Aging in Western Society: The Issue of Elderly and Poverty - Essay Example

Introduction John Stott (2006) the famous British theologian said “…dignity and worth of human beings is of utmost importance today… for the welfare of society.” Stott observed that, ”When human beings are devalued, everything in society turns sour. Women are humiliated and children despised. The sick are regarded as a nuisance and the elderly as a burden. Ethnic minorities are discriminated against. The poor are oppressed and denied social justice. Capitalism displays its ugliest face. Labor is exploited in the mines and factories. Criminals are brutalized in the prisons.” Adequate caring for the elderly is about dignity. Something that is intrinsic to every individual in the world we live in, be the person a he or she, white, black or brown from whatever gender, language or age. This inherent dignity of men and women behooves us to treat all of them as equals. Why should the elderly therefore not have the care, the services, or privileges that children, youth and younger men and women have? The case could be made out that they should have more as the majority of them have already served society by caring and working in various ways. Even if they have been mere consumers they have contributed in untold ways to the profit of conglomerates and the existence of generations after them. There is a debt of gratitude that is owed to them which cannot be ignored or swept aside because they have aged. Because they were, we are. Mental ascent alone that the elderly should be cared for alone will not do. We should put our money where our mouth is. We must ensure that there is adequate care for the elderly. A thorough investigation has to be undertaken as to the resources enjoyed by this segment of society compared to other demographic segments and the affect it has on their welfare or poverty. There is a moral responsibility for us to ensure that the aged enjoy there freedom of choice as long a possible which preserves their endowed dignity and lets them live in the security of their homes up until the day that it is simply impossible. It is imperative therefore that the number of geriatrics who are serving the aged populace must be increased, the poverty levels faced by them must reduce the stabilizing right they enjoy staying in surroundings familiar to them must be protected. The Impending Crisis The most consistent thing about aging is that it occurs throughout the person’s lifetime. The complexity arises out of the fact that aging in a person is multifaceted. It can occur in a macro sense in a sense of his whole being in somewhat predictable stages. However in a micro sense each organ in a person can age at different speeds and with differing effects, which makes the process of aging somewhat a conundrum. The factors that effect aging are diverse and can vary widely from person to person. The factors that contribute to this process are the genetic make up, lifestyle, stress levels, diet, vocation, and levels of medical intervention. It’s might be determined by genetics but its modulation is very much based on the environment. While it can be determined as the process of getting old certain stimuli like exercise can cause a sense of youthfulness to be maintained while the chronological age increases. It can be defined as the process of getting old with a larger number of people facing its scepter currently than ever before specially in the west. “In 1996, the baby boomer generation of approximately 78 million began turning 50 at the rate of 300,000 a month. This has had a phenomenal impact on the senior population, which now includes people whose lives were influenced by everything from the Great Depression to the civil rights movement, and whose ages range from 50 to over 100. In an unprecedented paradigm shift, both parents and their children are now members of the senior population.” (Brock. D.A). A BBC news report of 30th March 2006 states “that the "oldest old" - those over 85 - are the fastest growing age group in Britain. There are now 1.1 million people over the age of 85 in the UK - but the number living in care or nursing homes has fallen as the population has grown.” What has to be done to keep this aging populace living with dignity? Six dimensions have been suggested. “No physical disability over the age of 75 as rated by a physician; Good subjective health assessment (i.e. good self-ratings of ones health); Length of undisabled life; Good mental health; Objective social support; Self-rated life satisfaction in eight domains, namely marriage, income-related work, children, friendship and social contacts, hobbies, community service activities, religion and recreation/sports.(Gilmer & Aldwin 2003). This would entail good specialist care, adequate income to support food and recreation, board which will enhance family contact, and comfort. Specialist Care While the exact benchmarks of the aging process is somewhat unpredictable the onset of issues with regards to hearing, vision, diet and being prone to lose balance and falling are certainties. One of the emerging and frightening specters of aging in recent years is the increasing occurrence of dementia. Having specialized care can certainly assist in the management of these issues and ensuring the six dimensions mentioned by Gilmer&Aldwin are achievable. When these issues occur early diagnosis is quintessential. Therefore they need to be monitored closely and watched carefully which highlights the need for more geriatricians’ s to keep up with the increase in the numbers of the elderly. There is a school of thought that the regular physician whom the elderly are used to would be the best medical practioner who could care for them when aging issues begin to surface. However it is felt that the treatment for the elderly has to consider other dimensions than general medical care if not the treatment could be worse than the ailment. There is a balance between curing a patient while ensuring adequate comfort, which geriatricians have been, trained for, that other medical practioners might not be able to understand. A younger doctor might not spot the onset of dementia. Surgeons do surgery. Yet there is a difference in dealing with a lump in the breast when one is 18 and when ones is eighty. Geriatricians specialize themselves in the effect of various drugs as well as various procedures and their effect on the elderly. In the case of the lump they would take a view regarding her chances of surviving surgery to arrest a rapidly spreading cancer. The elderly still resist from consulting geriatricians. Partly, due to their attachment to the usual doctor and partly due to ignorance. However it would be a crime if the reason were the lack of geriatricians or inadequate access to them. Such crimes are in the making. The main reason for a dearth of geriatricians is that gerontology does not pay well. The average salary of a geriatrician according to sources in the medical profession is around USD 140k, with a potential of about USD 180 k, which is only slightly over a pharmacist, and physiotherapist. Physicians and surgeons have an earning capacity, which is at least three times more. The shortage of geriatricians has not gone without attention with at least one attempt by the congress to pass a bill, which would pay back the education costs of a doctor if he should decide to specialize in gerontology. The lack of consistent action and progress however cause one to suspect that this was mere political opportunism. A true recognition of dignity of aged individuals should go beyond mental agreement to processes and budgets if not they remain as failure of human rights. The Elderly and Poverty Another aspect that needs to be probed, and that urgently when thinking about the aging population of the west is poverty. To be sure poverty levels have been declining in the west for sometime now. While most believed that overall poverty in the U.S was shrinking during the 90’s on a revised formula applied by the US Census Bureau shows an overall increase in poverty of 15.7 % according to data obtained 2009. According to the same statistics “ Most staggering is the increase under the revised formula for the elderly. According to the official poverty figures, 8.9 percent of those 65 and older were living in poverty in 2009. But when out-of-pocket medical costs and other expenses are taken into account, the elderly poverty rate nearly doubles to 16.1 percent” (Grey ;2011). It begs the question; how does one get about reducing the poverty rate among the elderly. The answer is in the above statement at least in part. Engage the out of pocket medical costs of the elderly. Reducing this component would take poverty levels among the elderly closer to the original 9% levels. The main argument here could centre around health insurance. This debate can turn acrimonious due to its current public nature and party loyalties. Divorced from this there is hope that health insurance which could tackle the out of pocket expenses of the aged and thereby reduce poverty amongst them. A holistic approach will help. Thinking out of the box, if we begin from the premise that children do care about their parents, and that parents financial situations does effect children, why not have an add on to the premium of the children’s health insurance which can contribute to some extent to the parents out of pocket expenses. A further suggestion is for health insurance to pay for preventive care which all agrees is much cheaper than treatment. Reduction of poverty needs to be a goal for the whole community. There are possibilities for the private sector to embrace this. Supermarkets can have an elder’s hour where the best discounts on food are offered at a specified hour to pre registered elders. Similar operations can be done prior to opening black Friday shopping. In the current black Friday mêlée it is certainly the survival of the fittest. Giving a window to the elderly with modalities and limits managed can assist them tremendously. The same could be applied to all goods and services where the elderly is concerned. The argument here is that reduction of poverty in the elderly cannot be left to state agencies and officials alone. It is a dignity issue and has to be engaged by society at large, with the for profit sector becoming an important facilitator in this. The best deals should go to the worst off and that would fit the humanistic philosophy of the west. The ‘x’ generation is deemed to care about social issues, as does the writer of this paper and it is time poverty reduction amongst the aged is brought to the open and made to bite with whom it can make the biggest difference. The savings that are obtained through these means could then be diverted towards better nutrition and recreation. Location of Elders To achieve the six dimensions proposed by Gilmer in elderly care will also need consideration given to the location of where the aged spend their twilight years. Given the pervasive nature of dementia amongst the elderly in the recent past this aspect requires utmost attention. Prevention of dementia also involves a societal aspect. The more the aged are able to engage with others and keep engaging their minds it is better for the brain cells. Due to rapid increase in mobility of people in countries such as the U.S the elderly can find themselves in almost foreign surroundings or in familiar surroundings with only strangers around them. The “Elders home” or retirement complexes have been the popular solution for this phenomenon. The most effective solution could be to locate the elderly as close as possible to kith and kin. Often this would mean within the houses of children. After cardiac arrest the biggest health issue is supposedly the aged being prone to falling. Familiar surroundings, amongst familiar people can assist the aged in having a better quality of life. This is something which is evident too when studying the aging population in the east. Given economic conditions their elderly appear to enjoy greater family interactions than those in the west and consequently a better quality of life. Families might need assistance with this. While grants might not be feasible in an era where economic concerns overshadow humanistic concerns a tax concession for children who are taking care of their parents could well be an option. This might require that families looking after elders be registered with the social services, which in itself might be a good thing. To supplement this there could also be a need to run elderly day care where parents can be with children but left in a day care, during the day, just like smaller children and child care to avoid long hours alone. This would give them the opportunity to enjoy a standard of life with mobility and enhanced interaction with the rest of society. Finally if there is no option but to place the elderly in resident care the complex has to be brought to life. Activities such as bridge and poker competitions and Scrabble payoffs have to be systematized and become a feature of society such as basketball and football for the young. Ife has to be lived as long as there is life, and society, leaders as well as families have to take on this responsibility. Conclusion This paper started with a quote from Stott and would conclude with the completion of this quote “…But when human beings are valued as persons because of their intrinsic worth, everything changes. Men, women and children are all honored. The sick are cared for, and the elderly enabled to live and die with dignity. Dissidents are listened to, prisoners rehabilitated, minorities protected, and the oppressed set free. Workers are given fair wages, decent working conditions, and a measure of participation in both the management and the profit of the enterprise… Because people matter. “ The dignity of the elderly needs to be protected by providing specialist care, by alleviating poverty amongst them, and ensuring a quality of life. does This further bestows dignity on the society the people who undertake this economically difficult but noble task. Citations Brock, J. The evolution of the aging population. Retrieved from http://robinson.gsu.edu/magazine/aging.html http://news.bbc.co.uk/2/hi/uk_news/4860722.stm Grey, Barry (2011). US Census Bureau: Rising Levels of Poverty in America. Retrieve from http://www.globalresearch.ca/index.php?context=va&aid=22690 Diane F. Gilmer; Aldwin, Carolyn M. (2003). Health, illness, and optimal ageing: biological and psychosocial perspectives. Thousand Oaks: Sage Publications. ISBN 0-7619-2259-8 Stott, J. (2006) Issues facing christianity today. Zondervan. Michigan. Retrieved form www.millersvillebiblechurch.org/_files/HumanDignityandDepravityAHolisticBiblicalUnderstanding.pdf Aging is a developmental process that begins at conception and ends at death. Since everyone ages at different rate with body systems and organs aging at different rates in different individuals, it is impossible to categorize people based on chronological age alone. Aging is becoming older; the process that is genetically determined and environmentally modulated. As we age, our body changes in many ways that affect the function of both individual cells and organ systems. These changes, although very inconspicuous, grow and progress at an alarming rate. Research in aging is beginning to find out the reasons for these changes and the a few of which are: Genetic and Environmental Factors, Healthy life style, Behaviors changes associated with aging, Bodily changes associated with aging (changes in height, weight and composition), Other changes in aging, normal aging and disease and changes in the function of body systems. A rapidly expanding aging population is one of the factors that will impact the entire world, especially health care in this century. Most aging statistics are based on age 65 and older because full Social Security and Medicare benefits become available at that age; however there is no mandatory retirement age except in certain occupations such as airline pilot. Some people retire from a full time position at age 50 and some never retire. The amount of older people in the United States, from 1900 to 2030, at age 65 is expected to triple according to a report. (American Association of Retired Persons and The Administration on Aging, 1999). The United States is not unique in its growing share of seniors. In many other developed countries of the west, including Italy, Japan, Germany, Sweden, and the United Kingdom, the proportion of seniors to the rest of the population is even greater. Half of the people that are sixty five or older of age live in nine states, led by California, Florida and New York. At present, the white constitute the majority of the senior population in the US. The fraction of the other races like the black and the Asians is also growing rapidly, within the next 50 years the elderly black population will triple. Although normal aging does not imply disease, the chances of chronic disease increases with increasing age. The most common chronic diseases that occur in old age groups are: Arthritis, Hypertension, Heart disease, Hearing impairment, orthopedic impairment, Sinusitis and Diabetes mellitus. Chronic disease is more common than acute illnesses in the older age group. A chronic disease refers to illnesses that last 3-6 months or more and is usually treatable-but-not curable such as Arthritis. The major causes of death are not much different from those of older adults. Younger adults are more likely to die from a motor vehicle accident and work related injuries, while older people die more often as a result of complications following accidental falls. Another problem in this age group is the number of Co morbidity or the presence of several chronic diseases in one person which makes treatment and quality of care and life more difficult. Health care services for chronic illnesses are expensive because they are long term often, needed for months, if not years. The major causes of death in older adults analyzed are the cardiovascular stroke, cancer, lung disease, cardiovascular trauma, accident and/ or fall. The following major issues listed affecting older people according to an analysis are: Transportation, Safe, Adequate and comfortable housing, Crime, abuse and financial exploitation, Prevalence of ageism in society and among health care providers, Inadequate access to quality health care and long-term care, Multiple chronic illnesses, Inadequate financial resources, Limited family or friend support (outlive family and friend), and Isolation, loneliness and depression. Needs are individualized at all ages based on personal preferences and current physical and mental status. The basic needs of older adults include: Health care and long-term care, housing, nutrition, safety, transportation, employment, education, finance and social support. It is our prime duty, the duty of each individual of the state to look upon these basic needs for our older generation, striving to improve their standards of living and their lives worth living. The need for comprehensive health care for older adults includes health promotion, wellness strategies and long term care. People as a result of the successful treatment of medical technology and healthcare live longer. There should be more effort on promotion of health and wellness such as good nutrition and exercise. When chronic illness and / or disabilities occur, independent living may not be possible. In previous years the Gerontology nursing facility was considered the only alternative to independent living. Providing private homes or apartments where they may live alone or with a family member and providing mobile home parks specially designed for older people can make their lives more comfortable in their last days. Moreover, maintaining subsidized low-rent apartments, housing for those with minimal income and facilitating the ones with a retirement centre enables them independent living with some services provided. Most important needs of older adults are healthy, available and nutritious food based on their age, physical condition and possible health problems. For a variety of reasons, older adults are at a risk for poor nutrition. The fifth leading cause of death in older adults is accidents and / or fall, decreasing vision, poor balance, dizziness from low blood pressure and or medications and environmental factors. Older people should be helped to move about safely in their homes and other places they visit. A major need is transportation both in urban and rural areas. Some having financial resources to purchase/maintain personal car may even have vision and / or hearing defects that make driving hazardous. Older people continue to want to learn, both formally and informally. Many colleges and universities offer short courses and / or reduced tuition for regular credit courses as well as specially designed courses. For example, the University of San Francisco offers a classes called the Fromm program for older adults. Elder hostel arranges for older people to live in a university or college campus. Some older people prefer and need (for personal and/ or financial reasons) to continue employment wither full or part time, beyond the common retirement ages of 62 or 65. Social support needs from older adults is the need from others such as family, friends, neighbors, church members, and other individuals in the persons life. Additional finances to meet the needs and to provide a comfortable lifestyle are essential, especially to provide adequate housing, nutrition, healthcare, sources of income after retirement from full time work come from Employer pension, Savings and Investment. Providing all above elderly needs like living with their families, old age security, health care, co residence and houses with services with old age compatibility, finances, transport, entertainment can approve elderly poverty. For some individuals, unfortunately, the social security is the primary, if not the only source of income. The social security system has been under much scrutiny in recent years. The goal is for it to continue to be available to future generations especially the baby boomers (those born between 1946 and 1964) who will become eligible for social security benefits beginning in 2011. One of the most important factors in successful aging is a strong support system. It is helpful when older people develop friendships with younger people because as one reaches the oldest age groups (85 and older) peers such as ones spouse, friends and even children may die first. (Hogstel, Smith & Reckling, 2000).According to the book Adult Development and Aging (Papalia, Camp, Feldman, & Sterns 2007), the average stay for elderly patients who die in a nursing home is 2 years. I have witnessed first hand the desperate attempt of my grandmother. It was about 10 years ago, I saw my grandmother as a very vibrant, energetic, lively and extremely active lady. She was past sixty five; her mental abilities were astonishing, healthy and vibrant. She had put on extra weight, which impeded her free movement around. It all started when she first suffered a stroke; although she survived a massive blow but her body became home to Insomnia, Alzheimer and Arthritis and Parkinson. She suddenly started looking old and aged. In spite of the best medical treatment she died after five years. I studied all theses symptoms very carefully and I have reached the conclusion that the last 5 years were the most crucial in her life where in spite of our best efforts, we could not give her life, and now when I see such cases I feel that this is the most important time in the life span of an individual when he/she needs to get the utmost attention and care. Gerontological Nursing is a broader term including health promotion, education, and disease prevention. Combining geriatric and gerontological gives gerontic nursing that encompasses both the health problems and holistic aspects of older adult nursing care. The Geriatricians are the people who know to co ordinate care for their elderly patients, to avoid interacting drugs and to improve quality of life. Geriatrician is a health care provider, a doctor, a pharmacist, a mental health provider, nurses and ailed health workers who have completed advanced training in caring for older patients. In many ways these geriatricians may function in a different way as compared to the general physician who treat the adults because the older people very often have more then one medical ailment, The geriatricians specializes to look at the multiple problems as one whole, and administer the treatment accordingly. The geriatrician knows the syndromes of ageing that are not in any particular specialty, like mental confusion, urinary incontinence, instability and gait disorders, failure to thrive and depression. The objective of the geriatricians is to improve and enhance the quality of life, keep the older people going and help them to remain independent as long as possible. There are limited geriatricians, and as time has gone by Americans baby boomers will be hitting age sixty five in 2011. According to magazine Social Work today (2011), "78 million would have done the same almost double the number of people this age in 2005" ("anonymous", 2011). Given the rising number of seniors requiring care, the current shortage of health-care providers for older patients (i.e. geriatrician) will become a major social problem. Research by Medial News today " salaries for geriatricians average $150,000 while radiologists, orthopedists earn more than $40,000, and many medical schools have higher salaries, and more training for geriatricians , to ensure that there are enough medical professionals with the specific skills needed to treat seniors. … Students Paper: … treat seniors. As an individuals health status declines, their need for a care by a doctor different specialists … http://www.ec-online.net/Knowledge/Newsletters/beacon010103.htm … Rich OBoyle As an individuals health status declines, their need for care by a doctor and other … … different specialists, under going numerous tests, records and has a bag full of prescription drugs. In such a scenario a geriatrician will be helpful. The chronic health problems are more likely to be experienced by older adults. Older adults often have multiple health concerns e.g. a patient may be receiving treatment for high blood pressure, cataracts and back pain. Even the broken bones and cold take longer to heal. This calls for the increased demand of Gerontology nursing or geriatrician. and other health care professionals increases. As one is faced with multiple medical ailments, he is being treated by For a majority of the elderly people, depression, incontinence and loss of memory impairs … Students Paper: … memory impairs their ability to live independently. "Careful management of these conditions by a multi-disciplinary team becomes a paramount to maintaining long-term health, vigor, and the capacity for personal growth and independence" the AAR said in a report critical of current medial staffing … http://www.ec-online.net/Knowledge/Newsletters/beacon010103.htm … direct threat to their ability to live independently. "Careful management of these conditions by a multi-disciplinary team becomes paramount to maintaining long-term health, vigor, and the capacity for personal growth and independence," the AAR said in a report critical of current medical staffing … 1. … medial staffing ratios: In view of the above aspects for older adult care there is a critical need to increase the geriatricians. Also, increasing the geriatricians is one aim, on the other hand the Geriatricians in this regard have a critical role to play in making the health care system more efficient and more responsive to an aging population. As people age there is a need of options to make older adults stay at homes by providing them with houses built according to senior compatibility and mind. Making the "aging place" much safer , easier, more practical and more enjoyable to stay at home. Making sure the house is provided with basic services like groceries and pharmacy to have a perfectly adapted house. Older people in villages should be provided with adequate network facilities and all needed services like healthcare, financial aid, entertainment, shopping facilities and exercising like yoga , aerobics and dance classes and excursion trips out of town. Revising living arrangements as people age will provide them with more options to stay at home. The nucleus of initiative can be the geriatricians themselves and other geriatric ally prepared health professionals. They are the people who are most expert at seeing the patient as a whole, not merely as a host for a disease process. In healthcare as a whole, the unique expertise of geriatric professionals will become increasingly important, given the western nations aging population and rising disabilities. The perspective that is absent in clinical trials that focus on narrow patient segments can be brought about by a geriatrician. Conclusion The world of today is facing the impact of aging societies with the in adequate health care policies, there is now a dire need to compensate for the glaring shortage of trained and emotionally oriented personnel who are able to provide medical help and care to the aging persons. In other words, there is a need of geriatricians who look after the older adults with determination, dedication and selfless services. Since the number of students who would like to specialize in aging is quite discouraging because of lack of aging knowledge for their practice, therefore there is a need to improve the curriculum awareness of aging bias, and hence increase the competency of youth in their interaction with older people (Lun, 2011). Moreover, there is a need to start a campaign at national and international level to develop a dedicated and comprehensive strategy to control ageing. This may include human services and resources, social work programs, training of future, awareness of aging, encourage people to enter aging specialties within the field of human services and social services, professionals, interdepartmental collaboration, ageing curriculum improvement, comprehensive health care policy and discouraging negative attitude towards older people etc. The potential lies within us to move closer than ever to our goals for delivering high quality care to our population specially the aging population. This is possible only if we can generate a solid commitment to preserve and improve quality of the healthcare inextricably linked to our quality of life and national prosperity. But as the time is running out for Medicare, hence we must act quickly (H.W. Jenkins, Jr., 2005). No physical disability over the age of 75 as rated by a physician; 2. Good subjective health assessment (i.e. good self-ratings of ones health); 3. Length of undisabled life; 4. Good mental health; 5. Objective social support; Self-rated life satisfaction in eight domains, namely marriage, income-related work, children, friendship and social contacts, hobbies, community service activities, religion and recreation/sports. ^ a b c Diane F. Gilmer; Aldwin, Carolyn M. (2003). Health, illness, and optimal ageing: biological and psychosocial perspectives. Thousand Oaks: Sage Publications. ISBN 0-7619-2259-8Bibliography American Association of Retired Person and Administration on Aging (1999), (pp1-2), US Department of Health and Human Services. Retrieved on 17th April 2011 from http://books.google.com.pk/books? Hogstel, M. O. Smith, H. N. & Reckling, D. (2000). Eldercare/Faith in action program (5th Ed.). Fort Worth, TX: Torrant Area community of churches. Papalia, D., Harvey S. Feldman, R, Cameron, C. (2007) Adult development and aging in a changing world. L Wagner (Ed), Adult development and Aging (pp. 1-31). New York: The McGraw-Hill. Retrieved on 17th April 2011 from http://search.barnesandnoble.com/Adult-Development-and-Aging/Diane-E-Papalia/e/9780072487343 H.W. Jenkins, Jr., (2005), "managed Retreat?" Wall Street Journal. Retrieved on 17th April 2011 from http://content.healthaffairs.org/content/early/2005/09/26/hlthaff.w5.r90/suppl/DC1 Lun, M. (2011). Student knowledge and attitudes towards older people and their impact on pursuing aging careers. Educational Gerontology, 37(1), 1-11. Retrieved on 17th April 2011 from http://www.informaworld.com/smpp/section?content=a931176611&fulltext=713240928 Read More