Practice Recommendations
Psychology
In the older adult phase of life, mental health is very important to possess. Anxiety and depression reigns prevalent within this stage of life. There are multiple ways to gain mental and emotional balance and diminish the rates of suicide, depression, substance abuse and forms of anxiety. It is recommended that older adults take the time to utilize tools that are available to them such as scales and questionnaires that are designed to assess symptoms and monitor treatment progress (Administration on Aging, 2013). After participating in the assessments and questionnaires the older adult is able to make their next decision on what should be sought after, whether it is treatment or continuing their day-to-day lifestyle. Please see links below that will lead you to screening assessments and questionnaires for your journey to positive mental health:
Screenings and Questionnaires:
Geriatric Depression Scale (GDS): A 15-item screening measure for depression in older adults.
(http://www.stanford.edu/~yesavage/GDS.html).
Those who reach the age of 65+ must take the assessments, at home or with a doctor, as a new policy in the United States. By going through assessment and attaining the help needed negative rates will be reduced and positive outcomes will manifest.
(Information acquired from Administration on Aging website)
In the older adult phase of life, mental health is very important to possess. Anxiety and depression reigns prevalent within this stage of life. There are multiple ways to gain mental and emotional balance and diminish the rates of suicide, depression, substance abuse and forms of anxiety. It is recommended that older adults take the time to utilize tools that are available to them such as scales and questionnaires that are designed to assess symptoms and monitor treatment progress (Administration on Aging, 2013). After participating in the assessments and questionnaires the older adult is able to make their next decision on what should be sought after, whether it is treatment or continuing their day-to-day lifestyle. Please see links below that will lead you to screening assessments and questionnaires for your journey to positive mental health:
Screenings and Questionnaires:
Geriatric Depression Scale (GDS): A 15-item screening measure for depression in older adults.
(http://www.stanford.edu/~yesavage/GDS.html).
- Patient Health Questionnaire (PHQ-9): A 9-item scale that assesses DSM-IV depression criteria (http://www.phqscreeners.com). The first two questions of the PHQ- 9 are often referred to as the PHQ-2 and can be used to identify the need for a more complete assessment of depressive symptoms using the PHQ-9 or GDS.
- The Generalized Anxiety Disorder 7-item Scale (GAD-7): A 7-item scale that assesses common anxiety symptoms.
Those who reach the age of 65+ must take the assessments, at home or with a doctor, as a new policy in the United States. By going through assessment and attaining the help needed negative rates will be reduced and positive outcomes will manifest.
(Information acquired from Administration on Aging website)
Elder Abuse
It is recommended that social workers, health care workers and other professionals who serve the older adult population, assess their clients for elder abuse. This practice recommendation is based the lack of accurate statistics regarding the rate of elder abuse in the United States. Several aspects are involved in the lack of elder abuse statistics; elders may fear retaliation by the perpetrator and do not report, many abuse victims lack the ability to report due to physical and mental health issues such as dementia, stroke, injuries related to falls, etc., signs of abuse may be missed by caregivers due to the lack of education regarding detection of elder abuse and with the vast majority, 90%, of elder abusers being family members, their victims may not report because they care about their abuser and do not want to see them face criminal charges. It is recommended that trained social workers, health care workers, etc., who serve the older adult population utilize a screening measure such as, the Indicator of Abuse (IOA) screening tool, to identify risk factors for elder mistreatment and potential cases of elder abuse. The identification of risk factors and cases of abuse, could provide much needed data to improve the accuracy of statistics of elder abuse. The identification of risk factors as well as accurate statistics would improve risk profiles for both victims and abusers which would aid in the development of prevention programs that address elder abuse (Pillemer, K. et al. 2011).
It is recommended that social workers, health care workers and other professionals who serve the older adult population, assess their clients for elder abuse. This practice recommendation is based the lack of accurate statistics regarding the rate of elder abuse in the United States. Several aspects are involved in the lack of elder abuse statistics; elders may fear retaliation by the perpetrator and do not report, many abuse victims lack the ability to report due to physical and mental health issues such as dementia, stroke, injuries related to falls, etc., signs of abuse may be missed by caregivers due to the lack of education regarding detection of elder abuse and with the vast majority, 90%, of elder abusers being family members, their victims may not report because they care about their abuser and do not want to see them face criminal charges. It is recommended that trained social workers, health care workers, etc., who serve the older adult population utilize a screening measure such as, the Indicator of Abuse (IOA) screening tool, to identify risk factors for elder mistreatment and potential cases of elder abuse. The identification of risk factors and cases of abuse, could provide much needed data to improve the accuracy of statistics of elder abuse. The identification of risk factors as well as accurate statistics would improve risk profiles for both victims and abusers which would aid in the development of prevention programs that address elder abuse (Pillemer, K. et al. 2011).
Living Arrangements for Older Adults
A housing strategy that allows older adults the opportunity to age in place are Naturally Occurring Retirement Communities (NORCs). NORCs are communities with a large population of older residents. NORCs generally occur naturally, a population of similar aged individuals who remain in their residence and age together thus created an aged community. NORCs provide the residents the opportunity to age in place by addressing care and service needs through community partnerships with social service providers, government programs and philanthropic organizations, while allowing them to maintain their autonomy (www.norc.org).
In the 1980’s, the Federation of Jewish Philanthropies of New York, began a new model of community-based social services that promoted healthy aging and independence that became known as NORCs (www.norcs.org). The vital components of NORCs consist of case management, social work services, health care management, and prevention programs that include education, socialization and recreational activities for its residents (www.norcs.org). This early model provided a much needed housing option for our aging adult community.
The 2010 U.S. Census reported the population of older adults, age 65 and up, was 40,267,984, an increase in over 15% from the 2000 census (2011). According to the Administration on Aging, this number is expected to grow to 72.1 million by the year 2030. Existing housing choices will not be abundant enough to meet the needs of this growing population. Many of these older adults will want, or need, to remain living in their own home, even as the natural complications of aging impact their ability to do so. It is paramount that policy makers, program managers and researchers work together to maintain and create new housing options to meet the needs the older adult population.
NORCs are a housing strategy, that research shows, is ideal for our aging population,. Aging adults can remain in their homes while their physical, social, psychological and other needs, associated with aging, are met. NORCs unite housing communities, their multigenerational residents, health and social service providers, etc. before any crisis related to aging occurs and provides for the changing needs of the aging population (www.norcs.org). .
According to Siegel and Rimsky (2013), NORCs rely heavily on volunteers to provide the support that the older community members require (p.233). This is a win-win situation. It allows the older community members to receive supportive services that will aid them in remaining in their home. These services can include transportation assistance, meal preparation, handyman services, etc., and are obtained from the younger resident volunteers. Siegel and Rimsky (2013) also find that, this multigenerational interaction also allows the older adults to share their time, expertise, experience and wisdom with younger community members, providing them with dignity, self-worth and the opportunity to continue to build upon their community connections (p.233). This interaction is not only a factor of appeal for NORCs but also key to allowing our older adults the opportunity to maintain autonomy and dignity as they age (Siegel & Rimsky. 2013. p 233).
Health Care Practices
According to the American Geriatrics Society (2012), over 50% of adults 65 years old or older have three or more chronic health conditions, known as comorbidity or multimorbidity. The presence of a combination of conditions or diseases makes the evaluation, treatment, and prognosis of diseases complicated. There are effective strategies and interventions for common diseases among the elderly, such as diabetes and cancer, but the main issue with currently used healthcare model is the lack of inclusion of comorbidities. Most clinical practice guidelines (CPG) concentrate on the management of a single disease, which makes CPG based care impractical and even harmful for individuals dealing with comorbidities. Older adults with comorbidities are often excluded or underrepresented in observational studies and trials, which results in deficiencies of guideline development and implementation for CPG based care in patients with multiple conditions. This highlights the need for more research on the growing elderly population in order to optimize health care outcomes and enhance quality of life (American Geriatrics Society, 2012).
According to the American Geriatrics Society (2012), over 50% of adults 65 years old or older have three or more chronic health conditions, known as comorbidity or multimorbidity. The presence of a combination of conditions or diseases makes the evaluation, treatment, and prognosis of diseases complicated. There are effective strategies and interventions for common diseases among the elderly, such as diabetes and cancer, but the main issue with currently used healthcare model is the lack of inclusion of comorbidities. Most clinical practice guidelines (CPG) concentrate on the management of a single disease, which makes CPG based care impractical and even harmful for individuals dealing with comorbidities. Older adults with comorbidities are often excluded or underrepresented in observational studies and trials, which results in deficiencies of guideline development and implementation for CPG based care in patients with multiple conditions. This highlights the need for more research on the growing elderly population in order to optimize health care outcomes and enhance quality of life (American Geriatrics Society, 2012).