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Stewardship to Meet the Needs

“We are all aging and, eventually, we all need aging services.”

What we advocate is no less than a revolution to reform the mindset of those who provide aging services.  What do we seek and why is it necessary?

A credible aging services industry would be characterized by its commitments and by the integrity with which resources are deployed to meet those commitments.  This calls for financial integrity.

Let’s break that down a bit.


The core commitment might be to address the growing dependence and increasing frailty which makes the very old so needy.  There is a continuum of aging services from congregate needs after employment ends through the support services to accompany life’s closing transitions.


Meeting those commitments requires money.  Money to pay people.  Money to provide buildings for gathering and housing.  Money to buy equipment.


The use of money involves stewardship. 

Where are we now?  Aging services combine private business activity; nonprofit businesses and nonprofit charities for the helpless or indigent; and government business programs to deliver services on a universal platform.   Each form of organization has its strengths and its weaknesses.

Private enterprise can respond quickly to creative concepts for quality improvement or lower costs.  Nonprofits avoid tax obligations need only be accountable to mission.  Government programs benefit from the coercive capacity of government and from taxes as a funding source.


Forms of Organizations Providing Aging Services

As Jane Austen might have written, “It is a truth universally acknowledged, that a young person with good fortune will eventually confront the challenges of age.”

As our health improves, we live longer and that has expanded the need for aging services and the industry that provides them.  Now the demand for aging services is expected to increase dramatically as the generation of post-World War II babies passes the landmark ages of 60, 70 and beyond.

Services are provided by:

1.       Government,

principally through Social Security, Medicare, Medicaid, and the Older Americans Act;

2.       Nonprofit organizations,

principally eldercare in hospitals, affordable housing, home and community based services, programs of all-inclusive care for the elderly (PACE), and Continuing Care Retirement Communities (CCRCs); and

3.       Private investor-funded organizations,

principally for insurance services; tax-credit financed affordable housing; assisted living; skilled nursing; and other congregate housing.


These forms of organization differ in their sources of financing:  Government has access to tax revenues and to the borrowing capacity of the government; Nonprofit benefit for tax exemption and can solicit tax advantaged donations; Private organizations have access to equity investment capital.

Government has the least accountability, due to the doctrine of sovereign immunity; nonprofits are subject to regulatory oversight and can lose their tax exemption unless they operate within prescribed limits; while private enterprise is subject to both regulatory oversight and to accountability to its investors.




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Adminstration:  Active Aging Advocates, 2855 Carlsbad Blvd., N116, Carlsbad, CA 92008

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