MOST Bermuda seniors have incomes under $30,000 a year, a major new study has revealed.

And more than a quarter of those aged between 65 and 79 have an annual income of less than $12,000, as do 53 percent of those aged 80 and older.

Seven per cent of younger seniors and 19 per cent of older seniors have incomes under $6,000.

"Ageing in Bermuda: Meeting the Needs of Seniors", the study produced by Professor Irene Gutheil, Henry C. Ravazzin Professor of Gerontology, and Professor Roslyn Chernesky, both of Fordham University's Graduate School of Social Service in New York, has produced a very clear picture of the current situation of Bermuda's senior citizens.

Funded by the Bermuda-based Atlantic Philanthropies, in what can only be seen as an extraordinary gift to the people of Bermuda, the study will bring additional pressure to bear on Government to take concrete action to relieve the economic and psychological pressures facing the most vulnerable sector of Bermuda's society.

In an exclusive interview with the , the professors were quick to praise the strength and resilience of Bermuda's seniors, who comprise 11 per cent of the population, and the study underscores those qualities ? despite their relatively straitened financial circumstances, 67 per cent of younger seniors and 70 per cent of older seniors "feel their incomes and assets meet their needs".

Professor Gutheil wanted to stress the level of co-operation that had been shown by the entire community.

"We were so impressed with the support of the whole community," she said, "and how responsive people were to our requests for information, particularly the seniors. We could not have done it without our distinguished advisory board, and Mariann Sherratt and her Bermuda Field Team.

"In many ways, the picture of ageing in Bermuda is very similar to other industrialised countries. Much of what we expected to find, we did find. For example, the heroic r?le played by family care-givers in supporting seniors in the community.

Professor Gutheil said that, while it wasn't especially surprising, it did appear that Bermuda offered limited support to seniors and family care-givers in comparison to the situation in other countries. Asked whether, given the afflence of Bermuda, the Government was doing enough for Bermuda's seniors, Professor Gutheil responded diplomatically, stressing that they had not studied Government programmes and that the study was produced for the entire community, not just for Government.

"My sense, from the people in Government I have spoken to, is that they are really interested in seniors, and very concerned about making life better for them. Clearly, more has to be done, because seniors are not getting all of the support they need.

"Many of the seniors are struggling on very low incomes, but are managing, despite the concerns they have, and concerns about their ability to manage in the future. The good news is that most seniors in most places are resilient, but what stands out a little bit here, is that many seniors have low incomes, so it is quite impressive to see the level of their strength and resilience, on very limited incomes. In that sense, they are stars!"

However, the study reports that 34 per cent of younger seniors and 30 per cent of older seniors admit to having "some difficulty" in meeting their needs. Nearly 30 per cent of younger seniors and over 35 per cent of older seniors report that their health insurance is not adequate for doctor visits or medication. Nearly 70 per cent of seniors worry to some extent about their ability to manage or cope with health problems in the next few years.

There are "relatively high levels of psychological distress among the seniors participating in the survey", with 12 per cent of the younger and 14 per cent of the older seniors fitting the symptoms for "clinically significant depression", and 21 per cent of the younger and 28 per cent of the older seniors experiencing "clinically meaningful anxiety".

Professor Gutheil thought it critically important to highlight the role of family care-givers, a term used to denote all family or friends providing care for a senior without being paid.

"They are providing the overwhelming majority of care to seniors," reported the Professor. "With the strong economy and high employment, care-givers are often juggling work, maintaining the family, and caring for their parents or grandparents.

"They are really the heroes of this situation, and if they are not supported, it's going to be hard for them to continue providing the level of care, because eventually people burn out. It is only through their efforts that seniors are relatively highly functioning."

The study more than bears out that contention, and describes the emotional and psychological pressures on care-givers.

Unsurprisingly, 84 per cent of family care-givers are women, two-thirds of whom are married or living with a partner, and 28 per cent of them report having incomes under $36,000 last year. Two-thirds of them work, and they average a 36-hour week. The ages of the seniors receiving care range from 63 to 98, with an average age of 83.

Most of the care provided is to parents, with a spouse or partner the next most likely to receive care.

Most younger seniors need little help in the "activities of daily living" (ADLs), such as bathing, grooming or dressing, but between ten and 20 per cent of older seniors need help with these tasks. Similarly, younger seniors don't need a lot of help with "instrumental activities of daily living" (IADLs), but 64 per cent of older seniors need help with heavy housework, and between 25 and 42 per cent of older seniors need help with such other IADLs as preparing meals, doing light housework, shopping, paying bills and managing finances, transportation, and last but by no means least, cutting toenails.

For those seniors who need help with ADLs, family care-givers provide about half of the care, and paid help about one-third. For most of the IADL tasks, family care-givers undertake from over 50 per cent to as much as 90 per cent of these varied activities. Over 80 per cent of family care-givers have been providing care for more than a year.

Caregivers report that seniors receiving care have, on average, three health problems, the three most frequently named being problems with mobility, arthritis, and hypertension. Almost one-quarter of seniors have Alzheimer's disease or another form of mental confusion.

"We have hard data that tells us that one of the greatest strains that care-givers feel is emotional," said Professor Gutheil, "although they also feel a considerable amount of physical and financial strain. From the focus groups, we had considerable commentary from care-givers who said that they were exhausted. We had someone say that you can end up being sicker than the person you are caring for. These were the type of comments that came up over and over in the focus groups.

"Hard data doesn't capture the desperation the way that the focus group comments do. Working care-givers are particularly strained. Some care-givers are literally providing round-the-clock care. If they are dealing with someone with moderate to advanced Alzheimer's, they are on call 24 hours a day, and I can hardly think of a more distressing and stressful situation, because they are probably not getting proper sleep at night."

The amount of care required, and the need to balance work and other responsibilities, clearly exacts a considerable toll on family care-givers. Seventy-six per cent report emotional stress, 64 per cent suffer physical strain, and 46 per cent experience financial pressure.

More than half of the care-givers say they have less time for themselves or with friends, 30 per cent have less time to spend with other family members, and almost one-third have given up a vacation or hobbies because of the demands of care-giving.

"We have recommendations for the Bermuda community," advised Professor Gutheil, "rather than recommendations specifically for Government. We have identified the services that are needed, and directions about how to proceed in taking action."

"One of our principal recommendation involves care-givers," added Professor Chernesky, "one of the areas we have highly recommended should be pursued, not necessarily just by Government, but perhaps as a public/private partnership, is some sort of support centre for care-givers, which would include resources and information, but care-givers are interested in counselling and emotional support. They are asking for that, and we believe that's essential.

"We also asked service providers about their perceptions of the needs of seniors, and what services would be good for them, and part of the reason that this focus was so necessary, if Government will not be the only entity that has to formulate plans, is that there's going to be more required of existing organisations.

"They will have to expand or move in new directions. We looked at those who are already serving seniors, and those who are not. And, while there's a commitment to seniors, and an understanding of their needs, the fact of the matter is that most of the organisations are struggling also.

"It's parallel with what we are hearing from the care-givers. The reason for the struggle is that they are working with limited funding, having to spend a lot of time raising funds, and recruiting, training, and keeping volunteers.

"So the organisations are saying that if they have to take on more responsibility for seniors, they will need more funding, staff, volunteers and training. There is a concern in the Bermuda community, that if there are to be more programmes and services, how will they be handled? The private sector certainly can't do that alone, and neither can Government."

The report provides a long list of recommendations for specific services that will improve the lot of Bermuda's seniors: care co-ordination, to inform seniors and care-givers of services available, help them identify the best services, and assist them in making contact with those services; care-giver assistance; day programmes outside the home to provide personal care, social services, and social activities; emergency beepers to alert others to seniors in crisis situations; friendly visitors; home modifications to help seniors be more safe and comfortable; a hotline or central phone number to call for information; in-home services;mental health services; training for staff and volunteers; and transportation programmes.

Based on all of the study findings, the report recommends two initiatives as "good places to start": a care-giver resource centre and a care information service.

Professor Gutheil was aware that there had been considerable public and media discussion about the economic difficulties facing seniors, and that a number of seniors planned to leave Bermuda because of the high cost of living.

"That would be a particularly sad situation, because while our study was a 'needs assessment', we also found through this and the people we spoke to, that seniors are a tremendous resource to this community. They are enthusiastic volunteers, and do that into their later years.

"Many are still working, and they are themselves care-givers, either to older relatives, spouses, or to grandchildren. They are an asset to this community, and it would be a terrible shame if they had to move out for whatever reason. Then you're losing the history of the community."

The report concludes, perhaps optimistically, that "Bermuda is positioned to improve the lives of its seniors and their family care-givers. The country's size and healthy economy are a combination of assets that few other countries have.

"Bermuda has the opportunity to envision and create a model environment integrating focused public policy, an effective safety net, and an array of quality services."