Ohio's State Plan on Aging, 2019-2022

The Ohio Department of Aging develops a strategic framework, required by the federal Older Americans Act, to provide leadership that improves and promotes quality of life and personal choice for older Ohioans, adults with disabilities and their families and caregivers. The most recent framework, or state plan, covers state fiscal years 2019 through 2022.

The plan is built upon a comprehensive statewide needs assessment that provided a clear perspective of older adult needs. We found that the most significant gaps represent basic needs that can interfere with independence and ability to age in place. The plan contains goals, strategies and objectives organized into five primary focus areas: Access to information and advocacy services, population health, caregiving, civic engagement and aging in place.

State Plan Focus Areas

Access to information and advocacy services

Access to Information and Advocacy Services

GOAL: Older Ohioans, adults with disabilities and their caregivers will be able to make person-centered decisions through seamless access to information and advocacy services.

Goal Summary: Access to Information and Advocacy Services

Finding the right services can be daunting for older Ohioans and their family members. The biggest obstacles that families and individuals face when seeking older adult services include a general lack of awareness of what is available, not knowing where or how to apply for programs and an assumption that the application process for public services is difficult.

Accessing services may require working with multiple agencies and organizations, as well as meeting varying requirements and enrollment processes, depending on the program. This is a challenge at any time but is particularly so when families are in crisis and trying to find the best options for a loved one in need of crucial care.

This state plan goal focuses on ensuring that older adults, adults with disabilities and their caregivers have the information and assistance they need to make person-centered decisions. Ohio’s aging and disability resource network is a resource for older adults and families for accurate and complete information regarding services and supports. Strategies in the state plan enrich and improve the resource network. They strengthen advocacy efforts, legal assistance development, anti-ageism campaigns and efforts to prevent and better respond to elder abuse, neglect and exploitation by focusing on the unique needs of priority populations and incorporating these approaches into services and supports.

OBJECTIVES

ACCESS TO INFORMATION: Develop standards and measures for quality and performance regarding operation, information and resources for a consistent front-door experience for consumers.

ADVOCACY: Heighten awareness of the needs and priorities of Ohio’s older adults and people with disabilities with community, government, non-profit and private sector entities to achieve inclusion in decision-making opportunities that inform policies, infrastructure development processes and strategic plans. 

ELDER ABUSE, NEGLECT AND EXPLOITATION: Coordinate with partners in the prevention and response to incidences of elder abuse, neglect and exploitation.

AGEISM: Change Ohioans’ perspectives and conversations regarding the bias about aging and promote the value of older adults' knowledge, wisdom and resources to strengthen the community.

PRIORITY POPULATIONS: Ensure that Ohio’s aging network is aware of and focused on the unique needs of our older adult priority populations.

Population health

Population Health

GOAL: Educate and empower older Ohioans, adults with disabilities and their caregivers to live active, healthy lives to maintain independence and continue to contribute to society.

Goal Summary: Population Health

Our bodies change throughout our lives. This is a simple fact that has important impacts on our health and wellness as we age. With an increased risk for chronic conditions come many new concerns, such as managing the symptoms of those conditions to maximize our independence and considering how various conditions, symptoms and treatments increase our risk in other areas, such as falls, medication misuse, pain management and malnutrition, to name a few.

Many of the concerns for older adults are the very same that Ohio’s public health programs focus on every day. This state plan goal focuses on health outcomes and other factors that can positively or negatively impact the health and well-being of older Ohioans and people with disabilities.

  • Chronic Disease Management and Prevention – More than three out of four older Ohioans adults age 65 years and older have at least one chronic condition such as heart disease or diabetes; 43 percent have two or more. People living with chronic conditions often experience a lower quality of life and higher rate of disability.
  • Nutrition – Good nutrition supports a healthy and active lifestyle, reduces frailty and disability, improves health outcomes and reduces health care costs. Malnutrition is caused by a range of factors (from physical changes to limited incomes, lack of transportation and more) and can lead to a range of problems, including increased rates of chronic conditions and disability.
  • Falls Prevention – Falls are the leading cause of injury-related emergency department visits, hospitalizations and deaths among older Ohioans. Falls are not a normal part of aging, yet many processes of aging (e.g., loss of muscle strength and bone density, chronic conditions and medication use) can lead to a higher risk for falls. However, most falls can be prevented through strategies that improve health, create safer environments and manage the fear of falling.
  • Pain Management – Chronic pain is common among older adults and is one of the most common conditions reported to health care professionals. When not managed properly, pain can lead to reduced mobility, avoidance of activity, falls, depression and anxiety, sleep impairment and isolation. Some treatments for chronic pain can increase risk in other areas, such as falls and medication misuse.
  • Dental, Vision and Hearing – Changes in vision, hearing and oral health are natural effects of aging. Yet, needs related to these areas are frequently unmet in older adults. Often, changes in these areas are not reversible, so regular, preventive care is crucial. When problems in these areas are not addressed in a timely fashion, they can lead to poorer overall health and wellness and increased disability.
  • Mental Health – Prevalent, ageist views hold that older adults become less happy with age and that depression, memory loss and cognitive decline are normal parts of aging. While this is not true, many factors, such as isolation, disability, grief and loneliness, can contribute to poorer mental health and increased rates of suicide among older adults. Older adults are less likely than younger adults to receive treatment for mental and substance use disorders. The early recognition of mental issues, such as depression, anxiety, substance abuse and more, can prevent life-threatening outcomes.
  • Substance Abuse and Addiction – With an increase in the incidence of chronic health conditions comes increased use of opioids and other medications to treat symptoms. While medication is generally intended to lessen symptoms and improve quality of life, it can cause harm in some situations. Studies have shown that about three in five older adults take their prescription medications improperly. Further, body changes can interfere with how the medicines work or impair the ability of the older adult to follow the physician’s instructions.

This goal represents the state plan’s largest section of objectives and strategies and stresses the importance of nutritious meals, tobacco cessation, physical activity, falls prevention and dental, vision and hearing screenings. This section also includes objectives and strategies that support vulnerable populations, such as people living with dementia, behavioral health impairment and substance abuse or addiction.

OBJECTIVES

CHRONIC DISEASE MANAGEMENT AND PREVENTION: Offer and promote interventions that help older adults prevent chronic disease, as well as assist older adults who are living with chronic disease to reduce and control symptoms that would otherwise alter the quality of their lives.

NUTRITION: Address food insecurity and malnutrition in older adults and maximize use of current nutrition services programs, including home-delivered and congregate meals.

FALLS PREVENTION: Strengthen existing falls prevention activities, identify opportunities for new initiatives and continue the educational campaign to reduce the risk of falls for older Ohioans.

PAIN MANAGEMENT: Support increased use of alternative interventions that older adults can use to manage their temporary or chronic pain without the use of controlled substances.

DENTAL, VISION AND HEARING: Promote the need for increased access to dental, vision and hearing health screenings and services for older adults, especially those with low incomes.

MENTAL HEALTH: Increase awareness of the need for mental health resources and services for older Ohioans.

SUBSTANCE ABUSE AND ADDICTION: Support increased access to the resources and services needed by older adults to better prevent and manage substance abuse and addiction.

Caregiving

Caregiving

GOAL: Ohio's caregivers have access to resources and services to enable them to continue to provide care for their loved ones.

Goal Summary: Caregiving

Family caregivers are the backbone of Ohio's long-term care services and supports system, providing care that, if provided by paid caregivers, would cost $16.5 billion each year. We expect the importance of family caregivers to only grow as our aging population places increasing strain on our health care and long-term care systems.

Family caregivers are crucial in keeping older adults connected to their communities and ensuring they receive care that meets their needs and matches their values and priorities. Studies have shown that family caregivers reduce the likelihood of their loved ones being hospitalized and delay or prevent the need for more intensive paid care, like that available in a nursing home or assisted living facility.

Over the years, family sizes have gradually decreased and traditional family structures have changed, meaning that there are fewer potential family caregivers at a time when the need for them is increasing. As a result, the pool of potential caregivers is growing to include neighbors, friends and others, in addition to family members.

Despite their importance in providing the majority of care for their loved ones, family caregivers often have little training or support in their caregiver roles. Further, many caregivers juggle their family responsibilities with their work obligations and other roles, such as being a parent. Many have had to adjust their work schedules, sacrifice work performance or leave work entirely because of their caregiving responsibilities.

In addition to adults of many ages taking care of older loved ones, family caregiving also includes older adults who, for varying reasons, serve as primary caregivers to their grandchildren or other young relatives. Ohio’s widespread opioid epidemic is one of the largest contributors to this trend. Many of these kinship caregivers face significant obstacles, including poverty, disability and legal barriers.

Acknowledging and investing in all caregivers’ needs is a vital component of Ohio’s overall approach to providing long-term services and supports. This state plan goal builds resources and supports to enable caregivers to continue to provide person-centered, informed care to their loved ones. Strategies focus on education and awareness, development of respite, resources and supports for working caregivers and kinship caregivers.

OBJECTIVES

CAREGIVER SUPPORT: Provide meaningful education and heighten awareness on caregiving issues.

WORKING CAREGIVERS: Encourage employers' adoption of best-practice policy reforms that support caregivers in the workplace.

KINSHIP CARE: Support older adults in kinship situations to better care for themselves and their young loved ones.

Civic engagement

Civic Engagement

GOAL: Recognize and value older adults' knowledge, social and economic contributions and establish opportunities for engagement in their communities.

Goal Summary: Civic Engagement

Today’s older adults are not only living longer, they desire to remain connected and involved in their communities longer. Research has shown that older adults benefit from civic engagement in a variety of ways, from increased mental and physical health, higher levels of well-being and less isolation and cognitive decline. Further, communities benefit by using the time and talents of older adults to address key societal concerns. Senior volunteers help fill service gaps in key areas such as home and community-based supports for fellow seniors, early childhood education, medical care, public safety and more. Volunteers allow public offices to reduce workforce costs while helping to meet the needs of their community members.

Older volunteers’ interests are varied and growing beyond the opportunities historically offered. One area where this is particularly evident is in intergenerational programs that promote the transmission of cultural traditions and values from older to younger generations. These programs build a sense of personal and societal identity while encouraging tolerance and service. Intergenerational programs bring together diverse groups and networks and help dispel inaccurate and negative stereotypes.

In addition to their volunteer service, older Ohioans also play a larger part in the state's workforce today. For a variety of reasons, more older adults are choosing to remain in the workforce or return to the workforce after traditional retirement age. However, many older workers find navigating today's job market challenging, while many employers are discouraged by misconceptions about older workers.

The Ohio Department of Aging supports older Ohioans’ desire and efforts to access rewarding employment, lifelong learning and volunteer opportunities that are skill-relevant and economically viable. This state plan goal focuses on promoting and empowering older adults to work, volunteer and engage in their communities. Key partnerships will leverage the use of volunteers in high-need areas. Strategies will focus on innovation and efficiency as solutions to priority issues facing our older adults by partnering with organizations across Ohio.

OBJECTIVES

VOLUNTEERISM:  Engage more older adults and Ohioans of all ages in volunteer activities that support both older adults and community needs.

EMPLOYMENT: Expand and enhance opportunities for older workers and job seekers to participate in and contribute to Ohio's workforce.

INTERGENERATIONAL CONNECTIONS: Promote intergenerational opportunities that benefit participants both personally and professionally.

Aging in place

Aging in Place

GOAL: Enable older Ohioans, persons with disabilities and their caregivers to be active and supported in their homes and communities.

Goal Summary: Aging in Place

Most Ohioans want to remain in their own homes and communities as they grow older. Many factors must come together to make this a reality for older Ohioans, including some of the areas previously addressed in this state plan, including population health, community engagement, caregiving and access to services.

Access to affordable housing also is key, but so is the need for that housing to designed for and responsive to the unique needs of aging occupants. Similarly, transportation options that are convenient for and attractive to older adults is another top criteria in helping older Ohioans age in place in the settings they choose.

The aging network must have a rich infrastructure and workforce capacity to support older adults and respond when urgent needs arise. This state plan goal supports these areas and raises awareness among older adults about the importance of emergency, financial, long-term care and other planning. Strategies evaluate interventions that address advance care needs, including the use of technology to support older adults’ continued independence.

OBJECTIVES

CARE MANAGEMENT: Provide comprehensive person-centered assessment and care services and supports that anticipate and address current and emerging needs as they arise.

WORKFORCE CAPACITY: Increase and sustain the capacity of the direct care workforce and increase interest in professional and non-professional careers that serve older adults.

LONG-TERM CARE PLANNING: Advocate for the importance of long-term care planning for older Ohioans to support their choice to age-in-place.

LIVABLE COMMUNITIES: Heighten awareness and adoption of livable community models in Ohio communities.

TRANSPORTATION: Participate in alignment efforts to achieve sufficient community transportation options (multi-modal) and a supportive infrastructure for older Ohioans.

HOUSING: Advocate for programs and interventions that support safe and affordable housing and enable older adults and people with disabilities to age in place.

HOMELESSNESS: Create better understanding older adult homelessness and advocate for interventions.

EMERGENCY PREPAREDNESS: Strengthen planning efforts and response protocols that address the needs of vulnerable older adults during emergencies.

 

Dementia and the State Plan on Aging

Dementia is an area of population health that is addressed throughout the state plan. Hundreds of thousands of older Ohioans struggle with the day-to-day challenges of living with or caring for someone who is living with dementia. While many states have a stand-alone dementia plan, Ohio includes dementia strategies in our comprehensive state plan on aging. Doing so allows us to leverage progress in other areas of the plan, such as caregiver support, access to information, aging in place and even civic engagement for a more integrated approach.