Improving Older Adults’ Mental and Emotional Well-Being with Home Health Care

Seniors go through a lot of changes that can impact their mental and emotional health. Some of these changes are minor and occur gradually, while others are significant and abrupt.

Below are some of the challenges older adults face that may compromise their psychological well-being.

Challenges That Impact Seniors’ Emotional and Mental Health

Isolation and Loneliness

Different factors can fuel feelings of loneliness and isolation among older adults. These include:

– the death of their spouse, relatives, or close friends
– losing their jobs
– retiring from careers that defined their identity and gave them a sense of purpose and self-worth
– the absence of people they can regularly talk to and confide in
– mobility and transportation challenges that also lead to decreased social activities

Prolonged loneliness can have detrimental effects on seniors’ health. It can weaken their immune system and put them at higher risk of chronic diseases.

Loss of independence

As their health continues to decline, older adults find themselves unable to do things on their own. They may need help cleaning the house, rely on others for transportation, or require assistance when using the toilet or taking a bath. Others may be suffering from chronic illnesses or recovering from injuries that keep them in bed for weeks or months.

All these may leave your elderly loved one feeling helpless and frustrated. They may fear losing their independence and having less control over their lives.

Memory issues

Occasional memory lapses are a normal part of aging. But factors like illnesses, lack of sleep, or depression may worsen older adults’ forgetfulness.

These memory issues can frustrate older adults and even pose threats to their health and safety. They may forget to take medications on time, or accidentally leave stoves and ovens on.

Vulnerability to stress and mental health concerns

Aside from the changes mentioned above, other challenges can increase stress among the elderly.

Their fear of slipping or getting injured can make them more anxious to go to the bathroom alone or leave the house without a companion.

Financial concerns may also weigh them down. They may be worried about not being able to pay for growing medical and living costs or long-term care.

Chronic stress can increase the risk of mental health issues among seniors. According to the World Health Organization, 7 percent of adults over 60 years are suffering from depression and 3.8 percent from anxiety disorders. Data from the Centers for Disease Control and Prevention also revealed that men 85 years or older had the highest suicide rate of any age group.

Chronic illnesses also leave seniors more vulnerable to depression and other mental health concerns. These mental health issues can further impact their physical health and recovery. For instance, seniors suffering from loneliness and depression have higher mortality rates. Depression also affects the success and duration of cardiovascular treatment in older adults. It can even aggravate insomnia and memory loss.

Augmenting Psychosocial Support for the Elderly Through Home Health Care

The benefits home care workers provide go beyond physical assistance. They become additional sources of psychosocial support, helping seniors navigate challenges that come with aging.

Regular emotional support

Having someone to talk to may help older adults manage difficult emotions like loneliness, fear, and frustration. Moreover, having constant emotional support can help reduce their risk of developing mental and physical issues.

Companionship and socialization

The companionship home care workers provide can alleviate chronic loneliness among seniors. They can also help older adults maintain an active social life by:

– driving them to community activities or visits to family and friends
– accompanying them during walks
– helping them use video chat tools to keep in touch with relatives and friends

These activities help seniors stay connected, keeping feelings of isolation and loneliness at bay. Participating in social activities gives them something to look forward to and allows them to create new memories and connections.

Supporting healthy routines

Healthy eating and exercise keep seniors strong and improve their balance. These also keep their memory sharp, boost their mood and help them relax and manage stress.

In-home senior caregivers and home health aides can help older adults stay fit and stick to healthy routines. For example, they can prepare nutritious meals and ensure these meet seniors’ dietary requirements. They assist them during light exercises, accompany them during walks, and inspire them to resume their hobbies.

Physical support to maintain their independence and quality of life

Aging in place allows seniors to retain their sense of independence and control over decisions that affect their lives. Living in a familiar place, surrounded by things that bring them comfort, may also give them a sense of security amidst the changes they are going through.

Home care workers help seniors stay independent while reducing the risks and difficulties that come with aging in place. They help older adults keep their homes clean and safe by handling light housekeeping tasks and removing hazards like electrical cords and rugs. They help them maintain personal hygiene by assisting them with bathing and dressing.

Home health care agencies provide seniors and their loved ones with cost-effective home care options. This flexibility in terms of the type of care and cost can reduce seniors’ financial stress. Clients can decide how often to request these services and what tasks they need help with. Older adults who are recovering from injuries or illnesses can also save on hospitalization costs through in-home skilled nursing care.

Promoting Holistic Health for Seniors

Changes that come with aging can hurt your elderly loved one’s mental and emotional well-being.

This is an area where home care can help. Home care workers become constant sources of social support for seniors, helping them experience healthy aging and a better quality of life.

Stressed Out Caregivers Are Using ER Visits for Respite, Study Finds

Emergency room staff call it a “pop drop” – when a disabled older person comes in for medical attention, but it seems like the person who takes care of them at home is also seeking a break from the demands of caregiving.

It’s been hard to actually study the phenomenon. A new University of Michigan study suggests that tired family caregivers are associated with greater ER visits and higher overall health care costs for the person they care for.

In a paper in the new issue of the Journal of the American Geriatrics Society, the team reports their findings from a study of 3,101 couples over the age of 65, each with one spouse acting as caregiver for their disabled partner.

The researchers looked at the Medicare payments and emergency department visits for the disabled spouses in the six months after the caregiver spouses took standard tests to measure their fatigue, mood, sleep habits, health and happiness.

Even after they took into account many factors, the researchers found that in just those six months, emergency department visits were 23 percent higher among patients whose caregivers had scored high for fatigue or low on their own health status.

Patients with fatigued or sad caregivers also had higher Medicare costs in that same time period: $1,900 more if the caregiver scored high for fatigue, and $1,300 more if the caregiver scored high for sadness, even after all other factors were taken into account.

The cost of unpaid help

“Many of us who work in clinical settings feel that patients with high home caregiving needs, such as dementia, often rely on the medical system as a source of respite for their spouses or other caregivers, because other respite isn’t paid for,” says lead author Claire Ankuda, M.D., M.P.H. “But there hasn’t been a lot of data about it, and only recently has our society been talking about caregivers and potential ways to incentivize and support them as a way of keeping patients living at home.”

Ankuda, who led the study during her time at in the Robert Wood Johnson Clinical Scholars program at U-M’s Institute for Healthcare Policy and Innovation, is now training in palliative care at the Icahn School of Medicine at Mount Sinai.

“Informal caregivers, including spouses, enable older adults with functional disability to stay out of the nursing home and live at home where they’d prefer to be,” says senior author Deborah Levine, M.D., M.P.H., an assistant professor of internal medicine and neurology at U-M.

We need to do a better job of identifying and supporting caregivers experiencing distress, in order to help caregivers feel better and hopefully improve outcomes in older adults with disability.” Deborah Levine, M.D., M.P.H.

Long-term data gives key insights

The couples in the study were all taking part in the long-term Health and Retirement Study, conducted by the U-M Institute for Social Research on behalf of the National Institutes of Health. Ankuda, Levine and their colleagues probed HRS data because it allowed them to correct for factors that other, short-term studies can’t – such as the baseline level of Medicare costs, demographic differences including income and education, and even whether the couples have adult children living nearby.

The findings add hard new data about the link between caregivers’ own experiences and the amount the Medicare system pays to take care of those the caregivers take care of at home.

Nearly 15 million older adults get help with everyday activities from spouses and other family or friend caregivers. In the new study, the researchers included couples where one spouse got help from the other with activities such as bathing, dressing, walking, getting into or out of bed, shopping, cooking, and taking medications.

Helping with these tasks on a daily basis, without pay or respite, can take a toll on the caregiver’s own health, wellness and mental state – which can lead to burnout. Medicare does not offer payment or formal respite coverage for family or friends who take regular care of older adults – and only covers home care by certified agencies under certain circumstances.

More research & services needed

Ankuda notes that studies on the impact of supporting family caregivers more formally are just beginning to produce results.

Meanwhile, health policy researchers are beginning to suggest that it may make fiscal sense to incentivize home caregiving, to keep seniors from needing more expensive nursing home care.

“I definitely think there are specific services that could help caregivers, if we can identify those people who are highest risk and provide a basic level of support such as an around-the-clock geriatric care call line that could help caregivers feel less isolated and talk to a nurse about whether, for example, to go to the emergency department,” Ankuda says. “This is a high-cost, vulnerable population.”

Formal respite care, peer support groups and other options could also help stave off fatigue and sadness – and the hospital staff who notice “pop drop” practices could help steer caregivers to such options. So could the primary care clinicians who take care of both the disabled spouse and the caregiver.

Because the new study takes into account the level of Medicare spending for the disabled spouse in the six months before their caregiver was interviewed, it may actually underestimate the impact of caregiver fatigue, she notes.

Indeed, before the authors corrected for the full range of factors, they documented that Medicare costs were lower for patients whose spouse-caregivers who reported being happy or rested. They also saw higher costs among patients whose caregivers had higher depression scores on a standard mood questionnaire.

One factor that wasn’t associated with higher costs in the new study was the caregiver’s score on a standard measure of sleep habits. Sleep disruption is harder to quantify in older people, Ankuda notes. But the measurement of fatigue, which can result from both the strain of caregiving and poor sleep, was clearly associated with both higher rates of emergency department visits and higher overall costs.

Elder Abuse in the Twenty-First Century

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In this “silver tsunami” era, elder populations are outnumbering the younger workforce. This creates significant inequity and more than enough opportunity for people to take advantage. Whether financially, neglectfully, emotionally, physically or sexually, seniors in the United States are at a high risk for exploitation.

Seniors can be abused by underpaid and overworked employees. Nursing shortages, along with an explosion of senior populations, lead to less competent care resulting in bedsores, malnutrition, falls, sepsis or other damages from neglect. In addition, economic woes lead to a rise in physical and financial abuse perpetrated by family members, caretakers and even outsiders. Older people are more susceptible in giving of information without asking questions, which makes financial abuse a low-risk, high-reward crime area. Having adequate representation can be a problem as well.

Social Security and other government assistance is typically managed by a person with power of attorney, but occasionally the government will designate someone to perform economic functions. The potential for abuse necessitates records to be very exact and reported regularly. Social security, wills, estate management, retirement portfolios and such accounts are difficult for most clear thinking people. It has been reported that any older person, much less those with dementia, make bad financial decisions.

Trends

Knowledge of elder abuse is not up with the times, decades behind the experts in the field. It’s difficult to even get a report filed. The myriad of potential problems is worsened due to many inappropriate state laws being slow in prosecuting offenses. Institutional Review Boards don’t commonly deal with such cases and there are not many federal regulations. Meanwhile, seniors don’t always have a great memory for testimony to help their cause in getting charges.

It is going to be hard for the courts to catch up with the times. Currently, elder abuse is acknowledged by WHO as a human rights violation with one in ten seniors falling prey to some crime. That ratio becomes one in two concerning people with dementia. As bad as the current populations trends look now, the future looks worse. 85+ is the fastest growing age group in the United States and the 60+ population is expected to double to over 2 billion people by the year 2050.

What to do?

Local district attorneys need tougher laws that focus on stopping predators and ways to enforce those laws. Whether with state or private agencies, seniors need more representation in housing placements or other living transitions and their monetary affairs.

Elders need younger people to show interest. Nursing home staff is going to be more careful with people they know are being checked on. Other relatives that are taking care of a loved one, should be helped out too. Stopping by or ask about older family members shows that someone is cared for, reducing the abuse risk. Importantly, it also breaks the cycle of care and provides everyday caretakers with the knowledge that they could get a break if needed.

The marks of abuse need to be more commonly known and easy to identify. Upwards of 500,000 seniors are victimized, but very few of these cases are ever identified, much less reported and charged. It helps to have advocates who can sense physical harm, negligence, medical malpractice and other atrocities. Physical and sexual abuse are easier to spot than most neglect, so it takes a concerned loved one to spot personality changes or injuries that are inconsistent with the individual.

Mistreatment is more likely to occur to seniors who have experienced past abuse, in part because those people are frequently left in bad situations and never given much help. Senior women are more victimized than men, as are people in poorer health and those with lower incomes. Many other obvious risk factors and tell tale signs exist to make others aware. We need to be more empathetic and better educated.

The onus is on the concerned relatives to care about what facility seniors are placed in. For-profit corporate chain nursing homes often have less than ideal conditions for staff or residents. Relatives should take the time to tour various homes, make observations, and find the right fit. The most important way to combat elder abuse is by being involved. We just can’t put elders into homes and forget about them. It’s not supposed to be a prison for people we can’t help anymore. Nursing homes are expensive places that should be treating residents like royalty. It takes our effort to keep things as they should be.

To facilitate better treatment, we need to listen to both seniors and caregivers. We need to be attuned to what seniors needs and worries are. We need to speak up and file charges when something has happened. One in ten reported cannot be acceptable. If a caregiver is stressed or burned out, we need to make sure they can get the breaks they deserve to provide the best care, just as we must make sure caregivers are getting paid adequately for the grueling work they put in.

As with raising a child, it takes a village to care for our elders. We need to impress upon society in general that it is everyone’s responsibility and how this needs to happen. We are all going to be in this position someday, we should be doing everything we would want others to do for us as we become more helpless.  

Are We Forgetting About The Sandwich Generation?

By Ed Kashi and Julie Winokaur
By Ed Kashi and Julie Winokaur

When working with elderly patients in health care facilities, it is likely that we may forget about the needs of their adult children aka The Sandwich Generation. The sandwich generation is adult children typically between the ages of 30-50 who are caring for their aging parents while taking care of their own family as well.

Taking care of young children while caring for aging parents puts a great deal of stress on the adult children. In my experience working with families in hospice, I’ve noticed some factors that contribute to the stresses of this generation:

  1. Financial Concerns – Older Americans are living off their fixed income such as Social Security, VA pension, and personal savings which may not be enough to pay for certain expenses. Many retirees can not afford to live in assisted living facilities, or private home attendants, and monthly expenses in their current homes. The children often struggle as they have to figure out how to pay for these expenses if their income is limited as well. This issue is very common for funeral expenses since many retirees don’t have life insurance.
  2. Feuding Relatives – Adult children may have a long history of sibling rivalry which can leave an impact on the care of their elderly parents. One child may agree to hospice care while the other beliefs in aggressive treatment. The rivalry can easily be carried into a facility where we, the social workers usually witness the drama.
  3. Lack of Awareness – You will be surprised how many adult children are not aware of health care proxy, advance directives, or how life insurance works. Some assume that their parents’ insurance will cover everything. Many times I had to inform the children that Medicare does not cover long term costs which brings back to #1 on this list.
  4. Bad Timing– Sometimes adult children may wait till the last minute to make handle their parents’ affairs. Reasons for this occurrence may be that they learn about the resources too late, procrastination, denial, or lax in their own time management. I had adult children asking me how they can get a power of attorney for their parents, and the patient is unresponsive, and near death.
  5. Mom and Dad Are Not The Same –  We know our parents from the time we were born. We are not use to seeing our parents getting older and sicker. Many adult children may not be prepared to watch their parents deal with a debilitating condition such as Alzheimer’s Disease. On the other hand, adult children may have their own personal issues about their parents that was unresolved. These changes can bring emotional distress to the children.

When working in hospitals, assisted living facilities, home care agencies, or adult day programs it’s very common to see these issues surface with this generation. However, social workers who work in private practice or other settings might encounter someone who experiences this as well. Unfortunately, we are unable to prevent adults from getting older and prevent the sandwich generation to face this situation.  We can, however, take some steps to reduce the burden and educate this generation at our place of employment. Here are a few things to consider:

  1. Assess All Legal Health Forms –  Many hospital staff is required to ask patients and families about advance directives, and health care proxy. Families should be educated on the advantages of having these forms in place. This can make health care decisions easier for the adult child.
  2. Discuss Available Services –  Be aware of the services in your community which will allow you to share them with your clients. Services include, Medicaid, home care services, senior subsidized housing, and elder law attorneys are some examples of resources for the elderly. It’s very important to be aware of the referral process of these services. For example, filing for food stamps in NYC is entirely different than filing it on Long Island. If we are knowledgeable about the services than the family is well informed of their options.
  3. Review their coping techniques – Caregiving is physically and emotionally stressful. It’s very important that we assess how adult children are coping. Do they have a counselor to who they can speak to? Do they receive support through their place of worship? Are they attending caregiving support groups? What are their personal issues about their parents that they are struggling with? These questions are some of the examples we can ask when assessing their situation.

How social workers intervene depends on the needs of the adult children. In one situation, the child may have all the concrete needs in place but still requires emotional support. On the other hand, there will be another case where the social worker may have to review health care proxy, discuss Medicaid service, and mediate the feuding siblings.

At the end of the day, you could never give too much emotional support to the sandwich generation.

CleverCare Watch Brings Peace of Mind

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A few weeks ago at the Home and Community Health Association conference, I met some of the team behind CleverCare, a new service that connects an Android smart watch to a web interface and a 24-hour call centre.

CleverCare is the brain-child of Maria Johnston. As the website explains, “developing the Clevercare system was driven from a personal need for Maria to make a positive difference in the everyday life or her parents. She then found that her family’s problems were experienced by many and now, through Clevercare making lives better with independence and peace of mind can be achieved for many.”

clevercareMedicalAlarmUPDATEDFEB2015-e1429159091562Designed for people with dementia, the Android watch runs a simple app and contains a GPS geolocator. The device is tracked via Google Maps in an online dashboard. Boundaries can be set to alert family, friends or support workers if someone wanders beyond a safe distance. Reminders can be pushed to the watch via the dashboard.

The watch will also alert a call center at the push of a button. The watch can receive phone calls from the call centre (in fact any phone), to establish the person’s need. If unanswered the call centre will contact a nominated person or send an ambulance to the GPS location.

As a user of a Bupa alarm, which is wired to your home, the CleverCare watch’s potential to be a safety net to a wider range of people was instantly obvious to me. I was soon talking to Maria and Shane, CleverCare’s sales rep, about the possibilities for younger people with unique function living independently, but anyone who may be vulnerable to risk and need assistance could utilize the device.

I notice that since the conference, CleverCare has widened its target audience to include children, people working alone, cyclists and more. At the end of the conference Maria and Shane offered me a watch to use. Already I am noticing the peace of mind my Bupa alarm gives me at home but, of course, with the watch, I have it wherever I am.

The dashboard is currently oriented to be ‘driven’ by the support/contact person, not the watch wearer, because of the focus on dementia support. A reorientation could put the watch wearer in the driving seat and, if more contact people were able to be added, a chain of contact, similar to my Bupa alarm, would make this technology truly revolutionary in terms of providing people a sense of safety and confidence.

The watch CleverCare uses at the moment is not the most attractive accessory but, again, it is designed for simplicity of use by older people and those with unique cognitive function. I’m not sure what I’ll do when I get my Apple Watch!

Which brings me to what I see could be the ultimate opportunity – the development of a standalone CleverCare app. Whether on a smart watch, phone, tablet or even desktop device, an app could bring this safety technology to anyone, anywhere.

If you see the benefit of CleverCare for yourself or someone else, do contact them directly or let me know so I can pass the interest on to Maria and her team. There is a cost but I understand it can be funded by the likes of ACC or Individualised Funding. And of course, the bigger CleverCare’s market, I’m sure the more cost effective it can become.

https://www.youtube.com/watch?v=PwQcPc580bQ

A Gentle Approach to Dementia for Care Providers

dementia-patient

When I first became a hospice social worker, I was stunned to realize more than half of my patients were diagnosed with advanced dementia. I had been under the assumption that I would be working with mostly people with cancer or other chronic illnesses such as Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF). While many of my patients have suffered from those maladies in the latter category, the prevalence of dementia is rather high. After seven years as a social worker “in the trenches,” I would have to learn a whole new skill set if I was to survive and thrive in hospice.

Most of these patients eventually end up in nursing facilities as the burden of their care becomes too great for family members to keep them at home. In visiting such facilities, I have came to find that many more people than just those in hospice were in various stages of dementia. It is a fascinating phenomenon with several different causes, but I have developed my own way of working with these individuals based on their current level of capability to engage interpersonally. As a result, I have identify several areas of concern regarding the treatment elderly patients receive from care providers and other medical professionals.

Aside from the ways dementia affects different people on a physical level which can include the ability to ambulate, muscle contraction, etc., the mental symptoms can range from extreme forgetfulness to devastating interpersonal impairment. Some of the most pleasant conversations of my day are sincerely answering the same three questions over and over again for an hour with the same patients, but they have little to no short term memory.

I have also spent a lot of time in constant redirection and assurance with people that can no longer recognize relatives with whom they have spent the last eighty years. I have seen these individuals coddling realistic looking baby dolls as part of their care and have played music for people that are nearly catatonic, only to watch their bodies come alive with movement at the faint and automatic memory of their favorite songs, something that blessedly seems to remain long after their ability to speak has faded. I have heard ninety year old patients insist that their mother had just been to visit them or that their young children were running around the facility.

The common thread with which I approach these wounded patients is a measured gentleness that preserves their dignity and, to the greatest possible degree, facilitates their comfort in the immediate moment. For most of these people the present moment is all they have. Thus my preferred method is to redirect them in conversation and to by no means challenge their obviously factually incorrect assertions with harsh reality.

If an elderly woman whose mother has obviously passed insists that she must know when (her mother) will be visiting, I will respond that she’ll probably be around later. I have witnessed facility nurses and aides confronting such patients with the fact that their mother will not be visiting because “she’s dead,” repeating this every time the person asks. I will just as gently take such workers aside and explain that they are effectively breaking the news of the death of a patient’s loved one several times a day, each instance with its own accompanying trauma.

Another of my concerns is when I see people with dementia being treated like children because “they don’t know any better.” Almost every culture in the East has, currently or at some time in their history, had a practice of revering their elders simply for the fact they have lived longer and accrued more life experience than most.

Watching people with little wisdom earned through the kind of adversity their patients have faced treat said individuals as mere nuisances to be quieted makes me sad to say the least. I labor under the belief that my patients are people, whether they be completely lucid and able to participate in conversation or if they are unresponsive. As such, I also believe that each of these persons have the right to my full presence and attention and that, while their minds may have been rendered functionally impaired, their spirits are perfectly intact and engaging with mine. In short, I am no better than these people just because my mind is still functional.

Lastly, watching the pain endured by the family members of such patients is nearly unbearable. They faithfully and dutifully make their regular visits in the vain hope that they will see even the briefest signs of recognition in the eyes of their loved ones, only to inevitably leave disappointed and heartbroken. They deserve to know that their family members are being treated with the highest level of respect and dignity and with a kindliness and gentleness reserved for the most vulnerable amongst us.

Please keep these concerns in mind the next time you encounter a person with dementia. They are locked in a special kind of hell that I hope you and I will never have to experience.

Elder Abuse: Don’t Let It Be Your Grandma!

By Denise Bartley, Andre Juste, Rachel Meadows, and Guiseline Momplaisir

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According to a study by the National Center on elder abuse, 63.7% of the reported abuse cases were elderly women? Statistics suggest that the majority of elderly Americans, our grandmothers and grandfathers, are being abused and neglected. For those of you who don’t know, elderly abuse refers to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.

The problem is that we fail to recognize just how vulnerable the elderly are. The elderly are often seen as a wise and loving population who aim to educated and guide the young. But the sad truth is that elderly people are very likely to suffer from various illnesses and disabilities such as dementia. 14 million adults over 65 year in the U.S have some form of disability. Approximately 5.1 million adults over 65 in the U.S have some form of dementia and almost half of the adults over 85 have Alzheimer’s disease—or a disease closely related to.

Now, when you throw in the fact that the elderly are highly reluctant to report abuse because they fear worsening their situation it is clear that they are indeed vulnerable. They shouldn’t have to deal with abuse or neglect, and it is time for a change. Even though this population is reluctant to report their abuse, Adult Protective Services (APS) have shown that there is an increasing trend in the reporting of elderly abuse.

Research estimates that only 1 in 14 elderly abuse cases are actually being reported.  According to the New York State Elder Abuse Prevalence Study, it estimated for every 1 case of elderly abuse reported 24 cases go unreported. A sample study of adult women with disabilities showed that 67% experienced physical abuse and 53% experienced sexual abuse. In another study 55% of adult men experienced physical abuse after becoming disabled, 12% of which said it was from a personal assistance service provider. It is estimated that roughly 90% of the abusers in elderly cases were family members, the remainder of which being mostly service providers.  These statistics are a disgusting truth and can no longer go unheard.

For those of you, who may not empathize with the elderly after reading this, imagine if it was you. The U.S Census recorded the highest ever recorded population of individuals over the age of 65 in 2010 which is 13% of the U.S population or 40.3 million people. The currently fastest growing portion of the U.S population is the 85 and up elderly. By 2050, there will be an estimated 19 million people 85 years or older in the U.S making up 20% of the population.  If the national elderly abuse crisis is not rectified soon then based on the preceding statistics, it likely will be you.

There are various resources for the elderly across the country. Eldercare Locator is provided by the Department of Health and Human Services and helps connect older adults and their families with local service providers for the elderly. Eldercare Locator can be contacted at 1-800-667-1116 (Monday- Friday 9 a.m. – 8 p.m. Eastern Time) or at eldercare.gov (24/7). Because the majority of elderly abuse cases go unreported, ending abuse must start with reporting the abuse. If there is an immediate danger or threat of danger to your health, safety, or well-being call 911! Also, you can contact your local social services agency with their Adult Protective Services division to report suspected elder abuse in homes and care facilities.

In addition, we can stop the abuse by being there for our aging population. If they say someone is abusing them— listen and do something about it! Take action! We are all in the same boat, we are all aging, and we all know someone who is aging. By taking action we are not only protecting our grandparents, and we are not only protecting our future selves, we are protecting everyone!

We are students passionate about empowering people, and we’ve started this campaign to give a voice to those who don’t have one #‎outofyourshadow.

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Spotlighting the Launch of the DOJ’s Elder Justice Website

Recently, the United States Department of Justice announced the launch of the Elder Justice website which was created to help further combat elder abuse and financial exploitation of seniors. Being the caregiver of a member of the Silent Generation and being a helping professional, I understand how dire it is to protect the older members in our society, and to report any forms of abuse or neglect they may endure.

Elderly Black Woman 1With a plethora of resources out there, it can be overwhelming to figure out what information is appropriate and current to utilize and pass along to those who need it. The U.S. Justice Department has taken steps to provide an online informational “hub” for older Americans, their families, law enforcement, helping professionals, and other stakeholders who have a vested interest in ensuring that older Americans’ rights and humanness are respected.

The Focus Behind Elder Justice:

The need for such a new resource is imperative, especially since one in ten Americans over the age of 60 suffer from abuse and neglect in this country.  Elder Justice’s aim is to be another proactive measure to assist in preventing elder abuse and financial exploitation.

Elder abuse can consist of an older individual experiencing physical, emotional/mental, financial, and/or sexual abuse; and neglect in one’s well-being and care, which can include health care.  The devastating effects of elder abuse is not just felt by the individual targeted, but by those within the community as well.  Elder abuse dwindles the resources set aside for elderly individuals, families, businesses, and public programs (including Medicare and Medicaid) by billions of dollars each year.  This depletion causes tremendous strains on our healthcare, financial, and judicial systems to transpire.

Protecting the elderly has continued to be a priority of the Justice Department, which were evident by the remarks Associate Attorney General Tony West made at the outreach event of the website launch in mid-September:

The launch of the Elder Justice website today marks another milestone in reaching our shared goal of keeping older Americans safe from abuse and neglect  …  The more we embrace our elders with respect and care, the stronger our society will be.  This tool helps move us closer to that goal.

Various forms of abuse and neglect are not the only issues concerning our seniors the Elder Justice website tackles.  Financial exploitation by consumer scams and healthcare fraud are forms of deception this population experiences.  Seniors are estimated to lose almost 3 billion dollars each year from these kinds of exploitation.  The consequences can greatly diminish older adults’ quality of life by creating a loss of independence and self-sufficiency, and increasing the infliction of health and psychological distress.  The Justice Department has taken several steps to focus on these matters, such as prosecuting those who purposefully targeted seniors with scams involving reverse mortgages and lotteries.  In regards to healthcare fraud, the implementation of enforcement, prevention, and consumer protection initiatives has aided to curb financial exploits of our seniors.

What to Expect When You Visit the Elder Justice Website:

Assistant Attorney General Stuart F. Delery made the following statement about what the public and professionals can find on the Elder Justice website:

The website provides resources and a means for improved communication among prosecutors, supports victims and families, and establishes a mechanism for collaboration for researchers and practitioners … While there are many other victim support websites available, we believed that the department could add significant value in this domain by consolidating information nationwide and making it more user-friendly.  The Civil Division will continue to strengthen its efforts to protect the elderly.

The website is easy to navigate, and seems to be very accessible for users of different technological abilities.  There are several tabs on the left column of the homepage that directs visitors to resources and information that may pertain to their unique situation or interests, such as “support for victims and families,” “practitioner resources,” “financial exploitation,” and “researcher resources.”  Each resource link provides several subcategories of information for that particular topic.

The “support for victims and families” resource link has the best information available on the website, in my opinion, because you can search for organizations in your particular state.  When I viewed the resources for South Carolina page, I was amazed at the simplistic layout the information listed was arranged in – the information was housed in an easy to read table format with the title headings “organization’s name,” “address,” and “contact numbers.”  Every organization listed was categorized under its appropriate mission focus, so that users would understand the kind of assistance to expect if they were to contact that organization.

You can also search for organizations by keyword, distance, zip code, or categories.  The various ways of finding organizations in your particular state/area is a great feature because it widens the possibility of connecting with agencies that could be a lifeline for you, your family, or your clients.  I critically viewed the functionality of the website through two lenses:  As a self-proclaimed semi-techie, I judge resource websites like this harshly because it should not be complicated or frustrating to search and locate information that could help and possibly save lives.

The website is accessible and can be effectively used by a layman or a professional equally with very little difficulty, which is how most websites should be.  As a helping professional, the Elder Justice website will make it easier for social workers and other professionals to be more aware of what resources they can direct clients and families to who are in need.  To me, the website is a great page to bookmark for future use, and to share with those who could benefit from the data compiled.

Final Thoughts About Elder Justice:

I was pleasantly surprised at the launch of a valuable resources such as this on the federal level.  As our elderly population grows with the Baby Boomers gracefully entering their golden years, the development of this website is indeed timely.  Though this website focuses on the elderly, it can be used for all populations that are vulnerable to abuse, neglect, and exploitation, including those with disabilities.

As one ages, the likelihood of acquiring a disability increases exponentially, so many of the adults who make up our senior population are living with disabilities or will be.  Their quality of life and well-being matters, just as that of a younger person.  Our seniors need us to protect and support them as they adjust to aging, and possibly living with chronic health conditions.  Resources like Elder Justice makes it easier to inform, empower, protect, and advocate for them, and to encourage them to empower and advocate for themselves.

(Featured headlining image:  Courtesy of Healthy Black Woman.)

Reducing the Risk of Developing Dementia: Is Freedom 55 Really Attainable?

Dementia is a debilitating illness that is characterized by degeneration of memory, cognition, behaviour and the ability to perform activities of daily living. Approximately 35.6 million people worldwide have dementia and there are 7.7 million new cases every year, given the projected increase of the aging population. In addition, although dementia mainly affects older adults, it is not a normal component of aging because it has led to much disability and lack of independence among older adults throughout the world.

Elderly Woman Smiling Wearing a Swimming Cap in a Swimming PoolAlthough incidences of dementia, the most common being Alzheimer’s disease, have been rapidly increasing, no treatment has been developed to cure the disease or reverse its deterioration of the brain and individuals’ functioning capacity. Therefore, research needs to take place to establish inexpensive ways to help individuals reduce their risk of dementia and maintain cognitive function.

Recent studies suggest that people who delay retirement have a decreased risk of developing Alzheimer’s disease or a related dementia. However, researchers believe that the age of onset of Alzheimer’s disease and dementia is affected by many more complex risk factors and protective factors that extend beyond simply delaying retirement, which makes this topic relevant to the future health of older adults.

Although, many individuals enter into a pursuit of attaining Freedom 55, this may not be the healthiest option for older adults. A recent study lead by Carole Dufouil concluded that every additional year of work could reduce the risk of developing dementia by 3.2 percent, decreasing the risk of developing Alzheimer’s disease or a related dementia. However, the findings of the study are reliant on many more complex protective factors than only retirement such factors include education, occupation and retirement age.

Firstly, education produces health and well-being, which thus lowers an individual’s risk of developing dementia. In addition, each year of education may decreased the risk of developing dementia by 12 percent. Secondly, employment can be both mentally and socially stimulating, thus helping an individual maintain cognitive abilities. Thirdly, level of occupation, retirement age and education may have greater cognitive reserve capacity that may delay onset of dementia. Other protective factors may include a healthy diet, exercise and continued cognitive stimulation activities later in life.

Therefore, since the amount of people with dementia is expected to double by 2040, it is evident that a means to reduce the risk of dementia needs to be developed. However, older adults must decide what activities will be the most effective in helping them maintain cognitive and mental health throughout old age. For some this may be continuing to work or retirement, depending on their current occupation and job satisfaction. It does not make sense for an individual to continue working if they hate their job; therefore, an older adult must choose unique ways of exercising their brains that will work for them. Freedom 55 may be attainable for some; however, not for all.

References

Basu, R. (2013). Education and dementia risk: results from the aging demographics memory study. Research on Aging, 35, 7-31.

Lupton, M.K., Stahl, D., Artcher, N., Foy, C., Poppe, M., Lovestone, S. et al. (2009). Education, occupation and retirement age effects on age of onset of Alzheimer’s disease. International Journal of Geriatric Psychiatry, 25, 30-36.

Marchione, M. (2013, July 15). Delaying retirement can delay dementia, large study finds. The Associated Press. Retrieved from .

World Health Organization (2012).Dementia Retrieved November 15, 2013 from .

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Successful Aging: Is This a Beneficial Term?

by Megan Ferguson

Successful Aging
Successful Aging

Since the 1960’s, there has been an increased attention towards positive discourses of aging.  This dialogue strives to promote active, healthy, positive and productive aging; however, are these realistic goals?  While  successful aging may be attainable for some individuals, it may not be for others who have been struck with diseases that limit their abilities to support these aging ideals.  However, as social workers, we must not completely eliminate successful aging, but take a critical approach in adapting this term to extend beyond the goal of postponing old age.

In addition, by solely focusing on delaying old age, professionals are in fact subordinating older adults that are not aging successfully based on our personal assumptions, expectations and definitions of what growing older should entail.  In a way, we are pigeonholing individuals and not allowing them to be individuals with unique ways of living their lives.

Much emphasis is also placed on individual responsibility of aging and postponing old age as well.  People are constantly surrounded by advertisements and messages for beauty products, supplements and medical treatments that promote successful aging.  However, holding an individual accountable for how they age can be problematic, as this blames the aging individual.  Although this may be true, I do not want to “sugar-coat” that an individual has no responsibility in how they age, as aging is dependent on how one treats their body.

However, my goal in this statement is to highlight that social workers must engage in a paradigm shift from an emphasis on individual responsibility of aging to a balanced prototype of aging. Aging is dependent on personal health practices as well as other determinants of health such as income and social status, gender, culture and early childhood development.  All of these factors thus may lead to “successful” or  “unsuccessful” aging.

With a tendency to dissociate aging and disease, emphasize delaying old age and blame victims of “unsuccessful” aging, it is evident that the term, successful aging has limitations.  However, a temporary solution may be to incorporate this term in practice through a person-centered approach to successful aging.  Personal, social, economic and environmental factors all determine the health status of individuals and therefore, individuals have different opinions regarding what they view as being important to their personal health.  Therefore, it may be beneficial to become increasingly mindful of different perspectives of successful aging when working with individuals.  The term successful aging is quite ambiguous; therefore, it is only beneficial when we take into account the different personal definitions of the term.

Photo Credit: brainworldmagazine.com

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