care). In addition, coordination with the long-term care community is needed to ensure that adequate, appropriate-level, high-quality care for the elderly is available in the community.

This is a measure of "care capacity," one that could presumably be based on information from the Area Agency on Aging. Accountability for developing and maintaining the full continuum of care can best be described as a shared responsibility, since government, voluntary organizations, and the health care industry may all be needed to create the capacity.

  1. Library readership, voting.

    Social participation is a health-enhancing feature of an elder's lived experience and a manifestation of expanded function. This indicator cluster is a direct attempt to characterize the participation of elders in the social life of the community. Other possible measures might include senior theater, cinema, or other special event tickets per population base; bus ridership; church membership; and membership in the American Association of Retired Persons. Final selection of the measures included in this indicator should be appropriate to the community's social structure (e.g., bus ridership may not be appropriate in rural areas with no regular bus routes).

  2. Senior citizen income and property ownership.

    It is very difficult to measure the "prosperity" of the elderly. Income data are available but may underrepresent the wealth and savings of the elderly. Property ownership is an indirect measure of economic well-being but is a major component of the personal estate of older people in our society. Other possible approaches to assessing economic well-being might be to use Internal Revenue Service data to characterize income or bank data to measure savings, but both of these approaches seem less feasible. Accountability for economic well-being at a community level is difficult to establish, but the identification of populations in special need or at special risk would seem to be feasible if economic well-being can be measured.

  3. Crimes against elderly persons or residential burglaries.

    This measure of well-being is focused on personal safety, a major quality-of-life issue among the elderly, who may be viewed as "easy targets" by criminals. This information should be available from the public safety databases within a community. Accountability, at the first level of analysis, may reside with the



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