Executive Summary

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In preparation for the development of the Orange County Master Plan for Aging (OCMPA), the County of Orange conducted a needs assessment to better understand the opinions, perspectives and circumstances of older adults who reside in Orange County and their caregivers. The information presented within this Executive Summary represents the collective feedback gathered through a series of surveys and highlights areas that Orange County residents believe are important or can be improved.
 

Community Survey Participants

The community assessment was voluntary and intended for those 55 years and older who resided in Orange County when they completed the survey. The survey period was September 2023 through January 2024.

The average age of participants was 70 years old. For those who opted to share demographic information, the highest represented categories were:

  • 27.3% 60-64 years old
  • 48.4% earned a Bachelor’s degree or higher
  • 58.5% owned their own home or condo
  • 29.5% had a household income of less than $25,000
  • 48.5% identified as White
  • 36.3% resided in Anaheim, Irvine or Santa Ana

Community Survey Key Findings

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The following are key findings that emerged within the Community Survey:

  • Participants rated their city of residence on different community features and care options. The lowest favorability ratings were accessible housing; daytime care options; and long-term care options.
  • The top five aging concerns were all health-related:

        1. Alzheimer’s disease and dementia
        2. Arthritis
        3. Cancer
        4. Heart Disease and Stroke
        5. Emotional Well-being

  • While nearly all participants were covered by health insurance (97.6%), disparities in uninsurance rates by race/ethnicity were identified with Hispanic/Latinos disproportionately more likely to be uninsured (8% versus 2.4% overall). Hispanic/Latinos also reported higher concerns for certain medical-related items relative to other racial/ethnic populations.*
  • Transportation services and in-home care were the two services rated as “most important for older adults.”
  • The top barriers to accessing medical and/or mental/behavioral health services were:

        Appointments not available at convenient times
        Don’t know where to get help
        High cost of copays
        Lack of transportation

  • Participants also rated their city of residence low on quality and variety of employment.
  • Approximately 1 in 3 participants reported experiencing age-based discrimination, with higher rates reported by those aged 70 years and older.
  • Isolation and loneliness were a highly rated contributor to participants’ health and mental/behavioral health issues.
  • Approximately 1 in 4 participants reported politics as the highest contributor to their mental/behavioral health issues.
  • Approximately 1 in 4 participants were not comfortable with technology or using the internet.
  • Approximately 1 in 3 participants reported caring for someone 55 years and older within the past year. The percent of those saying that they cared for someone increased as household income increased.
  • Financial insecurity and becoming homeless, although a relatively low concern for the overall sample, was endorsed at a higher rate by those aged 55 – 64 years old and those who were non-homeowners.
  • Approximately 3 in 20 participants reported that cost of living and economic instability contributes to their medical issues and/or behavioral health issues.
     

Caregiver Survey Participants

For this survey, caregivers were defined as individuals (e.g., family, friends, volunteers) who were 18 years or older and not paid for the assistance they provided to another person in activities of daily living at home (e.g., shopping, cleaning, cooking, etc.).

  • 935 valid responses​
  • 77% identified as female​
  • 47% identified as white​
  • 67% spoke English with the person for whom they cared​
  • On average, provided care for seven years​
  • Average age for the person they cared for was 79 years

Caregiver Survey Key Findings

  • Caregiving affects the social lives and emotional well-being of caregivers, with 2 out of 3 participants reporting caregiving had impacted their social lives and approximately 4 out of 10 feeling isolated and/ or depressed. Caregivers 50 years and older tended to report higher rates, as well as White caregivers.*
  • About 1 in 3 have their own health concerns, with Asian and White caregivers tending to report higher rates than caregivers who were Hispanic/Latino.*
  • A majority said caregiving was “somewhat” or “very” difficult, with the emotional and physical tolls tending to be somewhat higher among Asian and White caregivers and the financial toll somewhat higher among Asian and Hispanic/Latino caregivers.*
  • Approximately 6 out of 10 participants reported that they also held a full-or part-time job. For these working caregivers, the most commonly reported impact was having to rearrange their work schedule to accommodate their caregiving responsibilities.
  • Despite challenges reported by caregivers, participants shared that they find a great deal of value and meaning in their role as a caregiver.
  • Their areas of biggest concern were related to not having enough time for their responsibilities or themselves, or knowing what resources are available.
  • There was considerable interest in free respite care, with 9 out of 10 participants interested. Caregivers also preferred online support over in-person support.

Paid Provider Survey Key Findings

Most paid provider participants, 51%, identified their field of work as in-home nursing care or supportive services, followed by 25% who identified as a caregiving resource provider.

  • The most pressing health and social issues paid providers are seeing in communities they serve are:

        Alzheimer’s disease and dementia
        Caregiving
        Mental Health
        Disability

  • In relation to the accessibility of services for older adults in the communities they serve, most paid providers felt services are moderately accessible, requiring effort and flexibility.
  • In relation to the availability of services in the communities they serve, most paid providers felt services were available, but insufficient to meet the needs for older adults.
  • On average, participants rated 5.3 out of 10 for how easy it is to keep up with new programs and services.

Conclusion & Next Steps

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The results of this assessment provide valuable insights for the County of Orange, community organizations, stakeholders and public to come together to better understand and address the needs of older adults. These assessment findings, in combination with County of Orange resource mapping and capacity assessment, will be used in the development of the OCMPA.

The OCMPA will continue to evolve and respond to future trends. This needs assessment is a starting point on which future surveys can build upon the findings in this report, expand on planned areas within the OCMPA and ask additional information that was not incorporated into this needs assessment. The County of Orange will monitor the efforts within the OCMPA through emerging trends and data reported by the California Master Plan for Aging. Ultimately, the County of Orange’s goal is to ensure that it fosters a safe, healthy and fulfilling place for older adults today and in the generations to come.

*Disparities analysis limited to subgroups with over 100 participant responses.