Aging in America - Essay Example

ID: 10916 Order 197051 December 25, 2007 Aging in America Guided by the welfare initiative under the Supreme Court's Olmstead Decision in1999, and a New Freedom Initiative (NFI) in 2001, all American States are expected are modify their respective long term care (LTC) policies to provide comprehensive health care services dedicated to the needs of older Americans. Federal, State, and local agencies and organizations will formulate policies to reduce hurdles to community living for older people on long-term basis. U.S. Department of Health and Human Services (HHS) has granted funds and technical assistance for States and has adopted a LTC Systems Change Framework. This framework is expected to reform the following areas to increase well being of older Americans: - Access: Comprehensive information about available services. - Services: Consumer choice in types of settings and providers. - Financing: Streamline funding across services that supports consumer choice. - Quality: Ensure quality of services. Many states have begun using systems change to better improvements in long-term care reform for the aged, in overcoming various inadequacies they suffer. Using the Systems Change Framework as a guide, this paper examines reform in the State of Oregon and how reform efforts have affected them. In Oregon, LTC services are administered on a local level, so as to increase the number of options available to seniors citizens. Situated in the northwest America, Oregon has a population of 3.6 million (in 2005). About 7% of Oregon's population are less than 5 years old, 25% under 18, and 13% are 65 or older. Women constitute 51% of the population. Of these, most settlers originally came from Europe. Others like Mexican Americans, Hispanics, Asians form a large part. The Asian community forms slightly less than 5% of the population. Program information was obtained through interviews with people over 65 years of age, health care professionals and health service providers about each of the four component areas of the LTC Systems and Change Framework. Interviewees provided details regarding the impact of services across available services, satisfaction with services, and future plans for reforms. Unrelated to governmental policy changes though, a technical experts meeting held during April 2000 had underscored the fact that the issue of older population is currently under-addressed, is poorly understood and widely unrecognized. It said that not many organizations are taking into account the comprehensive health issues, medical systems and reimbursement, environmental issues, and education that are necessary to help older Americans live better. To utilize available funds effectively, resources must be tailored to the needs of the aged. The 25% of the population who are over age 50 today control 70% of the total net worth of U.S. households and are seasoned consumers (Dychtwald 1990). Baby Boomers, already in there 60s, are already pushing the market to produce goods and services that are relevant to their needs. They do not like to be thought of as old. Many of these goods and services will increasingly be health-related such as gyms, ski slopes, and dating services for older adults. Since they have resources to spend, the market will respond to meet their demands. To meet the needs of the elders, the government has framed Older Americans Act (OAA). The OAA aids state agencies to cover their social service needs. All people over age 60 are eligible, regardless of need or income. Further the State Units on Aging establish local Area Agencies on Aging (AAA) to develop and administer service plans within local areas. These provide referral services, case management, transportation, home services, day care, nutritional information, community meals, legal services, senior centers, employment programs, and protective services. Access is the most important concept to remember when planning services for the aged. They will try to avoid services that they perceive are inappropriate, too expensive, or uncomfortable. Another important point is transportation, especially in rural areas where distances to services may be great. Culture and environment also influence a great deal. Elders need safety from attacks. Fear of inability to contact assistance when required is another major concern of elders who live alone. Systems of daily checks by mail carriers and telephone systems is reassuring to them. Poverty, ethnic minority status, poor health, and unsafe living arrangements are other major issues. Ethnic minorities include Mexican Americans, African Americans, Hispanic Americans, Native Americans, and Asian Americans. They suffer cultural isolation, language differences, lack of trust and in service providers. Older women are the fastest growing today. Those above 85 outnumber men of their own age in a ratio of five to two. They are more resilient and better withstand discontinuity and loss. Many aged ones living in urban environments have access to many services, including transportation. Rural older people have more financial resources but find themselves physically isolated from services but they interact more with family and friends. Most people are happiest in the type of community in which they lived during their earlier lives. Relocation causes a great deal of stress. When they move, they tend to stay within the same community. Living arrangements for older adults include independent housing, planned/retirement communities, congregate housing, and nursing homes. But they find maintaining independent houses expensive and costly. Congregate housing provides communal services, a central kitchen, and dining facilities for all residents. Multilevel care communities provide options of independent living, and congregate living. Other long-term care approaches include home care, foster care, assisted living, and adult care. Long-term care is provided in a comprehensive and coordinated manner to maintain the older adult at maximum function with minimum restriction and cost. Any community resource benefiting the total community also benefits its older residents. Segregation, when done to provide special services to a needy older population, alienates and separates them rather than helps. A community with good housing, religious institutions, recreation, transportation, social interaction, economic opportunities, volunteer organizations, etc., is good for them given that the person-environment fit is satisfactory. To translate this noble plan into action, organizations need to reach beyond their comfort zone. For example, many older people are not likely to walk if they live in neighborhoods that have no sidewalks. It is, therefore, important for public health professionals to learn about local transportation planning and how to older adults require an integrated approach that will include community health professionals, health care providers, community centers, transportation experts, and other diverse professional expertise. As suggested, approaches to address barriers to physical well being of older population require attention into five categories: Research, living arrangement, workplace, medical systems and public policy. Research strategies identify steps needed in research, including medical, social, behavioral, policy and marketing research. The living arrangement strategies take into account the nature of how people live and carry out the normal tasks of daily life. Workplace strategies recognize that people generally work in or near the community in which they live. Medical systems include health care delivery centers. Public policy and advocacy strategies can be carried out at the local, state and national level. The key to success lies in developing resources, for the benefits of the elderly. We must remember that creatively meeting the special needs of an aging population while integrating them into a successful greater community is a commendable goal. References: http://www.aoa.gov/press/fact/pdf/ib_ltc.pdf http://www.isapa.org/ISAPA_Newsletter/ http://en.wikipedia.org/wiki/Oregon Read More