Is Indiana ready for its changing demographics?

By Lynn Sygiel, editor, Charitable Advisors |

Ellen Miller is an optimist, a person who sees the glass as half full. She looks at statistics that show the nation’s 65-and-over population is expected to double to 83.7 million by 2050. And while many see that as cause for alarm, Miller sees it as an opportunity.

“It’s no surprise to anyone that our society is aging. We’ve known it’s coming. It’s predictable,” said Miller, executive director of U-Indy’s Center on Aging since 2001. “People like to frame the aging of our society as, ‘Oh, my gosh, our society is aging.’

“It’s just as easy to say, ‘Cool, our society is aging, we’ve never had these kinds of demographics before.’ What’s the opportunity to think about this and use it to our advantage?”

In 2010, Indiana’s 65+ population was 13 percent, but by 2030 that will increase to 20 percent. The foremost question appears to be: Are we ready for this changing demographic?

That is precisely what the Central Indiana Community Fund’s (CICF) Senior Fund is focused on. Miller, H. Ken Bennett, executive director of the Center for At-risk Elders and Jim Leich, the CEO of LeadingAge Indiana, are three of the fund’s advisers, and each brings first-hand work experiences to the discussion table.

Since 2003 when the Indianapolis Retirement Home closed, the $10 million endowment which resulted has gone to support programs and opportunities for low- to moderate-income older adults in Central Indiana. The fund was placed at CICF, which manages it and relies on 10 advisers to help make grant decisions.

Over the past several years, the advisers have approved proposals that push the needle on issues such as community housing, social and civic engagement and the arts. The fund accepts requests in four areas of interest.

  • Basic needs. Among the services in this interest area are transportation, food and emergency food and services.
  • Health and wellness. Includes prevention and screenings and neighborhood community wellness and fitness programs.
  • Environment of choice. Services can be affordable housing and home modification programs and support for strengthening residential care programs for low-income adults.
  • Life-affirming opportunities. Creation or support for programs for seniors to thrive culturally and intellectually.

In 2009, the fund committed three years of support for the Elders at the Table (EAT) Initiative. The project brought service providers together to improve the food delivery system for seniors, and not only provide access to nutritious food and meals, but include chances to socialize. Key to the project was service providers working collaboratively.

“You shouldn’t have five service providers home-delivering meals in one area and zero in another,” said Miller. “Those organizations that we brought together are still working together.”

Although a portion of the grants still provides operational support for some programs, the Senior Fund has worked to spur new thinking said Leich.

“We’re always looking for new and innovative things. We’re seeing more innovative ways to do home modifications. We’ve seen some volunteer programs pop up,” he said.

These three advisers would like to see more grant requests in the environment of choice and in life-affirming opportunities areas.

Bennett, who has practiced elder law for 33 years, said one grant from the Senior Fund has helped nursing homes restructure to ease the paperwork burden and increase staff time with residents. Another grant funded adult daycare, Joy’s House, a nonprofit with innovative programming. Still another provides funding to Connect2Help 2-1-1 to help caregivers find information and referrals.

And while there is work to provide diverse programs for seniors on a local, state and national level, Miller said there has been a gradual shift in thinking.

“It cannot be just because it’s a nice thing to do for older adults. It needs to be ‘We need a healthier society, we need an economically sound society’ and it’s good on all of those fronts,” said Miller. “It’s this kind of general shift towards, ‘Let’s think about how we can support people of all ages.’”

In 2002, the United Nations’ Madrid Plan of Action challenged communities to think about ways to make cities and towns accessible to all, and that’s exactly what the statewide Lifelong Coalition has been working to build.

For several years, Marie Beason, the director of Special Initiatives at the Indiana Philanthropy Alliance, has spearheaded the group made up of public, private and philanthropic partners. They work across public and private sectors to secure broad, inclusive support for policies, investments and direct services that support more age- and ability-friendly communities.

Bennett urges groups to think about new long-term care models for Hoosiers. He cites Dr. William Thomas’s work, and said Thomas’s first project was the Eden Alternative in the 1990s. Bennett thinks another Thomas initiative, the Green House project, which designs group homes in residential neighborhoods where 11 to 12 elders – and their caregives – live together, is worth studying.

Bennett said how long-term care is funded in the state is the next big issue. LeadingAge’s Leich, who runs Indiana’s association of nonprofit retirement communities, said some communities are continuing to grow and do innovative things. But overall it is a stressful time as the funding changes. He is seeing more nonprofits working collaboratively and consolidating.

“In some ways our association serves as their corporate office. We do a ton of training, we did 54 education events last year, and we’re increasing that this year,” said Leich.

With an aging demographic comes the need for an array of services for everything from independent living for healthy vibrant people to end-of-life care for those in nursing homes.

“I think the challenge is being able to figure out how do we allow people to progress in that continuum in the best way, in the most independent way that they can,” said Miller.

At one end of the spectrum, U-Indy’s Center is working with IU’s Regenstrief Institute and IU’s geriatrics department to find ways to decrease unnecessary hospitalizations for nursing home residents.

Called the OPTIMIST project and funded by the Centers for Medicare and Medicaid services, the partners have been studying the root causes and systems that need changes, then suggests those modifications. Indianapolis was one of seven demonstration projects funded for four years, and the project has just applied for a second round of funding.

“We’re really excited to be a part of that one and our role at Center on Aging is to be involved in the education portion — what do staff who are working in nursing homes need to know to understand — knowledge, skills and ability – to be able to make this kind of transition,” said Miller.

There are other new programs that target specific populations. One in particular is for adults who have no one to help with medical and care decisions. In 2010, Robin Bandy and Dr. Lisa Harris began Wishard’s Volunteer Advocates Program, as the hospital struggled to find guardians to make health-care decisions for patients who did not have family members available. In 2013, it combined with the Center for At-Risk Elders (CARE) and began operations as a nonprofit. Since then CARE has assumed guardianship for 205 adults, 118 of which are adults over the age of 65.

And there is other work that still needs to be tackled. One area that Bennett sees a need for improvement is advocacy for elder issues.

The only way, according to Miller, that legislation and perceptions are going to change is awareness. The fact that the Indiana Housing and Community Development Authority (IHCDA) and other state agencies and organizations have an aging piece on their website is a win.

“We need to be ready to care for this aging population, but also determine how we benefit from the aging and use legislation to allow people to age with the maximum dignity, maximum choice, maximum independence for as long as they’re able.”

Miller said there are a number of Indiana schools that have aging studies programs and Bennett mentioned law schools that have elderly law courses. But is it enough?

“If I had my way, there isn’t a student who came out of undergraduate education without having a course in understanding the aging of our society and their own aging. Aging isn’t something to say, ‘Oh, I hope it doesn’t happen.’ How do we understand the aging of our society, the aging of our families and those that we love and care for, and the aging of ourselves?”

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