Independence among Elderly - Assignment Example

CHAPTER ONE Independence among Elderly: Helping Older People to Live Independently in Their Homes Introduction The objective of the dissertation Older people are known to suffer from illnesses more often than young people, as well as develop diseases or medical conditions that are related to old age, and which require support, medical and otherwise. It has been shown that a global demographic transition is occurring, and the percentage of old people in the world is rapidly growing (Young, Robinson, Chell, Sanderson, Chaplin, Burns et al., 2005). This suggests the need to pay more attention to the subject of treating elderly people, offering them sufficient and proper care for their various special needs and promoting their independence so they could live and function well. This dissertation comes to examine in depth the subject of elderly dependency, including the causes of their dependency, factors affecting it, measures and methods to dealing with it, as well as the welfare state of older people in the past and the present. An overview of the welfare state for older people The global demographic transition has caused health and social care services worldwide to address the needs of older people as a priority. Frail older people, who are elderly people with physical or mental impairments, are major users of these services. Attending to their needs in personal, and to those of the entire population of elderly people, is quite a challenge. Proper care is needed in order to make a positive impact on the health and independence of the elderly. However, the situation today is insufficient and does not always comply with the requirements. Home care for older people in England is often "inflexible, misses opportunities to promote independence and suffers chronic staff shortages", shows a report published by the Commission for Social Care Inspection. The commission has found that services are concentrated on older people with severe needs, and this is why many other older people, who would certainly benefit from home care, do not receive it. Also, the commission's report reveals that some employers attempt to save money on selection and recruitment of home care nurses, and 39% of inspected agencies failed to meet the national minimum standards in this area. Be that as it may, home care services have improved since in the past years. For instance, three-quarters of providers were found to comply with the minimum national requirements, and inspectors of the commission praised certain aspects of personal care, which were associated with "respectful, caring and helpful attitudes of staff"(Hocking, 2006). There are different opinions as to the current welfare state of elderly people today and the services provided- some claim it is highly insufficient and others claim it is evolving well, especially after the report of the commission has been released. Either way, the significance of this matter is obvious and tangible. Generally, the growing number of older persons in our society is well recognized. Less well recognized or understood, however, are the implications of this growth. (Tenhoor, 1985) Welfare programs are developed in order to address the growing problems that the increasing population among the elderly has brought about in the community. Policies and programs were and are developed in order to deal with this problem. From the simplest things such as their daily needs, to their health care, as well as their insurance, the government takes part in every way. As a result, there had been an increasing elderly dependency among the elderly. In the context of Government Legislation These issues concerning the various dependency problems of the elderly had been soliciting a great amount from the government. A large part of the national fund goes through the welfare state programs that address the problems that concern the elderly. However, much as the government has been giving too much attention to providing them their needs as they grow older, there has been lesser attention given as to the methods of encouraging the elderly to become independent as they grow older. According to BBC (21 March, 2005), there are 1.7 million elder people in need of services and care, but how awful is the fact that Government is still not serious in taking measures for elderly independance. Harding (1999) while highlighting some of the depressed opinions about the effectiveness of UK community care states, "older people have not had a way of voicing their own priorities or discussing how best to meet them." Another is a statement by Parker (1999) that "care management, as implemented in the UK, cannot be for the carer; the focus must logically be on the user." (Boldy et al, 2001, p. 91) In UK, there have been two large studies in the past. The first study listened closely to the views of 1000 elderly people living in 100 large residential homes (Willcocks et al, 1987); the second study analysed the experience of 7,000 older people living in 175 homes (Booth, 1985). These studies focussed on large elderly care institutions which uniquely identified that even when enlightened methods of care were used and better training was given to staff, there seemed to be little effect on reducing the damaging effects of institutionalisation. The results were based upon serious objections raised by older people to traditional large residential and nursing homes. Five major criticisms with respect to older people in large institutions were identified (1) it is not their own home, (2) they lack control over their own lives, (3) they become increasingly dependent on others, (4) they lose their own individuality, and (5) it is a strict and isolating experience. (Boldy et al, 2001, p. 102) The health care system in UK is tax-funded. Financial responsibility for elder care services has been transferred to the local level, although some benefits and an allowance for institutional care is contributed by the national social security scheme. Long-term care policy and legislation have established one central assessment, which aims to establish the extent and severity of long-term care needs. In Britain, this is the Community Care Assessment under the 1990 National Health Service and Community Care Act. Britain in this context must deal with the critical question of the extent of state regulation on providers to guarantee equitable provision to all. Furthermore, problems of medicalising elder care and compartmentalising care between various services in particular, between health and social care services lead to inadequate provider service delivery. Giving frail older persons much more choice and control over their care arrangements, that is, empowering them more, implies first an increase in the availability of sustainable care arrangements beyond the unpaid labour of informal caregivers or facility-based care, and second, service delivery that is not provider-led but rather responds to users' needs in innovative and flexible ways. (Boldy et al, 2001, p. 236) National policy in the United Kingdom is certainly in transition from a mere "social services" model to a "participation" model, in Moody's terminology (Moody, 1976). So are most of the field agencies, particularly the local social services authorities that are responsible for the policy performance in their areas. Indeed, we shall suggest below that there are respects in which, for most users in many areas, a transition is being made toward a "self-actualization" model, though less in the forms adopted than in the style of specific activities conducted within the forms. The British national government worked the themes of empowerment and independence through at the level of policy logic. The exercise of pressure on field agencies to implement that logic has had an intensity that has been rare and arguably unequalled in any other country taken as a whole. Perhaps it is for that reason that some of the policy statements and guidance about how to implement them have almost the status of sacred texts in certain other countries. (Boldy et al, 2001, p. 43) UK policies have wrestled with dilemmas over services, eligibility, and the roles of the private and public sectors in accepting responsibility for the frail. Concern with resources and the recognition that the needs of the elderly have far-reaching effects on society have generated debates and proposals to pass a new legislation, at both federal and state levels. III. Significance of the situation to the community/society Clearly, it is utmost important to take care and support the fragile and vulnerable parts of the society, among which the elderly are included. Seeing as how the percentage of older people in society is increasing, it is even more significant to make sure that elderly people are well taken care of. Taking good care of older people is important to the entire community, since it may improve the living conditions of everyone (if more clinics and care facilities are opened, for example). Also, everyone in the community has a family member, a friend, an acquaintance who is old, and mistreating the old people can indirectly affect them, as well as directly hurting the old people. Providing appropriate housing conditions to the elderly, cannot reckon towards the material significance alone, it has its own moral values. The importance lies in the situation in which we as parents are unable to give proper time and attention to our new generation, which causes umpteen complexities and psychological disorders among our children. Our elder parents are not only able to take interest in our children thereby shielding them from many complex situations but are also able to teach them awareness through their experiences. Government may provide housing for individuals needing a supervised living situation, in which minimal assistance is provided. Alternatively, sheltered or assisted housing may be a form of care provision itself, in which more extensive medical and personal care assistance is available. Assisted living brings into focus the sometimes conflicting priorities of the social services, housing experts, and health care providers whose emphases in residential care may vary. In long-term care for the elderly, the roots of the dichotomy between housing and care are similar to the conflicts between the medical and social models of care. The biological and biomedical models of aging have contributed to the perception of old age as an individual problem (physiological decline with chronological age). Aging is thus seen as independent of social structure and as largely a medical problem. This view does not, however, take into account social factors contributing to elderly disease nor their social problems. Finally, if a society does not value its seniors, or only provides very limited program policy choices for care management in old age, these become impediments. This is especially true for those seniors who lack the financial resources to make up the difference in societal ignorance or complacency. In some cases the choices are there but society fails to provide the information or knowledge to make optimal choices. This is most prevalent when certain ethnic or economic minorities are systematically uninformed or only provided with the options available to the majority. The ultimate impediment is always ageism on the part of a society. (Boldy et al, 2001, p. 43) One of the most effective ways of overcoming the impediment of negative societal values regarding the role of elderly people in any society is by changing the attitudes of people across all segments of society. We, as a society are responsible for breaking up the stereotypes regarding our elder generation and as psychological research has shown, the best way to break down stereotypes is through personal interaction and learning that all people are unique and that everyone has something to offer to the common good. Leino-Kilpi et al. (2001), while considering elderly independence, illustrate four dimensions of privacy. That means elderly privacy should be based upon a framework composed on four factors: Physical, psychological, social and informational. However, as Bland (1999) argues in relation to the delivery of residential care in Britain, it is likely that social conventions regarding privacy continue to be breached because of the perceived need to minimise exposure to risk by maintaining a close surveillance of residents' behaviour. Thus, the results point to a conclusion that post reform community care does seem to improve the sense of users' control over their own lives quite substantially, compared with what would be predicted in the absence of such reforms. References & Bibliography Boldy P. Duncan, Heumann F. Leonard & Mccall E. Mary, (2001) Empowering Frail Elderly People: Opportunities and Impediments in Housing, Health, and Support Service Delivery: Praeger: Westport, CT. Moody, H. R. 1976. Philosophical foundations of education for old age. Educational Gerontology (1): 1-16. Leino-Kilpi, H., Valimaki, M., Dassen, T., Gasull, M., Lemonidou, C., Scott, A. & Arndt, M. (2001) 'Privacy: a review of the literature', International Journal of Nursing Studies, 38, 663-671. Willcocks, D., S. Peace and L. Kellaher. 1987. Private lives in public places. London: Tavistock Booth, T. 1985. Hometruths: Older people's homes and the outcome of care. London: Gower Publishing. Read More