Needs Assessment: Can It Help Improve Aging Services?
Why conduct a needs assessment?
Older adults are the fastest growing segment of the population. With mortality rates declining, particularly among the oldest segment, there will be more need for services to help maintain older adults’ well-being and quality of life than ever before. At the same time, funding for aging services remains stagnant at best, whether it comes from Federal or State grants or from local property taxes. A carefully conducted community based needs assessment helps to identify the needs of the older population within a particular place. It provides valid and reliable data to inform and guide the planning, targeting, and delivery of local aging services to help make the expenditure of public funds more effective and efficient.
The IOG has a long track record of conducting older adult needs assessments at the state, county, and city level. Most recently, we reported findings from a needs assessment of older adults in Calhoun County, Michigan. Our report was based on a broad population survey, a stakeholder survey of service providers, leaders, and experts in the local aging network, and several focus groups of aging service clients from around the county. We followed community based participatory research (CBPR) principles and pursued a multi-method data collection strategy, an approach that results in a deeper and richer understanding of the local conditions and unique circumstances and needs faced by the county’s older adults.
What did we learn?
We found that the needs of older adults in Calhoun County vary significantly by health, socioeconomic status, family and living circumstances, and geography. In a broad sense, those who report needing the most supportive services tend to have below-average health, functional or sensory limitations, lower income, lower levels of education, and be single or widowed and living alone in rental housing located in Battle Creek or Albion. However, the older population of Calhoun County is quite diverse, and a great many older Calhoun residents in need do not fit this profile. Plenty of married homeowners in Marshall and Tekonsha and Newton Township also report a need for services to help them maintain their health and independence at home. When it comes to older adults and aging services, one size does not fit all.
The most needed services reported by Calhoun’s older population fall into a few basic categories: Health, independence, and information. Although the vast majority, particularly those age 65 and older, have health insurance, their insurance coverage often does not extend to dental, vision, and hearing services. Those were among the top needed services identified across our three major data collection efforts, in addition to exercise and wellness programs for seniors.
Home repair, chore, and maintenance assistance to help older county residents stay in their homes are the top needed independence services, along with utility assistance for those in financial need and transportation for those who do not drive. In the category of information, stakeholders and focus group participants alike called for more outreach and public awareness efforts, enhanced information and assistance services, and innovative ways of providing access and informing older adults about the options and services that may be available to them.
While rural-dwelling survey respondents were less likely to report living alone and more likely to report having friends and family members they can count on for help, focus group participants from rural areas were more likely to report feeling lonely and isolated. Seniors in sparsely populated areas especially value opportunities to socialize with fellow seniors, so they value the wellness and congregate meal programs not only for their health benefits, but because they facilitate peer interaction as well.
Our focus groups and key stakeholders survey helped us not only to gauge the level of need in the community, but also to gather ideas about ways in which service delivery can be improved. Many participants advocated for greater community partnership, for reaching out beyond the aging network to collaborate with other groups and businesses that have an interest in serving the older population. Churches, service and fraternal clubs, coffee shops and diners, and other locally based organizations may be enlisted to help distribute information, identify seniors in need, and provide an access channel to services. Those already providing aging services can work together more closely to coordinate services, reduce duplication, and close gaps.
What does it matter?
This is just a brief overview of our findings; a copy of our detailed report is available upon request. Of course, the ultimate purpose of a needs assessment is not merely to produce a report, but to inform and guide action. We are pleased that our community needs assessment results have already helped the Calhoun County Office of Senior Services and the Region 3B Area Agency on Aging determine where and how to allocate funding that better responds to the needs of older adults in their county. They have consolidated dispatch and transportation programs to save money and provide better service. They have developed pilot programs for cost-effective chore and home modification services. They have increased funding for dental, vision, and hearing assistance. They have initiated efforts to integrate whole person wellness, health screening, congregate meals, recreational programs, and benefits counseling into combined sessions in rural areas to promote social engagement, reduce isolation, and provide increased access to services. And they are expanding efforts to coordinate services and build relationships with service providers and community organizations. These are just some examples of the ways in which needs assessment research can be used to help strengthen community efforts to support older adults while enhancing effective stewardship of public resources.