YOUR TURN

Since her husband suffered kidney failure eight years ago, Gladys has given him full-time care at their rural home in McClure.

Much of the elderly couple's savings goes toward his medical expenses, leaving her unsure how many dollars will be left for her future.

Indeed, the current political focus on "family values" rarely spotlights the needs of older adults and the people who care for them. Yet the aging of the American population makes these needs increasingly important to families and communities — and to those elected to shape public policy.

Of particular concern is the quality of life for elderly women, who live longer than men but often lack equivalent financial and social resources.

By age 84, there are two Illinois women for every man, according to the state's Department on Aging. By age 99, the ratio jumps to five women for every man. And, on average, women's retirement incomes are half their male counterparts' — partly due to past wage disparities, and partly because many elderly women spent prime potential earning years caring for families.

This reality has important public policy implications if we are to plan for the future intelligently. It's not enough to expect family and social relations to provide the elderly with all the services they need. And, while current rhetoric still favors mothers staying at home to look after young children, no government policies or widespread labor practices exist to ensure that women will have adequate incomes during the many retirement years they likely will spend living alone.

It's not enough to expect family and social relations to provide the elderly with all the services they need.

In 1995, the state's Rural Life Panel project surveyed nearly 2,000 adults over age 60 who live in rural Illinois communities. They were questioned on a range of quality of life issues.

The survey results show that womens' experiences and needs are different from mens'.

As a result, it is important to educate women in Illinois, which has the sixth largest elderly population in the United States, about the importance of protecting their assets and planning independently to support themselves during old age. It is also important that state and community leaders begin planning support services for older women.

Otherwise, society faces an exponentially larger financial bill down the road — and a humanitarian crisis.

Population shifts

Older adults make up a growing portion of the American population. By 2030, one of four Americans will be 60 or older. And seniors are living longer, requiring more care as they become frail. The "old-old" population — people 75 and older — grew by 46 percent between 1970 and 1990. Moreover, people over 85 make up the fastest growing segment of the population, which is expected to nearly double by the year 2020.

Today, almost one in five Illinois residents is 60 or older, with rural areas of the state aging more rapidly than urban areas. In urban Illinois counties, people over 60 represent 16 percent of the total population, compared to 22 percent in rural counties.

Further, Illinois women of all ages outnumber men by a ratio of 3 to 2. And this gap widens with advancing age. At age 65, women can expect to live another 18.8 years, while men can expect to live 15.2 years. As the largest component of the "old-old" population, women require the lion's share of health care, long-term care and basic support services.

Married seniors living with their spouses are fortunate because husbands and wives support each other's needs. But many seniors, particularly women, are not this fortunate. The great majority of men surveyed — 84 percent — are married and living with their wives, but only 36 percent of females surveyed are married and living with their husbands.

So a significant trend is for an older woman to provide care for a frail husband, only to find herself alone and in need of care after her husband's death.

Further, older women tend to have substantially smaller incomes. Because women usually have fewer earning years and earn less than men, they

30 * January 1996 Illinois Issues

receive smaller pensions and Social Security benefits. While many women receive spouse's or widow's Social Security benefits, these benefit amounts also are lower than those received by men.

What's more, the elderly have reason to worry about the future of government support programs.

One survey respondent wrote, "Our income now is sufficient, but with the new Congress and their request for us to pay $60 more for Medicare, it's like taking [the cost of living allowance] back for three years. If this happens, I will need to work part-time."

In fact, for many seniors, the rising cost of health care is the greatest financial worry. "My husband is disabled and requires expensive medication," one woman wrote. "I am on three medications. Our bill runs from $500 to $600 a month. Our insurance does not cover our prescription drugs."

Long-term care is another burden. "As my husband and I age," one woman wrote, "we become more concerned as to whether our income can be stretched to pay for medical care.... We worry about being incapacitated and requiring long-term care — and becoming a burden to our children."

The rising costs of health care and long-term care are especially difficult for women.

With medical costs rising faster than the cost of living, older women often make unpleasant choices — between food and medicine, heat and medical treatment.

In the face of these worries, senior citizens who can lean on their children for financial and other support are lucky. In fact, 45 percent of women surveyed and 31 percent of men said they receive help from an adult child or other relative. Yet this finding has implications beyond the current generation of elderly women. Research indicates that when family members care for elderly relatives, women are most likely to provide this support — even to the extent of giving up their own jobs to become care givers. This sacrifice has a negative effect on younger women's earnings potential, reducing their own retirement entitlements and ultimately decreasing their own chance of enjoying a comfortable old age.

With medical costs rising faster than the cost of living, older women often choose between food and medicine.

Looking ahead

This situation requires additional income support programs for elderly women so they can remain independent longer. The alternative of housing and caring for them entirely at public expense is, in the long run, much more costly. And, while the current debate regarding Medicare has touched on seniors' worries about probable increases in deductibles, it has not highlighted the greater burden these increases will pose for frail elderly women who already labor under income disadvantages.

Such difficulties should be addressed by political leaders while framing Medicare reform. Additional policies also are needed to protect the belongings and quality of life of a surviving elderly person whose spouse has required costly medical or long-term care in the house before his or her death. Now, all of a couple's property and savings may be absorbed to care for the first spouse who becomes frail, leaving the survivor destitute. This threat is particularly significant for women.

Statistics on senior citizens can inform today's public policy decisions. It's obvious the numbers of elderly women needing care will only increase, so public planning and public services, supported by public funding, are necessary to avert an escalating humanitarian crisis. Gladys' future seems unclear now. We shouldn't leave another generation of women to the same fate. *

Lucinda M. Beier is director of the Applied Social Research Unit at Illinois State University in Normal. Michael Spring, a graduate student in political science, assisted her with this rural life survey project.

The Rural Life Survey Seniors responding to the survey came from all regions of the state, although the west and south are best represented, with 34 percent of those who participated living in western Illinois and 27 percent living in southern Illinois. These regions have larger concentrations of elderly residents than the northern and eastern areas of the state. More than half of the respondents live in communities with fewer than 5,000 residents, while just over a quarter live in communities with populations of more than 10,000. The great majority are white. More men (58 percent) than women (42 percent) responded to the survey. In keeping with general demographic trends, female respondents were older than their male counterparts, with 31 percent, compared to 24 percent of males, being over 76 years of age. Regarding income, how rnuch is enough to live on? Many older adults take pride in making a little go a long way Thus, it is difficult to interpret what respondents say about their financial needs. About three in 10 of the participants indicate that their incomes are either "almost sufficient" or "insufficient" for their needs. However, female respondents find it harder to make ends meet, with 32 percent reporting that their incomes are "almost sufficient" or "insufficient," compared to 28 percent of the men. Lucinda M. Beier and Michael Spring

Illinois Issues January 1996 * 31