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Aging and Independence Services: a Q&A with Becky Kurtz

As Metro Atlanta’s Area Agency on Aging, ARC Serves Needs of Older Residents

Becky Kurtz, managing director of ARC’s Aging and Independence Services Group.

As the planning agency for the Atlanta region, the Atlanta Regional Commission wears many hats. ARC, among many other things, is metro Atlanta’s Area Agency on Aging, which is responsible for disbursing federal funds across 10 counties so that older adults can live healthy and independent lives.

This is critically important work. Metro Atlanta is aging fast. The metro Atlanta region experienced unprecedented growth in its older adult population between 2010 and 2020, outpacing all peer metros and even the nation.

And over the next few decades, the population ages 65 and older will grow at a faster rate than any other age group. In 2019, approximately 518,068 people ages 65 or older lived in the 10-county region — that’s 1 in 9 of us. By 2050, more than 1 in 5 metro Atlanta residents will be 65 or older.

In fiscal year 2021, ARC distributed $22 million for services and programs for older adults in the 10-county region (ARC’s planning functions cover an 11-county region, but the Area Agency on Aging serves all counties except new ARC member Forsyth).

An influx of federal COVID funding allowed ARC to use state funds to pay for home repairs and modifications for older adults. In a typical year, this is an expense that ARC does not cover because funds are not sufficient to cover those services ARC regularly funds, including in-home meals and services, transportation, respite care, congregate meals, etc.

I talked to Becky Kurtz, managing director of ARC’s Aging and Independence Services Group, to learn more about the role ARC plays in supporting this vital population.

Aixa Pascual: The perception is that metro Atlanta is an overwhelmingly young region. Yet data shows that the population of older adults is growing at a faster clip than for younger age groups, and that older adults will continue to be an engine of growth for years to come. What accounts for this growth?

Becky Kurtz: A lot of people moved to the Atlanta region in the 1970s, 1980s and 1990s and decided to stay. Our population boomed, and those people are now older. A lot of older adults are now moving to the region to be close to children and grandchildren, or to retire.

Also, birth rates are going down, and people are living longer, so the population ages 60 and over is growing at a faster rate. All these factors explain why older adult populations are growing at faster clip than younger populations.

AP: Is the Atlanta region prepared to meet the needs of this segment of the population?

BK: Are we ready? Right now, we’re not meeting all the current needs. The fact that the older adult population is growing quickly means that we need to do a lot more to meet both current and future needs.

In addition to service needs, we need to think broadly about how to support an older population. For example, how do employers provide flexibility in employment that enables older workers to work longer? Are we providing the transportation services that an older population needs? Most individuals outlive their ability to drive a car by 7 to 10 years. What does that mean for our transportation system? Are our transit systems taking people where they want to go, or are they only sufficient to go from home to work and back? Are our neighborhoods safe to walk in? Is our housing stock accessible and affordable for an older population? A split-level house with lots of stairs and a huge yard in the suburbs may no longer be the house an older person can thrive in.

A group of older persons from the metro Atlanta area enjoy a hike together.

AP: When we talk about older persons, what ages are we referring to?

BK: This varies, and it depends on the context. There’s a variety of programs and services that start at different ages. For example, when it comes to eligibility for public benefits, Medicare kicks in at 65. When it comes to services and resources offered under the Older Americans Act, it’s for adults ages 60 and over. Full retirement for Social Security benefits depends on when you were born. For people born after 1960, full retirement age is 67.

It’s hard to define what “old” is. And because life expectancies vary dramatically, for some 65 is longer than the life expectancy in their community. For others, they can reasonably expect to live well into their 80s or beyond. “Old” is an arbitrary number. There is no magic number.

AP: What is the correct terminology to use when we talk about older adults?

A group of older persons from the metro Atlanta area enjoy a hike together.

BK: There are various opinions on this. The FrameWorks Institute researched what understandings come with different terminologies. It has found that we use the term “older person” to refer to people in the age range of 65 and over. Based on this research, I find that “older persons” or “older people” are appropriate and accurate terms in most contexts.

“Older adult” tends to make people think of adults ages 55 and over, a slightly younger population. Personally, I avoid the term “elderly” because it connotes weakness and frailty for an entire age group, which isn’t accurate. “Elder” is a respectful term, but it tends to be used less by the general public. Sometimes it is used in a more formal context and isn’t only used to describe age (for example, some churches use the term “elder” for leadership positions).

AP: How, and why, does the federal government fund services and resources for older people?

BK: The federal government started offering Social Security in the 1930s because the U.S. had a huge poverty rate among older adults. Social Security was passed to afford income security and decrease the poverty level among older persons. There’s still poverty among older people, but not as severe as decades ago.

Medicare was later introduced, in 1965, to provide health care for older persons. That year, Congress also passed the Older Americans Act to support the independence of individuals so they can stay at home and in their communities as long as possible. This saves money on the Medicare side and improves the quality of life for millions of older persons.

State government, through the Georgia Department of Human Services, also provides funds. One of the key ways is funding the home- and community-based program that expands on the federal funds. Federal funds are never enough for the need. The state adds to that by funding additional home delivered meals, services for caregivers, and other services. And still, it’s not enough. We still have long waiting lists in our region – and across the state – for those services.

ARC receives Older Americans Act federal funding through state government grants and distributes these monies to county governments and nonprofits in the 10-county metro area that our Area Agency on Aging serves. Counties typically have a senior services office that provide these services.

A recipient of ARC’s services stands outside of a Clayton events center.

AP: How does ARC distribute these funds from the federal and state governments?

BK: It’s a mix. Some of the services we provide directly with ARC staff and volunteers. But the majority of federal and state funds we distribute through grants to our county-based and nonprofit partners. These partners then provide direct services that include home-delivered meals, congregate meals in senior centers, transportation to doctor appointments, material aid, homemaking, respite care, and much more.

AP: What are some of the services that ARC funds for older people?

BK: The support and services that we offer focus on maximizing the independence, health, and wellbeing of older persons, individuals with disabilities, and their care partners today, while preparing the region for the future. We call our aging and disability services Empowerline. Last year, we served more than 37,000 people through our Empowerline services and programs. Thousands more received information on our website:

One important Empowerline service is information counseling. Our certified professional counselors connect older persons, adults with disabilities, and their caregivers with resources and services in their communities. This unbiased, free service is available regardless of income. We connect people to services available to them, and sometimes they may need to pay out of pocket for these services.

During the pandemic, we have been able to offer some additional services. For example, through our CARES Flex service, we provide a monthly budget to family caregivers who provide services such as bathing and dressing to individuals 60 years and older, relieving some financial pressure from those most impacted by the pandemic.

Also last year, thanks to state funding, we were able to provide more than $1 million to three nonprofits (Habitat for Humanity, Meals on Wheels, and HouseProud) to help low-income older adults make critical modifications and repairs to their homes so they can age safely in place.

AP: Social Security is the largest single item on the federal budget, and Washington spends hundreds of billions of dollars a year on Medicare expenses. For 1 in 5 older adults in this country, Social Security is their only source of income. Why are these government programs not enough to cover expenses during old age?

BK: Medicare, which includes hospital and medical insurance, does not cover all healthcare expenses and does not cover most long-term care in one’s home or in a residential setting. Health-related and long-term care expenses can be overwhelming. A lot of people think Medicare is going to cover long-term care, and it doesn’t.

Long-term care is the biggest uninsured risk that Americans face. Health care expenses are the number one reason for individual bankruptcy, for all ages. When adults reach old age, quickly many individuals are unable to afford to have those services they need to stay alive and healthy.

A recipient of ARC’s services stands outside of a Clayton events center.

AP: Do most older people want to age in their homes and communities?

BK: Oh yes, by far. According to AARP, 77% of adults 50 and older want to remain in their home as they age. That figure has been consistent for more than a decade.

For one thing, some individuals don’t want to live in housing segregated by age. They are more comfortable in their own home. Especially if they have memory or vision loss, they may feel safer where they’re familiar with their surroundings, have relationships with their trusted neighbors, and are engaged in their communities.

For many people, their quality of life is better if they can remain safely in their own home with services and supports as needed.

AP: Do we rely too much on institutional settings for older people?

BK: All options for housing are a good fit for different people, depending on their goals, circumstances, and needs. There is no one-size-fits-all solution. This is a very diverse population in terms of needs and resources. Some individuals have a need for 24-hour care, and an assisted living or nursing facility may be a good fit for them. Other older adults may like the social benefits of independent living settings. That’s appealing to some.

It’s a mix of what they need and what they want. When it comes to public funding, Medicaid automatically pays for nursing homes for anyone who qualifies, but it doesn’t automatically pay for home- and community- based services. Instead, the state has to request a waiver from the federal government, and that program is capped, so there are usually waiting lists to get these services. And it’s never automatic. In Georgia, we are unable to meet the current demand for home- and community-based services.

AP: How have older people fared over the past two years?

BK: It’s been mixed. The bad news is that older adults died at much higher rates, got sick, and were hospitalized at much higher rates. And, because of the justifiable fear of getting COVID, they didn’t leave their homes, with many also refusing services they needed because they didn’t want people coming into their home. Some became very socially isolated. The pandemic, especially at the beginning, was very harsh on older adults.

The good news is that with COVID, we were reminded once again that older adults have amazing resilience. Based on ARC’s Metro Atlanta Speaks survey, we heard that they generally have had less anxiety and stress than younger people during the pandemic. They were also less likely to experience financial challenges. In general, the financial stress was lower for older persons than for younger age groups.

Other good news is that older adults got vaccinated pretty quickly and at high rates. Our region has incredibly high vaccination rates for older people. Almost 100% of older people in our region have had at least one vaccine, and the vaccine reduces the risk of serious illness and death.

AP: What can each of us do to fight ageism in our society?

BK: The first thing is a mindset change, which is not a small change. We all need to realize that each day we are getting older, and we will be an old person one day. Any time we are exhibiting ageist attitudes, we don’t admit what our age is, or we don’t embrace getting older, we are discriminating against our own future. Your future is as an older person.

We need to recognize that too many of our communities are not set up for older people to thrive. Many of our communities are set up for young adults. We need more communities where older people can move about freely and safely. We don’t have a housing stock that is accessible, why is that? Why are we building and buying houses we know we won’t be able to use in a few years? Why are we building showers without a no-step entrance?

We are not planning transportation for all ages. Many older people who cannot drive need transportation to go to the supermarket, the doctor, church, and to visit family and friends, rather than transportation to a workplace. How can we help them get to services they need and places they want to go? We haven’t designed that in our communities. Too often, we have had an ageist approach to planning.

AP: What are some of the blessings that come with aging?

BK: Resiliency, strength, and character. Generosity. Generosity of having the time to share wisdom and life stories. Some of these individuals are carrying on the culture, the multicultural understanding, and heritage of their families, and they are shared with future generations through the storytelling of our older family members

Many older people may have more time and maybe more resources and so they are often in position to give time or money generously. Volunteerism is much higher for older than for younger adults. They are able to give back to the community in meaningful ways, and this gives them meaning in their lives.


To search for services for older people and people with disabilities in the Metro Atlanta area, check out our Search Services page, or visit the Empowerline website to be connected with counseling. Portions of this article appeared previously in the Aging and Health section of the ARC News Center. 


Author: Aixa Pascual

Aixa M. Pascual is a writer, editor, and content creator who recently joined the ARC’s Center for Strategic Relations. A former journalist for BusinessWeek, TIME, People, and the AJC, Aixa also has experience in community relations, civic engagement and external affairs. She is originally from Puerto Rico and lives in Roswell. She expects to age in the Atlanta region.

Join Health Equity and Social Justice Discussion Club – Upcoming Sessions

The Ohio Chapter of the AAFP invites all AAFP members to participate in their discussion club and upcoming events in July, September, and November.  GAFP’s Public Health Committee encourages all Georgia Academy members to review this offering:

The Health Equity & Social Justice Discussion Club will alternate between traditional books and a curated collection of virtual content.

This club is a safe and respectful virtual space to discuss important literature on topics of social justice and health equity all from the comfort of your home or office. Guided conversations will provide unique opportunities for insightful reflection and open-minded sharing with your peers. Each session will take place via Zoom under the guidance of a physician moderator.

Members participating in the Health Equity & Social Justice Discussion Club can submit a Continuing Medical Education (CME) Reporting Form to the American Academy of Family Physicians (AAFP) member resource center to claim CME credit as a professional enrichment activity. Credit may be claimed, commensurate with participation, for partaking in other medical educational experiences and activities, such as informal self-learning activities. These activities may or may not be documented, and are not certified by the AAFP, AMA, AOA, but are of a nature of professional enrichment to the family physician.

Financial support for this program was provided by the AAFP Foundation to the Family Medicine Philanthropic Consortium (FMPC) and is funded by members like you! Help programs like this continue to support family medicine by giving to the AAFP Foundation. Select “Chapter Grants” when making your gift online. Thank you!

Thursday, July 21, @ 7:30 p.m. Discussion Registration Discussion Resources | Moderator: Mary Krebs, MD, FAAFP
  Providing Compassionate Care to Survivors of Domestic Violence

Participants will review a selection of virtual content including videos, articles, and blogs to inform their discussion.

Wednesday, September 21, @ 7:30 p.m. Discussion Registration | Moderator: Roxanne Cech, MD, FAAFP
  Canary in the Coal Mine: A Forgotten Rural Community: A Hidden Epidemic, and a Lone Doctor Battling for the Life, Health and Soul of the People

When author and family physician Will Cooke, MD, an idealistic young physician just out of medical training, set up practice in the small rural community of Austin, IN, he had no idea that much of the town was being torn apart by poverty, addiction, and life-threatening illnesses. But he soon found himself at the crossroads of two unprecedented healthcare disasters: a national opioid epidemic and the worst drug-fueled HIV outbreak ever seen in rural America.

Confronted with Austin’s hidden secrets, Dr. Cooke decided he had to do something about them. In taking up the fight for Austin’s people; however, he would have to battle some unanticipated foes: prejudice, political resistance, an entrenched bureaucracy―and the dark despair that threatened to overwhelm his own soul. Canary in the Coal Mine is a gripping account of the transformation of a man and his adopted community, a compelling and ultimately hopeful read in the vein of Hillbilly ElegyDreamland, and Educated.

Tuesday, November 29, @ 7:30 p.m. Discussion Registration | Moderator: Dana Vallangeon, MD
  Health Equity for Marginalized Populations Struggling with Homelessness, Mental Health, and Substance Use Disorder

Participants will review a selection of virtual content including videos, articles, and blogs to inform their discussion.


Advertorial: ASGE Colorectal Cancer Screening Campaign

The Georgia Academy is encouraging every physician in the state to visit the American Society for Gastrointestinal Endoscopy (ASGE) ‘Colorectal Cancer Screening Appropriate Use’ web page to download some great patient education resources, including a printable office/practice poster, patient letter templates (for positive and negative test results), and an article for local newspapers.     

ASGE Immediate-Past President Douglas Rex, MD, MASGE, explains, “More than 30 percent of U.S. adults aren’t getting screened for colon cancer and it’s a disease that has a 90 percent survival rate when detected early. Further, most cancers can be prevented through polyp removal at colonoscopy. So, this campaign will save many lives.” 

Dr.  Rex also stresses that, “It is crucial for physicians to help their patients understand which colorectal cancer screening option is appropriate for them, keeping in mind that this can vary for each individual based on their history and risk factors.”

Today, colorectal cancer screening is recommended to begin at 45 years of age and screening options include colonoscopy, fecal immunochemical test (FIT) and MT-sDNA (Cologuard).

Dr. Rex says, “Colonoscopy can be used to screen high- and average-risk patients, meaning patients with no history of precancerous colorectal polyps or cancer, or who have no symptoms. For those who have had previous colorectal cancer or precancerous polyps, then surveillance colonoscopy is the only appropriate tool to monitor the patient and prevent cancer. The same is true for patients with colorectal symptoms, who should only be evaluated by colonoscopy.”

He adds, “For asymptomatic average-risk patients undergoing screening, stool tests are also appropriate options for screening. Average-risk means that age is the only risk factor, and particularly when there is no strong family history of colorectal cancer.  For such patients, FIT and MT-sDNA tests can also be used for screening and are an alternative to colonoscopy. These tests aren’t appropriate options for high-risk screening patients, surveillance patients who have a history of adenomatous polyps, sessile serrated polyps or colorectal cancer, or symptomatic patients.”

ASGE recommends that patients of any age who are exhibiting symptoms (e.g., rectal bleeding, anemia, a change in bowel habits, persistent abdominal pain, or unintentional weight loss) or who are high-risk (e.g., they’ve had a pre-cancerous colorectal polyp or colorectal cancer) or whose family has a strong history of colorectal cancer should talk to their gastroenterologist or primary care physician about the need for colonoscopy.

Visit to download ASGE’s ‘Colorectal Cancer Screening Appropriate Use’ resources for physicians.

Physicians can refer their patients to for an easy-to-understand infographic on the appropriate screening test.

With nearly 15,000 members, ASGE has been the global leader in the GI field for more than 80 years. ASGE empowers its members with the latest information, state-of-the art education, and unparalleled professional resources. Visit for additional information.