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"At present nursing homes are designed . . . like outmoded zoos. Residents are kept in small rooms, emotionally isolated. Occasionally they are visited by family members who reach through the bars and offer them treats. Aides keep their bodies clean and presentable. . . . America invests huge amounts of money to maintain the body while leaving the person to languish, cut off from all they love." From Nobody's Home
After caring for his mother at the end of her life, Thomas Edward Gass felt drawn to serve the elderly. He took a job as a nursing home aide but was not prepared for the reality that he found at his new place of employment, a for-profit long-term-care facility. In a book that is by turns chilling and graphic, poignant and funny, Gass describes America s system of warehousing its oldest citizens.
Gass brings the reader into the sterile home with its flat metal roof and concrete block walls. Like an industrial park complex, it is clean, efficient, and functional. He is blunt about the institution s goal: keep those faint hearts pumping and the life savings and Medicaid dollars rolling in. With 130 beds in the facility, the owner grosses about three million dollars annually. As a relatively well-paid aide, Gass made $6.90 an hour.
Seventeen of the twenty-six residents on Gass s hall were incontinent, and much of his initiation to the work was learning to care for them in the most intimate ways. One of the many challenges was the limited time that he had available for each of his charges 17.3 minutes per day by his calculation. Even as he learned to ignore all but the most pressing demands of the residents, he discovered the remarkable lengths to which aides and their patients will go to relieve the constant ache of loneliness at the nursing home.
With Americans living longer than ever before, elder care is among the fastest growing occupations. This book makes clear that there is a systemic conflict between profit and extent of care. Instead of controlling costs and maximizing profits, what if long-term care focused on our basic need to lead meaningful and connected lives until our deaths? What if staff members dropped the feigned hope of forestalling the inevitable and concentrated on making their charges comfortable and respected? These and other questions raised by this powerful book will cause Americans to rethink how nursing homes are run, staffed, and financed as well as the circumstances under which we hope to meet our end."
Is the United States prepared for the Baby Boomers to grow old? This book seeks to answer these questions. It also suggests strategies to make sure that the answer to these questions becomes YES.
Much has been written about the Baby Boom generation but this is the first book to address current issues they face while simultaneously projecting ahead to challenges and benefits that are likely to characterize this next generation of older persons. It is based on keynote presentations by noted leaders in the field of aging, who discuss their expectations of their old age. Thus, it is both an introductory primer to aging today as well as a book that raises questions, suggests solutions, and indicates avenues of planning for the future.
The book takes a close look at the state of readiness of health and social service providers for the large numbers of older persons in society's future. A careful look is taken at what is and what might be in the areas of income security, health security and health care, long-term care, and housing and living arrangements. The importance of this book lies in the fact that it addresses the lack of planning by both the Baby Boomers and services providers, and identifies steps to be taken, with particular emphasis given to needed changes in the education of health and social service professionals to prepare them for what lies ahead.
Almost forty percent of American adults age sixty-five and over spend some time in a nursing home, and residents in nursing homes will be increasingly diverse racially and ethnically because of changing demographics. The decision to place a family member in a nursing home is often extremely difficult, especially when the family belongs to a group with a strong tradition of filial responsibility. Despite these realities, little has been written about the stresses families of diverse cultural backgrounds experience in making this challenging decision.
This book describes the experiences of seventy-five African American and Afro-Caribbean, white Jewish, and Latina/o residents and their relatives and friends who have been their caregivers. Integrating original qualitative research with quantitative data and theoretical perspectives and findings from other studies, Patricia Kolb not only presents new perspectives on how caregiving varies across racial and ethnic backgrounds but also dispels numerous stereotypes about nursing home placement among diverse groups.
This book places significant issues related to the health, mental health, and well-being of older adults and their caregivers within the context of social work service delivery. By presenting the research of social work scholars, all experts in specific research areas, the editors clarify the value that social work brings to the larger realm of health care for older adults and their families.
Special consideration is given to such issues as case
management, urban, African-American elders, grandmothers raising
grandchildren, aging persons with developmental disabilities, home
health care, and more.
In virtually all the developed countries of the Western world, people are living longer and reproducing less. At the same time, costs for the care of the elderly and infirm continue to rise dramatically. Given these facts, it should come as no surprise that we are experi- encing an ever-increasing concern with questions relating to the proper care and treatment of the aged. What responsibilities do soci- eties have to their aging citizens? What duties, if any, do grown chil- dren owe their parents? What markers should we use to determine one's status as "elderly"? Does treatment of pain in aged patients present special medical and/or moral problems? How can the com- peting claims of autonomy and optimal medical care be reconciled for elderly persons who require assisted living? When, if ever, should severely demented patients be included in nontherapeutic clinical tri- als? These questions, and others of similar interest to those con- cerned with the proper treatment of the aged, are discussed in depth in the articles included in this text. The essays in this volume of Biomedical Ethics Reviews fall loosely into two broad categories. The first four articles-those con- tributed by Sheila M. Neysmith, Allyson Robichaud, Jennifer Jackson, and Susan McCarthy-raise general questions concerning the propri- ety of Western society'S current mechanisms for dealing with and treat- ing elderly citizens. The remaining four articles-those by Simon Woods and Max Elstein, Marshall B.
Elderly Americans - Issues & Programs
Given the impact that good nutrition and keeping fit have on health and well-being in later life, WHO, in collaboration with the Tufts University USDA Human Nutrition Research Center on Aging, organized a consultation to review the scientific evidence linking diet and other factors - especially exercise - affecting nutritional status, disease prevention and health promotion for older persons. The consultation focused primarily on practical issues, including the establishment of explicit recommendations to improve the health and nutritional status of older persons in a wide variety of socioeconomic and cultural settings. During the production of a comprehensive report, representing the outcome both of the preparatory work and of the consultation itself, it was recognized that new information emerging in several key areas should also be included. The combined results presented here are intended as an authoritative source of information for nutritionists, general practitioners, gerontologists, medical faculties, nurses, care providers, schools of public health and social workers.The specific recommendations concerning nutrient intakes, food-based dietary guidelines, and exercise and physical activity should also interest a larger audience, including the general reader. The main body discusses the epidemiological and social aspects of ageing, health and functional changes experienced with ageing, the impact of physical activity, assessment of the nutritional status of older persons, and nutritional guidelines for healthy ageing. Additional material covers food-based dietary guidelines for older adults - with particular emphasis on healthy ageing and prevention of chronic noncommunicable diseases - and guidelines for promoting physical activity among older persons. "...This report is significant, representing an authoritative consensus related to the epidemiological and social aspects of ageing, health and functional changes experienced with age, and the impact of physical activity. This valuable source of information is relevant to a wide range of health professionals; the clear and specific recommendations concerning food/nutrient consumption and physical activity for older adults should also interest a larger audience."- The Journal of the Royal Society for the Promotion of Health "...The book is a timely publication, which provides an exhaustive review of studies...This publication will certainly serve as a reference manual for all those involved in nutrition, gerontology and geriatrics. " - Indian Journal of Medical Research
Operators of assisted living facilities interpret aging in place very differently than residents do. This difference in interpretation must be taken into account by regulators, policymakers, and operators so that they may reconsider assisted living's place along the traditional continuum of care.
With the growing number of assisted living facilities opening across the United States, it is essential for scholars and practitioners to understand residents' experiences in these environments. The author examines the ideals versus the realities of assisted living and the aging in place/continuum of care debate surrounding assisted living.
While the author presents the results of a detailed, comprehensive anthropological study, she also addresses policy issues which are of concern on the national level. The book combines academic and applied approaches to create an ethnographic fieldwork investigation relevant to housing and health care policies for the elderly in the United States.
Using a multidisciplinary approach to service learning in elder care, Seperson and Hegeman assist students in their actual experience with clients. With this text in hand, a professor can offer students an overview of all aspects of aging, community service, and social policy without putting 40 different articles on reserve.
Part I describes the diverse service-learning experience. Part II provides basic information on aging from demographic, biological, physiological, and psychosocial perspectives. Part III describes a service learning classroom and the many tools a student and a professor can use to maximize the learning in this special kind of class. Part IV is devoted to communication. Here, interviewing, surveying, and oral history skills are defined.
Part V helps the student prepare for the unexpected--what to do when one is actually in a service learning experience with an elder or a group of elders. Part VI is devoted to elder-care policy. Students and their professors will gain a perspective on how to think about and debate issues about aging. Part VII is devoted to case studies of very different service-learning experiences. Following are four comprehensive appendixes, including annotated bibliographies for further reading about service-learning and aging, a code of ethics, and a service learning elder-care manual for implementation of a program.
This report shows that managers in NHS and social care organizations struggle to prevent discrimination on the grounds of age. Based on a telephone survey of 75 senior managers in hospitals, primary care groups, community trusts and social services departments, it shows that while the majority support moves to combat age discrimination, they lack practical tools for the job. They feel unsure about how to identify age discrimination in practice, and whether age-related policies and practices are ever justifiable. The report concludes that the Government's stated objective of eradicating ageist practices from the NHS will not be achieved unless local managers are given more help to implement policy, and suggests ways to do this.
With the number of elderly persons needing long-term care expected to double to 14 million over the next two decades, assisted living has become the popular choice for housing or care. Assisted living represents a promising model of long-term care that blurs the sharp distinction between nursing homes and community-based care and reduces the gap between receiving long-term care in one's own home and in an "institution."
"Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly" examines the evolving field of residential care and focuses on national issues of regulation, reimbursement, and staffing. The book is based on a four-state study of assisted living facilities and describes the facilities, the persons residing in them and their needs, and how the services vary by facility. Because one-third to two-thirds of residents in assisted living facilities have cognitive impairment, special attention is devoted to dementia care. The book also focuses on how today's long-term health care environment evolved, and it examines the future direction and implications of assisted living.
"Assisted Living: Needs, Practices, and Policies in Residential Care for the Elderly" brings together a group of nationally recognized experts to help define the types of residential care that should be encouraged and sets guidelines for selecting an appropriate type of facility.
What gives a frail and isolated or institutionalised older person their sense of wholeness and self? What makes later life meaningful? This clear and practical text presents much-needed guidance for health and social care practitioners, as well as for religious professionals, seeking to identify and meet the spiritual needs of older people in their caring role. Drawing on in-depth interviews with older people, Elizabeth MacKinlay, an experienced nurse and chaplain, develops an understanding of spirituality that enables the reader to explore the spiritual dimension of ageing and to learn how it contributes to well being and health in later life. This accessible and inspiring book will be a useful text for students, trainers and academics, policy makers and practitioners in health and social care, as well as religious professionals, in hospital, residential and other caring settings.
This groundbreaking book provides a comprehensive treatment of the political economy of aging. From the founder and key thinker in the field comes a work that aims to contribute to the understanding of old age and aging in the context of problems and issues of the larger social order in America. Since Carroll Estes' first writing on the political economy of aging in 1979, there has been growing recognition and incorporation of her critical perspective as one of the major paradigms in the field of aging.
The only comprehensive book-length treatment of the subject, Social Policy and Aging addresses the globalization of capital and developments in health care restructuring. Combining social gerontological theory and major theoretical advances in work on the welfare state, this text keeps readers abreast of the new development within the discipline. Students and researchers alike will appreciate this critical perspective, widely acknowledged as one of the major paradigms in the field of aging.
"My parent needs help, but refuses to consider a nursing home."
That's the dilemma facing millions of baby boomers today. How can
we ensure responsible, compassionate, even uplifting care for our
aging parents at home?
This manual provides state-of-the-art, practical materials to detect, prevent, and intervene with older adults who are at-risk and problem drinkers. It provides the first systematic, practical approach for working with the growing vulnerable population of older adults who use alcohol at risk levels often unnoticed in everyday clinical practice. Including guides to alcohol screening, protocols for managing withdrawal care, and an English/Spanish Health Promotion Workbook for Older Adults, this book is designed as a hands-on text for use in a range of primary and mental health care settings. Physicians, nurse practitioners, nurses, social workers, psychologists, and case managers will all be able to use it profitably.
Assisted living is a rapidly evolving industry, and many personnel lack adequate knowledge of emerging regulatory and reimbursement issues, resident care models, and marketing needs. A panel of experts covers clinical, business, and operational aspects of assisted living, presenting innovative approaches to providing a superior atmosphere of care. Most operators/administrators of assisted living (AL) facilities have backgrounds in long-term care or other residential care facilities and are familiar with basic facility operations. This book is designed to assist these individuals to cross train in their new positions. While avoiding both the dry detail of an operations textbook and the theoretical focus sometimes found in academic texts, this book thoughtfully covers the key business aspects and the fundamental resident care aspects of assisted living success.
Training and education are indispensable for the growth and success of those assisted living administrators who, although familiar with basic facility operation methods, lack specific knowledge about regulatory requirements, Medicaid and Medicare reimbursement issues, health prevention and promotion models, and marketing needs specific to an AL facility. This book provides readers with innovative approaches to operation of different components of an assisted living facility and relies on examples and case studies to show how a superior atmosphere of care can be provided.
?Treatment of Late Life Insomnia is an extremely valuable, authoritative and comprehensive resource not only for practitioners of sleep medicine but also for any health-care practitioner who finds themselves working with the elderly population.? ?Michael V. Vitiello, Ph.D. Professor, Psychiatry and Behavioral Sciences, University of Washington & Editor in Chief (for the Americas) of Sleep Medicine Reviews Insomnia occurs among older adults (65+ years) at a rate 50% to 100% higher than in younger age groups, and the consequences of insomnia in the elderly are much more severe than in younger age groups. Elders who exhibit a chronic pattern of insomnia dwell on their anticipation of a poor night?s sleep. In many cases, this worry takes on an obsessive quality that degrades multiple aspects of the individual?s life. In the past decade there has been a great deal of clinical research directed toward the development of effective interventions for insomnia among older adults. Methods of insomnia assessment have been developed and key diagnostic issues have crystallized. Yet until now, no book has gathered together this flourishing body of literature. Treatment of Late-Life Insomnia provides a comprehensive research/clinical accounting of insomnia treatment in older adults. The first section of the book, Overview, describes typical normal and disturbed sleep patterns in older adults, demographics, and methods of evaluation and differential diagnosis. The core of the book, the middle section, entitled Intervention Strategies, reviews the clinical outcome research of the major treatments for late-life insomnia and teaches the clinical procedures in the style of a clinical handbook. The final section, Special Treatment Topics, explores cutting-edge research and methods of clinical management for pressing topics in late-life insomnia that have only recently attracted systematic investigation. This book is geared toward students, scientists, and health practitioners engaged in the areas of geriatrics, sleep disorders, and behavioral medicine. These disciplines cut across a wide variety of professional groups that would find such a book useful, including psychology, psychiatry, counseling, internal medicine, geriatric medicine, nursing, and social work.
"Cultural Issues in End-of-Life Decision Making creates an engrossing tension as chapters on philosophical topics are interwoven with clinically-oriented ones including case examples that ground the reader in the reality of most human decisions. I highly recommend this book to researchers, health care providers, clergy, and other practitioners dealing with end-of-life issues." ---Catherine Hagan Hennessy, Health Care and Aging Studies Branch, Center for Disease Control and Prevention
End-of-life decision making is one of the most difficult but crucial challenges faced by patients and their families. In most cases, resources or counselors providing guidance in these decisions are not available. This book is intended to prepare nurses, physicians, and other health care workers to fill this role, insofar as they are most frequently in contact with the patient and his/her family and significant others at the time choices must be made. In this informative, practical book, Braun, Pietsch, and Blanchette first review the medical, legal, and ethical context of the dying experience, discussing ethnic perspectives and religious issues. For example, providing cultural and spiritually sensitive care requires that nurses, physicians, social work and others know and understand the implications of family members beliefs about life and death, supportive rituals and other activities. This book does a creditable job of presenting the issues and a broad overview of culture and common religions in America.
About the Editors:
Kathryn L. Braun, Dr.P.H., is Director of the University of Hawaii Center on Aging and an Associate Professor at the University of Hawaii School of Public Health. She is a Fellow in the Gerontological Society of American and the Association for Gerontology in Higher Education. James H. Pietsch, J.D., is Director of the University of Hawaii Elder Law Program (UHELP), an Associate Professor at the William S. Richardson School of Law, and a Clinical Adjunct Professor at the John A. Burns School of Medicine. In 1990, he was the recipient of the Fifth Annual Paul Lichterman Memorial Award for contributions to the advancement of Law and Aging.
Patricia L. Blanchette, M.D., M.P.H., is a Professor of Medicine and Public Health at the John A. Burns School of Medicine and School of Public Health at the University of Hawaii at Manoa. Dr. Blanchette is the Director of the Medical School?s cross-departmental Geriatric Medicine Program, and Geriatric Medicine Fellowship Program, the Pacific Islands Geriatric Education Center of Excellence in Geriatric Medicine. Dr. Blanchette has won numerous awards and honors, including an Excellence in Teaching Award, Distinguished Alumni, Best Doctors in America, and the Soroptimist?s Women of Distinction Award.
Like all other advanced Western societies, Germany is coming to
terms with the phenomenon of an ageing population. The demographic
challenge posed by population ageing is generally seen in terms of
potential crisis in the funding of health and social programmes.
Some social scientists have even suggested that the early decades
of the next century will be marked by conflict between the
generations, with young and old competing for increasingly scarce
resources. This is the first book written in English to address
comprehensively ageing policies in Germany and the contribution of
older people to German society.
Despite the rapid aging of the population and the tremendous growth in ethnic and racial diversity among the elderly in our society, empirical studies on long-term care needs and service use of minority elders have been lacking. Based on two national datasets, this is the first comprehensive analysis of long-term care needs, patterns, and determinants of in-home, community-based, and nursing home service utilization and informal support among African American and Hispanic elders, as compared to those of their non-Hispanic White counterparts. The authors also compare caregiver burden within the three groups and present recommendations for ethnic-sensitive long-term care policy and practice for minority elders.
Noted scholars of environment-aging relations and environmental psychology examine the value of selected classic, contemporary, and in one instance, completely new theories for enhancing both research and service provision on housing for elderly populations. The contributors examine the housing needs of older populations and provide theory-driven innovative solutions for improving the fit between older persons and their residential environments. Some issues covered are the need for greater understanding of the psychological needs of older individuals seeking environmental support; for a holistic understanding of elder-environment relations in physical, social, and phenomenological contexts; for inclusion of ignored perspectives; and for recognition of the continuing value of major founding theories. This book will be of interest to students, scholars, and professionals in psychology, gerontology, environmental policy, housing, and social services.
Human stories are the core of identity and meaning. This book is an invitation to the engaging and reforming power of telling stories. It is also an invitation to heal the story of health care for older adults by improving the communication between professionals in medicine, psychology, and religion.
At any age the process of genuinely listening and expressing hopes and fears is an intimacy rarely matched in human interaction. Life stories can be told, revised, and rewritten through psychotherapy and improved by a health care which integrates the best of medicine, religion, and psychology. This book invites health care reform by renewing old principles. Through clinical experience, research, and listening to seniors and their families, life stories can be retold to promote healthy treatment and healthy aging. This book will be of interest to students and professionals in psychology, medicine, nursing, religion, and social work.
The ageing of the population is a demographic phenomenon, a social problem and a policy issue. The increase in the numbers of aged and in the costs of supporting and caring for them have also brought increases in family care, in deinstitutionalisation of aged care services and in issues of quality and outcomes of care and consumer rights. The growing recognition of the feminisation of ageing also has significant social and policy consequences. In this 1998 book, Diane Gibson synthesises a wide range of material to provide an overview of these issues and policy responses worldwide. The book then looks in-depth at Australia, a country typical in the problems it faces, and a world leader in many of its solutions. Gibson also offers a more conceptual examination of theoretical implications and practical consequences. She elucidates debates in ways which will set new standards for aged care policy and practice worldwide.
This book covers three main themes. The first is centred on Accessibility and Design for All, including good practice examples. The second is about users and users empowerment and involvement. The last is about Assistive Technology research and technological developments. Factors that support the uptake of AT technologies such as standards and legal and economic factors are considered as well. This work reports on the third congress organised by TIDE (Technology Initiative for the integration of Disabled and Elderly people). TIDE not only has contributed to the social objectives of enhancing independent living and social integration through technological applications, but has also contributed to the creation of an important market in new products and services which meet the needs of older people and people with disabilities. This has been done through co-operation in R&D projects of research centres, commercial and industrial companies, rehabilitation and care professionals, public and private services providers, and last but not least users and their organisation.
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