papre ch14

profileitstrmtrm
COBH5_4607CH14.ppt
Home>Education homework help>papre ch14

Chapter 14
Reframing Aging Issues to Ensure a Better Future

Objectives (1 of 3)

Understand that countries throughout the world are experiencing aging at different rates because of different social, political, economic, and environmental opportunities, and be able to explain some of the reasons for this and consequences of it.

Objectives (2 of 3)

Describe ways in which structural inequalities create unequal opportunities for healthy aging and explain the challenges for policies to be relevant to current societal needs.

Understand and describe the respective and collaborative roles of the family and healthcare professionals in caring for frail older adults.

Objectives (3 of 3)

Explain how individual beliefs influence health in late life.

Identify the critical role of healthcare professionals in the field of aging in shaping a more positive social environment for the future.

Aging: A Global Perspective (1 of 4)

  • In 2015, the global population over age 65 was 562 million
  • 8% of the world population
  • Developed nations sustain larger older populations better due to:
  • Better access to health care and technology
  • Greater economic prosperity

Aging: A Global Perspective (2 of 4)

  • Age composition
  • Distribution by age within populations
  • Vast majority of African countries have a younger age structure due to recent improvements in:
  • Nutrition
  • Vaccinations
  • Sanitation

Aging: A Global Perspective (3 of 4)

  • Rate of aging is expected to outpace previous growth over the next 50 years
  • Population aging is a global issue
  • Nearly every aspect of life is affected
  • Nations worldwide are looking for solutions to the challenges related to living and working longer

Aging: A Global Perspective (4 of 4)

  • Failure to think deeply about population aging is a weakness in gerontology as a discipline
  • Nations cannot rely solely on known trends within their populations
  • Unknown realities remain
  • Structural changes among the older adult population are anticipated

Aging as a Social Enterprise
(1 of 12)

  • U.S. government began providing assistance to the older adult population in the 1930s
  • Programs based on need and entitlement have contributed to enhanced older adults’:
  • Economic security
  • Social engagement
  • Health
  • Well-being

Aging as a Social Enterprise
(2 of 12)

  • As each generation reaches age 65, it distinguishes itself from the previous generation by bringing new challenges and demands
  • When policies do not keep pace with changing demographics and social circumstances, structural lag occurs

Aging as a Social Enterprise
(3 of 12)

  • Structural inequalities
  • Biopsychosocial factors contribute to the heterogeneity among older individuals:
  • Race, gender, and age
  • Living arrangement
  • Socioeconomic status
  • Sexual orientation and sexual identity
  • Marital status

Aging as a Social Enterprise
(4 of 12)

  • Cumulative advantage/disadvantage (CAD) framework
  • Lifetime of exposures and experiences accumulate and provide a partial explanation for health disparities found in late life
  • Aging is not uniform across the population
  • Individuals experiencing cumulative disadvantage may be vulnerable to preventable adverse health outcomes

Aging as a Social Enterprise
(5 of 12)

  • Socioeconomic security
  • Educational attainment
  • Key to gaining access to employment opportunities, achieving economic prosperity, and enabling retirement security
  • Newer cohorts of older adults report more years of schooling than previous cohorts
  • Bodes well for improved health and well-being among the aging population in the future

Aging as a Social Enterprise
(6 of 12)

  • Employment opportunities
  • Older adults are physically and mentally able to work longer today than in the past
  • Labor force participation among older adults continues to rise in the United States
  • Individuals with higher educational attainment typically remain in the workforce longer
  • Individuals with less education often have more physically demanding jobs at lower wages

Aging as a Social Enterprise
(7 of 12)

  • Financial security in retirement
  • Historically a three-legged stool, with contributions coming from Social Security, workplace pension, and personal savings
  • Now Social Security provides the largest source of retirement income for older adults
  • Individuals with higher-paying jobs are more likely to accrue a pension and have enough money to save for retirement

Aging as a Social Enterprise
(8 of 12)

  • Considerable variability of success by Social Security in keeping individuals out of poverty
  • Older individuals with the greatest need to continue working into late life are most likely not able to continue working because of cumulative disadvantages affecting their health

Aging as a Social Enterprise
(9 of 12)

  • Health inequalities
  • Overall improvements in health have been observed among older adults
  • Chance to grow old and have relatively good health is unequal
  • People with the greatest need often have the fewest resources available
  • Geographic disparities continue to prevail

Aging as a Social Enterprise
(10 of 12)

  • Telehealth
  • Supports and promotes long-distance clinical health care and health-related education through telecommunications technologies
  • Reduces burden of travel
  • Improves monitoring of health conditions
  • Enhances timely communication
  • Patient-centered

Aging as a Social Enterprise
(11 of 12)

  • Health care
  • Rising costs are a major concern
  • Large portion of healthcare expenditures specifically cover prescription drugs, nursing home care, and home health services
  • Benefits of technological innovations may outweigh concerns about rising costs

Aging as a Social Enterprise
(12 of 12)

  • Health care for older adults is available through a variety of insurance programs
  • Often combines:
  • Individual resources (out-of-pocket or private insurance)
  • Public health insurance (Medicare)
  • Need-based insurance (Medicaid)
  • Affordable Care Act (ACA) expanded health care coverage, but may be repealed

Aging as a Family Affair (1 of 15)

  • Family caregiving
  • Family members provide more than 90% of long-term care to older adults
  • Changing demographic trends are creating a new reality for family caregiving
  • Caregiver support ratio is projected to decline from 7:1 to 3:1 by 2050

Aging as a Family Affair (2 of 15)

  • Families often provide care and support
  • Hierarchy of caregivers:
  • Spouse
  • Adult children
  • Extended kin
  • Formal service providers
  • Changing family formations also changes expectations of providing care to older adults

Aging as a Family Affair (3 of 15)

  • Concept of family care needs to be strengthened
  • Should be diversified to include new family structures
  • Important to attend to the needs of caregivers to reduce risk of burnout and adverse health outcomes

Aging as a Family Affair (4 of 15)

  • Emotional and health impacts
  • Caregiving experience is shaped by:
  • Care recipient’s level of need
  • Caregiver’s own problems
  • Caregiver’s strengths
  • Availability of support
  • Having more information and support would likely reduce risk of adverse health outcomes for the caregiver

Aging as a Family Affair (5 of 15)

  • Caregivers are:
  • At increased risk of health problems, including:
  • Stress
  • Depression
  • Anxiety
  • Chronic physical health concerns
  • More likely to miss or delay seeking preventive healthcare visits

Aging as a Family Affair (6 of 15)

  • Caregivers experience psychosocial benefits from caregiving
  • View caregiving as a rewarding experience
  • Older adults benefit from informal care
  • May retain a sense of autonomy
  • Express less concern about inadequate care
  • Experience greater satisfaction and higher quality of life

Aging as a Family Affair (7 of 15)

  • Economic costs
  • Informal caregivers are rarely compensated
  • Caregiving responsibilities may interfere with employment and can create a financial burden
  • About 1 in 5 caregivers report financial stress
  • Attempts to shift more care on families would have unequal ramifications for disadvantaged groups

Aging as a Family Affair (8 of 15)

  • Caregiver policies are currently a patchwork of uncoordinated services that do not meet the current needs of caregivers
  • Policies and programs are needed to promote:
  • Financial support
  • Flexible employment
  • Social support

Aging as a Family Affair (9 of 15)

  • Family and Medical Leave Act of 1993
  • Allows eligible employees up to 12 weeks of unpaid, job-protected leave
  • Modifying policies like FMLA can:
  • Extend protections for new caregiving arrangements
  • Compensate for cumulative disadvantage across the life course

Aging as a Family Affair (10 of 15)

  • A Matter of Balance program
  • Originally a professional-led health promotion program to reduce the rate of falling among older adults
  • Modified to become a trained volunteer lay leader model

Aging as a Family Affair (11 of 15)

  • Formal caregiving
  • Often a last resort to help care recipients remain in their homes and communities for as long as possible
  • Affordable services and supports are available through Medicaid or the Older Americans Act for vulnerable families
  • Typically complements rather than replaces ongoing family care

Aging as a Family Affair (12 of 15)

  • Home and community-based services (HCBS)
  • Part of a coordinated system of care that is person-centered, effective, and efficient in addressing diverse needs of older adults
  • Help with medical and nonmedical needs of people with chronic conditions
  • Availability and type of services vary
  • Contributes positively to the quality of life of recipients

Aging as a Family Affair (13 of 15)

  • HCBS (continued)
  • Eligibility is often based on income
  • Near-risk populations who perceive a need for assistance but do not meet the criteria are overlooked
  • Variety of resources paying for services contributes to service fragmentation
  • Less expensive than institutionalized care

Aging as a Family Affair (14 of 15)

  • Direct-care workforce (DCW)
  • Comprised of nursing assistants, home health aids, and personal care or home care aides
  • Provide supportive, nonmedical services
  • Number of DCWs needs to grow with the rapidly aging population
  • Workers are perceived as unskilled, untrained, underpaid, and overworked
  • Acute shortage of workers

Aging as a Family Affair (15 of 15)

  • DCW could attract and retain quality workers by:
  • Offering living wages and extended labor protections
  • Providing innovative training
  • Creating a better work environment

Aging as an Individual Experience (1 of 6)

  • Self-perceptions and attitudes
  • Ageism at the societal level
  • Restricts lives and livelihood of older adults by limiting work opportunities and restricting access to health care
  • Ageism at the individual level
  • We all tend to hold some level of ageist beliefs
  • Self-perceptions about age affect our behaviors and health

Aging as an Individual Experience (2 of 6)

  • Ageist ideas and stereotypes can affect individuals’ health at any age
  • Negative attitudes are associated with adverse health outcomes
  • Positive attitudes are associated with greater longevity and likelihood of engaging in positive health practices
  • Effects of negative and outdated stereotypes extends to the family, community, and society

Aging as an Individual Experience (3 of 6)

  • Prevalence of ageism is magnified by social media, television, and film
  • Even prevalent within groups of older adults
  • We can adjust our views to redefine productivity, forging new pathways for older adults in society
  • Awareness is the first step

Aging as an Individual Experience (4 of 6)

  • Health behaviors
  • Cumulative inequality theory
  • Early disadvantage in childhood increases risk of exposure to additional risks later in life
  • Increased life expectancy does not equate to increased healthy life expectancy
  • Many individuals are at risk of living more years with functional limitations and poorer health

Aging as an Individual Experience (5 of 6)

  • Various factors contribute to health outcomes across the life course
  • Early childhood disadvantage
  • Individual and familial beliefs about aging
  • Racial and ethnic minority groups tend to have lower socioeconomic positions

Aging as an Individual Experience (6 of 6)

  • Prevention has the potential to improve the likelihood of healthier years throughout life
  • Primary care offices are in a position to support prevention programs and efforts with the appropriate supports and incentives to conduct preventive screenings
  • Interventions can target modifiable factors to reduce risk of further decline

Conclusion (1 of 4)

  • The concerns facing our current aging population will persist, and potentially intensify, in the future
  • Structural inequalities, unless specifically addressed, are likely to proliferate
  • Strong family commitments to provide care for one another are likely to continue
  • Filial expectations can contribute to the development of adverse outcomes for caregivers

Conclusion (2 of 4)

  • Support for informal caregivers is a growing need
  • Person-centered collaborations with the direct care workforce could potentially alleviate some of the unique challenges associated with each group

Conclusion (3 of 4)

  • If aging issues go unaddressed, there are potential negative long-term ramifications:
  • Internalized negative beliefs about aging will adversely affect health
  • Providing care to older adults will continue to take its toll on informal and formal caregivers
  • Systemic inequalities will continue to provide unequal opportunities for health and well-being in late life

Conclusion (4 of 4)

  • Responsibilities of healthcare professionals
  • Develop an awareness of how ageism can be communicated
  • Reflect on your own personal biases toward age
  • Empower and encourage decision-making among older adult clients
  • Develop skills to enhance your cultural competencies to meet the diverse needs of an aging population