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Medical advances have enabled us to live longer, but have not improved the <br />delivery of chronic care services. According to Chronic Care in America: A <br />21St Century Challenge, a report from the Robert Wood Johnson Foundation: <br />"There is no effective system to care for those with chronic conditions in the <br />United States. As a result, much of the care that is available is fragmented, <br />inappropriate, and difficult to obtain." Furthermore, the report states, "In <br />1995, one in six Americans-41 million people - had a chronic condition that <br />inhibited their lives to some degree." Some of the chronic conditions listed <br />were arthritis, cancer, heart disease, diabetes, emphysema, Alzheimer's <br />disease, blindness, hearing impairments, mental retardation and mental <br />illness. (AoA, Ref #7) <br />In 1998, 28.8 % of those in the 65-74 age group reported limitations in their <br />daily activities because of a chronic condition. This percentage increased <br />with age to over half (50.6%) for those in the 75+ age group. The U.S. <br />Administration on Aging's A Profile of OlderAmericans: 2001 (AoA. Ref #6), <br />reported a 1997 study indicated that more than half (54.5%) of the older <br />Americans (65+) had a least one disability of some type (physical or <br />nonphysical). Furthermore, 37.7% of Older Americans had at least one <br />severe disability, 14.2% (4.5 million) had difficulty in carrying out activities of <br />daily living (ADCs), and 21.6% (6.9 million) had difficulty with instrumental <br />activities of daily living (IADLs) (Figure 3). ADCs are defined as basis self- <br />care activities such as bathing, dressing, eating, toileting and hygiene. IADLs <br />include tasks related to independent living, such as telephoning, shopping, <br />preparing meals, doing housework, taking medication properly and handling <br />money or managing finances. <br />Figure 3: Percent 65 Years and Older with Disabilities, 1997 <br />Page 5 of 18 <br />At least one At least one Difficulty with Difficulty with <br />disability severe disability ADCs IADLs <br />