- Lack of economic boom - caused unplanned development (needs of those that need it most are often ignored or not considered); downsizing, lose pensions, 401(k), now have to pay for by self, many can't afford to do so, or get insurance
- People want a free ride (growth and security), but they don't want to pay for it. (Lower tax is good for votes, but is it good for society? - Tax non-essentials, but not essentials)
- People want same stuff, but at less cost (Cadillac on VW budget)
- How to convince people to continue to invest?
- Industries are going abroad for cheap labor
- Attracting many non-English speaking immigrants
- Higher land prices driving up land taxes. Having to sell family land - breakdown of mountain culture
- Many factories have retirement at 65 (not much to live off and limited opportunity for employment)
- More homelessness
- Medicare reforms limiting acceptable physicians. Some services not being paid for anymore. Reluctance for rehab and other care, want to only pay for essentials
- Lack of transportation, not only health care but other services that can help them to remain at home (rural, inner city, and other places)
- Need a real visionary plan, most of what we have are only Band-Aids
- Many people pay full price for PA and don't get doctors - get lost in circle - doctor can't afford to take time to listen (many PA and RN are trained to respond to elderly, most PA can handle most elderly problems)
- Limited amount of doctors that will take Medicaid/Medicare
- Children/family moving away, isolation, long-distance decision-making and caregiving
- Home health agencies not covering all in-home services, don't want to handle the small things
- No organized transportation, or not enough
- Aging issues not priority for elected officials
- Restrictions on church transportation assistance because of insurance
- Not enough activities or needs being met for elderly in churches
- Influx of elderly - causes bad traffic and increases property values
- Infrastructure not keeping up with growth
- Do not see government elected officials at many senior meetings and conferences
- Respite care needs to have business involvement for elders as well as young children
- Scams and fraud targeting seniors - mail and phone
- Increase in crime
- County governments not supporting new immigrants, they will have no benefits when they retire
- Increase of drugs, incarceration and deaths among youth - no one to care for elders
- NC is 49th in physical fitness
- "Plastic economy" - increases in debt
- Working poor - no benefits
- Not enough communication between doctors and elderly
- Literacy problems
- Negative attitudes toward the elderly by doctors/nurses
- Discrimination by age
- Demise of small county hospitals and merger of larger hospital systems that specialize so patients must travel
- Employers are looking to part-time employment to avoid having to offer benefits
- Underemployment (growth of service jobs)
- Employers don't keep employees long enough to earn pensions
- More competition for the same jobs
- Rapidly changing technology
- Smaller family support groups - more spread apart
- Traffic growth makes it more difficult for elderly, especially frail elders, to access services
- Politics involved in decision-making makes the process slower
- Technology advances can limit choices
- Technology can be overdone (ex. medical)
- Sedentary life style - more people sitting at work - effects on health
- More technology is leading to less opportunities for interpersonal communication
- Housing prices have increased, very little for low or moderate income
- Downsizing industries (textile, furniture)
- Business and industries not recognizing aging of workers, i.e. 12 hour shifts
- Lack of doctors understanding geriatric issues
- Lack of dentists for Medicaid population
- People not accessing preventive services
- Lack of transportation
- Lack of resources
- Lack of service providers
- Lack of affordable independent units
- Public school curriculum not having aging courses
- Lack of retirement - financial planning at early age
- Not enough eldercare, family friendly policy
- Medical expenses, i.e. prescription drugs
- Staffing problems in care facilities
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Positive Influences