participants wanted someone to help clean the house. 11 participants wanted a social worker to identify any assistance available. 4 participants wanted someone to help with bathing and dressing. 3 participants wanted a nurse to check on their condition. 2 participants wanted someone to help with medicine. 2 participants wanted a physical therapist to come to the home.
MOST VALUABLE SERVICE NOT RECEIVED
Of the 2% of participants who received services at home, 18 participants used a home health system. 8 participants used another service. 1 participant used hospice.
TYPES OF SERVICES
PAGE 45
43
2923
31
8
0
20
40
60
Cab/Taxi Bus Van service None Does NotKnow
Per
cent
of S
ampl
e
Yes95%
No5%
SECTION 3: ACTIVITY/MOBILIY
Reliable transportation [12]
NO RELIABLE TRANSPORTATION BY AGE, SEX, AND RACE
Age 3% of 55-64 year olds
3% of 65-74 year olds
11% of 75 years and older
Race 3% of whites
12% of blacks
Sex 8% of females
2% of males
85% of participants had access to a car that they drove themselves.
24% had access to a car that someone else drove.
29% were transported in someone else’s car by a family member, friend, or neighbor.
1% used a community transportation service.
2% used a bus or other public transportation.
USUAL SOURCES OF TRANSPORTATION (MULTIPLE RESPONSES POSSIBLE)
8% of participants reported using any of these other modes of transportation.
OTHER AVAILABLE TRANSPORTATION
PAGE 46
Always90%
Never1%
Sometimes3%
Most of the Time6%
SECTION 3: ACTIVTY/MOBILITY
Availability and time of arrival for ambulance service [16]
Seatbelt use [14]
NEVER USES SEATBELT BY RESIDENCE
Residence 1% of urban residents
1% of mid-size county residents
3% of rural residents
3 participants reported it would be more than one hour for the arrival of an ambulance.
AMBULANCE SERVICE
Less Than 15 Minutes
72%
No Service 1%30 Minutes to
1 Hour 2%
15-30 Minutes 20%
Does Not Know Time
4%
Does Not Know If There
Is Service 1%
PAGE 47
No5%
Yes95%
No4%
Yes96%
SECTION 4: HEALTH SERVICES UTILIZATION
Age 10% of 55-64 year olds
0% of 65-74 year olds
1% of 75 years and older
Race 3% of whites
8% of blacks
Sex 5% of females
3% of males
Insurance for health care [1]
NO HEALTH INSURANCE BY RACE, SEX, AND AGE
61% of participants had Medicare. 25% had Medicare supplemental insurance. 9% had Medicaid. 7% had both Medicaid and Medicare. 34% had insurance through an employer. 25% had other private insurance. 6% had insurance through a VA program.
TYPES OF HEALTH INSURANCE (MULTIPLE RESPONSES POSSIBLE)
NO DOCTOR BY SEX
Sex 4% of females
6% of males
Regular doctor for health care [2]
PAGE 48 SECTION 4: HEALTH SERVICES UTILIZATION
38% of participants had seen a doctor within the last month.
41% had seen a doctor within the last six months.
9% had seen a doctor within the last seven to twelve months.
4% had seen a doctor within the last one to two years.
2% had seen a doctor more than two years before.
1% had never seen a doctor or did not know.
LAST VISIT TO GENERAL HEALTH CARE DOCTOR
6% of participants had not seen a doctor in the last year.
11% had one visit in the last year.
40% had two to four visits in the last year.
28% had five to eleven visits in the last year.
10% had twelve to eighteen visits in the last year.
3% had nineteen to twenty-four visits in the last year.
3% had more than twenty-five visits in the last year.
NUMBER OF DOCTOR VISITS IN THE LAST YEAR
3% of participants did not know or never had a physical exam.
49% had a physical exam within the last six months.
27% were examined from six months to one year ago.
9% were examined between one and two years ago.
11% were examined more than two years ago.
LAST PHYSICAL EXAM
69% of participants saw more than one doctor.
66% saw a specialist.
2% saw more than one doctor because of convenience.
1% saw more than one doctor because of cost.
1% saw more than one doctor because of insurance.
MORE THAN ONE DOCTOR
Doctor visits [2-3]
PAGE 49
71 69
57
0
20
40
60
80
Mammogram Breast Exam Pap Smear
Per
cent
of W
omen
71
0
20
40
60
80
1
Perc
ent o
f Men
SECTION 4: HEALTH SERVICES UTILIZATION
Examinations performed within the last year [8]
38 37 36
0
20
40
60
Stool Blood Test Colon Screening Digital Rectal Exam
Per
cent
of S
ampl
e95
8982 81 78
0
20
40
60
80
100
BloodPressure
Blood Drawn Blood Count Cholesterol Blood Sugar
Perc
ent o
f Sam
ple
Prostate Exam
PAGE 50 SECTION 4: HEALTH SERVICES UTILIZATION
No76%
Yes24%
Needed doctor visit but did not go [5]
12% of participants said that they put off going to the doctor.
6% cited lack of money as a reason.
3% cited transportation problems.
2% cited fear.
1% cited they were unsure of whom to see.
1% cited they were dissatisfied with their provider.
Less than 1% cited distance as a reason for not seeing a doctor.
REASONS FOR NOT SEEING DOCTOR DESPITE NEED (MULTIPLE RESPONSES POSSIBLE)
NEEDED DOCTOR VISIT BUT DID NOT GO BY RESIDENCE, RACE, SEX, AND AGE
Residence 19% of urban residents
31% of mid-size county residents
30% of rural residents
Age 29% of 55-64 year olds
22% of 65-74 year olds
18% of 75 years and older
Race 22% of whites
30% of blacks
Sex 27% of females
20% of males
PAGE 51 SECTION 4: HEALTH SERVICES UTILIZATION
No77%
Yes23%
Emergency Room visit within the last year
EMERGENCY ROOM VISITS WITHIN LAST YEAR BY RACE, SEX, AND AGE Age
20% of 55-64 year olds
20% of 65-74 year olds
31% of 75 years and older
Race 21% of whites
27% of blacks
Sex 25% of females
20% of males
NUMBER OF EMERGENCY ROOM VISITS IN LAST YEAR
17% of participants had one Emergency Room visit within the last year.
4% had two Emergency Room visits within the last year.
2% had three to five Emergency Room visits within the last year.
1% had five or more Emergency Room visits within the last year.
PAGE 52 SECTION 4: HEALTH SERVICES UTILIZATION
No69%
Yes31%
Hospitalizations in last year [10]
HOSPITALIZATIONS IN LAST YEAR BY AGE, RACE, AND RESIDENCE Residence
30% of urban residents
38% of mid-size county residents
29% of rural residents
Age 28% of 55-64 year olds
31% of 65-74 year olds
37% of 75 years and older
Race 33% of whites
26% of blacks
NUMBER OF HOSPITALIZATIONS
21% of participants had one hospitalization within the past year.
5% had two hospitalizations within the last year.
4% had three to five hospitalizations within the last year.
1% had five or more hospitalizations within the last year.
PAGE 53 SECTION 4: HEALTH SERVICES UTILIZATION
No99%
Yes1%
Resident at a nursing home, mental health facility or VA facility in last year [11]
FACILITY RESIDENT BY AGE
No12%
Yes88%
43% of participants had prescriptions from multiple doctors. 86% took their medicine as directed by a physician. 5% took medicine only when they feel they need it. 12% changed the prescription due to cost. 17% were unable to afford prescribed medications. 4% took medications prescribed for others.
PRESCRIPTION MEDICATIONS
Age 0.2% of 55-64 year olds
1% of 65-74 year olds
2% of 75 years and older
Prescription medication use [13]
PRESCRIPTION DRUG USE BY AGE, SEX, AND RESIDENCE
Sex 90% of females
85% of males
Age 84% of 55-64 year olds
89% of 65-74 year olds
93% of 75 years and older
Residence 87% of urban residents
93% of mid-size county residents
87% of rural residents
PAGE 54 SECTION 4: HEALTH SERVICES UTILIZATION
Age 20% of 55-64 year olds
30% of 65-74 year olds
35% of 75 years and older
Race 25% of whites
34% of blacks
Sex 30% of females
24% of males
Residence 26% of urban residents
26% of mid-size county residents
35% of rural residents
No28%
Yes72%
Prescription medication insurance [12]
NO PRESCRIPTION MEDICATION INSURANCE BY AGE, RACE, SEX AND RESIDENCE
24% of participants had private insurance.
34% had insurance through their employer.
7% had Medicaid insurance.
8% had VA insurance.
5% had another type of insurance.
TYPES OF INSURANCE (MULTIPLE RESPONSES POSSIBLE)
Of the 87% of participants who took prescription medications,
the average spent per month on prescription medications was $96.33.
COST OF PRESCRIPTION DRUGS
PAGE 55
3% of participants had been told by a physician that they had liver disease.
2% had been told that they had Alzheimer’s Disease or dementia.
2% had been told that they had epilepsy or a seizure disorder.
1% had been told that they had Parkinson’s Disease.
3% were paralyzed.
OTHER MEDICAL CONDITIONS
SECTION 5: MEDICAL HISTORY
Medical conditions [1-34]
10.1
11
12.9
13.5
14.6
20.5
21.1
21.2
25.3
29.4
38.8
41
62.4
62.5
0 20 40 60
Stroke/TIA
Peripheral Neuropathy
Anemia
Osteoporosis
Thyroid
Respiratory Problems
Diabetes
Spinal Stenosis
Cancer
Circulation Problems
Digestive Tract Problems
Heart Problems
Arthritis/Gout
Hypertension
Percent of Sample
PAGE 56 SECTION 5: MEDICAL HISTORY
Surgeries [35]
3.8
5.2
5.5
8.1
12.1
12.5
16.4
23.4
0 20 40 60
Hip
Stomach
Bladder
Back
Knee
Heart
Gall Bladder
Cataract
Percent of Sample
10% of the male participants had undergone prostate surgery (approximately half were for prostate cancer).
7% of the female participants had undergone breast cancer surgery.
2% had colon cancer surgery.
1% had lung cancer surgery.
OTHER SURGERIES
PAGE 57 SECTION 5: MEDICAL HISTORY
Medical conditions by age
55-64 64-74 75+ Hypertension 56% 64% 70% Arthritis 54% 66% 71% Heart 33% 42% 52% Digestive tract 36% 43% 38% Circulation 25% 29% 36% Cancer 18% 27% 34% Spinal Stenosis 23% 23% 17% Diabetes 19% 26% 19% Respiratory 20% 21% 20% Thyroid 12% 16% 16%
Anemia 12% 12% 15% Neuropathy 10% 12% 11% Stroke 5% 12% 16% Renal/Kidney 4% 7% 9% Liver Disease 3% 4% 2%
Osteoporosis 10% 13% 20%
55-64 64-74 75+ 1 Hypertension Arthritis Arthritis 2 Arthritis Hypertension Hypertension 3 Digestive Tract Digestive Tract Heart 4 Heart Heart Digestive Tract 5 Circulation Circulation Circulation 6 Spinal Stenosis Cancer Cancer 7 Respiratory Diabetes Respiratory 8 Diabetes Spinal Stenosis Osteoporosis 9 Cancer Respiratory Diabetes 10 Anemia (10/11) Thyroid Spinal Stenosis 11 Thyroid (10/11) Osteoporosis Thyroid 12 Neuropathy Anemia (12/13) Stroke 13 Osteoporosis Neuropathy (12/13) Anemia 14 Stroke Stroke Neuropathy 15 Renal/Kidney Renal/Kidney Renal/Kidney
Medical conditions ranked by age
PAGE 58 SECTION 5: MEDICAL HISTORY
Medical conditions by race
Medical conditions ranked by race
White Black 1 Arthritis Hypertension 2 Hypertension Arthritis 3 Heart Circulation 4 Digestive Tract Heart 5 Cancer Digestive Tract 6 Circulation Diabetes 7 Spinal Stenosis Respiratory 8 Respiratory Cancer 9 Diabetes Anemia
10 Thyroid (10/11) Spinal Stenosis 11 Osteoporosis (10/11) Stroke 12 Anemia Neuropathy 13 Neuropathy Thyroid 14 Stroke Osteoporosis 15 Renal/Kidney Renal/Kidney
White Black Hypertension 56% 80% Arthritis 61% 67% Heart 43% 36% Digestive tract 41% 32% Circulation 26% 38% Cancer 28% 19% Spinal Stenosis 24% 13% Diabetes 17% 31% Respiratory 21% 19% Thyroid 16% 10%
Anemia 12% 14% Neuropathy 11% 10% Stroke 10% 11% Renal/Kidney 7% 5% Liver Disease 3% 2%
Osteoporosis 16% 6%
PAGE 59 SECTION 5: MEDICAL HISTORY
Medical conditions by sex
Medical conditions ranked by sex
Male Female Hypertension 60% 64% Arthritis 55% 68% Heart 42% 40% Digestive tract 33% 43% Circulation 25% 33% Cancer 29% 23% Spinal Stenosis 21% 21% Diabetes 21% 21% Respiratory 18% 22% Thyroid 7% 20%
Anemia 6% 18% Neuropathy 11% 11% Stroke 9% 11% Renal/Kidney 6% 6% Liver Disease 3% 4%
Osteoporosis 1% 23%
Male Female 1 Hypertension Arthritis 2 Arthritis Hypertension 3 Heart Digestive Tract 4 Digestive Tract Heart 5 Cancer Circulation 6 Circulation Cancer 7 Spinal Stenosis Osteoporosis 8 Diabetes Respiratory 9 Respiratory Spinal Stenosis (9/10)
10 Neuropathy Diabetes (9/10) 11 Stroke Thyroid 12 Thyroid Anemia 13 Anemia (13/14) Stroke 14 Renal/Kidney (13/14) Neuropathy 15 Dementia Renal/Kidney
PAGE 60 SECTION 5: MEDICAL HISTORY
Medical conditions by residence
Medical conditions ranked by residence
Rural Mid-Size Urban Hypertension 63% 66% 61% Arthritis 61% 72% 59% Heart 42% 47% 39% Digestive tract 44% 44% 35% Circulation 32% 32% 28% Cancer 23% 27% 25% Spinal Stenosis 24% 25% 19% Diabetes 23% 23% 20% Respiratory 19% 23% 20% Thyroid 13% 15% 15%
Anemia 15% 18% 11% Neuropathy 11% 12% 11% Stroke 12% 9% 10% Renal/Kidney 10% 7% 5% Liver Disease 3% 3% 3%
Osteoporosis 8% 15% 15%
Rural Mid-Size Urban 1 Hypertension Arthritis Hypertension 2 Arthritis Hypertension Arthritis 3 Digestive Tract Heart Heart 4 Heart Digestive Tract Digestive Tract 5 Circulation Circulation Circulation 6 Spinal Stenosis Cancer Cancer 7 Cancer Spinal Stenosis Diabetes(7/8) 8 Diabetes Respiratory Respiratory(7/8) 9 Respiratory Diabetes Spinal Stenosis
10 Anemia Anemia Thyroid 11 Thyroid Thyroid (11/12) Osteoporosis 12 Stroke Osteoporosis (11/12) Neuropathy 13 Neuropathy Neuropathy Anemia 14 Renal/Kidney Stroke Stroke 15 Osteoporosis Renal/Kidney Renal/Kidney
PAGE 61 SECTION 5: MEDICAL HISTORY
Surgeries by age
Surgeries ranked by age
55-64 64-74 75+ Cataract 8% 22% 49% Gall Bladder 15% 18% 17% Heart 9% 14% 16% Knee 12% 13% 11% Back 8% 8% 8% Bladder 3% 7% 7% Stomach 5% 6% 5% Hip 5% 3% 9% Colon Cancer 1% 2% 5% Lung Cancer 0.2% 1% 1%
55-64 64-74 75+ 1 Gall Bladder Cataract Cataract 2 Knee Gall Bladder Gall Bladder 3 Heart Heart Heart 4 Back Knee Knee 5 Cataract Back Hip 6 Stomach Bladder Back 7 Bladder Stomach Bladder 8 Hip Hip Stomach (8/9) 9 Colon Cancer Colon Cancer Colon Cancer (8/9)
10 Lung Cancer Lung Cancer Lung Cancer
PAGE 62 SECTION 5: MEDICAL HISTORY
Surgeries by race
Surgeries ranked by race
White Black Cataract 26% 17% Gall Bladder 19% 9% Heart 15% 6% Knee 13% 9% Back 10% 3% Bladder 7% 2% Stomach 6% 5% Hip Surgery 4% 3% Colon Cancer 2% 3% Lung Cancer 1% None
White Black 1 Cataract Cataract 2 Gall Bladder Gall Bladder 3 Heart Knee 4 Knee Heart 5 Back Stomach 6 Bladder Back 7 Stomach Hip (7/8) 8 Hip Colon Cancer (7/8) 9 Colon Cancer Bladder
10 Lung Cancer
PAGE 63 SECTION 5: MEDICAL HISTORY
Surgeries by sex
Surgeries ranked by sex
Male Female Cataract 22% 24% Gall Bladder 11% 21% Heart 20% 7% Knee 13% 11% Back 8% 8% Bladder 2% 8% Stomach 4% 6% Hip 2% 5% Colon Cancer 2% 3% Lung Cancer 1% 1%
Male Female 1 Cataract Cataract 2 Heart Gall Bladder 3 Knee Knee 4 Gall Bladder Back 5 Prostate Bladder 6 Back Heart 7 Stomach Breast Cancer 8 Hip Stomach 9 Bladder Hip
10 Colon Cancer Colon Cancer
9.7% of men reported prostate surgery. 6.8% of women reported breast cancer surgery.
PAGE 64 SECTION 5: MEDICAL HISTORY
Surgeries by residence
Surgeries ranked by residence
Rural Mid-Size Urban 1 Cataract Cataract Cataract 2 Gall Bladder Gall Bladder Gall Bladder 3 Heart Knee Knee 4 Back Heart Heart 5 Knee Back Back 6 Bladder Stomach Bladder 7 Stomach Bladder Stomach 8 Hip Hip Hip Surgery 9 Colon Cancer Lung Cancer Colon Cancer
10 Lung Cancer Colon Cancer Lung Cancer
Rural Mid-Size Urban Cataract 21% 23% 24% Gall Bladder 14% 20% 16% Heart 14% 13% 12% Knee 6% 16% 13% Back 7% 12% 7% Bladder 6% 7% 5% Stomach 5% 8% 4% Hip Surgery 3% 4% 4% Colon Cancer 1% 0.4% 4% Lung Cancer None 1% 1%
PAGE 65
Yes20%
No80%
No60%
Yes40%
SECTION 5: MEDICAL HISTORY
Incontinence: Fecal [41]
Incontinence: Urinary [38]
FECAL INCONTINENCE BY RACE Race
21% of whites
16% of blacks
URINARY INCONTINENCE BY AGE, RACE, SEX, AND RESIDENCE Race
42% of whites
35% of blacks
Sex 53% of females
23% of males
Residence 37% of urban residents
42% of mid-size county residents
49% of rural residents
Age 35% of 55-64 year olds
44% of 65-74 year olds
44% of 75 years and older
PAGE 66
Yes31%
No69%
Yes6%
No94%
SECTION 5: MEDICAL HISTORY
Pressure ulcers [42]
Constipation [39]
Residence 28% of urban residents
33% of mid-size county residents
39% of rural residents
PRESSURE ULCERS BY RACE Race
7% of whites
3% of blacks
CONSTIPATION BY AGE, RACE, SEX, AND RESIDENCE Race
28% of whites
38% of blacks
Sex 39% of females
20% of males
Age 23% of 55-64 year olds
33% of 65-74 year olds
41% of 75 years and older
PAGE 67
No Medications7%
One to Tw o 21%
Three to Four 25%
Five to Eight25%
Eight or More22%
26% of participants took at least one medication without knowing the reason.
9% took two or more medications without knowing the reason.
7% took at least one medication using a dosage different from the prescribed dosage.
SECTION 5: MEDICAL HISTORY
PERCENT OF PARTICIPANTS REPORTING EIGHT OR MORE MEDICATIONS BY AGE, RACE, SEX, AND RESIDENCE
Number of medications
Race 23% of whites
18% of blacks
Sex 25% of females
17% of males
Residence 17% of urban residents
28% of mid-size county residents
29% of rural residents
Age 17% of 55-64 year olds
25% of 65-74 year olds
24% of 75 years and older
PAGE 68
Less Than 205%
20 to 24.927%
25 to 29.937%
More Than 3031%
SECTION 6: DIET AND NUTRITION
Body Mass Index (BMI)* [1-2]
BMI LESS THAN 20 BY AGE, SEX, AND RESIDENCE
Age 3% of 55-64 year olds
5% of 65-74 year olds
8% of 75 years and older
Sex 7% of females
2% of males
Residence 4% of urban residents
8% of mid-size county residents
4% of rural residents
BMI GREATER THAN 30 BY AGE AND RACE
Race 26% of whites
41% of blacks
Age 34% of 55-64 year olds
34% of 65-74 year olds
20% of 75 years and older
*Body Mass Index (BMI) is a measure of body fat for adults. It is based on height and weight. A BMI between 20 and 25 is considered normal for adults. A BMI of 25-29.9 indicates overweight, and over 30 indicates obesity. A BMI under 20 indicates underweight.
PAGE 69
Three or more63%
One 4%
Irregular3%
Two30%
Very good51%
Poor3%
Good36%
Fair 10%
SECTION 6: DIET AND NUTRITION
FAIR OR POOR APPETITE BY AGE, RACE, SEX, AND RESIDENCE
Number of meals eaten per day [6]
Description of Appetite [5]
Race 11% of whites
15% of blacks
Sex 14% of females
10% of males
Residence 10% of urban residents
16% of mid-size county residents
15% of rural residents
Age 11% of 55-64 year olds
9% of 65-74 year olds
18% of 75 years and older
FEWER THAN THREE MEALS A DAY BY AGE AND RACE
Race 29% of whites
45% of blacks
Age 39% of 55-64 year olds
33% of 65-74 year olds
27% of 75 years and older
2% of participants reported skipping meals because of a lack of food. GOING HUNGRY
PAGE 70
Someone Else Shops
22%
Shops for Self 78%
Self68%
Other3%
Other Family4%
Spouse25%
SECTION 6: DIET AND NUTRITION
DOES NOT SHOP FOR GROCERIES BY SEX
Person who prepares meals [9]
Shopping for groceries [8]
Sex 11% of females
37% of males
16% of participants reported that their spouse shopped for groceries.
6% reported that another family member does the shopping.
1% reported that a friend does the shopping.
Less than 1% of participants reported that a neighbor, home health assistant or somebody else shopped.
WHO DOES THE GROCERY SHOPPING
1% or participants reported that they ate out.
1% had meals prepared by a friend.
1% had meals prepared by neighbors, community meal programs, home health
assistant or another source.
OTHER MEAL PREPARATION
PAGE 71
No95%
Yes5%
SECTION 6: DIET AND NUTRITION
PARTICIPANTS WHO EAT AT SENIOR CENTER BY AGE, RACE, AND SEX
Participants who eat at a senior center [11]
Age 2% of 55-64 year olds
5% of 65-74 year olds
9% of 75 years and older
Sex 6% of females
3% of males
Residence 4% of urban residents
3% of mid-size county residents
10% of rural residents
Senior Center meals are predominantly lunch; only two participants reported having breakfast.
1% of participants had meals delivered to their homes.
1 participant had meals delivered daily.
4 had meals delivered 5-6 days per week.
4 had meals delivered 2-4 days per week.
7 had meals delivered once a week.
Lunch was the main meal delivered (10 participants).
Frozen meals were delivered to 5 participants.
MEALS DELIVERED TO HOME
PAGE 72
No59%
Yes41%
*The Nutritional Screening Initiative, a project of the American Academy of Family Physicians, the American Dietetic Association and the National Council on Aging, Inc. developed a checklist to determine nutritional risk. Scores range from 0 to 21. A score of 0-2 is no risk, 3-5 indicates moderate nutritional risk; 6 or more indi-cates nutritional risk. (Questions listed in Appendix C.)
SECTION 6: DIET AND NUTRITION
Nutritional Risk*
Participants who usually eat meals alone [10]
USUALLY EATS ALONE BY AGE, RACE, AND SEX
Race 38% of whites
49% of blacks
Sex 56% of females
20% of males
Age 33% of 55-64 year olds
41% of 65-74 year olds
53% of 75 years and older
NUTRITIONAL RISK BY RACE AND SEX
Race 27% of whites
18% of blacks
Sex 24% of females
16% of males
No Risk 41%
Moderate Risk 39%
Nutritional Risk 20%
PAGE 73
No 82%
Current 6%
Former 12%
Current Smoker
14%
Quit Less Than 1 Year
Ago4%
Quit 1 Year Ago or More
38%
Never Smoked44%
SECTION 6: DIET AND NUTRITION
Use of other tobacco products [16]
Cigarette smoking status [15]
CURRENT USE OF OTHER TOBACCO PRODUCTS BY AGE, SEX, AND RESIDENCE
Residence 4% of urban residents
6% of mid-size county residents
14% of rural residents
Sex 2% of females
11% of males
CURRENT CIGARETTE SMOKER BY AGE AND RACE
Race 13% of whites
17% of blacks
Age 20% of 55-64 year olds
15% of 65-74 year olds
5% of 75 years and older
Ever Current Total
Pipe 6% 1% 7%
Cigar 5% 2% 7%
Smokeless tobacco 3% 3% 6%
Snuff 2% 1% 3%
EVER/CURRENT USE OF OTHER TOBACCO PRODUCTS (MULTIPLE RESPONSES POSSIBLE)
PAGE 74
No64%
Yes36%
SECTION 6: DIET AND NUTRITION
PARTICIPANTS WHO USE ALCOHOL BY AGE, RACE, SEX, AND RESIDENCE
Participants who use alcohol [17]
Residence 42% of urban residents
25% of mid-size county residents
29% of rural residents
3 OR MORE DRINKS PER DAY BY AGE AND SEX
Race 38% of whites
30% of blacks
Sex 29% of females
45% of males
Age 46% of 55-64 year olds
33% of 65-74 year olds
24% of 75 years and older
Sex 2% of females
13% of males
Age 11% of 55-64 year olds
5% of 65-74 year olds
1% of 75 years and older
7% had three or more drinks when they drank.
1% of participants were possibly alcohol dependent.*
ALCOHOL USE
*The CAGE is an instrument to assess probable alcohol dependence (see Question 17b-e).
A positive response to two or more questions indicates probable alcohol dependence.
PAGE 75 SECTION 7: COGNITIVE FUNCTIONING
Symptoms of depression* [GS1-15]
SIX OR MORE SYMPTOMS OF DEPRESSION BY SEX AND RESIDENCE Sex
14% of females
8% of males
Residence 8% of urban residents
16% of mid-size county residents
15% of rural residents
*The Geriatric Depression Scale is a validated and reliable index of depressive symptoms to screen for possible depression in older adults. The short form consists of 15 yes/no questions about a per-son’s feelings over the week prior to the assessment (see questions GS1-15). Six to 10 symptoms indicate mild to moderate depression, and 10 or more symptoms indicate severe depression.
Fewer than Six Symptoms
89%
Six to Ten Symptoms
8%
Ten or More Symptoms
3%
PAGE 76 SECTION 7: COGNITIVE FUNCTIONING
Cognitive Impairment (adjusted for education)* [MS1-15]
PROBABLE COGNITIVE IMPAIRMENT BY AGE AND RACE Race
5% of whites
13% of blacks
Age 5% of 55-64 year olds
6% of 65-74 year olds
12% of 75 years and older
*The Mini-Mental State Exam developed by Folstein in 1975 is one of the most widely adopted screening tests for cognitive impairment. Scores range from 0 to 30. For persons with at least 8 years of education, a score lower than 24 is indicative of probable impairment or dementia. It has been suggested that a score lower than18 be used for persons with less than an 8th grade edu-cation.
Impaired7%
Not Impaired 93%
PAGE 77 SECTION 8: SPIRITUALITY
No12%
Yes88%
Membership in a religious organization [1]
Twice aMonth
7%
Occasionally20%
Never13%
Once a Week30%
More ThanOnce a Week
30%
Frequency of attendance at a religious service [2]
ATTENDANCE ONE OR MORE TIMES A WEEK BY AGE AND RACE
NO ATTENDANCE BY AGE AND RACE
Race 58% of whites
68% of blacks
Age 56% of 55-64 year olds
64% of 65-74 year olds
64% of 75 years and older
Race 16% of whites
6% of blacks
Age 13% of 55-64 year olds
12% of 65-74 year olds
14% of 75 years and older
Age 84% of 55-64 year olds
91% of 65-74 year olds
91% of 75 years and older
Race 85% of whites
95% of blacks
MEMBERSHIP BY AGE, RACE, SEX, AND RESIDENCE
Sex 90% of females
85% of males
Residence 88% of urban residents
85% of mid-size county residents
93% of rural residents
PAGE 78 SECTION 8: SPIRITUALITY
No62%
Yes38%
Preference for more frequent worship service attendance [3]
PREFERENCE TO ATTEND MORE FREQUENTLY BY AGE, RACE, AND SEX
Age 38% of 55-64 year olds
34% of 65-74 year olds
44% of 75 years and older
Race 35% of whites
48% of blacks
Sex 44% of females
31% of males
REASONS FOR NOT ATTENDING RELIGIOUS SERVICES AS OFTEN AS DESIRED (MULTIPLE RESPONSES POSSIBLE)
13% of participants cited health problems.
7% cited transportation problems.
1% cited accessibility of building.
3% cited availability of services.
1% cited church leaders.
2% cited church members.
1% cited clothes or money.
18% cited other unspecified reasons.
PAGE 79 SECTION 8: SPIRITUALITY
No54%
Yes46%
Participation in other religious activities [4]
PARTICIPATION IN OTHER RELIGIOUS ACTIVITIES BY RACE, SEX, AND RESIDENCE
Race 42% of whites
58% of blacks
Residence 46% of urban residents
40% of mid-size county residents
55% of rural residents
Sex 50% of females
41% of males
RELIGIOUS ACTIVITY FREQUENCY
8% of participants attended other activities more than once a week.
21% attended other activities once a week.
4% attended other activities twice a month.
5% attended other activities monthly.
5% attended other activities occasionally.
PAGE 80 SECTION 8: SPIRITUALITY
Important18%
Not Important14%
Very Important
58%
SomewhatImportant
10%
SUPPORT FROM FAITH COMMUNITY IMPORTANT BY RACE, SEX, AND RESIDENCE
Race 83% of whites
94% of blacks
Residence 84% of urban residents
88% of mid-size county residents
91% of rural residents
Sex 88% of females
84% of males
Importance of support received from faith community [5]
No73%
Yes27%
Decreased religious attendance over last year [6]
14% of participants cited health problems.
5% cited transportation problems.
2% cited church leaders.
2% cited church members.
1% cited clothes or money.
9% cited other unspecified reason.
DECREASED ATTENDANCE BY AGE, RACE AND SEX
Age 25% of 55-64 year olds
27% of 65-74 year olds
32% of 75 years and older
Race 25% of whites
35% of blacks
Sex 33% of females
20% of males
REASONS FOR DECREASED ATTENDANCE (MULTIPLE RESPONSES POSSIBLE)
PAGE 81 SECTION 8: SPIRITUALITY
Not Active9%
Active or Very Active64%
Somewhat or Occasionally
Active27%
Private spiritual life activity [7]
Race 88% of whites
96% of blacks
Sex 95% of females
85% of males
PRIVATE SPIRITUAL LIFE ACTIVITY BY RACE AND SEX
5%
25%35%
49%
75%80%
0
50
100
PersonalSpiritualActivity
Church Television Radio Other No SupportReceived
Sources of spiritual support (multiple responses possible) [8]
PAGE 82
No83%
Yes, In Household
8%
Yes, Not In
Household9%
11% of participants provided transportation assistance.
10% provided assistance with shopping.
10% provided assistance with meals.
9% provided assistance with medication management.
9% provided assistance with household chores.
8% provided assistance with finances.
7% provided assistance with personal care services.
TYPES OF CARE PROVIDED
8% of participants reported caring for only one person and that persons lived with the participant.
1% reported caring for two or more people who lived with the participant.
ASSISTANCE PROVIDED WITHIN THE HOUSEHOLD
SECTION 9: SOCIAL CARE
Assistance with daily living provided to others by participants [1]
ASSISTANCE PROVIDED BY AGE AND SEX
Sex 19% of females
15% of males
Age 20% of 55-64 year olds
18% of 65-74 year olds
13% of 75 years and older
PAGE 83
Of participants providing care, 36 said that sitter services would be helpful. 24 said that a community meals program would be helpful. 21 said that respite care would be helpful. 9 said that social support services would be helpful. 7 said that financial support would be helpful. 6 said that assistance with chores would be helpful. Less than 1% said that support in education/counseling, medical, or transportation would
be helpful.
SUPPORT SERVICES HELPFUL TO CAREGIVERS
SECTION 9: SOCIAL CARE
Assistance with daily living provided to others (cont.) [1]
Hours of care Of participants providing care, 74 provided care one to nine hours per week. 29 provided care ten to nineteen hours per week. 23 provided care twenty to thirty-nine hours per week. 22 provided care forty to fifty-nine hours per week. 46 provided care sixty or more hours per week (27 of these provided care 24 hours/day).
Assistance with care (multiple responses possible) Of participants providing care, 72 received no assistance. 66 received assistance from family members other than a spouse or child. 49 received assistance from children/grandchildren. 19 received assistance from their spouse. 17 received assistance from paid sitters, nurses, or home health services. 15 received assistance from friends. 9 received assistance from church or community agencies. Stress associated with providing care Of participants providing care, 73 said that providing care was somewhat or extremely stressful.
TIME, ASSISTANCE, AND STRESS ASSOCIATED WITH CARING
PAGE 84
ExtremelyLikely72%
SomewhatUnlikely
4%
ExtremelyUnlikely
3%
Unsure8%
Somewhat Likely13%
No62%
Yes14%
Possible14%
Doesn'tKnow10%
SECTION 9: SOCIAL CARE
POTENTIAL CARGIVER BY AGE, SEX, AND RESIDENCE
Likelihood of care for self from family, if needed [3]
Anticipation of becoming a caregiver in next 10 years [2]
Age 17% of 55-64 year olds
15% of 65-74 year olds
7% of 75 years and older
Sex 15% of females
13% of males
Residence 16% of urban residents
13% of mid-size county residents
7% of rural residents
NOT SURE/UNLIKELY TO RECEIVE CARE FROM FAMILY BY SEX
Sex 18% of females
12% of males
PAGE 85
ExtremelyLikely57%
SomewhatUnlikely
2%
Somewhat Likely20%
ExtremelyUnlikely
3%
Unsure18%
SECTION 9: SOCIAL CARE
Potential sources of care in the event of a minor illness (multiple responses possible) [5]
Likelihood of care for self from health care system, if needed [4]
NOT SURE/UNLIKELY TO RECEIVE CARE FROM HEALTH CARE SYSTEM BY
RESIDENCE
Residence 24% of urban residents
23% of mid-size county residents
13% of rural residents
17
63
0
20
40
60
Friend Hired Caregiver Not Sure/No One
Perc
ent o
f Sam
ple
46
52
23
0
20
40
60
Spouse Child Other Relative
Per
cent
of S
ampl
e
PAGE 86 SECTION 9: SOCIAL CARE
Potential primary long term caregiver, if needed [7]
38
31
7
0
20
40
Spouse Child Other Relative
Per
cent
of S
ampl
e
1
17
6
0
20
40
Friend or Neighbor Hired Caregiver Unsure/No One
Perc
ent o
f Sam
ple
PAGE 87 SECTION 9: SOCIAL CARE
Anticipated living arrangements if unable to care for oneself [6]
Race 8% of whites
9% of blacks
Sex 10% of females
5% of males
Residence 4% of urban residents
12% of mid-size county residents
17% of rural residents
ANTICIPATED NURSING HOME PLACEMENT IF UNABLE TO CARE FOR SELF BY RACE, SEX, AND RESIDENCE
58
92
0
20
40
60
Own Home withHelp
Child's Home Other Relative'sHome
Perc
ent o
f Sam
ple
8 82
0
20
40
60
Nursing Home Assisted LivingFacility
Retirement Home
Per
cent
of S
ampl
e
NOT SURE WHERE CARE WOULD BE RECEIVED BY RACE, SEX, AND RESIDENCE Sex
14% of females
12% of males
Residence 14% of urban residents
13% of mid-size county residents
9% of rural residents
Race 15% of whites
9% of blacks
PAGE 88
Not Employed,
Not Drawing Benefits
2%Employed
26%
Not Employed,
Drawing Benefits
72%
SECTION 10: RETIREMENT PLANNING
Retirement benefits and employment status [R1A-C]
72% of participants were not employed and were drawing benefits. The average age of these participants was 71, and ranged from 55 to 96.
15% of participants planned to retire in the future. The average anticipated retire-ment age was 65, and ranged from 57 to 81 years.
5% of participants said they did not know when they would retire.
7% of participants said they would never retire.
5% of the sample had never been employed.
Of the 71% of formerly employed participants drawing retirement benefits, the aver-age age they stopped working was 59, and ranged from 16 to 91 years. The median age these participants stopped working was 62.
30 participants were not currently employed and not drawing any retirement bene-fits. The average age of the 25 of these participants who expected to draw benefits in the future was 63, and ranged from 60 to 66. 5 participants did not expect to ever draw social security or other retirement benefits
EMPLOYMENT HISTORY AND RETIREMENT AGE
A majority of participants planned to live in Alabama after retirement, ranging from 94% of those still employed, to 98% of those not employed.
RETIREMENT IN ALABAMA
PAGE 89
Retired/Not Employed (N=890)
Yes76%
No19%
Don't Know 5%
Currently Employed (N=314)
Don't Know18%
No 27%
Yes55%
SECTION 10: RETIREMENT PLANNING
Adequacy of retirement plan to provide basics [RA3,RB2]
Has retirement plan [RA3,RB2]
Retired/Not Employed (N=890)
No Retirement
Plan40%
Has Retirement
Plan60%
Currently Employed (N=314)
Has Retirement
Plan82%
No Retirement Plan18%
PAGE 90 SECTION 10: RETIREMENT PLANNING
Retirement plans other than Social Security (multiple responses possible) [RA3,RB2]
NO SAVINGS BY RACE, SEX, AND RESIDENCE Race
82% of whites
91% of blacks
Sex 87% of females
81% of males
Residence 84% of urban residents
91% of mid-size county residents
79% of rural residents
NO RETIREMENT PLAN BY AGE, RACE, AND SEX Age
33% of 55-64 year olds
42% of 65-74 year olds
52% of 75 years and older
Race 38% of whites
51% of blacks
Sex 51% of females
28% of males
24%
8% 9%6% 4% 3%
9%
9% 6%
2%2%
2%
0%
10%
20%
30%
40%
Work-RelatedPension
401K Savings StateRetirement
TeachersRetirement
Other Pension
Per
cent
of S
ampl
e
Currently Employed Retired/Not Employed
PAGE 91 SECTION 10: RETIREMENT PLANNING
Currently Employed (N=314)
Not Applicable2%
Yes 9%
Don't Know5%
No84%
Retired/Not Employed (N=890)
No 71%
Don't Know3%
Yes 21%
Not Applicable5%
Retirement activities (multiple responses possible) [RA5, RB4]
Adequacy of Social Security to maintain standard of living [RA4]
11% 11% 9%5%
36%
21%19%
0%
10%
20%
30%
40%
50%
Hobbies Travel Volunteer No Retirement
Per
cent
of S
ampl
e
Currently Employed Retired/Not Employed
PAGE 92 SECTION 11 : LONG TERM CARE PLANNING
LONG TERM CARE INSURANCE POLICY HOLDER BY RACE AND RESIDENCE
Long Term Care Insurance Policy Holder Status [1]
Race 13% of whites
7% of blacks
Residence 13% of urban residents
10% of mid-size county residents
7% of rural residents
Of participants who had Long Term Care Insurance policies, 65 purchased it less than five years ago. 33 purchased it between five and ten years ago. 24 purchased more than ten years ago. 5 were unsure about when the policy was purchased.
WHEN PURCHASED
Of participants who had had Long Term Care Insurance Policies, 18 people reported three years of coverage. All others did not know or indicated another term of coverage. No one reported having only one year of coverage. 92 people had nursing home room and board coverage. 82 people had in-home service coverage. 76 people had assisted living facility coverage. 58 people had day care coverage. 51 people had nursing home ancillary services coverage.
LENGTH AND TYPE OF COVERAGE
Plan to Buy 11%
Has Policy11%
Does Not Have a Policy and Does Not
Plan to Purchase
78%
PAGE 93 SECTION 11 : LONG TERM CARE PLANNING
CONSIDERING PURCHASE OF LONG TERM CARE INSURANCE BY AGE AND RACE
Considering purchasing Long Term Care Insurance* [2]
Race 14% of whites
10% of blacks
Age 18% of 55-64 year olds
12% of 65-74 year olds
6% of 75 years and older
Plans in the event of death [3]
35%
64%66%70%
0
40
80
Purchased a cemetary plot
Discussed w ishes w ith
family
Prepared a property w ill
Purchased a pre-paid
burial plan
Per
cent
of S
ubje
cts
*Excludes those (5 participants) who had already purchased a plan.
PAGE 94
No Plan 9%
Has Plan 91%
Very Much46%
Somewhat27%
Not Very Much 15%
Not At All12%
Plan in the event of death [3]
NO PLAN BY AGE, RACE, AND RESIDENCE
Race 6% of whites
17% of blacks
Residence 9% of urban residents
13% of mid-size county residents
7% of rural residents
Age 12% of 55-64 year olds
8% of 65-74 year olds
7% of 75 years and older
SECTION 11 : LONG TERM CARE PLANNING
Amount of thought for medical care decisions if participant were incapacitated 4]
VERY MUCH THOUGHT GIVEN TO MEDICAL CARE DECISIONS BY AGE, RACE, SEX, AND RESIDENCE
Race 49% of whites
38% of blacks
Sex 49% of females
42% of males
Residence 47% of urban residents
48% of mid-size county residents
36% of rural residents
Age 40% of 55-64 year olds
50% of 65-74 year olds
49% of 75 years and older
PAGE 95
40
48
8
0
20
40
60
Spouse Child Other Relative
Per
cent
of S
ubje
cts
Of participants who preferred a non-relative to make medical decisions if they were incapacitated,
18 named a friend.
Other preferences included pastor, clergy/religious advisor, and physician.
NON-RELATIVE DECISION MAKERS
SECTION 11 : LONG TERM CARE PLANNING
Preferred surrogate medical decision maker [5]
PAGE 96
21
29
4
0
20
40
Spouse Child Other Relative
Per
cent
of S
ampl
e
No45%
Yes55%
SECTION 11 : LONG TERM CARE PLANNING
Person with whom participant discussed health care preferences [6]
Expressed health care preferences if seriously ill [6]
EXPRESSED CARE PREFERENCES BY AGE, RACE, AND SEX
Race 59% of whites
47% of blacks
Sex 59% of females
51% of males
Age 52% of 55-64 year olds
60% of 65-74 year olds
56% of 75 years and older
Of participants who talked with a non-relative about care preferences if the participant were seriously ill,
16 reported talking with a friend.
Other specified preferences included a physician.
NON-RELATIVE
PAGE 97
No68%
Yes32%
No18%
Yes82%
SECTION 11 : LONG TERM CARE PLANNING
DOES NOT KNOW ABOUT LIVING WILLS BY AGE, RACE, SEX, AND RESIDENCE
Has a living will [8]
Knowledge of living wills [7]
Race 11% of whites
37% of blacks
Sex 15% of females
21% of males
Residence 16% of urban residents
15% of mid-size county residents
26% of rural residents
DOES NOT HAVE A LIVING WILL BY AGE, RACE, SEX, AND RESIDENCE Race
61% of whites
87% of blacks
Sex 64% of females
73% of males
Residence 64% of urban residents
69% of mid-size county residents
79% of rural residents
Age 16% of 55-64 year olds
14% of 65-74 year olds
24% of 75 years and older
Age 74% of 55-64 year olds
64% of 65-74 year olds
65% of 75 years and older
PAGE 98
No74%
Yes26%
No44%
Yes56%
SECTION 11 : LONG TERM CARE PLANNING
DOES NOT KNOW ABOUT HEALTH CARE POWER OF
ATTORNEY BY RACE
Signed legal document naming someone to make medical decisions [10]
Knowledge of health care power of attorney [9]
Race 37% of whites
61% of blacks
DOES NOT HAVE A SIGNED LEGAL DOCUMENT NAMING SOMEONE TO MAKE MEDICAL DECISIONS BY AGE, RACE, AND SEX
Race 69% of whites
88% of blacks
Residence 71% of urban residents
79% of mid-size county residents
80% of rural residents
Age 80% of 55-64 year olds
74% of 65-74 year olds
66% of 75 years and older
PAGE 99 SECTION 11 : LONG TERM CARE PLANNING
Designated Health Care Proxy [10]
Of participants who had not signed a legal document for health care,
288 said they had not thought of it.
119 said they did not have the time.
115 said it was not necessary now.
104 said they did not know where or how to do it.
28 said it was hard to think about it.
20 said they did not know who to name.
77 did not give any reason.
REASON FOR NOT SIGNING A LEGAL DOCUMENT FOR HEALTH CARE (MULTIPLE RESPONSES POSSIBLE)
8
13
2
0
5
10
15
Spouse Child Other Relative
Per
cent
of S
ampl
e
Of participants who designated a non-relative as a health care proxy:
7 named a friend.
Other specified preferences included a clergy/religious advisor and physician.
NON-RELATIVE HEALTH CARE PROXIES
PAGE 100
My Home73%
Relative's Home
3%
Hospital or LTC Facility
13%
Not Determined
11%
SECTION 11 : LONG TERM CARE PLANNING
PREFERS HOSPITAL/LONG TERM CARE FACILITY BY SEX AND RESIDENCE
Focus for end-of-life care [12]
Preference for location of end-of-life care [11]
Sex 15% of females
10% of males
Residence 11% of urban residents
14% of mid-size county residents
18% of rural residents
AN APPROACH THAT FOCUSES ON EXTENDING LIFE EVEN IF IT CAUSES PAIN AND SUFFERING BY RACE AND RESIDENCE
Race 3% of whites
10% of blacks
Residence 5% of urban residents
4% of mid-size county residents
7% of rural residents
Relieve Pain80%
Extend Life 5%
Does Notknow15%
PAGE 101 SECTION 11 : LONG TERM CARE PLANNING
Life-saving procedures at late stage of life-threatening illness [13-15]
VENTILATOR WANTED BY RACE Race
6% of whites
14% of blacks
2415
8
816
9
69
83
68
0%
20%
40%
60%
80%
100%
CPR Feeding Tube Ventilator
Perc
ent o
f Sam
ple
Yes Unsure No
CPR WANTED BY RACE AND SEX Race
20% of whites
35% of blacks
Sex 19% of females
30% of males
FEEDING TUBE WANTED BY RACE AND RESIDENCE Race
10% of whites
27% of blacks
Residence 14% of urban residents
11% of mid-size county residents
20% of rural residents
PAGE 102
Should NotBe Legal
47%
Legal withRestrictions
28%
Should Be Legal
11%
NoOpinion
12%
Refused2%
SECTION 11 : LONG TERM CARE PLANNING
Views on physician assisted suicide [16]
PHYSICIAN ASSISTED SUICIDE SHOULD NOT BE LEGAL BY AGE, RACE, SEX, AND RESIDENCE
Race 45% of whites
55% of blacks
Sex 49% of females
45% of males
Residence 46% of urban residents
48% of mid-size county residents
51% of rural residents
Age 44% of 55-64 year olds
47% of 65-74 year olds
52% of 75 years and older
27% of participants said they could imagine a situation where they would request
physician assisted suicide if legal.
61% said they could not imagine such a situation.
11% were unsure.
1% refused to answer.
WOULD CONSIDER REQUESTING PHYSICIAN ASSISTED SUICIDE
PAGE 103
Should NotBe Legal
49%
NoOpinion
12%
Should Be Legal
9%
Legal WithRestrictions
28%
Refused2%
SECTION 11 : LONG TERM CARE PLANNING
Views on euthanasia [18]
EUTHANASIA SHOULD NOT BE LEGAL BY AGE, RACE, SEX, AND RESIDENCE
Race 48% of whites
54% of blacks
Sex 51% of females
48% of males
Residence 47% of urban residents
52% of mid-size county residents
53% of rural residents
Age 45% of 55-64 year olds
51% of 65-74 year olds
55% of 75 years and older
27% of participants said they could imagine a situation where they would request euthanasia if legal.
61% said they could not imagine such a situation.
11% were unsure.
1% refused to answer.
WOULD CONSIDER REQUESTING EUTHANASIA
PAGE 104 SECTION 11 : LONG TERM CARE PLANNING
End-of life concerns (multiple responses possible) [20]
CONCERN ABOUT BEING A BURDEN BY RACE, SEX, AND RESIDENCE Race
59% of whites
42% of blacks
Sex 58% of females
49% of males
Residence 52% of urban residents
61% of mid-size county residents
56% of rural residents
55
3023 22 20
0
20
40
60
Being aBurden on
Others
No Worries orConcerns
Being in Pain Not HavingDignity
Respected
What WillHappen to My
Family
Per
cent
of S
ampl
e
13 128 4 4
0
20
40
60
Having OtherSevere
Symptoms
Being Alone Don'tKnow/Haven't
ThoughtAbout
What WillHappen To
Me After I Die
Other
Per
cent
of S
ampl
e
REFERENCES: CITATIONS PAGE 105
Alabama Commission on Aging and the University of Alabama Center for Aging. Statewide Survey of Alabama’s Elderly. (Available from the University of Alabama center for Aging, CH19-201, University Center, Birmingham AL 35294.) Alabama County Data Book. April 1997. Montgomery, AL: Alabama Department of Economic and Community Affairs. Cardiovascular Health Study. Manual of Operations. Vol. 1 and 2, 1989. Charlson ME, Sax FL, Mackenzie CR et al. Assessing illness severity: Does clinical judg-ment work? Journal of Chronic Diseases. Folstein MF, Folstein SE, McHugh PR, Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 1975;12: 189-198. Health Status of Rural Alabamians. Montgomery, Alabama Rural Health Association, 1998. Kovar M, Lawton M. Functional disability. Activities and instrumental activities of daily living. In: Lawton M, Teresi J, eds. Focus on Assessment Techniques. 1994, pp 57-75. The Nutrition Screening Initiative: Determine your nutritional health. Washington, DC: Nutri-tion Screening Initiative, 1992. Sheikh JL, Yesavage JA. Geriatric Depression Scales (GDS): Recent evidence and devel-opment of a shorter version. Clinical Gerontologist, 1986;5:165-174. United States Census 2000. http://www.census.gov/main/www/cen2000.html University of Alabama Center for Business and Economic Research, 2001. http://cber.cba.ua.edu/edata/data.html
References
Appendix A Questionnaire
Appendix B Frequency Tables
1
CHARTING THE COURSE
SECTION INTRO - IDENTIFICATION INFORMATION Frequency (n) Percent 1. SEX
Male 514 42.7 Female 690 57.3
2. TYPE OF HOUSING
Single-family home 1082 89.9 Multi-family home 91 7.6 House with one or more apartments 3 0.2 Apartment building 21 1.7 Housing especially for the elderly 4 0.3 Other 3 0.2
3. AMENITIES IN THE HOME Electricity 1204 100.0 Special phone service (TTY/TDD) 28 2.3 Air conditioning 1175 97.6 Stairs inside the home 396 32.9 Fans available 1116 92.7 Heat available 1204 100.0 Outside stairs leading into the home 701 58.2 Inside plumbing 1204 100.0 Ramp 92 7.6 Computer 556 46.2 Internet Access 458 38.0
SECTION 1: BACKGROUND Frequency (n) Percent 1. AGE RANGE (55-96) Mean = 68.54
55 – 64 494 41.0 65 – 74 382 31.7 75 – 84 279 23.2 85 +
2. BIRTHDATE NA NA
3. RACE/ETHNICITY
Black, not of Hispanic origin 328 27.2 White, not of Hispanic origin 876 72.8
4. MARITAL STATUS
Refused 1 0.1 Married 596 49.5 Widowed 392 32.6 Separated 18 1.5 Divorced 154 12.8 Never married 43 3.6
2
Section 1 cont’d Frequency (n) Percent 5. BIRTH PLACE
Alabama 870 72.3 Surrounding south 186 15.4 North east 88 7.3 Mid west 36 3.0 North west 7 0.6 South west 7 0.6 Other country 8 0.7
6. LENGTH OF RESIDENCE IN ALABAMA
Less than one year 1 0.1 One to five years 12 1.0 Six to ten years 22 1.8 Eleven to twenty years 50 4.2 More than twenty years 1119 92.9
7. CURRENT PROPERTY OWNER
Yes 1046 86.9 No 157 13.0 Does not know 1 0.1
8. HAS VALID ALABAMA DRIVERS LICENSE Yes 1107 91.9 No 97 8.1
9. REGISTERED VOTER IN ALABAMA Yes 1131 93.9 No 71 5.9 Does not know 2 0.2 PREVALENCE OF VOTING
Regularly 972 80.7 Sometimes 101 8.4 Rarely 56 4.7
VOTE IN LOCAL ELECTIONS Yes 1084 90.0 No 120 10.0
VOTE IN STATE ELECTIONS Yes 1084 90.0 No 120 10.0
VOTE IN NATIONAL ELECTIONS Yes 1090 90.5 No 114 9.5
3
Section 1 cont’d Frequency (n) Percent 10. NUMBER OF PEOPLE LIVING IN HOUSEHOLD
One 421 35.0 Two 595 49.4 Three 121 10.0 Four 31 2.6 Five 19 1.6 Six 7 0.6 Seven 10 0.8 WHO LIVES IN THE HOUSEHOLD
Spouse 584 48.5 Parent 17 1.4 Child 205 17.0 Grandchild 99 8.2 Other relative 46 3.8 Unrelated person living in home 22 1.8
11. HAVE CHILDREN Yes 1103 91.6 No 101 8.4 A. HOW MANY CHILDREN
One 147 12.2 Two 311 25.8 Three 271 22.5 Four 165 13.7 Five 90 7.5 Six 45 3.7 Seven 29 2.4 Eight 18 1.5 Nine or more 27 2.2
B. HOW MANY STILL LIVING None 15 1.2 One 158 13.1 Two 337 28.0 Three 255 21.2 Four 157 13.0 Five 78 6.5 Six 43 3.6 Seven 30 2.5 Eight 13 1.1 Nine or More 17 1.4
C. HOW MANY LIVE WITHIN ONE HOUR None 195 16.2 One 355 29.5 Two 261 21.7 Three 158 13.1 Four 70 5.8 Five or more 48 4.0
4
Section 1 cont’d Frequency (n) Percent
D. NUMBER THAT LIVE IN ALABAMA None 136 11.3 One 300 24.9 Two 302 25.1 Three 187 15.5 Four 93 7.7 Five or more 69 5.7
E. COMMUNICATE WITH CHILDREN Never 5 0.4 Three times a year or less 7 0.6 Four to ten times a year 8 0.7 Once a month 28 2.3 Two to three times a month 29 2.4 Once a week 117 9.7 Two to four times a week 193 16.0 Five or more times a week 701 58.2
F. PROVIDE CARE FOR CHILDREN Yes 168 14.0 No 920 76.4
12. HAVE GRANDCHILDREN Yes 1004 83.4 No 200 16.6
A. COMMUNICATE WITH GRANDCHILDREN Never 19 1.6 Three times a year or less 25 2.1 Four to ten times a year 41 3.4 Once a month 70 5.8 Two to three times a month 87 7.2 Once a week 135 11.2 Two to four times a week 190 15.8 Five or more times a week 437 36.3
B. PROVIDE CARE FOR GRANDCHILDREN Yes 171 14.2 No 833 69.2
13. HAVE LIVING PARENTS OR PARENTS-IN-LAW
Yes 359 29.8 No 845 70.2 A. PARENTS ABLE TO LIVE INDEPENDENTLY
Yes 236 19.6 No 117 9.7
B. PARENT REQUIRES ASSISTANCE Yes 139 11.5 No 169 14.0
Parent lives with family 58 4.8 Parent lives in assisted living 17 1.4 Parent has a live in caretaker 16 1.3 Parent lives in a board and care home 2 0.2 Parent lives in a nursing home 42 3.5 Parent has some other arrangement 22 1.8
5
Section 1 cont’d Frequency (n) Percent
C. PARENT LIVES WITHIN ONE HOUR DRIVE Yes 210 17.4 No 116 9.6
D. PARENT LIVES IN ALABAMA Yes 236 19.6 No 91 7.6
E. COMMUNICATE WITH PARENT Never 6 0.5 Three times a year or less 15 1.2 Four to ten times a year 11 0.9 Once a month 25 2.1 Two to three times a month 26 2.2 Once a week 61 5.1 Two to four times a week 64 5.3 Five or more times a week 118 9.8
14. PARTICIPANTS WITH LIVING BROTHERS
Range (0-12) 771 64.0 15. PARTICIPANTS WITH LIVING SISTERS
Range (0-13) 813 68.0 16. NUMBER OF FAMILY MEMBERS WITHIN ONE HOUR DRIVE
None 93 7.7 One to Two 200 16.6 Three to Five 169 14.0 More than five 742 61.6
17. SERVED IN THE MILITARY Yes 332 27.6 No 872 72.4 A. BRANCH
Army 182 15.1 Navy 50 4.2 Marine 13 1.1 Air Force 71 5.9 Coast Guard 2 0.2 Other 14 1.2
B. NUMBER OF YEARS SERVED Mean = 7.54 One to Two 112 9.3 Three to Five 112 9.3 Six to Nineteen 46 3.8 Over twenty years 63 5.2
C. ELIGIBLE FOR VETERAN’S BENEFITS Yes 221 18.4 No 111 9.2
6
Section 1 cont’d Frequency (n) Percent 18. FAMILY MEMBER SERVED IN THE MILITARY
Yes 996 82.7 No 207 17.2 Does not know 1 0.1 A. RELATIONSHIP
Spouse 294 24.4 Other 682 56.6
B. ELIGIBLE FOR VETERAN’S BENEFITS Yes 87 7.2 No 830 68.9 Does not know 69 5.7
19. HIGHEST GRADE LEVEL COMPLETED
Range (1 – 17) Does not know 1 0.1 First to Eighth grade 120 10.0 Ninth to Eleventh grade 187 15.5 High School or GED 365 30.3 Some college 201 16.7 Completed tech / Jr. college (Assoc. Degree) 72 6.0 College Graduate 117 9.7 Some graduate / Professional school 24 2.0 Graduate or Professional degree 117 9.7
20. EMPLOYMENT STATUS (multiple responses possible)
Employed full time 236 19.6 Employed part time 107 8.9 Disabled 137 11.4 Retired 773 64.2 Volunteer 36 3.0 Never worked outside the home 37 3.1 Unemployed 24 2.0 Looking for work 6 0.5 Refused 1 0.1
21. ABILITY TO AFFORD BASIC EXPENSES Refused 2 0.2 Does not know 3 0.2 Impossible 10 0.8 Very Difficult 180 15.0 Somewhat difficult 325 27.0 Not very difficult 684 56.8
22. OVERALL INCOME ACCEPTABILITY
Is not enough to make ends meet 146 12.1 Gives just enough to get by on 322 26.7 Keeps you comfortable but permits no luxuries 352 29.2 Allows you to do more or less what you want 337 31.3 Refused 4 0.3 Does not know 3 0.2
7
Section 1 cont’d Frequency (n) Percent 23. TOTAL ANNUAL INCOME
A. Less than $5,000 29 2.4 B. $ 5,000 - $ 7,999 99 8.2 C. $ 8,000 - $ 11,999 122 10.1 D. $ 12,000 - $ 15,999 123 10.2 E. $ 16,000 - $ 19,999 87 7.2 F. $ 20,000 - $ 29,999 147 12.2 G. $ 30,000 - $ 39,999 116 9.6 H. $ 40,000 - $ 49,999 96 8.0 I. $50,000 - $ 74,999 109 9.1 J. $75,000 - $ 99,999 57 4.7 K. $100,000 - $149,999 37 3.1 L. $150,000 or more 22 1.8 M. Does not know 49 4.1 N. Refused 110 9.1
SECTION II: GENERAL HEALTH Frequency (n) Percent 1. GENERAL HEALTH (SELF RATING)
Poor 157 13.0 Fair 315 26.2 Good 372 30.9 Very Good 219 18.2 Excellent 141 11.7
2. COMPARE HEALTH TODAY VS THREE YEARS AGO
Worse 511 42.4 Same 524 43.5 Better 169 14.0
QUESTIONS 3 – 14 ASKED ABOUT POSSIBLE SYMPTOMS OVER THE LAST MONTH
3. NOT TAKEN INTEREST IN DOING THINGS
Never 676 56.1 Almost never 151 12.5 Sometimes 256 21.3 Very often 73 6.1 Always 48 4.0
4. FELT DOWNHEARTED AND BLUE Never 531 44.1 Almost never 189 15.7 Sometimes 366 30.4 Very often 95 7.9 Always 22 1.8 Refused 1 0.1
8
Section II cont’d Frequency (n) Percent 5. FELT RELAXED AND FREE OF TENSION
Never 104 8.6 Almost never 117 9.7 Sometimes 363 30.1 Very often 343 28.5 Always 277 23.0
6. NERVOUSNESS / NERVES Never 697 57.9 Almost never 139 11.5 Sometimes 247 20.5 Very often 67 5.6 Always 54 4.5
7. FELT TENSE OR HIGH STRUNG
Never 557 46.3 Almost never 177 14.7 Sometimes 329 27.3 Very often 95 7.9 Always 46 3.8
8. EXPERIENCED FATIGUE Never 344 28.6 Almost never 134 11.1 Sometimes 369 30.6 Very often 213 17.7 Always 144 12.0
9. SHORTNESS OF BREATH Never 687 57.1 Almost never 104 8.6 Sometimes 230 19.1 Very often 115 9.6 Always 68 5.6
10. EXPERIENCED NAUSEA Never 1035 86.0 Almost never 54 4.5 Sometimes 84 7.0 Very often 24 2.0 Always 7 0.6
11. TROUBLE WITH BALANCE Never 733 60.9 Almost never 81 6.7 Sometimes 264 21.9 Very often 70 5.8 Always 56 4.7
9
Section II cont’d Frequency (n) Percent 12. EXPERIENCED FAINTING
Never 1154 95.8 Almost never 30 2.5 Sometimes 17 1.4 Very often 2 0.2 Always 1 0.1
13. EXPERIENCED PAIN Never 412 34.2 Almost never 79 6.6 Sometimes 309 25.7 Very often 164 13.6 Always 240 19.9
14. AMOUNT OF PAIN Agonizing 138 11.5 Dreadful 89 7.4 Uncomfortable 320 26.6 Annoying 245 20.3 No pain 412 34.2 A. AMOUNT PAIN INTERFERED WITH DAILY WORK
Not at all 265 22.0 A little bit 168 14.0 Moderately 106 8.8 Quite a bit 142 11.8 Extremely 94 7.8
15. EXPERIENCE DEPRESSION OVER THE LIFETIME
No 520 43.2 Yes 684 56.8
Takes medication 194 16.1 Limits activities 91 7.6
16. EVER EXPERIENCE ANXIETY OR PANIC ATTACKS
No 913 75.8 Yes 291 24.2
Takes medication 106 8.8 Limits activities 27 2.2
17. EVER EXPERIENCE A NERVOUS BREAKDOWN
No 1137 94.4 Yes 67 5.6
Takes medication 32 2.7 Limits activities 18 1.5
18. HEARING AID USE
No 1071 89.0 Yes 133 11.0
10
Section II cont’d Frequency (n) Percent 19. HEARING ABILITY (SELF REPORT)
Does not know 1 0.1 Good or adequate 1056 87.7 Poor (partially deaf) 145 12 Totally deaf 2 0.2
20. HEARING ABILITY (INTERVIEWER’S EVALUATION) Good or adequate 1098 91.2 Poor (partially deaf) 105 8.7 Totally deaf 1 0.1
21. WEAR CONTACTS OR GLASSES No 49 4.1 Yes 906 75.2 Reading only 249 20.7
Legally blind 28 2.3 Congenital (from birth) 2 0.2 Acquired 26 2.2 Blind 8 0.7 Congenital (from birth) 0 0 Acquired 8 0.7
22. FREQUENCY OF EYE EXAMS
Never 14 1.2 Only if experiencing problems 226 18.8 Every two years 342 28.4 Annually or more often 597 49.6 Other 25 2.1 A. LAST EYE EXAM
Less than one year 700 58.1 One to five years 424 35.2 Over five years 56 4.7 Does not know 10 0.8
B. GLASSES PRESCRIBED No 321 26.7 Yes 869 72.2 BA. GLASSES OBTAINED
Yes 818 67.9 No 51 4.2
BAA. IF NO, REASON WHY Cost 20 1.7 No time 4 0.3 Other 22 1.8
23. HAVE EYE EXAM INSURANCE
No 439 36.5 Yes 722 60.0 Does not know 43 3.6
11
Section II cont’d Frequency (n) Percent 24. EYE GLASSES INSURANCE
No 733 60.9 Yes 380 31.6 Does not know 62 5.1
25. DIAGNOSED WITH SOME EYE DISEASE No 614 51.0 Yes 590 49.0
Limit activities 21 1.7 A. CATARACTS 450 37.4
Takes medication 29 2.4 Surgery 282 23.4
B. GLAUCOMA 108 9.0 Takes medication 65 5.4
C. OTHER EYE DISEASE 84 7.0 Takes medication 15 1.2
26. DIFFICULTY READING TRAFFIC SIGNS
Does not know 1 0.1 Does not apply 4 0.3 No 1105 91.8 Yes 94 7.8
A little 46 3.8 A moderate amount 23 1.9 A great deal 25 2.1
27. DIFFICULTY SEEING STEPS, STAIRS, CURBS
Does not know 1 0.1 Does not apply 4 0.3 No 1112 92.4 Yes 87 7.2
A little 55 4.6 A moderate amount 17 1.4 A great deal 15 1.2
28. DIFFICULTY READING NEWSPAPERS OR BOOKS Does not apply 4 0.3 Does not know 2 0.2 No 996 82.7 Yes 202 16.8
A little 99 8.2 A moderate amount 52 4.3 A great deal 51 4.2
12
Section II cont’d Frequency (n) Percent 29. DIFFICULTY READING SMALL PRINT
Does not apply 4 0.3 Does not know 2 0.2 No 744 61.8 Yes 454 37.7
A little 225 18.7 A moderate amount 100 8.3 A great deal 129 10.7
30. LAST ORAL EXAM
Does not know 21 1.7 Never 15 1.2 Over five years ago 282 23.4 One to five years ago 277 23.0 Less than one year 609 50.6
31. BEEN WITHOUT NEEDED DENTAL CARE No 1007 83.6 Yes 197 16.4 Why
Cost 135 11.2 Lack of Time 14 1.2 Other Reason 60 5.0
32. CHANGED EATING HABITS DUE TO DENTAL PROBLEMS
Does not know 1 0.1 No 1059 88.0 Yes 144 12.0
33. MOUTH RINSE USE Never 225 18.7 Less than one time per week 89 7.4 Once per week 43 3.6 A few times per week 131 10.9 Four or five times per week 60 5.0 At least once per day 656 54.5
34. FREQUENCY TO FLOSS
No teeth to floss (dentures) 276 22.9 Never 271 22.5 Less than one time per week 85 7.1 Once per week 56 4.7 A few times per week 106 8.8 Four or five times per week 48 4.0 At least once per day 362 30.1
13
SECTION III: MOBILITY
Frequency (n) Percent 1. SOCIAL ACTIVITY LEVEL
Active 594 49.3 Moderately active 334 27.7 Minimally active 200 16.6 Not active 76 6.3
2. BEING SATISFIED WITH AMOUNT OF SOCIAL ACTIVITY Satisfied 952 79.1 Not satisfied, too little 220 18.3 Not satisfied, too much 32 2.7
3. PHYSICAL ACTIVITY LEVEL Active 472 39.2 Moderately active 376 31.2 Minimally active 254 21.1 Not active 102 8.5
4. ABILITY TO WALK ¼ OF A MILE WITHOUT STOPPING Unable 219 18.2 A lot of difficulty 118 9.8 A little difficulty 151 12.5 No difficulty 706 58.6 Does not know 10 0.8
5. EXERCISE PARTICIPATION (multiple responses possible) Walking 495 41.1 Yard work 640 53.2 Gardening 357 29.7 Strenuous housework 509 42.3 General exercises 251 20.8 Exercise equipment 210 17.4 Aerobics 42 3.5 Dancing 37 3.1 Golf 41 3.4 Other 131 10.9 No activities 190 15.8
6. FALLEN IN THE PAST YEAR
No 883 73.0 Yes 321 26.7 A. TIMES FALLEN IN THE LAST YEAR
Mean = 4.23 NA NA One 164 13.6 Two 66 5.5 Three 37 3.1 Four 16 1.3 Five or more times 38 3.2
14
Section III cont’d Frequency (n) Percent
B. TIME OF THE LAST FALL 0 – 3 Months ago 163 13.5 4 – 6 Months ago 89 7.4 7 – 9 Months ago 37 3.1 10 – 12 Months ago 32 2.7
C. DID THE FALL RESULT IN INJURY Does not know 2 0.2 No 173 14.4 Yes 146 12.1
D. WAS MEDICAL TREATMENT RECEIVED No 227 18.9 Yes 94 7.8
7. MOBILITY AIDS CURRENTLY USED (multiple responses possible)
Cane 198 16.4 Walker 107 8.9 Wheelchair 68 5.6 Special “rising seat” chair or lift chair 25 2.1 Elevator / elevator chair 7 0.6 Crutch or crutches 9 0.7 Brace 18 1.5 Scooter 21 1.7 Transfer lift 5 0.4 Hospital bed 14 1.2 Bars or rails in bathroom, shower, or a bath chair 165 13.7 Roll in shower 3 0.2 Toilet seat / bedside commode 79 6.6 Bed pan system 12 1.0 Ventilator 7 0.6 Oxygen 52 4.3
8. OTHER EQUIPMENT USED Special orthopedic shoes 30 2.5 Artificial leg 7 0.6 Other equipment used 14 1.2 Other walking equipment 2 0.2
9. NEED EQUIPMENT BUT UNABLE TO AFFORD IT
Yes 127 10.5 No 1077 89.5 A. EQUIPMENT NEEDED
Scooter 43 3.6 Rails in the bathroom 21 1.7 Cane or walker 16 1.3 Wheelchair 9 0.7 Lift chair 9 0.7 Shoes 8 0.7 Other bathroom equipment 7 0.6 Other 14 1.2
15
Section III cont’d Frequency (n) Percent 10. EQUIPMENT COVERED BY INSURANCE
No 161 13.4 Yes 172 14.3 Not sure does not know 180 15.0 No equipment used 678 56.3 No insurance 13 1.1
11. IN NEED OF HOME HEALTH OR HOSPICE
Yes 65 5.4 No 1138 94.5 Does not know 1 0.1 A. CURRENTLY RECEIVE HOME HEALTH OR HOSPICE
Yes 24 2.0 No 41 3.4 AA. TYPE OF SERVICES RECEIVED
Home health system 18 1.5 Hospice 1 0.1 Other health care services 8 0.7
AB. HOME HEALTH PAID BY Health Insurance 1 0.1 Medicare 11 0.9 Medicaid 9 0.7 Self 5 0.4 Family 1 0.1 Not sure / refused 4 0.3
AC. SERVICE MEETS PATIENT’S NEEDS All of the needs 10 0.8 Most of the needs 6 0.5 Some of the needs 7 0.6 Very few of the needs 1 0.1
B. MOST VALUABLE SERVICE THAT COULD BE RECEIVED A nurse to check on the patient 3 0.2 Someone to help with medicine 2 0.2 Someone to help clean the house 17 1.4 Someone to help with bathing and dressing 4 0.3 A social worker to help identify what assistance is available 11 0.9 A physical therapist that works in the home 2 0.2 Does not know 3 0.2
12. HAVE RELIABLE MODE OF TRANSPORTATION
Yes 1140 94.7 No 63 5.2 Does not know 1 0.1
13. MOST FREQUENT MODE OF TRANSPORTATION
Access to car / drive themselves 1019 84.6 Access to car / someone else drives 289 24.0 Family, friend or neighbor transports them in other car 350 29.1 Community transportation service 16 1.3 Bus or other public transportation 20 1.7 Other 9 0.7
16
Section III cont’d Frequency (n) Percent 14. SEATBELT USE
Always 1086 90.2 Most of the time 69 5.7 Sometimes 31 2.6 Never 15 1.2 Never drive or ride in a car 2 0.2
15. OTHER TRANSPORTATION AVAILABLE IN THE AREA
Bus 352 29.2 Van service 282 23.4 Cab or taxi 520 43.2 Other 28 2.3 None 367 30.5 Does not know 101 8.4 A. USE ANY OF THEM
No 644 53.5 Yes 92 7.6
16. AMBULANCE SERVICE AVAILABLE
Yes 1175 97.6 No 13 1.1 Does not know 16 1.3 A. APPROXIMATE ARRIVAL TIME AFTER CALL
Less than 15 minutes 860 71.5 15 to 30 minutes 240 19.9 30 minutes to one hour 28 2.3 Over one hour 4 0.3 Does not know 43 3.6
IADL1. DIFFICULTY USING THE TELEPHONE
No 1131 93.9 Yes 73 6.1
Some difficulty 52 4.3 A lot of difficulty 16 1.3 Unable to do 5 0.4
IADL2. DIFFICULTY DOING LIGHT HOUSEWORK Does not do for other reason 43 3.6 No 1045 86.8 Yes 116 9.6
Some difficulty 60 5.0 A lot of difficulty 22 1.8 Unable to do 34 2.8
17
Section III cont’d Frequency (n) Percent IADL3. DIFFICULTY DOING HEAVY HOUSEWORK
Does not do for other reason 50 4.2 Does not know or refused 1 0.1 No 795 66.0 Yes 358 29.7
Some difficulty 123 10.2 A lot of difficulty 70 5.8 Unable to do 165 13.7
IADL4. DIFFICULTY PREPARING MEALS
Does not do for other reason 72 6.0 No 1032 85.7 Yes 100 8.3
Some difficulty 56 4.7 A lot of difficulty 17 1.4 Unable to do 27 2.2
IADL5. DIFFICULTY SHOPPING
Does not do for other reason 48 4.0 No 964 80.1 Yes 192 15.9
Some difficulty 94 7.8 A lot of difficulty 43 3.6 Unable to do 55 4.6
IADL6. DIFFICULTY MANAGING MONEY
Does not do for other reason 34 2.8 No 1109 92.1 Yes 61 5.1
Some difficulty 38 3.2 A lot of difficulty 7 0.6 Unable to do 16 1.3
ADL1. DIFFICULTY TURNING FROM SIDE TO SIDE IN BED No 1007 83.6 Yes 197 16.4
Some difficulty 135 11.2 A lot of difficulty 55 4.6 Unable to do 7 0.6
ADL2. DIFFICULTY GOING UP AND DOWN STAIRS
Does not do for other reason 2 0.2 No 809 67.2 Yes 393 32.6
Some difficulty 199 16.5 A lot of difficulty 117 9.7 Unable to do 77 6.4
18
Section III cont’d Frequency (n) Percent ADL3. DIFFICULTY GETTING OUT OF A BED OR CHAIR
No 924 76.7 Yes 280 23.3
Some difficulty 212 17.6 A lot of difficulty 65 5.4 Unable to do 3 0.2
ADL4. DIFFICULTY BATHING OR SHOWERING
No 1067 88.6 Yes 137 11.4
Some difficulty 82 6.8 A lot of difficulty 37 3.1 Unable to do 18 1.5
ADL5. DIFFICULTY DRESSING OR UNDRESSING
No 1095 90.9 Yes 109 9.1
Some difficulty 82 6.8 A lot of difficulty 19 1.6 Unable to do 8 0.7
ADL6. DIFFICULTY EATING
No 1163 96.6 Yes 41 3.4
Some difficulty 30 2.5 A lot of difficulty 10 0.8 Unable to do 1 0.1
ADL7. DIFFICULTY WALKING
Does not do for other reason 1 0.1 No 897 74.5 Yes 306 25.4
Some difficulty 157 13.0 A lot of difficulty 129 10.7 Unable to do 20 1.7
ADL8. DIFFICULTY GETTING OUTSIDE No 1081 89.8 Yes 123 10.2
Some difficulty 65 5.4 A lot of difficulty 49 4.1 Unable to do 9 0.7
ADL9. DIFFICULTY GETTING TO OR USING THE TOILET
Does not do for other reason 1 0.1 No 1138 94.5 Yes 65 5.4
Some difficulty 43 3.6 A lot of difficulty 19 1.6 Unable to do 3 0.2
19
SECTION IV: HEALTH SERVICES UTILIZATION
Frequency (n) Percent 1. HAVE HEALTH CARE INSURANCE (multiple responses possible)
No 49 4.1 Yes 1155 95.9
Medicare 734 61.0 Medicaid 106 8.9 Medicare supplemental insurance 294 24.5 Private insurance 306 25.4 Insurance through employer 414 34.3 VA program 69 5.7
2. HAVE A REGULAR DOCTOR TO SEE FOR HEALTH CARE
No 56 4.7 Yes 1148 95.3 A. LAST TIME TO SEE THIS DOCTOR
Within a month 454 37.7 Within 6 months 494 41.0 Within 7 – 12 months 102 8.5 Within 1 – 2 years 52 4.3 Over 2 years 24 2.0 Never 9 0.7 Does not know 13 1.1
3. SEE MORE THAN ONE DOCTOR
No 378 31.4 Yes 826 68.6 A. WHY (multiple responses possible)
Specialist 796 66.1 Convenience 22 1.8 Cost 7 0.6 Insurance 15 1.2
4. NUMBER OF TIMES LAST YEAR TO SEE THE DOCTOR Mean = 6.4 NA NA
5. NEEDED TO SEE THE DOCTOR BUT DID NOT GO No 918 76.2 Yes 286 23.8 A. WHY (multiple responses possible)
Transportation problems 31 2.6 Unsure of who to see 11 0.9 Lack of money 71 5.9 Fear 20 1.7 Distance 3 0.2 Dissatisfaction with provider 6 0.5 Just put it off 138 11.5 Some other reason 58 4.8
20
Section IV cont’d Frequency (n) Percent 6. GO WITH A MEDICAL EMERGENCY
Private physician 161 13.4 Hospital clinic 93 7.7 Emergency room 934 77.6 Health department 2 0.2 Other 6 0.5 Does not know 8 0.7
7. LAST GENERAL PHYSICAL EXAM
Less than 3 months 357 29.7 Less than 6 months 237 19.7 Less than one year 333 27.7 Less than 2 years 111 9.2 More than 2 years 134 11.1 Never 14 1.2 Does not know 18 1.5
8. CHECKED OR HAD DONE WITHIN THE LAST YEAR (multiple responses possible)
Blood drawn 1076 89.4 Blood count 989 82.1 Blood sugar 942 78.2 Cholesterol screening 974 80.9 Blood pressure check 1141 94.8 Colon screening 451 37.5 Digital rectal exam 437 36.3 Stool blood test 460 38.2 Pap smear 393 32.6 Breast exam 473 39.3 Mammogram 492 41.0 Prostate exam 366 30.4
9. BEEN TREATED AT AN EMERGENCY ROOM No 927 77.0 Yes 277 23.0 Mean = 1.67 NA NA B. REASON FOR VISIT
Bleeding 4 0.3 Mental / anxiety problems 4 0.3 Blood Sugar 7 0.6 Stroke 7 0.6 Kidneys 9 0.7 Animal bite / allergy 11 0.9 Blood pressure 12 1.0 Breathing 12 1.0 Virus 13 1.1 Other 21 1.7 Injury or pain 42 3.5 Heart 44 3.7 External problems 46 3.8 Internal problems 47 3.9
21
Section IV cont’d Frequency (n) Percent 10. BEEN TREATED IN A HOSPITAL OVER THE LAST YEAR
No 828 68.8 Yes 376 31.2 A. NUMBER OF VISITS TO A HOSPITAL
Mean = 1.87 NA NA B. REASON FOR THE LAST VISIT
Internal problems 114 9.5 Problem with heart or arteries 68 5.6 External problems, injuries or pain 68 5.6 Colon 25 2.1 Eyes 22 1.8 Virus or bacterial problem 17 1.4 Blood problem, blood pressure, bleeding 14 1.2 Asthma or other repertory problem 8 0.7 Allergy or animal bite 3 0.2 Other 37 3.1
11. BEEN A RESIDENT AT A NURSING HOME, MENTAL HEALTH FACILITY OR VA FACILITY THE LAST YEAR
No 1191 98.9 Yes 13 1.1 A. WHERE
Healthcare 4 0.3 Nursing home 3 0.2 VA facility 2 0.2 Mental health 1 0.1 Other 3 0.2
12. PRESCRIPTION DRUG COVERAGE (multiple responses possible) Does not know 9 0.7 No 323 26.8 Yes 872 72.4
Private insurance 288 23.9 Insurance through an employer 407 33.8 Medicaid 81 6.7 VA 93 7.7 Other 58 4.8
13. TAKE PRESCRIPTION MEDICATION No 146 12.1 Yes 1058 87.9 A. HAVE PRESCRIPTIONS FROM MULTIPLE DOCTORS
No 542 45.0 Yes 517 42.9
B. TAKE MEDICINE AS DIRECTED OR AT CONVENIENCE As directed by a physician 994 82.6 Only when I need it 20 1.7 Both 44 3.7
C. CHANGE THE PRESCRIPTION DUE TO COST Yes 149 12.4 No 913 75.8
22
Section IV cont’d Frequency (n) Percent
D. COST OF MEDICINE PER MONTH Prescription medication Average cost $96.33 NA NA Non prescription medication Average cost $22.30 NA NA
E. BEEN UNABLE TO AFFORD PRESCRIBED MEDICINE Yes 199 16.5 No 890 73.9
F. TAKEN SOMEONE ELSE’S MEDICATION No 1038 86.2 Yes 50 4.2
SECTION V: MEDICAL HISTORY Frequency (n) Percent 1. DIAGNOSED WITH HEART PROBLEMS
No 774 64.3 Yes 430 35.7
Limits activities 84 7.0 A. Heart failure, fluid on the lungs or enlarged heart 91 7.6
Takes medication 57 4.7 B. Chest pain with exertion or heart pain 95 7.9
Takes medication 50 4.2 C. Heart attack, coronary thrombosis or myocardial infarction 146 12.1
Takes medication 86 7.1 D. Irregular heart beat, cardiac arrhythmia or conduction disturbance
200 16.6
Takes medication 102 8.5 2. DIAGNOSED WITH HEART VALVE PROBLEMS
No 1069 88.8 Yes 135 11.2
Limits activities 14 1.2 A. Mitral valve prolapse 42 3.5
Takes medication 17 1.4 B. Mitral valve stenosis / regurgitation 7 0.6
Takes medication 4 0.3 C. Aortic valve stenosis / regurgitation 15 1.2
Takes medication 6 0.5 D. Other valve stenosis / regurgitation 10 0.8
Takes medication 3 0.2 E. Rheumatic heart problems 4 0.3
Takes medication 2 0.2 F. Heart murmur 59 4.9
Takes medication 3 0.2 3. HIGH BLOOD PRESSURE / HYPERTENSION
No 452 37.5 Yes 752 62.5
Takes medication 662 55.0 Limits activities 106 8.8
23
Section V cont’d Frequency (n) Percent 4. DIAGNOSED WITH CIRCULATION PROBLEMS
No 850 70.6 Yes 354 29.4
Limits activities 65 5.4 A. Peripheral arterial disease, poor circulation, hardening of arteries
129 10.7
Takes medication 51 4.2 B. Thrombophlebitis, or pulmonary embolisms 37 3.1
Takes medication 16 1.3 C. Swelling in feet and legs 244 20.3
Takes medication 117 9.7 D. Varicose veins 55 4.6
Takes medication 1 0.1
5. DIAGNOSED WITH DIABETES No 950 78.9 Yes 254 21.1 A. WHAT TYPE
Type I: Insulin dependent or juvenile type 30 2.5 Type II: Non-insulin dependent or adult onset 217 18.0
B. COMPLICATIONS AS RESULT OF DIABETES (multiple responses possible)
Hypoglycemia 59 4.9 Ketosis or ketoacidosis (DKA) 4 0.3 Neuropathy / arthropathy 50 4.2 Renal-kidney disease 17 1.4 Eye disease 48 4.0 Circulatory disorders 47 3.9
6. DIAGNOSED WITH RENAL OR KIDNEY DISEASE No 1130 93.9 Yes 74 6.1
Limits activities 7 0.6 A. RENAL OR KIDNEY FAILURE 28 2.3
Takes medication 9 0.7 B. REQUIRES DIALYSIS 5 0.4
7. RECURRENT URINARY TRACT INFECTIONS (UTI) Yes 154 12.8 No 1050 87.2
8. DIAGNOSED WITH LIVER DISEASE No 1166 96.8 Yes 38 3.2
Limits activities 1 0.1 A. CIRRHOSIS 5 0.4
Takes medication 1 0.1 B. HEPATITIS 22 1.8
Takes medication 4 0.3
24
Section V cont’d Frequency (n) Percent 9. DIAGNOSED WITH ANEMIA OR THYROID PROBLEMS
No 895 74.3 Yes 309 25.7
Limits Activities 13 1.1 A. ANEMIA 155 12.9
Takes medication 56 4.7 B. THYROID PROBLEMS 176 14.6
Takes medication 133 11.0
10. STOMACH, BOWEL OR DIGESTIVE PROBLEMS No 737 61.2 Yes 467 38.8
Limits activities 20 1.7 A. COLON 89 7.4
Takes medication 24 2.0 B. CROHN’S DISEASE 4 0.3
Takes medication 0 0 C. DIVERTICULITIS 80 6.6
Takes medication 18 1.5 D. GALL BLADDER PROBLEMS 99 8.2
Takes medication 2 0.2 E. STOMACH ULCER (PEPTIC OR DUODENAL) 91 7.6
Takes medication 31 2.6 F. ULCERATIVE COLITIS 13 1.1
Takes medication 6 0.5 G. GERD / REFLUX DISEASE 264 21.9
Takes medication 180 15.0
11. PARKINSON’S DISEASE No 1193 99.1 Yes 11 0.9
Takes medication 7 0.6 Limits activities 3 .2
A. INTERVIEWER OBSERVATION OF SHAKING OF HANDS No 1179 97.9 Yes 25 2.1
12. PERIPHERAL NEUROPATHY
No 1070 88.9 Yes 133 11.0
Takes medication 39 3.2 Limits activities 40 3.3
13. EPILEPSY OR SEIZER DISORDER
No 1184 98.3 Yes 20 1.7
Takes medication 13 1.1 Limits activities 5 0.4
25
Section V cont’d Frequency (n) Percent 14. HAD A STROKE
No 1134 94.2 Yes 70 5.8
Takes medication 35 2.9 Limits activities 23 1.9
15. HAD A TRANSIENT ISCHEMIC ATTACK (TIA)
No 1131 93.9 Yes 73 6.1
Takes medication 31 2.6 Limits activities 12 1.0
16. HAVE RESPIRATORY OR BREATHING PROBLEMS
No 957 79.5 Yes 247 20.5
Limits activities 32 2.7 A. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) 37 3.1
Takes medication 22 1.8 Oxygen 14 1.2
B. ASTHMA 95 7.9 Takes medication 67 5.6 Oxygen 12 1.0
C. CHRONIC BRONCHITIS 75 6.2 Takes medication 37 3.1 Oxygen 7 0.6
D. EMPHYSEMA 45 3.7 Takes medication 23 1.9 Oxygen 9 0.7
17. EVER REQUIRED HOME OXYGEN (02)
No 1161 96.4 Yes 43 3.6
18. EVER HAD ANY TYPE OF CANCER
No 898 74.6 Yes 305 25.3 Takes medication 12 1.0 A. BREAST
Surgery 47 3.9 Less than 1 year ago 3 0.2 1 – 5 years ago 18 1.5 More than 5 years ago 26 2.2
B. COLON, RECTUM OR BOWEL Surgery 29 2.4 Less than 1 year ago 4 0.3 1 – 5 years ago 15 1.2 More than 5 years ago 17 1.4
26
Section V cont’d Frequency (n) Percent
C. LUNG Surgery 9 0.7 Less than 1 year ago 1 0.1 1 – 5 years ago 5 0.4 More than 5 years ago 5 0.4 Limits activities 4 0.3
D. PROSTATE Surgery 27 2.2 Less than 1 year ago 7 0.6 1 – 5 years ago 19 1.6 More than 5 years ago 18 1.5 Does not remember / Refused 1 0.1
E. SKIN Surgery 113 9.4 Less than 1 year ago 42 3.5 1 – 5 years ago 47 3.9 More than 5 years ago 36 3.0 Limits activities 1 0.1
F. OTHER TYPE OF CANCER Less than 1 year ago 5 0.4 1 – 5 years ago 20 1.7 More than 5 years ago 48 4.0 Does not remember / Refused 1 0.1 Limits activities 2 0.2
19. FAMILY HISTORY OF CANCER (multiple responses possible) No 506 42.0 Yes 698 58.0 BREAST CANCER IN THE FAMILY 208 17.3
Sibling (s) 88 7.3 Parent (s) 53 4.4 Aunt (s) / Uncle (s) 70 5.8 Grandparent (s) 20 1.7
COLON CANCER IN THE FAMILY 131 10.9 Sibling (s) 40 3.3 Parent (s) 50 4.2 Aunt (s) / Uncle (s) 28 2.3 Grandparent (s) 21 1.7
PROSTATE CANCER IN THE FAMILY 83 6.9 Sibling (s) 28 2.3 Parent (s) 46 3.8 Uncle (s) 11 0.9 Grandparent (s) 7 0.6
OTHER CANCER IN THE FAMILY 534 44.4 Sibling (s) 214 17.8 Parent (s) 256 21.3 Aunt (s) / Uncle (s) 111 9.2 Grandparent (s) 71 5.9
27
Section V cont’d Frequency (n) Percent 20. DIAGNOSED WITH ARTHRITIS
No 488 40.5 Yes 716 59.5
Takes medication 245 20.3 Limits activities 156 13.0
A. TYPE OF ARTHRITIS (multiple responses possible) Osteoarthritis / degenerative arthritis 399 33.1 Rheumatism 35 2.9 Rheumatoid arthritis 102 8.5 Does not know 192 15.9 Other 21 1.7
B. WHERE IS THE ARTHRITIS LOCATED (multiple responses possible)
Hips 125 10.4 Knees 280 23.3 Hands 277 23.0 Back / spine 194 16.1 Shoulders 160 13.3 All over 153 12.7 Other 123 10.2
21. DIAGNOSED WITH OSTEOPOROSIS
No 1042 86.5 Yes 162 13.5
Takes medication 109 9.1 Limits activities 23 1.9
22. HAD A PINCHED NERVE OR COLLAPSED DISCS
No 949 78.8 Yes 255 21.2
Takes medication 65 5.4 Limits activities 97 8.1
23. DIAGNOSED WITH GOUT
No 1072 89.0 Yes 132 11.0
Takes medication 63 5.2 Limits activities 36 3.0
24. EVER FRACTURED OR BROKEN A BONE
No 609 50.6 Yes 595 49.4
Takes medication 13 1.1 Limits activities 30 2.5
A. WHAT WAS FRACTURED AND WHEN WAS IT Hip 29 2.4 Upper body 363 30.1 Lower body 295 24.5 Ruptured spinal discs 24 2.0 Vertebral compression fracture or broken back bone 26 2.2
28
Section V cont’d Frequency (n) Percent 25. HAD ANY TYPE OF PARALYSIS
No 1168 97.0 Yes 36 3.0
Limits activities 6 0.5 A. WHAT TYPE OF PARALYSIS
Polio 6 0.5 Monoplegia-paralysis affecting one side 20 1.7 Paraplegia-paralysis of both legs 2 0.2 Quadriplegia-paralysis of both arms and both legs 2 0.2
26. DIAGNOSED WITH ALZHEIMER’S DISEASE OR DEMENTIA No 1178 97.8 Yes 26 2.2
Limits activities 5 0.4 A. ALZHEIMER’S TYPE 9 0.7
Takes medication 4 0.3 B. DEMENTIA, STROKE 3 0.2
Takes medication 1 0.1 C. OTHER TYPE OF DEMENTIA 12 1.0
Takes medication 2 0.2
27. DIAGNOSED WITH SCHIZOPHRENIA No 1198 99.5 Yes 6 0.5
Limits activities 1 0.1 Takes medication 3 0.2
28. DIAGNOSED WITH PROSTATE PROBLEMS
No 332 27.6 Yes 182 15.1
Limits activities 9 0.7 A. PROSTATE DISEASE 39 3.2
Takes medication 16 1.3 B. BENIGN PROSTATE HYPERTROPHY (BPH) 104 8.6
Takes medication 43 3.6 C. PROSTATITIS 34 2.8
Takes medication 6 0.5 D. PROSTATE SURGERY 50
29. EVER BEEN PREGNANT No 66 5.5 Yes 624 51.8 A. How many pregnancies
One 84 7.0 Two 142 11.8 Three 139 11.5 Four 102 8.5 Five 77 6.4 Six to ten 69 5.7 Eleven to twenty 11 0.9
29
Section V cont’d Frequency (n) Percent
B. How many live births None 16 1.3 One 102 8.5 Two 170 14.1 Three 143 11.9 Four 84 7.0 Five to nine 99 8.2 Ten to sixteen 10 0.8
30. HAD ANY PROBLEMS WITH YOUR UTERUS No 400 33.2 Yes 290 24.1
Limits activities 1 .1 A. UTERINE FIBROIDS OR ENLARGED UTERUS 160 13.3
Takes medication 6 0.5 B. PROLAPSED OR FALLEN UTERUS 64 5.3
Takes medication 2 0.2
31. EVER HAD A HYSTERECTOMY OR C-SECTION Hysterectomy with removal of ovaries 232 19.3 Hysterectomy without removal of ovaries 180 15.0 C-Section or Caesarian delivery 42 3.5 Number or C-Sections One 23 1.9 Two 15 1.2 Three or more 4 0.3
32. AGE OF MENOPAUSE Mean = 44.08 NA NA
33. TAKEN HORMONE REPLACEMENT THERAPY
No 266 22.1 Yes 423 35.1 A. HOW MANY YEARS
Up to five years 108 9.0 Five to nine years 60 5.0 Ten to nineteen years 123 10.2 Twenty or more years 103 8.6
B. TYPE OF HORMONE REPLACEMENT THERAPY (multiple responses possible)
Pill 398 33.1 Patch 29 2.4 Cream 8 0.7
34. TAKING HRT NOW No 443 36.8 Yes 219 18.2 A. WHAT TYPE (multiple responses possible)
Pill 204 16.9 Patch 8 0.7 Cream 5 0.4
30
Section V cont’d Frequency (n) Percent 35. HAD ANY OF THE FOLLOWING SURGERIES (multiple responses possible)
Heart surgery 151 12.5 Back surgery 97 8.1 Knee surgery 109 9.1 Knee replacement 55 4.6 Hip surgery 21 1.7 Hip replacement 31 2.6 Bladder surgery 66 5.5 Gall bladder surgery 197 16.4 Stomach surgery 63 5.2 Appendectomy 318 26.4 Tonsillectomy 347 28.8 Other 867 72.0
37. NUMBER OF TIMES TO GO TO THE BATHROOM AT NIGHT None 211 17.5 One 413 34.3 Two 305 25.4 Three 176 14.6 Four or more times 99 8.2
38. LEAK EVEN A SMALL AMOUNT OF URINE No 720 59.8 Yes 484 40.2 A. TAKE MEDICATION
No 415 34.5 Yes 69 5.7
B. HAPPENED IN THE LAST YEAR No 17 1.4 Yes 467 38.8
C. PREVALENCE OF LEAKAGE Less than one time per month 113 9.4 One or more times per month 90 7.5 One or more times per week 95 7.9 Daily 169 14.0
D. HOW MUCH URINE LEAKS OUT A drop or two 184 15.3 Enough to dampen your undergarments 199 16.5 Enough to wet your outer clothing 84 7.0
E. RESTRICT NORMAL ACTIVITIES Not at all 387 32.1 Sometimes 56 4.7 Most of the time 24 2.0
31
Section V cont’d Frequency (n) Percent 39. CONSTIPATION
No 832 69.1 Yes 372 30.9 A. HOW OFTEN
Less than one time per month 91 7.6 One or more times per month 120 10.0 One or more times per week 81 6.7 Daily 80 6.6
40. CHRONIC DIARRHEA
No 1100 91.4 Yes 104 8.6 A. HOW OFTEN
Less than one time per month 15 1.2 One or more times per month 45 3.7 One or more times per week 25 2.1 Daily 19 1.6
41. EVER LOST CONTROL OF BOWELS
No 966 80.2 Yes 238 19.8 A. HOW OFTEN
Less than one time per month 169 14.0 One or more times per month 45 3.7 One or more times per week 19 1.6 Daily 5 0.4
42. HAD ANY OPEN WOUNDS OR SORES ON THE SKIN
No 1136 94.4 Yes 68 5.6 A. WHAT KIND (multiple responses possible)
Bedsore 1 0.1 Varicose vein ulcer 3 0.2 Wound due to lack of blood supply 5 0.4 Surgical wound 11 0.9 Other 37 3.1 Unknown 13 1.1
SECTION VI: DIET AND NUTRITION Frequency (n) Percent 1. HEIGHT (SELF REPORT) NA NA 2. WEIGHT (SELF REPORT) NA NA 3. ANY WEIGHT CHANGE OVER 10 POUNDS IN THE LAST 6 MONTHS WITHOUT TRYING
No 918 76.2 Yes 284 23.6 Does not know 2 0.2
32
Section VI cont’d Frequency (n) Percent A. WHAT KIND
Gained 142 11.8 Lost 122 10.1 Both gained and lost 14 1.2
4. CHANGE OF FOOD INTAKE DUE TO ILLNESS No 959 79.7 Yes 245 20.3
5. APPETITE
Very Good 629 52.2 Good 427 35.5 Fair 116 9.6 Poor 31 2.6 Does not know 1 0.1
6. AVERAGE NUMBER OF MEALS EATEN PER DAY One 43 3.6 Two 360 29.9 Three or more 762 63.3 Irregular 39 3.2
7. SKIP MEALS DUE TO LACK OF FOOD Yes 19 1.6 No 1185 98.4
8. SHOP FOR GROCERIES WITHOUT ASSISTANCE Yes 935 77.7 No 269 23.3 A. IF NOT WHO DOES (multiple responses possible)
Spouse 190 15.8 Family member 66 5.5 Neighbor 1 0.1 Friend 7 0.6 Home health assistance 3 0.2 Other 3 0.2
9. PREPARES THE MEALS
Self 816 67.8 Spouse 301 25.0 Family member 48 4.0 Neighbor 1 0.1 Friend 10 0.8 Community meals program 1 0.1 Home health assistance 4 0.3 Eat out 17 1.4 Other 6 0.5
10. USUALLY EAT ALONE Yes 491 40.8 No 713 59.2
33
Section VI cont’d Frequency (n) Percent 11. EAT MEALS AT A SENIOR CENTER
No 1148 95.3 Yes 56 4.7 B. WHICH MEALS ARE OFFERED (multiple responses possible)
Breakfast 2 0.2 Lunch 51 4.2
12. ANY MEALS DELIVERED
No 1187 98.6 Yes 17 1.4 A. HOW OFTEN
Everyday 1 0.1 Five to six days per week 4 0.3 Two to four days per week 4 0.3 Once per week 7 0.6 Less than once per week 1 0.1
B. WHICH MEALS ARE DELIVERED Breakfast 3 0.2 Lunch (hot meal) 10 0.8 Frozen meal 5 0.4
13. FREQUENCY OF INTAKE OF THE FOLLOWING FOODS A. VEGETABLES
14 times or more 446 37.0 8 to 13 305 25.3 4 to 7 362 30.1 Less than 4 88 7.3 Does not know / refused 3 0.2
B. FRUITS 14 times or more 207 17.2 8 to 13 237 19.7 4 to 7 459 38.1 Less than 4 297 24.7 Does not know / refused 4 0.3
C. MEAT & BEANS (EGGS, NUTS) 14 times or more 426 35.4 8 to 13 347 28.8 4 to 7 362 30.1 Less than 4 67 5.6 Does not know / refused 2 0.2
D. BREADS, GRAINS, PASTAS 14 times or more 489 40.6 8 to 13 302 25.1 4 to 7 299 24.8 Less than 4 110 9.1 Does not know / refused 4 0.3
34
Section VI cont’d Frequency (n) Percent
E. MILK AND DAIRY PRODUCTS 14 times or more 295 24.5 8 to 13 286 23.8 4 to 7 386 32.1 Less than 4 232 19.3 Does not know / refused 5 0.4
F. DESSERTS / CHIPS / OTHER 14 times or more 140 11.6 8 to 13 206 17.1 4 to 7 400 33.2 Less than 4 451 37.5 Does not know / refused 7 0.6
14. FOOD GROUPS CONSUMED THE DAY BEFORE (multiple responses possible)
Grains group (bread, cereal, rice or pasta) 1148 95.3 Vegetable group 1089 90.4 Fruit group 885 73.5 Milk group (milk, yogurt, cheese) 942 78.2 Meat & beans group (meat, poultry, fish, eggs & nuts) 1148 95.3
15. CIGARETTE SMOKING STATUS Never smoked cigarettes 529 43.9 Quit 1 year ago or more 459 38.1 Quit 1 year ago or less 47 3.9 Current smoker 169 14.0 A. NUMBER OF CIGARETTES SMOKED IN A DAY
Mean = 22.11 NA NA B. AGE WHEN STATED TO SMOKE
Mean = 22.11 NA NA C. STOPPED SMOKING AT WHAT AGE
Mean = 45.45 NA NA
35
Section VI cont’d Frequency (n) Percent 16. USED ANY OTHER TYPE OF TOBACCO PRODUCT
No 985 81.8 Yes 219 18.2 A. WHAT TYPE (multiple responses possible)
Smokeless tobacco 84 7.0 Current user 33 2.7 Former user 41 3.4
Snuff 35 2.9 Current user 12 1.0 Former user 21 1.7
Pipe 84 7.0 Current user 9 0.7 Former user 69 5.7
Cigar 88 7.3 Current user 19 1.6 Former user 64 5.3
Other 6 0.5 Current user 4 0.3 Former user 2 0.2
17. DRINK ALCOHOLIC BEVERAGES
No 775 64.4 Yes 429 35.6 A. HAVE MORE THAN 3 DRINKS PER DAY
No 350 29.1 Yes 79 6.6
B. FEEL THE NEED TO CUT DOWN ALCOHOL INTAKE No 51 4.2 Yes 28 2.3
C. OTHERS CRITICIZED DRINKING CONSUMPTION No 68 5.6 Yes 11 0.9
D. FELT BAD OR GUILTY ABOUT DRINKING No 65 5.4 Yes 14 1.2
E. EVER DRANK TO GET RID OF A HANGOVER No 76 6.3 Yes 3 0.2
SECTION VII: COGNITIVE FUNCTIONING AND EMOTIONAL HEALTH Frequency (n) Percent 1. KNEW THE DAY OF THE WEEK
Yes 1174 97.5 No 30 2.5
2. KNEW THE SEASON
Yes 1154 95.8 No 50 4.2
36
Section VII cont’d Frequency (n) Percent 3. KNEW THE DATE
A. Month 1177 97.8 B. Date 1099 91.3 C. Year 1177 97.8
4. KNEW THE COUNTY OF RESIDENCE
Yes 1187 98.6 No 17 1.4
5. KNEW THE ADDRESS OF RESIDENCE
A. Street address 1188 98.7 B. City 1198 99.5 C. State and zip code 1198 99.5 D. Telephone number 1178 97.8
6. REPEATED THE FOLLOWING WORDS CORRECTLY A. Airplane 1198 99.5 B. Dollar 1183 98.3 C. Apple 1181 98.1
7. SPELLED THE WORD WORLD BACKWARDS CORRECTLY A. “D” 1099 91.3 B. “L” 1003 83.3 C. “R” 808 67.1 D. “O” 848 70.4 E. “W” 1016 84.4
8. REPEATED THE FOLLOWING WORDS AGAIN A. Airplane 1011 84.0 B. Dollar 731 60.7 C. Apple 957 79.5
9. RECOGNIZED A WATCH Yes 1202 99.8 No 2 0.2
10. RECOGNIZED A PENCIL Yes 1199 99.6 No 5 0.4
11. REPEAT “NO IF’S, AND’S OR BUT’S”
Yes 1037 86.1 No 167 13.9
12. READ THE INSTRUCTIONS AND THEN CLOSED EYES
Yes 1143 94.9 No 42 3.5 Does not apply 18 1.5
37
Section VII cont’d Frequency (n) Percent 13. FOLLOWED THE FOLLOWING INSTRUCTIONS
A. Picked up paper with right hand 1042 86.5 B. Folds the paper with both hands 1168 97.0 C. Places the paper in their lap 1152 95.7
Subject is physically impaired 12 1.0 14. WROTE A COMPLETE SENTENCE
Right 1114 92.5 Wrong 54 4.5 Does not apply 35 2.9
15. COPIED TWO PENTAGONS Right 837 69.5 Wrong 329 27.3 Did not attempt 37 3.1
EMOTIONAL HEALTH OVER THE LAST WEEK 1. SATISFIED WITH LIFE 1078 89.5 2. DROPPED MANY ACTIVITIES OR INTERESTS 182 15.1 3. LIFE IS EMPTY 162 13.5 4. OFTEN GET BORED 274 22.8 5. GOOD SPIRITS MOST OF THE TIME 1142 94.9 6. AFRAID SOMETHING BAD WILL HAPPEN 103 8.6 7. FEEL HAPPY MOST OF THE TIME 1122 93.2 8. OFTEN FEEL HELPLESS 152 12.6 9. RATHER STAY AT HOME THAN GO OUT 560 46.5 10. HAVE MORE PROBLEMS WITH MEMORY THAN MOST 154 12.8 11. IS IT WONDERFUL TO BE ALIVE 1183 98.3 12. FEEL PRETTY WORTHLESS THE WAY YOU ARE NOW 121 10.0 13. FEEL FULL OF ENERGY 758 63.0 14. SITUATION IS HOPELESS 66 5.5 15. MOST PEOPLE BETTER OFF THAN YOU ARE 127 10.5
SECTION VIII: SPIRITUALITY Frequency (n) Percent 1. MEMBER OF A RELIGIOUS ORGANIZATION
Yes 1054 87.5 No 144 12.0
2. FREQUENCY OF ATTENDANCE TO SERVICES More than once a week 371 30.8 Once a week 355 29.5 Twice a month 81 6.7 Occasionally 235 19.5 Never 156 13.0
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Section VIII cont’d Frequency (n) Percent
3. DESIRE TO GO MORE OFTEN No 743 61.7 Yes 461 38.3 A. REASONS FOR NOT ATTENDING AS OFTEN AS DESIRED
Health problems 161 13.4 Transportation 86 7.1 Accessibility of building 7 0.6 Availability of services 34 2.8 Church leaders 16 1.3 Church members 20 1.7 Clothes or money 8 0.7 Other 215 17.9
4. PARTICIPATE IN OTHER RELIGIOUS ACTIVITIES
No 645 53.6 Yes 552 45.8 A. HOW OFTEN
More than once a week 97 8.1 Once a week 248 20.6 Twice a month 49 4.1 Monthly 63 5.2 Occasionally 62 5.1
5. IMPORTANCE OF SUPPORT RECEIVED FROM FAITH COMMUNITY
Very important 687 57.1 Important 216 17.9 Somewhat important 120 10.0 Not important 165 13.7
6. HAS ATTENDANCE DECREASED OVER THE LAST YEAR No 875 72.7 Yes 329 27.3 A. WHY
Health problems 170 14.1 Transportation 56 4.7 Church leaders 22 1.8 Church members 20 1.7 Clothes or money 7 0.6 Other 102 8.5
7. ACTIVE IN PRIVATE SPIRITUAL LIFE
No 115 9.5 Yes 1089 90.4 A. HOW ACTIVE
Very active 520 43.2 Active 254 21.1 Somewhat active 148 12.3 Occasionally active 54 4.5 No response 113 9.4
39
Section VIII cont’d Frequency (n) Percent 8. WAYS RECEIVED SPIRITUAL SUPPORT
Church 906 75.2 Television 595 49.4 Personal spiritual activity 961 79.8 Radio 425 35.3 Other 297 24.7 No support received 62 5.1
SECTION IX: SOCIAL CARE Frequency (n) Percent 1. PROVIDE ASSISTANCE WITH DAILY LIVING TO ANYONE
No 993 82.5 Yes 211 17.5 A. HOW MANY PEOPLE
One 170 14.1 More than one 101 8.4
B. CARING FOR SOMEONE IN HOUSEHOLD C. WHAT KIND OF ASSISTANCE
Medicine management 105 8.7 Transportation 134 11.1 Meal preparation 118 9.8 Household chores 110 9.1 Sitting services 60 5.0 Financial assistance 92 7.6 Shopping 119 9.9 Personal care 83 6.9 Other 5 0.4
D. WHAT COULD YOU USE AS A CAREGIVER Sitter services 36 3.0 Respite care 21 1.7 Community meals program 24 2.0 Other (included chores, financial, medical, transportation, etc.) 36 3.0
E. HOURS PER WEEK SPENDING CARE Mean = 40.27 NA NA
F. DOES ANYONE ELSE HELP PROVIDE CARE Spouse 19 1.6 Children 49 4.1 Other family members 66 5.5 Church or community agencies 9 0.7 Friends 15 1.2 No one 72 6.0 Other 18 1.5
G. HOW STRESSFUL IS IT TO PROVIDE THIS CARE Extremely stressful 22 1.8 Somewhat stressful 51 4.2 A little stressful 39 3.2 Not at all stressful 88 7.3 Not sure / does not know 10 0.8
40
Section IX cont’d Frequency (n) Percent
2. ANTICIPATE BEING A CAREGIVER IN THE NEXT 10 YEARS Yes 164 13.6 No 762 63.3 Possible 163 13.5 Does not know 114 9.5 Refused 1 0.1
3. WOULD FAMILY HELP IF NEEDED
Extremely likely 864 71.8 Somewhat likely 156 13.0 Not sure 95 7.9 Somewhat unlikely 47 3.9 Extremely unlikely 42 3.5
4. WOULD THE HEALTHCARE SYSTEM HELP IF NEEDED
Extremely likely 700 58.1 Somewhat likely 238 19.8 Not sure 211 17.5 Somewhat unlikely 19 1.6 Extremely unlikely 36 3.0
5. THE PERSON THAT WOULD HELP FOR MINOR ILLNESSES Spouse / partner 551 45.8 Child 631 52.4 Other relative 282 23.4 Friend or neighbor 207 17.2 Hired caregiver 75 6.2 There is no one 11 0.9 Cannot think of anyone 5 0.4 Not sure / does not know 14 1.2 Other 16 1.3
6. ANTICIPATED HOUSING IF UNABLE TO TAKE CARE OF ONESELF
Own home with help 695 57.7 Child’s home 103 8.6 Other relative’s home 19 1.6 Retirement home 30 2.5 Assisted living facility 98 8.1 Nursing home 100 8.3 Have not thought about it 72 6.0 Not sure / does not know 84 7.0 Other 3 0.2
41
Section IX cont’d Frequency (n) Percent
7. PRIMARY CAREGIVER Spouse / partner 458 38.0 Child 370 30.7 Other relative 78 6.5 Friend or neighbor 15 1.2 Hired caregiver 199 16.5 There is no one 7 0.6 Cannot think of anyone 12 1.0 Not sure / does not know 58 4.8 Other 7 0.6
SECTION X: RETIREMENT PLANNING Frequency (n) Percent A. FOR THOSE THAT HAVE NOT RETIRED YET 314 26.1 1. TENTATIVE AGE FOR RETIREMENT
Average Age 65 5.4 Does not know 56 4.7 Never 82 6.8
2. PLAN ON REMAINING IN ALABAMA AFTER RETIRING
Yes 294 24.4 No 18 1.5 Does not know 2 0.2
3. DO YOU PARTICIPATE IN ANY RETIREMENT PLAN (BESIDES SS)
No 58 4.8 Yes 256 21.3 A. WHAT TYPE OF PLAN
401K type plan 112 9.3 State employee’s retirement plan 30 2.5 Public school teacher’s retirement plan 24 2.0 Individual savings plan 74 6.1 Pension plan 113 9.4 Other pension plan 23 1.9 Other / does not know 8 .7
B. WILL THIS BE ENOUGH Yes 141 11.7 No 68 5.6 Not sure / does not know 47 3.9
C. CURRENTLY DRAWING ANY RETIREMENT FUNDS Yes 92 7.6 No 155 12.9
42
Section X cont’d Frequency (n) Percent
4. WILL SOCIAL SECURITY BENEFITS PAY ENOUGH Yes 28 2.3 No 264 21.9 Does not know 16 1.3 Not applicable 6 0.5
5. WHAT ARE YOUR PLANS FOR RETIREMENT Volunteer work 106 8.8 Pursue hobbies / recreation 137 11.4 Travel 131 10.9 No plans 50 4.2 No retirement 60 5.0 Other 38 3.2
B. QUESTIONS FOR THOSE NOT WORKING 1. AGE OF RETIREMENT
Average Age 57 4.7 2. PARTICIPATE IN ANY RETIREMENT PLAN (BESIDES SS)
No 336 27.9 Yes 524 43.5 A. WHAT TYPE OF PLAN
401K type plan 88 7.3 State employee’s retirement plan 68 5.6 Public school teacher’s retirement plan 52 4.3 Individual savings plan 114 9.5 Pension plan 286 23.8 Other pension plan 38 3.2 Other / does not know 28 2.3
B. FOR RIGHT NOW IS THIS ENOUGH Yes 398 33.0 No 98 8.1 Not sure / does not know 28 4.9
3. DOES SOCIAL SECURITY PAY ENOUGH
Yes 187 15.5 No 610 50.17 Does not know 21 1.7 Not applicable 44 3.7
4. SPEND YOUR FREE TIME Volunteer work 222 18.4 Pursue hobbies / recreation 415 34.5 Travel 238 19.8 Other 493 40.9
5. PLAN TO REMAIN IN ALABAMA Yes 842 69.9 No 16 1.3
43
Section X cont’d Frequency (n) Percent
C. QUESTIONS FOR PEOPLE THAT NEVER WORKED
1. AGE STARTED DRAWING SOCIAL SECURITY
Average Age 58 4.8 2. PLAN TO REMAIN IN ALABAMA
Yes 29 2.4 No 1 0.1
3. PARTICIPATE IN ANY RETIREMENT PLAN (BESIDES SS)
No 21 1.7 Yes 9 0.7 A. WHAT TYPE OF PLAN
401K type plan 3 0.2 State employee’s retirement plan 3 0.2 Public school teacher’s retirement plan 2 0.2 Individual savings plan 0 0 Pension plan 2 0.2 Other pension plan 1 0.1 Other / does not know 0 0
B. WILL THIS BE ENOUGH Yes 3 0.3 No 5 0.4 Not sure / does not know 1 0.1
4. WILL SOCIAL SECURITY PAY ENOUGH
Yes 4 0.3 No 28 2.3 Does not know 3 0.2 Not applicable 3 0.2
5. SPEND YOUR FREE TIME Volunteer work 11 0.9 Pursue hobbies / recreation 16 1.3 Travel 14 1.2 Other 22 1.8
SECTION XI: LONG TERM PLANNING Frequency (n) Percent 1. PURCHASED LONG TERM CARE INSURANCE POLICY
No 1068 88.7 Yes 136 11.3 A. WHEN WAS IT PURCHASED
Less than five years 65 5.4 Five to ten years 33 2.7 More than ten years ago 24 2.0 Does not know 14 1.1
44
Section XI cont’d Frequency (n) Percent B. HOW MANY YEARS OF COVERAGE DO YOU HAVE
Three years 18 1.5 Other 66 5.5 Does not know 52 4.3
C. WHAT TYPE OF SERVICES ARE COVERED In home service 82 6.8 Day care 58 4.8 Assisted living facility 76 6.3 Nursing home room and board 92 7.6 Nursing home ancillary services 51 4.2 Other 7 0.6 Does not know / refused 21 1.7
2. THINKING ABOUT PURCHASING LONG TERM CARE
Yes (Five already have some form of Long Term Care insurance) 140 11.6 No 941 78.2
3. PRECAUTIONS TAKEN IN THE EVENT OF DEATH
Prepared a property will 761 63.2 Purchased a cemetery plot 837 69.5 Purchased a pre-paid burial plan 425 35.3 Discussed wishes with family 794 65.9 No plans 89 7.4 Refused 22 1.8
4. TIME THOUGHT ABOUT WHO WOULD MAKE MEDICAL CARE DECISIONS IF YOU COULD NOT
Very much 549 45.6 Somewhat 329 27.3 Not very much 186 15.4 Not at all 139 11.5 Refused 1 0.1
5. THE PERSON THAT WOULD MAKE THE MEDICAL DECISIONS IF UNABLE
Spouse / Partner 482 40.0 Relative 667 55.4 Friend 18 1.5 Pastor, clergy or religious advisor 1 0.1 Physician 4 0.3 Other 8 0.7 No one 5 0.4 Not sure / do not know 19 1.6
45
Section XI cont’d Frequency (n) Percent
6. TALKED TO ANYONE ABOUT THE CARE YOU WANT TO RECEIVE IF YOU WERE SERIOUSLY ILL
No 536 44.5 Yes 668 55.5 A. WHO
Spouse / partner 249 20.7 Relative 385 32.0 Friend 16 1.3 Physician 1 0.1 Other / No response 17 1.4
B. THINK YOUR WISHES WILL BE RESPECTED Yes 622 51.7 No 6 0.5 Maybe 6 0.5 Does not know / No response 34 2.8
7. KNOW ABOUT LIVING WILLS
No 200 16.6 Yes 989 82.1 Does not know 15 1.2
8. SIGNED A LEGAL DOCUMENT DESCRIBING THE TYPE OF CARE YOU WISH TO RECEIVE IF TERMINALLY ILL
No 808 67.1 Yes 384 31.9 Does not know 11 0.9 Refused 1 1.1
9. KNOW ABOUT HEALTH CARE PROXIES No 505 41.9 Yes 673 55.9 Does not know 26 2.2
10. SIGNED A LEGAL DOCUMENT NAMING SOMEONE TO MAKE MEDICAL DECISIONS FOR YOU IF YOU WERE UNABLE
No 880 73.1 Yes 308 25.6 Does not know 15 1.2 Refused 1 1.1 A. WHO
Spouse / partner 96 8.0 Relative 189 15.7 Friend 7 0.6 Physician 1 0.1 Pastor, clergy, or religious advisor 1 0.1 Other 1 0.1 Unnamed 13 1.1
46
Section XI cont’d Frequency (n) Percent
10B. IF NO, WHY Not necessary now 115 9.6 Hard to think about 28 2.3 Unsure who to name 20 1.7 Do not know where or how to do it 104 8.6 Have not had the time 119 9.9 Never thought about it 288 23.9 Other 129 10.7 No response 76 6.3 Refused 1 0.1
11. DESIRED RESIDENCE AT THE END OF LIFE
In my home 879 73.0 In the home of one of my relatives 41 3.4 In a nursing home 70 5.8 In a hospital 38 3.2 In hospice hospital 17 1.4 In some other long term care facility 28 2.3 No preference 33 2.7 Have not thought about it 67 5.6 Does not know 29 2.4 Refused 2 0.2
12. PREFERENCE TOWARDS TREATMENT IN LIFE THREATENING SITUATIONS
Extending life even if it causes pain and suffering 60 5.0 Focuses on relieving pain even if it shortens life 955 79.3 Does not know 189 15.7
QUESTIONS 13 - 15 ARE ABOUT BEING IN THE LATE STAGES OF A LIFE THREATENING ILLNESS
13. WANT TO BE FED THROUGH A TUBE IF UNABLE TO SWALLOW
Yes 175 14.5 No 825 68.5 Maybe / unsure 196 16.3 Refused 8 0.7
14. WANT A VENTILATOR IF UNABLE TO BREATH
Yes 96 8.0 No 996 82.7 Maybe / unsure 109 9.1 Refused 3 0.2
15. WANT CPR IF HEART STOPPED BEATING Yes 286 23.8 No 815 67.7 Maybe / unsure 101 8.4 Refused 2 0.2
47
Section XI cont’d Frequency (n) Percent
16. VIEWS ON LEGALITY OF PHYSICIAN-ASSISTED SUICIDE It should not be legal 570 47.3 It should be legal in a few cases 100 8.3 It should be legal with restrictions 237 19.7 It should be legal 131 10.9 No opinion 141 11.7 Refused 25 2.0
17. IMAGINE REQUESTING PHYSICIAN-ASSISTED SUICIDE Yes 326 27.1 No 737 61.2 Unsure 130 10.8 Refused 11 0.9
18. VIEWS ON LEGALITY OF EUTHANASIA It should not be legal 594 49.3 It should be legal in a few cases 92 7.6 It should be legal with restrictions 241 20.0 It should be legal 109 9.1 No opinion 144 12.0 Refused 24 2.0
19. IMAGINE REQUESTING EUTHANASIA Yes 328 27.2 No 733 60.9 Unsure 130 10.8 Refused 13 0.9
20. HAVE ANY OF THE FOLLOWING WORRIES OR CONCERNS ABOUT THE END OF LIFE (multiple responses possible)
Being in pain 273 22.7 Having other severe symptoms 161 13.4 Being a burden on others 657 54.6 Being alone or abandoned 148 12.3 Not having my dignity respected 265 22.0 What will happen to me after I die 49 4.1 What will happen to my family after I die 236 19.6 Other worries or concerns 42 3.5 No worries or concerns 356 29.6 Does not know / have not thought about it 91 7.6
Appendix C Other Documentation
Nutrition Screening Initiative — DETERMINE
Question Points if Yes I have an illness or condition that has recently made me change 2 the kind and/or amount of food I eat. I eat fewer than two meals per day. 3 I rarely eat fruits, vegetables, and milk products. 2 I have three or more glasses of beer, liquor, or wine almost everyday. 2 I have tooth or mouth problems that make it hard for me to eat. 2 I don’t always have enough money to buy the food I need. 4 I eat alone most of the time. 1 I take three or more different prescription or over-the-counter drugs a day. 1 Without wanting to, I have lost or gained 10 pounds in the past 6 months. 2 I am not always physically able to shop, cook, and/or feed myself. 2 TOTAL SCORE 21