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Senior Citizens, specifically those in nursing or assisted living facilities, are apart of a special population who may frequently lack quality care, and access to services. They are often apart of long term care, which is expensive and demanding.

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Individuals age and so do their health problems. Broken bones, forgetfulness, increased medications, and physiological changes affect their everyday lives (CSU 2024). Access to care becomes challenging when factors such as transportation, technology, accessibility, and income play a role.

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Many senior citizens have a chronic condition that can cause them to need long term care, with more advanced and around the clock access to health professionals. Individuals who have to take multiple medications may need help ensuring they have taken their pills, help in and out of bed or walking, with memory, and hearing (Graham, 2024). Senior citizens with chronic conditions need specialty doctors, physical or occupational therapists, and respiratory therapy.

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Traditionally, patient's see their primary care providers on a yearly basis. They are evaluated using the 3 "needs" method above. Senior citizens may meet the basic needs, but lack in the psychological and self-fulfillment categories, as their friends and loved ones may have passed, they are no longer active and have no goals to meet activity wise. Senior citizens do not get the opportunities to participate in some events and may feel depressed, or saddened that they are missing out. Those in assisted or nursing facilities lack the needed physical activities, nutrient packed specific meals, and health promotion needed to keep their health from declining (Rahemi, et al., 2024)

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In senior citizens, they see a PCP, ophthalmologist, dermatologist, cardiologist, and maybe even an audiologist. Healthcare has advanced to offering telemedicine, but many senior citizens lack technology, and the knowledge on how to use it to take advantage of this. With so many visits and different doctors seniors need transportation to appointments, and if they are in a facility, rearrangements to be made.

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Medicare will cover for individuals in nursing homes, but not those in assisted living, home care, or private care. Although Medicare will cover nursing homes, the percentage of seniors in these facilities has greatly dropped over the last 16 years, with the price of living in one increasing tremendously (Shi, 2025)

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Seniors in long term care, nursing or assisted living facilities, do not have direct access to care for all of their needs. Nurses are on duty and can tend to their everyday needs, but if a patient experiences cardiac, memory, or respiratory issues, they need to be transported to the hospital. They will need to pay for this transportation, most likely an ambulance, which can cost their pockets

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1. During the COVID-19 pandemic, senior citizens were deemed more vulnerable to getting the disease, and having a harder time recovering from it, and being treated for underlying factors like heart disease, or diabetes instead of COVID, these patient's were deemed as a lower priority than younger ones (Graham, 2024).

2. Seniors are vulnerable in that they are in a cognitive and physical decline- they become dependent on others to care for them but due to income instability, cannot always access that care (Sanchini et al., 2022)

3. Seniors in long term care and assisted living cannot rely on insurance to pay- Medicare does not cover it and Medicaid requires LTC individuals to basically hit poverty before qualifying for coverage (Shi, 2025)

4. Higher risk for chronic diseases and disbailities- with almost 19 million seniors having a disbaility and not getting access to needed care due to equipment not allowing for patient's with immobility to get proper exams, scans, or weighed (Graham 2024).

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U.S. senior citizens being devastated by COVID-19 -- what's being done to help?

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Underserved populations need to be spoken, and advocated for to ensure they are getting necessities; more than healthcare but the transportation and nutrition as well

As an administrator keep up with current acts, explore how to premote change and help serve special populations.

Never forget what goals you are working for- goal of equal, quality, appropriate care for all.

Advocacy matters- as seen in the videos on migrant farmworkers the surrounding community and other partners need to speak up and step in when lower income groups need. The alliance with Partners in Health worked to help migrant workers get expanded COVID 19 testing and vaccinations so they could feel more safe and secure about traveling to new job sites. Keeping up with current events such as the higher income population signing up online to get the vaccine allowed for the community outreach and health programs to advertise for migrant workers.

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-Medicare Advantage Part C expansion- will help provide extra benefits for coverage on dental, vision, hearing, caretakers, transportation, support groups (DOEA, 2023)

-Inflation Reduction Act of 2022 allows for prices to be negotiated for high cost drugs, gives a rebate if prices raise faster than inflation, and in 2024 hired drug contractors to support dispensers and negotiate prices (GAO, 2025).

prices will be tracked and trends will be shown on prescription drug costs, and steady price rates- expected that prices will hold steady, and increase only when negotiated.

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-Between the ages of 70-90 healthcare expenses more than double (De Nardi, et al., 2016)

-Unaffordable premiums, especially when senior citizens do not have a steady income flowing, they are reliant on savings and 401k (Shi, 2025)

-Insurance may be a PPO or HMO plan, which may require senior citizens to receive referrals for every doctor they need to see. Tracking down offices, and getting necessary forms electronically is difficult.

-Chart above shows the expenses for healthcare ages 75+ higher on average than other age groups, again no income coming in, so costs are out of pocket.

-More prescriptions = more money, prescriptions not always covered by insurance plans, prior authorizations time consuming, difficult, and often denied as well.

In 2022 more than 20% of people age 65 and older did not fill or adhere to prescriptions due to cost related factors (Carter, 2023).

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chart of self pay healthcare expenses for senior citizens

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Carter, J. (2023, May 25). Study finds older adults skipping medications due to cost. Medicare Rights Center. https://www.medicarerights.org/medicare-watch/2023/05/25/study-finds-older-adults-skipping-medications-due-to-cost

CSU. (2024, April 17). Identifying vulnerable populations in healthcare and how nurses can make an impact . Identifying Vulnerable Populations in Healthcare and How Nurses Can Make an Impact | Cleveland State University. https://onlinelearning.csuohio.edu/blog/identifying-vulnerable-populations-healthcare-and-how-nurses-can-make-impact

De Nardi, M., French, E., Jones, J. B., & McCauley, J. (2016). Medical Spending of the US Elderly. Fiscal studies, 37(3-4), 717–747. https://doi.org/10.1111/j.1475-5890.2016.12106

DOEA. (2023, April 3). Federal older americans act (OAA) program - doea. DOEA . https://elderaffairs.org/programs-services/federal-older-americans-act-oaa-program/

GAO. (2025, April 28). Inflation reduction act of 2022: Initial implementation of medicare drug pricing provisions. Inflation Reduction Act of 2022: Initial Implementation of Medicare Drug Pricing Provisions | U.S. GAO. https://www.gao.gov/products/gao-25-106996

Graham, J. (2024, January 17). America’s Health System isn’t ready for the surge of seniors with disabilities. KFF Health News. https://kffhealthnews.org/news/article/navigating-aging-seniors-with-disabilities-us-health-system-unprepared/

KXAN. (2020, May 12). U.S. senior citizens being devastated by COVID-19 -- what’s being done to help? YouTube. https://www.youtube.com/watch?v=3jto0K_KZg0

Rahemi, Z., Bacsu, J. R., Shalhout, S. Z., Sadafipoor, M. S., Smith, M. L., & Adams, S. A. (2024). Healthcare Disparities Among Older Adults: Exploring Social Determinants of Health and Cognition Levels. medRxiv : the preprint server for health sciences, 2024.06.29.24309705. https://doi.org/10.1101/2024.06.29.24309705

Sanchini, V., Sala, R., & Gastmans, C. (2022, August 16). The concept of vulnerability in aged care: A systematic review of argument-based ethics literature - BMC Medical Ethics. BioMed Central. https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-022-00819-3#citeas

Shi, L. (2025). Shi & Singh’s Delivering Health Care in the United States. Jones & Bartlett Learning.