Critical Analysis
General
According to the National Institute of Aging (2009), the population of people over 65 years old will exponentially increase in the coming years, from 508 million elderly individuals in 2008 to an estimated 1.3 billion in 2040. This dramatic increase in the elderly population is attributed to advances in modern health care and health care practices, improved nutrition, higher levels of education, and other socioeconomic factors. Age 65 is considered a milestone and marks the beginning of late adulthood, although our bodies have been going through the aging process since birth. 65 is a socially accepted age for retirement, eligibility for Social Security and Medicare benefits, income tax advantages, and reduced admission to leisure activities, such as movie theaters. Adults 65 years and older are included in Erik Erikson’s eighth and final stage of psychosocial development, known as Integrity vs. Despair. This stage is characterized by individuals reflecting back on their lives. A question that depicts elderly individuals’ thought process at this stage is “Did I lead a meaningful life?” As elderly people go through this reflection period, they will come away with either a sense of fulfillment from a life well lived or a sense of regret and bitterness over a life misspent. The positive or negative emotions elderly individuals experience through this reflective stage can help or hurt their lifestyle choices going forward that can affect healthy aging, such as not smoking, using healthy coping mechanisms, not abusing alcohol, maintaining a healthy weight and diet, remaining physically active, and remaining connected to family and friends.
Diseases and Health Conditions
It is important to note that while the mortality rate in the elderly population has decreased by 18%, the morbidity rate has increased (Hutchinson, 2008, p.367). This reveals that as elderly individuals are living longer, they are at higher risk of developing age-related chronic conditions, such as heart disease, cancer, stroke, Alzheimer’s disease, and diabetes. The co-morbidity of diseases and conditions present among the elderly population complicate the treatment and prognosis process. Comorbidity or multimorbidity is related to higher rates of death, disability, adverse effects, institutionalization, use of healthcare resources, and poorer quality of life (Boyd, 2011, p. 341). It is imperative for health care professionals to individualize treatment plans based on an individual’s physical and mental health and preferences, and actively involve the elderly patient in the decision making process. An elderly individual may prefer quality of life over quantity of life, which will determine the treatment plan that is best suitable. For example, less aggressive treatments for elderly cancer patients is common because the more aggressive treatments are too harsh for elderly individuals to withstand, especially if they are dealing with a combination of other health conditions. The prevalence of chronic conditions varies among gender, race, lifestyle, and ethnicity. Since all systems in the body are affected by the aging process, it is essential for social workers to understand the physical, biological, psychological, and socioemotional changes that are simultaneously occurring in the elderly population (Hutchinson, 2008, p. 396).
Informal and Formal Resources
Elderly persons receive support and assistance from informal and formal support networks. Informal resources include family, friends, neighbors, and religious and community groups. According to Hutchinson (2008), family members can provide better emotional support to the elderly than other sources of support. However, support from family and friends is dependent on each family’s structure, time availability, location, and financial means.
Formal resources are made up primarily of four different Social Security trust funds established to provide resources to the elderly population. These trust funds include: Old-Age and Survivors Insurance (OASI), Hospital Insurance Trust Fund (Medicare Part A), Supplementary Medical Insurance (Medicare Part B), and Disability Insurance. Each of these funds have a different eligibility requirements, costs, and services provided; therefore, it is the job of the social worker to connect elderly individuals to the most need appropriate program.
According to the National Institute of Aging (2009), the population of people over 65 years old will exponentially increase in the coming years, from 508 million elderly individuals in 2008 to an estimated 1.3 billion in 2040. This dramatic increase in the elderly population is attributed to advances in modern health care and health care practices, improved nutrition, higher levels of education, and other socioeconomic factors. Age 65 is considered a milestone and marks the beginning of late adulthood, although our bodies have been going through the aging process since birth. 65 is a socially accepted age for retirement, eligibility for Social Security and Medicare benefits, income tax advantages, and reduced admission to leisure activities, such as movie theaters. Adults 65 years and older are included in Erik Erikson’s eighth and final stage of psychosocial development, known as Integrity vs. Despair. This stage is characterized by individuals reflecting back on their lives. A question that depicts elderly individuals’ thought process at this stage is “Did I lead a meaningful life?” As elderly people go through this reflection period, they will come away with either a sense of fulfillment from a life well lived or a sense of regret and bitterness over a life misspent. The positive or negative emotions elderly individuals experience through this reflective stage can help or hurt their lifestyle choices going forward that can affect healthy aging, such as not smoking, using healthy coping mechanisms, not abusing alcohol, maintaining a healthy weight and diet, remaining physically active, and remaining connected to family and friends.
Diseases and Health Conditions
It is important to note that while the mortality rate in the elderly population has decreased by 18%, the morbidity rate has increased (Hutchinson, 2008, p.367). This reveals that as elderly individuals are living longer, they are at higher risk of developing age-related chronic conditions, such as heart disease, cancer, stroke, Alzheimer’s disease, and diabetes. The co-morbidity of diseases and conditions present among the elderly population complicate the treatment and prognosis process. Comorbidity or multimorbidity is related to higher rates of death, disability, adverse effects, institutionalization, use of healthcare resources, and poorer quality of life (Boyd, 2011, p. 341). It is imperative for health care professionals to individualize treatment plans based on an individual’s physical and mental health and preferences, and actively involve the elderly patient in the decision making process. An elderly individual may prefer quality of life over quantity of life, which will determine the treatment plan that is best suitable. For example, less aggressive treatments for elderly cancer patients is common because the more aggressive treatments are too harsh for elderly individuals to withstand, especially if they are dealing with a combination of other health conditions. The prevalence of chronic conditions varies among gender, race, lifestyle, and ethnicity. Since all systems in the body are affected by the aging process, it is essential for social workers to understand the physical, biological, psychological, and socioemotional changes that are simultaneously occurring in the elderly population (Hutchinson, 2008, p. 396).
Informal and Formal Resources
Elderly persons receive support and assistance from informal and formal support networks. Informal resources include family, friends, neighbors, and religious and community groups. According to Hutchinson (2008), family members can provide better emotional support to the elderly than other sources of support. However, support from family and friends is dependent on each family’s structure, time availability, location, and financial means.
Formal resources are made up primarily of four different Social Security trust funds established to provide resources to the elderly population. These trust funds include: Old-Age and Survivors Insurance (OASI), Hospital Insurance Trust Fund (Medicare Part A), Supplementary Medical Insurance (Medicare Part B), and Disability Insurance. Each of these funds have a different eligibility requirements, costs, and services provided; therefore, it is the job of the social worker to connect elderly individuals to the most need appropriate program.
Sexual Activity
Many older adults are often desexualized. Those in late adulthood are seen as disinterested in sex or incapable of having sex. Research has shown that the frequency of sexual activity begins to decrease with age starting around the age of fifty years old (NSSHB, 2010). However, many of the individuals in late adulthood are actively engaging in sex and sexual behaviors (Kessel, 2001) (Gurvinder, Alka & Charles, 2011)(Lindau et al, 2007). New medications such as Viagra have allowed for older adults to engage in sexual activity more often. However, it seems that with these new medications allowing for more sexual activity less attention has been paid to practicing safe sex. Now we are seeing rising numbers of STDs among seniors and less older adults wearing condoms (“HIV/AIDS and STD” 2011)(NSSHB, 2010). This is a large concern for this population group. It is important that practicing safe sex be promoted within this group. More research needs to be done on why older adults are not using condoms as frequently. This information can help in more effective promotion of safe sex within this community. There needs to be more information readily available to this population group in regards to this issue. Organizations like Safer Sex For Seniors have done a great job at creating handouts and fact sheets addressing issues specific to sexual activity within the older adult population. Resources like this can have a very positive impact and be very helpful to this community if they are available or accessible to older adults.
Living Arrangements for Older Adults
As people age their needs and desires become more diverse which will impact their living arrangements. According to AARP, helping older adults with preserving their autonomy, while meeting all of their needs, is key to choosing the best housing option (ND). Older adults have many types of housing options available. Careful consideration of all aspects of one’s life (health, recreational activities, finances, physical ability…) must be explored to determine the most appropriate choice to meet the housing needs of those who are aging. These choices include aging in place, living with family members, public housing, assisted living facilities, continuing care retirement communities, naturally occurring retirement communities and long term care facilities. Maintaining autonomy is possible in all housing options listed. Keys to maintaining autonomy include affordable, suitable housing options in communities that offer supportive services and adequate mobility that allows older adults to live independently not only in their own home, but in assisted living facilities, retirement communities, and long term care facilities (AARP. ND.). Many tools and resources are available to assist older adults, family members, and care givers with choosing the housing option that will provide comfort, safety autonomy and peace of mind for all involved.
Many older adults are often desexualized. Those in late adulthood are seen as disinterested in sex or incapable of having sex. Research has shown that the frequency of sexual activity begins to decrease with age starting around the age of fifty years old (NSSHB, 2010). However, many of the individuals in late adulthood are actively engaging in sex and sexual behaviors (Kessel, 2001) (Gurvinder, Alka & Charles, 2011)(Lindau et al, 2007). New medications such as Viagra have allowed for older adults to engage in sexual activity more often. However, it seems that with these new medications allowing for more sexual activity less attention has been paid to practicing safe sex. Now we are seeing rising numbers of STDs among seniors and less older adults wearing condoms (“HIV/AIDS and STD” 2011)(NSSHB, 2010). This is a large concern for this population group. It is important that practicing safe sex be promoted within this group. More research needs to be done on why older adults are not using condoms as frequently. This information can help in more effective promotion of safe sex within this community. There needs to be more information readily available to this population group in regards to this issue. Organizations like Safer Sex For Seniors have done a great job at creating handouts and fact sheets addressing issues specific to sexual activity within the older adult population. Resources like this can have a very positive impact and be very helpful to this community if they are available or accessible to older adults.
Living Arrangements for Older Adults
As people age their needs and desires become more diverse which will impact their living arrangements. According to AARP, helping older adults with preserving their autonomy, while meeting all of their needs, is key to choosing the best housing option (ND). Older adults have many types of housing options available. Careful consideration of all aspects of one’s life (health, recreational activities, finances, physical ability…) must be explored to determine the most appropriate choice to meet the housing needs of those who are aging. These choices include aging in place, living with family members, public housing, assisted living facilities, continuing care retirement communities, naturally occurring retirement communities and long term care facilities. Maintaining autonomy is possible in all housing options listed. Keys to maintaining autonomy include affordable, suitable housing options in communities that offer supportive services and adequate mobility that allows older adults to live independently not only in their own home, but in assisted living facilities, retirement communities, and long term care facilities (AARP. ND.). Many tools and resources are available to assist older adults, family members, and care givers with choosing the housing option that will provide comfort, safety autonomy and peace of mind for all involved.
Elder Abuse
Elder abuse is a growing problem in the United States. Though, due to under-reporting of elder abuse and inaccurate statistics, the true realm of the problem is not known. The term elder abuse is a very broad phrase that encompasses every type of mistreatment endured by older adults. It includes physical, sexual, psychological and financial abuse, as well as neglect and self-neglect. Elder abuse can be perpetrated in the home or in institutional settings such as assisted living facilities and nursing homes. There is no specific “victim type” of elder abuse. Victims come from all cultures,
races, socioeconomic statuses and either gender can experience abuse, though victims tend to be frail and vulnerable. Perpetrators of abuse are also varied, by race, age, socioeconomic status and gender-males and females abuse elders
at a near equal rate. According to the National Center on Elder Abuse, family members constitute 90% of elder abuse perpetrators-50% of those are adult children and 20% are spouses or intimate partners. The remaining abusers include, other family members, friends, service providers, and caregivers. There is no definitive “best practice” technique to address elder abuse, though the National Center on Elder Abuse finds that a multidisciplinary approach to the identification and management of elder abuse is key. Professionals, including social workers, health care providers, law
enforcement and law makers, need to work in conjunction with one another to research and develop community approaches for addressing elder abuse. Other intervention and prevention practices include elder abuse education for caregivers and elder service providers to aid in their ability to recognize signs of abuse and neglect and increase reports of these acts. Raising awareness for ordinary citizens to be aware of the problem and know how to report any suspicions of abuse they may have. Finally, there needs to be more support systems in place to aid family members and caregivers of older adults to assist with the provision of care and to educate caregivers in recognizing signs of stress and feelings of becoming overwhelmed before their care giving skills collapse to the point of abuse or neglect.
Elder abuse is a growing problem in the United States. Though, due to under-reporting of elder abuse and inaccurate statistics, the true realm of the problem is not known. The term elder abuse is a very broad phrase that encompasses every type of mistreatment endured by older adults. It includes physical, sexual, psychological and financial abuse, as well as neglect and self-neglect. Elder abuse can be perpetrated in the home or in institutional settings such as assisted living facilities and nursing homes. There is no specific “victim type” of elder abuse. Victims come from all cultures,
races, socioeconomic statuses and either gender can experience abuse, though victims tend to be frail and vulnerable. Perpetrators of abuse are also varied, by race, age, socioeconomic status and gender-males and females abuse elders
at a near equal rate. According to the National Center on Elder Abuse, family members constitute 90% of elder abuse perpetrators-50% of those are adult children and 20% are spouses or intimate partners. The remaining abusers include, other family members, friends, service providers, and caregivers. There is no definitive “best practice” technique to address elder abuse, though the National Center on Elder Abuse finds that a multidisciplinary approach to the identification and management of elder abuse is key. Professionals, including social workers, health care providers, law
enforcement and law makers, need to work in conjunction with one another to research and develop community approaches for addressing elder abuse. Other intervention and prevention practices include elder abuse education for caregivers and elder service providers to aid in their ability to recognize signs of abuse and neglect and increase reports of these acts. Raising awareness for ordinary citizens to be aware of the problem and know how to report any suspicions of abuse they may have. Finally, there needs to be more support systems in place to aid family members and caregivers of older adults to assist with the provision of care and to educate caregivers in recognizing signs of stress and feelings of becoming overwhelmed before their care giving skills collapse to the point of abuse or neglect.
Psychology and the Elderly
Elder suicide has an overwhelming rate in the United States. 13% of the US population is age 65 and older and that group accounts for 18% of the suicide rate in this country (suicide.org, 2013). Educating care takers, families and the older adult population about mental health care is paramount in regards to the reduction of suicide rates among this age group. There are multiple help lines, crisis centers and 0rganizations that are available to assist. By promoting mental health, therapeutic ways to stay physically and mentally healthy and displaying the avenues of easily accessible interventions will not only improve mental stability, but will give hope to older adults who struggle with such issues. Education is power and with power there is hope to change negative situations to positive and make healthy, the lives of our older adults. Future studies can focus on ways to promote mental health for the older adult population that is appealing to their age group. By tailoring activities and assessments to what they like will attract their attention and help recognize the seriousness of this issue. The more participants, the better and the better our world will be as more and more people approach older adulthood.
Elder suicide has an overwhelming rate in the United States. 13% of the US population is age 65 and older and that group accounts for 18% of the suicide rate in this country (suicide.org, 2013). Educating care takers, families and the older adult population about mental health care is paramount in regards to the reduction of suicide rates among this age group. There are multiple help lines, crisis centers and 0rganizations that are available to assist. By promoting mental health, therapeutic ways to stay physically and mentally healthy and displaying the avenues of easily accessible interventions will not only improve mental stability, but will give hope to older adults who struggle with such issues. Education is power and with power there is hope to change negative situations to positive and make healthy, the lives of our older adults. Future studies can focus on ways to promote mental health for the older adult population that is appealing to their age group. By tailoring activities and assessments to what they like will attract their attention and help recognize the seriousness of this issue. The more participants, the better and the better our world will be as more and more people approach older adulthood.