Chapter 12 & 13 Flashcards
Elderly
Typically defined as 65 or older
Golden Age Myth
That life for older people was better in the past
- Canadians did not tend to reside in three generation households
- Higher mortality, lower life expectancy
3 Factors Contribute to longevity revolution
- Increased life expectancy/ decreased mortality
- Declining fertility
- Immigration patterns
The Longevity Revolution
- Aged population is expected to double by 2036, reaching 10.4 million
- Declining numbers of children 14 and under
- Substantial increases to life expectancy
Life Expectancy at birth (Canada, 2012)
79.4 (males) & 83.6 (women)
Living Arrangements
- 56.4% of those 65+ live with spouse or partner
- 25% live alone
- Trend toward cohabitation
- Living apart together
- Increase in multigenerational households
Patterns of Support
- Majority of support for older adults is non-paid or informal
- Older adults in turn provide financial and emotional support
- Exchange relations involving global reciprocity
5 Categories of Instrumental Support
- Home maintenance
- Transportation
- Household help
- Personal care
- Financial support
Life course trajectories
Fear that there will be shortage of adult children to look after aging parents
Positive effects of an aging population
Expansion of the family and availability of extended kin
Increased Cultural Diversity
- Distinctive family obligations and patterns of support
- Challenges our assumptions about family life and family ties
Issues Facing Aging Families
- Gendered patterns of care (majority women)
Sandwich Generation
- Caring for elders and children at the same time
- Often still in paid work
Seniors in Rural Areas
- Lack transportation, health services and organizations
- Often overlooked in the allocation of health resources
- Fragmented services and closing of smaller, rural hospitals
- Difficult to attract physicians, health workers and social service workers to rural areas
Dating, Cohabitation, Remarriage and Sexuality
- Most older men have partners, while most older women do not
- Complex decision influenced by economic, social, legal, religious and demographic factors
- Ageist views of sexuality persist
- Gay and lesbian seniors can face challenges accessing medical care, home care and services
Transition to Retirement
- Retirement is usually viewed as an individual choice
- There are intricate linkages to family and life course context
- Becoming a couple phenomenon
- More older Canadians in the workforce
- Weaknesses in pension plans and increased reliance on RRSPs
Family Context
Characteristics that precede retirement, can affect decisions and adaptation
The Modernization of Grandparenthood
- Vast majority of Canadians over 65 grandparents
- Declining mortality
- Advances in travel and communication
- Increased affluence and leisure time
- Can play an active role in grandchildren’s lives
Institutionalization and End of Life
- Only a minority of elderly people live in nursing homes or institutional settings
- Majority end their life in hospitals or long-term care facilities
- New models and practices for end- of- life care
Social Determinants of Health
- Factors beyond genetics or biology
- …“The economic and social conditions that influence the health of individuals, communities and jurisdictions as a whole”
- Highlights how structured inequality creates inequality of health conditions
Social Determinants of Heatlh
- Aboriginal status
- Early life
- Education
- Employment and working conditions
- food security
- Health care services
- Housing
- Income and its distribution
- Social safety net
- Social exclusion
- Unemployment and employment security
- Gender
- Social context
Life course perspective on social determinants of health
Social determinants of health operate at every level of development
Disability
Having difficulty performing “normal” daily activities (hearing, seeing, walking )
13.7% of Canadians have a disability
Disability and self-identification
- self- identification is significant
- shifts power of naming away from authorities
- Defining words is a political act
Biomedical
disability as disease, disorder
Functional
disability as a restriction of normal abilities
Social/Environmental
disability as a result of barriers in the social environment
Human rights
Focuses on respect for human dignity and protection against discrimination
Families with Disabilities and Special Needs Children
5-20% of children have special needs
- Lack of support
Fetal Alcohol Syndrome (FAS)
Cause of learning and behaviours difficulties which can lead to other problems
Mental Health Issues
- Families can be devastated by mental illness
- often experience complex loss
- Problems of denial and legal barriers to force compliance with doctors orders
- Can make social connectedness and stability very difficult
Caregiver burden
Stress and problems such as depression
dementia
alzheimer’s is the most common form of dementia
- Number of cases may increase to 1. 125 million by 2038
Symbolic interactionist perspective on coping (Dementia)
Family members use various strategies to help the afflicted person preserve identity
- concealing the diagnosis
- Interpreting behaviours as the disease (not real person)
- Assistance with dressing, grooming etc.
A “good death”
A “good death” helps family adjust after a family member’s passing
- on time
- physical comfort
- Social support
- Appropriate medical care
- Chance to say goodbye
Palliative Care
The care and management of end-of-life patients
- reduction of suffering
- family support into bereavement
- A complete program would include symptom control, spiritual support, bereavement support and education
Tobacco
*Tobacco use is the single most preventable cause of morbidity and mortality
Regional Variations in tobacco use
National average: 18%
BC: 14.3%
Ontario: 17%
Nunavut: 62%
Health promotion & Public Policy
Individual approaches tend to receive the most government support
- the strategies mask the social production of inequality and the social variability of health
Apocalyptic demography
Is the tendency to equate rapid population aging with a number of neglect implications for society and for the family, especially with respect to escalating health care and pension costs and associated caregiving issues
Filial piety
is rooted in the idea that the core of moral behaviour lies in several obligations that children owe to parents
Global reciprocity
refers to the tendency of families to balance exchanges of support over the course of their lives rather than at one particular point in time
Hierarchical-compensatory model
Suggests that people choose their supports initially from their inner family circle and then outward to receive assistance from less intimate sources as they need more help
skip-generation households
are those households in which grandparents live with at least one grandchild without the presence of the middle (parent) generation
Epigenetics
is the study of how our environment modifies and influences our genetic make-up and its expression over time to create health and illness
social epidemiology
is the empirical study of the socio-cultural, economics and political forces that shape patterns of disease and death in human populations
