The Future Of Social Services For The Elderly
Targeting of public social services has become a source of tension in recent decades. The Older Americans Act requires that services be made available to all older Americans, regardless of their income or assets. Yet today’s elderly are, on average, considerably more affluent than the aged were in 1965 when the act passed. As a result, OAA services often benefit elders who are middle-class members of the cultural majority. The recipients of programs funded under the act may not be those most in need of assistance (Barusch).
Congregate meals programs have been criticized as failing to serve cultural minorities and frail elders. The climate in most senior centers reflects the majority culture in the area. While not overtly hostile to cultural minorities, the activities, food, and atmosphere are often not familiar or welcoming. As a result, those most likely to use senior centers are typically of the majority culture. Similarly frail elders, those most in need of assistance to maintain their independence, are unable to participate in congregate meals. Yet congregate meals programs are popular, and have consistently been one of the AAA’s biggest budget items.
In response to this tension, the 1987 amendments to the Older Americans Act added Section 305 of Title III to require that states, ‘‘E) Provide assurances that preference will be given to providing services to older individuals with the greatest economic or social need, with particular attention to low-income minority individuals. . .’’ (italics added). Subsequent appropriations have revealed an increased emphasis on cultural minorities and vulnerable individuals. So, for example, funding for home-delivered meals constituted a much greater proportion of OAA spending in the late 1990s than it had prior to the amendment. Similarly, allocations for Native American tribes increased dramatically. Programs serving frail and vulnerable elders were also initiated, including in-home and protective services and caregiver support.
As the population of America’s elderly citizens grows, it becomes more diverse. There are more women, more cultural minorities, and more extremely old, frail people. The challenge for publicly funded social services will be to maintain a strong constituency that will support their continuation, even as they target services toward the very needy—those least likely to have a voice in the political arena.
This illustrates a fundamental tension inherent in the delivery of publicly financed social services. When public resources are scarce, there is a compelling argument in favor of targeting these services toward the most needy. Yet those most in need are least likely to provide political support when funding is up for debate. A program that benefits only low-income, homebound elders is likely to have few supporters at its budget review. Social services for the elderly must demonstrate their effectiveness—not only at reducing suffering of the vulnerable—but at enhancing the quality of life for the politically active.
AMANDA SMITH BARUSCH
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