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  • Writer's pictureCindy Davis

Where to Start Building Your Elder Care Network

Frustrated adult woman looking for resources on their laptop

Sitting in front of your computer, the clock ticks past another late hour. Today, like many days before, has stretched you thin. Your loved one, whether a parent, spouse, or friend, needs more help with daily activities than you can provide alone. They need assistance, perhaps with meals, mobility, or medication, and the burden of figuring out where to turn weighs heavily. "Aging agencies," they said, but which one? The names swirl in a mix of acronyms and titles, each more confusing than the last. How are they connected? Which can offer the help you desperately seek in your area, for your unique situation?


It's easy to feel at your wits' end, lost in a sea of bureaucracy when all you want is to find support and care for your loved one. But there's hope, and it starts here, with understanding the foundation laid out by the Older Americans Act (OAA), navigating through the federal, state, and local network of aging support, and finally connecting you directly to the resources you need.


This post doesn’t just connect the dots; it's a lifeline. We'll clarify the maze of agencies, pinpointing exactly how they interconnect to help you figure out what they could do for you. We'll provide you with the direct link to the Eldercare Locator and help line, ensuring you have the tools to build and expand a custom network of care for your loved one.


Take a deep breath. Comfort and direction are within reach. Read on to empower yourself with knowledge and take the first step towards assembling the support network your loved one deserves.


The Historical Bedrock: The Older Americans Act (OAA)

In response to the growing need for community social services for older persons, Congress enacted the Older Americans Act (OAA) in 1965. This landmark legislation, signed into law by President Lyndon Johnson, was designed specifically to address the social services needs of older Americans, marking a pivotal shift towards improving the status and welfare of older individuals across the country.


The OAA established a framework for organizing, coordinating, and providing community-based services and opportunities for older Americans and their families. It set forth specific objectives to maintain the dignity and well-being of older individuals, fostering an environment where they could live independently in their communities. The Administration on Aging (AoA), within the Department of Health and Human Services, was designated as the principal agency to administer the provisions of the OAA.


Over the years, amendments to the OAA have expanded and refined its scope, emphasizing the need for effective planning, coordination, and delivery of services at both state and local levels. This evolving legislation has underpinned the development of a comprehensive network of Aging and Disability Resource Centers, Senior Centers, State Units on Aging (SUAs), and Area Agencies on Aging (AAAs), dedicated to supporting more than 75 million Americans age 60 and above.


Federal Advocates for Aging: Enhanced Support Through HHS Divisions

The fabric of federal support for older Americans is woven largely through the efforts of the Department of Health and Human Services (HHS), a federal department with a broad mandate covering health and human services.

Diagram of how HHS, federal, state, and local agencies are connected
Department of HHS Older Adult Support Network

Within HHS, 12 operating divisions focus on various aspects of public health and human services, with three key divisions playing pivotal roles in supporting older adults:


  1. Administration for Community Living (ACL): As a crucial arm of the Human Services division, ACL is dedicated to enhancing access to community supports and resources for older Americans and people with disabilities. Within the ACL, the Administration on Aging (AoA) operates, focusing specifically on initiatives that help older individuals live independently in their communities. The AoA's work includes implementing the Older Americans Act and promoting a wide array of services, from healthcare and nutrition to caregiver support, thus championing the dignity and welfare of older adults across the nation.

  2. Centers for Medicare and Medicaid Services (CMS): Another cornerstone of the Human Services division, CMS oversees crucial programs like Medicare and Medicaid. These programs provide health coverage to a vast demographic, including older adults, those with disabilities, and individuals requiring long-term care. Medicare is known for its comprehensive health insurance for those aged 65 and older, while Medicaid extends its reach to low-income individuals of all ages, highlighting the federal commitment to ensuring older people and those with chronic illnesses receive the care they need.

  3. National Institutes of Health (NIH): As part of the Public Health Service, NIH is the primary federal agency responsible for biomedical and behavioral research. Within NIH, the National Institute on Aging (NIA) focuses on the aging process, age-related diseases, and specific challenges faced by the elderly. With a significant emphasis on Alzheimer's and related dementias, the NIA's research aims to improve the quality of life for older adults by uncovering new treatments and preventative strategies.


Understanding HHS Contributions to Federal Support

At the federal level, the intricate support network for older Americans is marked by the collaborative efforts of the AoA, CMS, and NIA, each contributing unique resources and expertise under the umbrella of HHS. These agencies, through extensive research, insurance funding, and nationwide program implementation, lay the foundational pillars of support for the aging population. Here’s a closer look at the contributions of each:

AoA Adult Child Caring for Parents

Administration on Aging (AoA), part of the ACL, is tasked with implementing the Older Americans Act and advancing services and programs that support older individuals to live independently in their communities. Through its nationwide network, the AoA ensures that older adults have access to a wide range of services, including healthcare, nutrition, and caregiver support, promoting their dignity and welfare.

Medicare & Medicaid Healthcare provider with older adult and caregiver

Medicare and Medicaid play a critical role in healthcare coverage, ensuring older adults and those with disabilities have access to necessary medical care. Medicare provides comprehensive health insurance covering hospital visits, medical care, preventive services, and prescription drugs, primarily for individuals aged 65 and older. In contrast, Medicaid, a federal-state partnership, offers health coverage to low-income individuals of all ages, with a significant focus on long-term care and support for older adults with chronic illnesses or disabilities.

NIA Woman with Dementia graphic

National Institute on Aging (NIA), under NIH, leads the charge in aging research, focusing on understanding the aging process and developing interventions for age-related diseases, including Alzheimer's and dementia, aiming to extend the healthy, active years of life for older adults.


This coordinated federal support system underscores the United States' commitment to ensuring older adults receive the care, respect, and dignity they deserve. Through the combined efforts of these agencies, the federal government provides a comprehensive network of support, paving the way for healthier, more secure aging for all Americans.


State-Level Strategy: Customizing Care with State Units on Aging

SUA graphic for planning and support

The OAA's 1973 amendments significantly restructured the Title III program, enhancing the role of state agencies in the planning and organization of services for older persons. State Units on Aging (SUAs) were established to develop and administer multi-year state plans, advocating for older residents and their families. The 56 SUAs are located in each of the 50 states as well as the District of Columbia, Guam, Puerto Rico, American Samoa, the Mariana Islands, and the Virgin Islands.


Note that “State Unit on Aging" is a general term. The specific title and organization of each governmental unit varies and may be called a Department, Office, Bureau, Commission, Council, or Board for the elderly, seniors, aging, older adults, and/or adults with physical disabilities. Hence, it is important to use the search resources to find the name of the entities that support you. So, there is no uniform SUA search term. Rather it is best to combine “State Unit on Aging” plus the name of the state in which you would like to find services to get the best results.


These SUA plans are tailored to meet the unique characteristics and demands of each state's population, working in concert with local agencies to arrange services. Each is responsible for dividing the state into geographic areas, known as planning and service areas (PSAs), to ensure that programs are customized to the specific needs of people residing in those areas. This level of planning and coordination is crucial for the effective delivery of services and for fostering state leadership in achieving cooperation among all concerned agencies and organizations.


The Frontline of Elder Care: Role of Area Agencies on Aging

AAA oversite of older adult direct service providers

At the local level, the intricacies of aging support are meticulously managed by the 629 Area Agencies on Aging (AAAs), instrumental in administering Title III funds and orchestrating services for the elderly within their Planning and Service Areas (PSAs). These AAAs, whether public (67%) or private (33%) nonprofit agencies, are designated by states to address the comprehensive needs and concerns of older persons, making the concept of aging in place a tangible reality for numerous seniors. Offering an array of services, AAAs are foundational in aiding independent living for older adults across their diverse geographic regions—be it a city, a single county, or a multi-county district, categorized variously as county, city, regional planning councils, or councils of governments.


The core functions of AAAs encapsulate four pivotal roles:

  1. Planning: Engaging in a proactive dialogue with consumers, service providers, and stakeholders, AAAs meticulously develop Area Plans. These strategic documents map out the pressing needs and articulate targeted recommendations for programs and services aimed at older adults, ensuring regular updates to mirror the evolving landscape of needs and trends.

  2. Advocating: Beyond their programmatic offerings, AAAs stand as staunch advocates for the older adult population. They actively engage in local and state-level discussions, championing the causes and needs of seniors beyond the immediate scope of the services they finance or directly provide.

  3. Contracting: In their role as facilitators for aging in place, AAAs contract with an estimated 29,000 local service providers utilizing approximately 500,000 volunteers to deliver the essential activities of daily living services that empower older adults to remain in their homes. This strategic arrangement covers a spectrum from meals to homemaker assistance, thereby enabling older individuals to tailor their living arrangements and services to best fit their preferences and needs.

  4. Consulting: Beyond arranging services, AAAs often directly offer expert guidance and support through Information and Referral/Assistance, case management, benefits/health insurance counseling, and family caregiver support programs. This direct interaction further cements their role as an invaluable resource for aging individuals seeking advice and support to navigate the complexities of senior living and caregiving.


Embedded in the community fabric, AAAs embody the frontline of aging support, translating the overarching goals of federal and state initiatives into actionable, localized services that address the nuanced needs of aging populations across the nation.


Connecting the Dots: How Federal, State, and Local Agencies Collaborate for Elder Care

The beauty of the OAA's structure lies in its ability to link the efforts of the AoA, SUAs, AAAs, and other public and private agencies in a cohesive network dedicated to expanding and improving programs for older persons. This tiered system ensures that while there is a unified approach to supporting aging Americans, there is also flexibility to adapt services to meet local needs effectively.


For individuals and caregivers seeking support, the first step is often reaching out to local AAAs or using resources like the Eldercare Locator to find services tailored to their specific needs. This local engagement is supported and enriched by the broader planning and resources available at the state and federal levels, creating a comprehensive ecosystem of support.

Navigating Aging Together: Finding Your Way with Available Resources

Remember, you are not alone. The network established by the OAA and expanded through the efforts of countless agencies and organizations at the federal, state, and local levels is there to support you and your loved ones through the last chapters of life. Whether you're seeking information on healthcare coverage through Medicare, support services for independent living, or resources for caregiving, there's a pathway designed to help you find the assistance you need.


We encourage you to reach out and explore the resources available in your current area, as well as any locations you may consider moving to in the future. The tiered system of support ensures that no matter where you are, there's a network ready to assist you.


For a streamlined search, we recommend you use the Eldercare Locator or call its accompanying phone service (800.677.1116) to help connect you to the appropriate agencies and services.

Your journey through aging and caregiving is unique, yet universally, it demands tapping into a diverse, interconnected network of support services. The framework established by the OAA and the continued efforts of federal, state, and local agencies provide a compass. Armed with this knowledge, you can confidently seek out the resources and supports designed meet your specific needs.


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