Services For the Aged

1
Services For the Aged

• Chapter 15

2
Introduction

• He who is of a calm and happy nature will hardly
  feel the pressure of age, but to him who is of an
  opposite disposition, youth and age are equally a
  burden.
• Plato

3
Introduction

• At the present time there are approximately
  25,000 Americans over the age of 100.
• Today, those over 65 have better health because
  of an awareness of the benefits of a moderate
  lifestyle, better nutrition, increased physical
  activity, and better care from the medical
  profession.
• The great majority of them do not fit the
  stereotype of rocking-chair sitters, slow and
  poor and sick elderly people.

4
Introduction

• In the 50s the poverty rate for those over 65
  was 35.2 percent by 1995 it was reduced to 10.3
  percent.
• In 1900 there were approximately 3 million people
  65 and older in the United States.
• In l950 there were approximately 12.4 million,
  and projections made by the Bureau of the Census
  place the number in the year 2000 at 35 million.
• By 2030 there will be 8 million Americans in the
  85 population, the ones most in need of health
  care and social programs.

5
Older Americans Act of 1965

• The Older Americans Act provides for
• Financial aid
• Community services
• Research into problems of the elderly
• Support for mental health
• Suitable housing
• Opportunity for employment
• Pursuit of meaningful activity
• Freedom, independence, and the free exercise of
  individual initiative in planning and managing
  their own lives.

6
White House Conference on Aging, 1971

• Four goals were set for making life more
  rewarding for the elderly
• An adequate income
• Appropriate living arrangements
• Institutional responsiveness and a new attitude
  toward aging
• Independence and dignity

7
Adequate Income

• The amount paid to individuals by Social Security
  changes when Consumer Price Index increases.
• In the latter part of 1999, Congress moved
  unanimously to reduce all limitations on earnings
  for individuals over 65.
• This means that individuals over 65 can receive
  full social security benefits and maintain
  full-time jobs.
• This new law encourages seniors to work full time
  longer, which, in turn, will contribute to
  society.

8
Adequate Income

• It is apparent that with the aging of baby-
  boomers the Social Security system as we now
  know it will be bankrupt if nothing new is done.
• President Clinton made a speech where he stated
  that after 2029, if no action is taken the trust
  fund will only be enough to cover 75 cents on the
  dollar of current benefits.

9
Appropriate Living Arrangements

• Appropriate living arrangements mean the elderly
  can continue to live in their own homes and
  services are provided to help them live in their
  own homes.
• For those elderly who are well enough to stay at
  home, but need some help, a variety of social and
  health services have been started.
• These include homemaker services, meals on
  wheels, visiting nurses, shopping, and counseling.

10
Case Management

• In an effort to keep old people in their homes as
  long as possible, implementing a concept of case
  management is a useful method.
• When elderly parents are cared for in their
  childrens homes the primary caregiver is usually
  a daughter.
• Case management helps old people to remain in
  their own homes by providing home health
  assistance and assistance tailored to individual
  needs.

11
Institutional Responsiveness and A New Attitude
Toward Aging

• No one ever dies of old age there is no such
  disease, according to the American Medical
  Association.
• About 75 percent of the elderly have suffered one
  or more chronic illnesses by age 75.
• Medical problems of the elderly include
• Heart disease
• Hypertension
• Diabetes
• Arthritis
• Loss of hearing

12
Institutional Responsiveness

• Medicare is limited in its ability to provide
  adequate health care.
• Some of the most frequently mentioned
  shortcomings are that it does not pay for
  long-term care in nursing homes, prescription
  drugs, eyeglasses, dental expense, or hearing
  aids.

13
Institutional Responsiveness

• Many older persons do not get adequate medical
  care because
• They are afraid they have terminal illness and do
  not seek help.
• See no need for regular check-ups.
• Afraid they cannot pay for the services.
• They or their families dismiss the symptoms as
  just a part of aging.
• They are afraid of hospitals.

14
Nursing Homes

• Nursing homes fill a genuine need among the
  elderly and are considered a prelude to death by
  many who go there.
• Some nursing homes provide the following
• Social workers to interpret their program to
  patient and family
• Social workers to help families share their grief
  and guilt
• Educational programs for patients
• Social programs for patients.

15
Mental Health

• Between 15 and 25 percent of the elderly living
  in the community are said to have moderate to
  severe psychiatric impairment.
• Major socio-psychological barriers to good mental
  health in later years are the inability to bounce
  back from psychosocial losses and failure to
  maintain meaningful life goals.

16
Independence and Dignity

• Senior citizens need to maintain a high degree of
  independence and self-mastery resulting in
  self-respect and dignity.
• People need the reward of secure place in the
  world where they have a serene sense of belonging
  and of adding significantly to society.
• Dignity and self-worth are qualities the majority
  of older people are able to maintain.

17
Employment and Retirement

• The retirement age of 65 should be waived for
  those who want to continue to work.
• Some gerontologists feel that the changes in
  ones life at retirement constitute the most
  critical major adjustment an older person has to
  make.
• Those who have retired from gainful employment
  are an important group in shaping government and
  consumer issues.

18
Employment and Retirement

• Volunteer work by the elderly gives many an
  opportunity to contribute to society and provides
  an outlet for their skills and knowledge.
• For those who want to continue working, two
  factors must be considered who wants to earn
  money and who wants to give of their time in
  public service.

19
The Aging Are Individuals Too

• Social workers like to work with the aged because
  each human being has value, they are often people
  society has lost interest in, and there is a
  search for what life has been, and the dreams and
  accomplishments of their work.
• Among the elderly, those particularly at high
  risk are
• Racial and ethnic minorities
• Widows
• The poor
• Physically impaired
• Emotionally fragile