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Gerontology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Why use social theories?

A
  1. Help us understand and explain changes in social relationships and systems that occur in late adulthood
  2. Provide basis for examining primary dimensions of age
  3. Serve as guide for further inquiry and suggest possible practice and policy interventions
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2
Q

The importance of social theory

A
  1. Many people make positive or negative assumptions on basis of chronological age
  2. Some stereotypes may be result of unconscious theorizing about the meaning of growing older
  3. Theory development is systematic attempt to explain why and how age-associated change or events occur
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3
Q

Theory building

A

Cumulative development of explaining and understanding observations and findings

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4
Q

Theory building represents what?

A

the core of the foundation of scientific inquiry and knowledge

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5
Q

Theory building understands what?

A

Understand phenomena in a manner that is reliable and valid across observations

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6
Q

Theories are never proven or disproven, they are what?

A

strengthened or weakened

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7
Q

Social theories are less well developed compared to what?

A

biological frameworks

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8
Q

Social theories are gathered through what kind of research?

A

qualitative and quantitative

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9
Q

Social theories lead to accumulation of knowledge and point to unanswered questions that may require what?

A

further research

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10
Q

Biological theories are useful in what?

A

guiding people’s health behaviors and lifestyle choices, as well as designing health services and policies…however they do not encompass all the reasons that people age and behave the way they do

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11
Q

Early social gerontology theories attempted to solve problems facing older people rather than what

A

explain social phenomena

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12
Q

There has been a shift from a focus on the objective and measurable problems of old age to more attention to the what

A

interactive process that affects aging, subjective meaning, and personal experiences.

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13
Q

Social Gerontology Theories before 1961

A

role theory
activity theory
disengagement theory
continuity theory

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14
Q

Social Gerontology Theories before 1961 emphasized what

A

the consequences of role loss with age and how and individuals personal characteristics affected adjustments to these changes

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15
Q

People have self-concept and self-worth based on what

A

the roles we identify

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16
Q

Roles can be associated with ages and stages in life

A

ages and stages in life

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17
Q

Role theory

A

a. We all play a variety of social roles across a lifespan
b. Each role is typically associated with a certain age or stage of life
c. Losing any of these roles can affect our well-being and opportunities to enjoy active aging

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18
Q

How well individuals adjust to aging depends on what

A

how they accept their “typical” role changes that occur during later years

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19
Q

Chronological age – often used to sort

A

range of norms, expectations and roles

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20
Q

Age norms

A

assumptions we all make about age-related capacities and limitations – beliefs that a person of a given age can and ought to do certain things

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21
Q

Ages alters not only the roles anticipated of people, but what else?

A

the manner in which they are expected to play them

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22
Q

how may role losses impact someone?

A

may erode a person’s sense of identity and self-esteem

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23
Q

The activity theory tries to answer what question

A

how individuals adjust to age-related changes such as retirement, chronic illness, and role loss

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24
Q

The activity theory defines aging as what

A

a social problem that can be addressed by trying to retain the status, roles, and behaviors similar to those of earlier life stages
- remain active!

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25
Q

The activity theory Replace past role with what

A

age-appropriate productive roles

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26
Q

The more active the older person, they are more likely to experience what?

A

greater their life satisfaction, self-concept and adjustment

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27
Q

Senior centers and community dining centers were often designed as ways to develop what for the older residents?

A

new roles, activities, and social integration

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28
Q

The activity theory is consistent with what?

A

the value placed by society on paid work, individual responsibility, and productivity
- Loss of these is viewed as evidence of decline

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29
Q

What does the activity theory NOT take into account?

A

personality, social class, gender, race and lifestyle

  • not all older adults seek or benefit from activity
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30
Q

What theory challenges the activity theory?

A

Disengagement theory (1961)

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31
Q

how does the disengagement theory view aging

A

as a time of withdrawal or separation from past roles and activities (maybe to transfer roles to younger generations)

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32
Q

What theory supports the idea that societies need orderly ways to transfer power from older to younger generations, and to prepare for disruption entailed by the death of oldest members

A

disengagement theory

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33
Q

How do social systems deals with the problem of aging?

A

by institutionalizing mechanisms of disengagement or separation from society
- Retirement, withdrawal from paid occupational roles

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34
Q

Older adults are presumed to benefit from

A

more passive roles, less frequent social interaction, and a focus on their inner lives

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35
Q

Disengagement is viewed as

A

inevitable and adaptive

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36
Q

What are challenges posed by the disengagement theory

A

a. Allows older people to maintain a sense of self-worth while adjusting to the loss of prior roles by withdrawing from social responsibilities
b. Challenges the assumptions that older people must be actively engaged in order to be well adjusted (Instead, views old age as a separate and distinct period of life, not an extension of middle age)
c. Cannot be assumed that older peoples withdrawal is necessarily good for society
d. Fails to account for variability in individual preferences, personality, culture, and opportunities within aging population

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37
Q

Why is the disengagement theory discounted by many gerontologist?

A

growing emphasis on active aging

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38
Q

What theory challenges both activity and disengagement theory?

A

continuity theory

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39
Q

Continuity theory focuses on what?

A

how individuals adapt to aging

  • says that individuals tend to maintain a consistent pattern of behavior as they age
  • Become more of what we already were when younger
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40
Q

The continuity theory says that older adults substitute similar types of roles for what

A

lost ones and keep typical ways of adapting to the environment

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41
Q

The continuity theory states that people do not change dramatically as they age and their personalities remain similar throughout their adults lives UNLESS

A

unless faces with major illness or highly disruptive life events

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42
Q

According to the continuity theory, when do older adults tend to be most satisfied?

A

if their current activities or lifestyles are consistent with their lifetime experiences

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43
Q

According to the continuity theory, what happens to personality as you age?

A

Central personality characteristics become more pronounced and core values more salient with age

For ex. People who have been more passive or withdrawn are unlikely to become socially active or volunteer upon retirement

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44
Q

The continuity theory overlooks what?

A

the role of external social, economic, historical and political factors that influence the aging processes

For ex: losing a job and home because of recession may have more impact on how one experiences aging than does ones personality and earlier life patterns

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45
Q

The continuity theory looks at individuals, does not account for what

A

biological and psychological changes that occur over time

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46
Q

What are some new Social Theoretical Perspectives

A
  • Age Stratification Theory
  • Social Exchange theory
  • Political Economy Theory of Aging
  • Social Construction
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47
Q

Age Stratification Theory

A

Examines how cohort and historical time periods affect aging

Just as societies are stratified in terms of social class, gender and race, every society divides people into categories or strata according to age
–> “young”, “middle-aged”, “young-old”, and “oldest-old”

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48
Q

A persons experiences with aging, including their roles and life satisfaction, vary with what?

give an example of this, and state what theory this relates to

A

varies with their position in age structure

For ex: a young old adult who is still employed exhibits different behaviors and attitudes as a result of their position in age structure
( Age Stratification Theory )

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49
Q

According to the Age Stratification Theory, a persons life stage and historical context (WWII, Great Depression, etc) explain what

A

differences in how people behave, think, and contribute to society

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50
Q

What theory does this explain: Great Depression cohort are more fragile and value self-sufficiency

A

Age Stratification Theory

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51
Q

Because of relationships to historical events, how do people in the old-age stratum experience aging process compared to older persons in the past

A

they experience aging processes differently

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52
Q

Why will baby boomers alter the age stratification system

A

given their large size, higher education and income levels, greater diversity, and redefined lifestyles

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53
Q

Give examples of how do baby boomers who are retiring today differ as a whole from the cohort that retired in the 1950s

A

Believe they should have lifestyle options

Reject notions of “seniors,” dependence, disability and frailty

More emphasis on remaining independent and productive

Technology savvy

View retirement and leisure more positively

Physically active and healthier

Live long enough to be great-grandparents

More planful and proactive about dying process

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54
Q

What happens as each successive cohort moves through the age strata?

A

they alter conditions so that later groups never encounter the world in the exactly the same way, and age differently

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55
Q

Social exchange theory

A

Draws upon an economic model of the cost-benefits of social participation to answer why social interaction and activity decreases with age often

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56
Q

Withdrawal and social isolation result from what? what theory does this relate to?

A

Results from unequal exchange process of “investments and reut unequal exchange

Social exchange

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57
Q

If an older person perceives the contributions are no longer valued by other, what happens?

A

they begin to withdraw from participating in social activities

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58
Q

Adaptive behavior

A

adjust to new less active role rather than actively seeking to influence their environment

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59
Q

Older adults generally seek to maintain _____. Explain

A

reciprocity

Offer resources to younger generations as long as possible, allowing them to exert some power in relationships – often a source of satisfaction

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60
Q

The Social Exchange Theory states that because of changes in roles, illness, or relocation, elders may have fewer economic or material resources to exchange, which can lead to what

A

their status may decline

- Not inevitable since they offer many nonmaterial assets (wisdom, love, respect, time)

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61
Q

Political Economy Theory of Aging views social class as

A

the primary determinant of older people’s position and life satisfaction

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62
Q

Inequality has increased, particularly among what age group

A

older adults

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63
Q

Groups in power trying to sustain their own interests by maintaining class inequalities ….what theory?

A

Political Economy Theory of Aging

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64
Q

“the rich get richer and the poor get poorer”

A

Political Economy Theory of Aging

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65
Q

What shapes the experience of aging and age inequalities in society

A

Socioeconomic and political constraints

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66
Q

inequalities are a result of what?

A

age, social class, race, ethnicity, gender, sexual orientation, and functional ability

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67
Q

Cumulative disadvantages

A

structural disparities experienced by people earlier in life are intensified in old age

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68
Q

Structural factors are institutionalized and reinforced by what

A

public policy

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69
Q

major problems faced by older adults are what

A

social constructed
- could be changes through political action and policy if those with power were willing to allocate more resources to their solution

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70
Q

Social Construction: Aging is defined as

A

a problem more by culture and society than by biology and bodily changes

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71
Q

Negative ways in which age is socially constructed has consequences of what

A

social policy, employer practices, public perception of elders, and how they are treated

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72
Q

Medicaid is disproportionately allocated toward nursing home care than toward home care and support…what theory

A

Social construction

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73
Q

General public tends to think of old age as

A

a homogenous physical condition, overlooking tremendous diversity that exists
*No one refers to childhood or adolescence solely as a physical condition *

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74
Q

We need to deconstruct the concept old and focus on

A

eliminating structural barriers

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75
Q

Social construction gives greater recognition to what

A

the importance of our interpersonal interactions in shaping the aging experience

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76
Q

What are Recent Developments in social Gerontological Theory:

A
  1. social phenomenology

2. Feminist gerontology

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77
Q

social phenomenology

A

a. more qualitative
b. Focuses less on understanding the meanings that people give to the social lives in the context of everyday living rather than on the explanation of the “facts” of aging

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78
Q

Theories that issues with the presumed “facts of aging,” and question the nature of age, how it is described, and whose interests are served by thinking of aging in particular ways… what theory does this describe

A

social phenomenology

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79
Q

social phenomenology aims to reveal..?

A

what role human awareness plays in the production of social action, social situations, and social worlds.

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80
Q

phenomenology is the believe that what?

A

that society is a human construction

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81
Q

social phenomenology attempts to discern

A

subjective meaning and data (through observation)

- information that cannot be uncovered by predefined measurement scales or survey questions

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82
Q

What is critical in understanding older adults and the aging process

A

The assumptions and interpretations of the purposed facts

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83
Q

Feminist gerontology

A

Feminists theorists have added a gender dimension to the political economy and life course perspectives regarding how institutionalized mechanisms disadvantage women across the life course

Gender-based inequalities and oppression of women across the life course differentially structure men and women’s experiences of aging

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84
Q

How does Feminist Gerontology contend hat current theories of aging are insufficient?

A

because they do not include gender relations as central to the aging experience

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85
Q

Feminist Gerontology limits what?

A

Limits labor market opportunities

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86
Q

Those living alone are more likely to be what

A

poor - they are more likely to live in poverty

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87
Q

What are the differences of older people living alone from 1900 to 2015?

A

6% in 1900

29% in 2015

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88
Q

what is the percentages of men and women over 65 years that are living alone?

A

37% of women over 65, 19% of men over 65; increases with age

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89
Q

What is the difference between living alone vs being alone (lonely)?

A

Many people who live alone have an actual social life

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90
Q

Describe the AARP survey about people who are 45 years of age.

A

found that 35% of people 45 and older were chronically lonely

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91
Q

Social isolation is a risk factor for what?

A

death

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92
Q

social isolation may exceed other risk factors, such as?

A

obesity and physical inactivity

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93
Q

Social factors affect a persons what

A

physical and mental health

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94
Q

How does a persons health affect relationships

A

Poor health may hinder people from initiating or sustaining social contracts/relationships

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95
Q

What may affect type and extent of informal social support needed?

A

Gender, race, and social class

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96
Q

Compare the older years of women compared to men

A

Women outlive men, more likely to be widowed, divorced, living alone

Women have strong and more supportive friends

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97
Q

Describe the prevalence of non-traditional families

A

becoming more prevalent

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98
Q

What are some reasons that nontraditional families will increase?

A

due to legalized same-sex marriages and civil unions

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99
Q

How are families defined (more recently)

A

family often defined by interactional quality; not blood ties

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100
Q

More couple ____ and _____

A

cohabitating and choosing not to have children

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101
Q

is there an increase or decrease in the % of children in the total population

A

decrease

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102
Q

more __________ are raising children

A

unmarried couples, gay/lesbian

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103
Q

more _______ are raising children without a partner to help raise them

A

single women

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104
Q

more _______ are working outside the home

A

mothers of young children

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105
Q

more _____ marriages

A

interracial

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106
Q

_____ families are increasing

A

multigenerational

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107
Q

What ethnicity is common for having multigenerational households?

A

African Americans, Latinos, and Asian families

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108
Q

In 2014, ____ of households encompass 3 or more generations

A

19%

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109
Q

What are skipped-generation households

A

Intergenerational, grandparent/grandchild households

Parent is not present in household

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110
Q

Explain house skipped-generational households are increasing

A

7% of children raised by grandparents in 2010

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111
Q

Why the increase in multigenerational households?

A
  • longer life expectancies

- rising increase of immigrants in the US

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112
Q

What is a primary factor for the increase in multigenerational households?

A

economic/financial factors

  • high employment, rising home foreclosure, lack of affording housing options
  • families are coming together to share space rather than spend money separately
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113
Q

Formal Supports (caregivers)

A

Professional services that are paid for (insurance, private pay, etc.) or are funded by local, state and federal government

  • Formal supports are very expensive
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114
Q

Examples of formal supports

A

Doctors, nurses, social workers, physical therapists, OT, NA, homemakers, ETC.

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115
Q

Homemakers do what

A

clean, make food, relationship

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116
Q

informal support (caregiver)

A

members of a person’s social network who provide informational, emotional, or instrumental assistance

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117
Q

Examples of informal support

A

Family members, friends, neighbors, community volunteers, acquaintances, pets

Friendly visits, transportation/ride, shopping and errands, caregiving, companionship

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118
Q

where does the bulk of the care come from in the US

A

informal supports

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119
Q

What is the most important source of informal support for older adults

A

family

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120
Q

___ of older men live in a family setting, compared to __ of women

A

70%; 40%

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121
Q

Who is more likely to live with children, sibling, or other relatives

A

Widowed women

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122
Q

Why do adult children move back into home?

A

Typically for financial reasons and to provide assistance and support to older parents

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123
Q

What race is more likely to live with a family member other than a spouse

A

AA, Asian Americans, and Latina elders

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124
Q

IADLs

A

instrumental activities of daily living

grocery shopping, laundry, cleaning, meal prep, yard care, medication management

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125
Q

ADLs:

A

Activities of Daily living

dressing, eating, grooming, walking, toileting, bathing

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126
Q

Increasing age increases the likelihood that older adults will what?

A

will need assistance from an informal caregiver

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127
Q

Support and assistance provided by non-paid supports –> this is example of what

A

informal caregiving

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128
Q

Care needs vary how?

A

from person to person

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129
Q

How many adults in the US are providing care to someone who is ill, disabled, or older?

A

43.5 mil

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130
Q

Caregiving averages

A

24 hours/week; 13 days a month on IADLs; 6 days on ADLs

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131
Q

How many are providing the care for someone 50+

A

34.2 mil

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132
Q

how many are providing care to someone with dementia

A

15.7 mil

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133
Q

___ of caregivers are female

A

66%

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134
Q

___ of caregivers are 18-49; __ are 65+

A

48%; 34%

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135
Q

how many care for 2+ people

A

34%

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136
Q

how much care for parents? inlaws?

A

42%; 7%

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137
Q

how much care for a friend, neighbor or other non-relative?

A

15%

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138
Q

how many care for grandparent?

A

7%

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139
Q

Annual economic value for informal caregiving in 2015 was estimated to be

A

470$ billion

- to put in perspective, Walmart has annual revenue of 422$ bil

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140
Q

Value of informal caregiving for 65+ is

A

234$ mil
- More than what is spent by medicare, medicaid, and private insurance for institutional and home/community based services

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141
Q

Informal caregivers constitute a large and overlooked component of what

A

American economy, Heath-care system, and long-term services/supports

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142
Q

Without informal caregivers, what could collapse - explain

A

formal healthcare and long-term services/support systems
- Government funding/programs already being cut

  • High pressure to quickly discharge patients from hospital and prevent re-hospitalizations
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143
Q

Cost of informal caregiving: Primary Stressors

A

hardships and problems anchored directly in caregiving

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144
Q

Cost of informal caregiving: secondary stressors

A

occur when primary stressors spill over into other aspects of caregivers life (job, friendships, etc.)
- Role strains, adjustment difficulties, financial losses

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145
Q

caregiver burden

A

physical, emotional, and financial costs associated with care

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146
Q

objective burden

A

daily physical tasks; time and finances devoted to care

Driving to appointments, managing medications and symptoms, handling legal, employment, financial aspects

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147
Q

subjective burden

A

caregivers emotional or feelings; how they perceive burden of care

  • Grief, anger, guilt, worry, loneliness, sadness
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148
Q

Caregivers experience stress/burdens in three primary areas, what are they?

A
  1. Poor physical and mental health outcomes
    a. Weakened immune system; hypertension; anxiety; depression; sleep disorders
  2. Financial
    a. Direct costs for medical care, equipment, hired help, lost income due to absence from work or quitting job
  3. Emotional
    c. Subjective burdens; loneliness; isolation; anxiousness; feeling overwhelmed; feeling fearful; and submerged in the care role
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149
Q

factors influencing level of caregiver stress?

A
  • Nature of relationship between the caregiver and recipient
  • Living with the care recipient
  • Limited financial resources
  • Timing in a caregivers life course (multiple demands/responsibilities)
  • Gender (females have higher levels of depression/anxiety)
  • Race and ethnicity (religion and spirituality may help some cope with stress)
  • Social support networks
  • Degree of reciprocity between caregiver and care recipient (can buffer stress)
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150
Q

Benefits of informal caregiving

A
  • Confidence building
  • Self-affirmation
  • Pride
  • Relief
  • Greater closeness with care recipient
  • Opportunities to improve relationships
  • Find personal meaning; giving back
  • Build resiliency
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151
Q

Elder abuse/mistreatment is not solely due to

A

caregiver stress

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152
Q

Elder abuse/mistreatment is most often connected to what?

A
  • Caregivers own emotional or behavioral problems
  • Mental or physical health problems
  • Alcohol or drug dependence
  • Resentment
  • Isolation
  • Poor coping mechanisms
  • Lack of experience/education
  • Power inequities (financial dependence between caregiver and care recipient)
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153
Q

Elder abuse/mistreatment

A

Any knowing, willful, or negligent act by a caregiver or other person that harms or causes risk of harm to a vulnerable, dependent adult

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154
Q

Elder abuse/mistreatment can occur in any style, such as

A

home, assisted living, nursing home, etc

155
Q

types of abuse/mistreatment

A
  • Physical
  • Sexual abuse/exploitation
  • Financial abuse/exploitation
  • Emotional/psychological abuse
  • Neglect/abandonment (either self-imposed or by another person)
156
Q

Neglect

A

caregiver fails to meet the needs of a person
–. Withhold nourishment, medications, medical care, hygiene, etc.

  • Not always intentional
157
Q

Self neglect

A

older adult engages in behavior (or lack of behavior) that threatens safety; fail to meet their own needs

Inability to perform essential self-care activities (medical care, meals, administer medications)

158
Q

Financial abuse and exploitation

A

improper use of an elder’s funds, property, or assets

  • Door to door scans
  • Professional swindles by insurance or investment agents
  • Caregiver, relative, acquaintance abuse
159
Q

How does Iowa go about elder abuse/mistreatment

A

each state has its own procedures for identifying and/or reporting abuse

160
Q

Per Iowa Dept of Human Services: Dependent Adult

A

“A person eighteen years of age or older who is unable to protect the persons own interests or unable to adequately perform or obtain services necessary to meet essential human needs, as a result of a physical or mental condition which requires assistance from another, or as defined by departmental rule”

161
Q

Per Iowa Dept of Human Services: Caretaker

A

“A related or non-related person who has the responsibility for the protection, care, or custody of a dependent adult as a result of assuming the responsibility voluntarily, by contract, through employment, or by order of the court”

162
Q

Currently, what must be evident for a state to investigate for elder abuse/mistreatment?

A

must be evidence that dependent adult is unable to protect themselves from abuse (dementia, cognitive deficits, severe mental health issues, etc)

163
Q

“Dependent Adult Abuse”: physical injury

A

Physical injury: to, or to which is at variance with the history given of the injury, or unreasonable confinement, unreasonable punishment, or assault of a dependent adult.

164
Q

“Dependent Adult Abuse”: The commission of a sexual offense

A

The commission of a sexual offense: under Iowa code 709 or section 726.2 with or against a dependent adult

165
Q

“Dependent Adult Abuse”: exploitation

A

Exploitation of a dependent adult which means taking unfair advantage of a dependent adult or the adults physical or financial resources for one’s own personal or pecuniary profit, without the informed consent of the dependent adult, including theft, by the use of undue influence, harassment, duress, deception, false representation, or false pretensions

166
Q

“Dependent Adult Abuse”: The deprivation of the minimum food shelter, clothing, supervision, physical or mental healthcare or other care

A

The deprivation of the minimum food shelter, clothing, supervision, physical or mental healthcare or other care necessary to maintain a dependent adults life or health as a result of the acts or omissions of the dependent adult.

167
Q

“Dependent Adult Abuse”: Sexual exploitation

A

Sexual exploitation of a dependent adult who is a resident of a healthcare facility, as defined in section 135C.1, by a caretaker providing services to or employed by the health care facility, whether within the healthcare facility or at a location outside of the healthcare facility

168
Q

Mandatory Reporting per Iowa Law:

A

social workers, police officers, psychologists, homemaker/home health aides, health practitioners (physicians, nurses, dentists, chiropractor, optometrist, EMS, etc.); staff of community mental health center, staff of supported community living service, sheltered workshop, or work activity center; outreach employees

169
Q

Must report suspected abuse or neglect to who?

A

DHS (or DIA is in a care center, assisted living, ETC.)

170
Q

What are we doing to stop elder abuse?

A
  1. FMLA (family medical leave act) and other dependent care workplace policies
  2. Respite care
  3. Caregiver support groups
  4. Educational/skills training events directed to caregivers
  5. Adult day services
  6. In-home services and supports (medicaid elderly waiver services, CDAC)
  7. Care centers; assisted living options
171
Q

Elder abuse prevention and intervention

A

Partnership with DHS, law enforcement, attorneys, health and human service providers and others

172
Q

Economic status often influences what?

A

how we feel about ourselves

- specifically our income and job

173
Q

Old age is profoundly influenced by economic status and social status –> what are some examples of the difference status’s

A

wealthy vs. poor
employed vs. retired
private pensions vs minimum amount of SS

174
Q

financial resources do not guarantee what?

A

quality of life and satisfaction

175
Q

What do financial resources effect

A

physical and mental health

176
Q

what is a relatively recent phenomenon in western society

A

retirement

177
Q

prior to the industrial revolution, how long did people work?

A

until they died

178
Q

What did retirement develop with?

A

industrialization, surplus labor, and a rising standard of living

179
Q

When did SS come about and what was the purpose

A

1935; established the right to financial protection in old age

  • based on economic contributions to society
  • supports people of all ages who are unable to work due to illness/disability
  • created new jobs for younger people by “removing” adults 65+ from the workforce
180
Q

What prolongs the amount of time people rely on SS and other retirement benefits?

A

earlier retirement and longer life expectancies

- more pressure on SS systems

181
Q

What inadvertently limits job and retraining options

A

the perception that people are “old” at age 65; people are seen as physically of cognitively incapable of employment or other activities

182
Q

do most people do extensive planning for long phase of their retirement?

A

no

183
Q

how do most adults derive most of their identity

A

from their job - many enjoy their jobs and get satisfaction from working

184
Q

Why do some adults prefer to keep working past retirement?

A

to feel productive and give them sense of meaning and purpose

185
Q

baby boomers assumed they would enter old age with what

A

adequate economic resources

186
Q

Many baby boomers are better off financially/economically, resulting from

A
  • Deferred marriage
  • Reduced and later childbearing
  • Higher education attainment
  • Longer work hours
  • Women increased labor force participation
  • Acquired most real estate and invested in the stock market
  • Multiple jobs/careers
  • Switching jobs voluntarily and involuntarily
  • Reinventing themselves in middle age
187
Q

The future of many baby boomers if significantly impacted by what

A

recent global economic downturn and US recession

188
Q

Why are baby boomers more negatively impacted by recession then prior cohorts

A
  • Borrowed more and saved less than their parents
  • Hold fewer assets
  • Real estate values plummeted
  • Private investments, esp. Individual retirement accounts or IRAs, decimated by economic downturn
189
Q

what percent of boomers reported significant losses in their retirement funds after what year

A

60%; 2006

190
Q

many baby boomers remain employed out of urgency and solely for what reason

A

financial

191
Q

a large amount of young adults and middle aged adults report having how many savings

A

no or little savings

192
Q

describe the retirement trend prior to 1986

A

Retirement age at 65 was mandatory for most jobs

- majority of people retired sooner –> 60-64

193
Q

average age of retirement in 2013 was ____, up from ____ two decades ago

A

61, 57

194
Q

what does the average American plan to retire at in 2019

A

66 or 67

195
Q

Other factors determine when most workers leave labor force

A

health, social relationships, economic status, extent of financial preparation, and geographical location

196
Q

Retirement goals change over the year, describe this and explain why is it the way it is

A

generous early retirement incentives to new incentives to delay retirement

  • This is because we do not have the same retirement funds set up through corporations, the private retirement plans that were available to a lot of people are not the same, and the SS programming is under so much more pressure with all the people coming into the program
197
Q

Why do older adults feel obligated to work longer?

A

a. Recession (2008) and reduced income and savings
b. Increased life expectancy and living up to 1/3 of life on a fixed income,
c. Decline in availability of private pensions
d. Escalating Medicare premiums and health care costs
e. Long-term care costs as they care for aging parents

198
Q

Changing perspectives of work and retirement: societal perspective

A

changing values about “appropriate age” for education, employment, retirement, and leisure require re-examination of employment policies and norms

  • “rewiring” rather than retiring
  • more middle-aged and older persons enter or reenter collage, take courses, move into new careers, or begin graduate/professional degrees
199
Q

Changing perspectives of work and retirement: other countries

A

Other countries are fostering new models of work and retirement

200
Q

Changing perspectives of work and retirement: some Scandinavian countries

A

year-long sabbaticals every 10 years to re-evaluate careers or take break

201
Q

Changing perspectives of work and retirement: Japan and European countries

A

“gliding out” plan of phased retirement in Japan and some European countries

–> Permits a gradual shift in a par time schedule and for older workers to train younger ones

202
Q

Changing perspectives of work and retirement: how can jobs be reconstructed

A

allowing longer vacations, shorts workdays, and more opportunities for community involvement during preretirement working years

203
Q

Encore Careers Movement

A

spawned nonprofit groups and programs that aim to help older workers find public service jobs that benefit society

204
Q

describe the rate of older unemployed adults

A

Number of older adults employed has increased steadily

205
Q

___ of 55+ were employed in 2013

Expected to hit ___ by 2019

A

20%; 40%

206
Q

Those 65+ and employed has increase at least ___ since 1977

A

10%

207
Q

The increase in number of women 65+ employed since 2000 was nearly ___ as much as for men

A

twice

208
Q

Labor force participation is greatest among who

A

those 65-69 and those who have highest levels of education

209
Q

More employed older adults are more likely to be employed ________________________.

A

full-time, though they prefer to have part-time flexible work

210
Q

Like all age groups, unemployment rate for 55+ is at ___ levels; ~___, highest since 1948

A

high; ~8%

211
Q

Describe the unemployment rate for older adults

A

unemployment rate has doubled since 2007

212
Q

what makes it hard for older workers to get hired

A

ageism

213
Q

Younger applications are often more desirable due to:

A
  • Their willingness to work for less
  • Their more “relevant” skill set
  • Being considered more trainable
214
Q

Barriers to unemployment

A
  • Lack of job-hunting and technological skills
  • Lack of confidence
  • Businesses less likely to modify work environments, allow part-time work, or provide job retraining for older workers
  • Age-based employment discrimination
  • Negative stereotypes about aging and productivity
215
Q

Age Discrimination in Employment Act (ADEA)

A

reduced blatant forms of age discrimination and eliminated mandatory retirement for most occupations

216
Q

Since businesses are less likely to modify work environments, allow part-time work, or provide job retraining for older workers, what is the focus on?

A

efficiency and reducing costs, not accommodating older workers needs

217
Q

Income sources for older adults

A

a. social security
b. assets
c. pensions
d. public assistance

218
Q

Income sources for older adults: social security

A

Provides a foundation of retirement protection for Americans

219
Q

What was SS intended to be

A

to be a supplement to other pensions and individuals savings

220
Q

Eligibility for SS

A

determined by what you have paid into the Social Security system through payroll taxes as an employee

221
Q

Social Security accounts for ___ of aggregate income for older population

A

33%

222
Q

___ of beneficiaries depend on SS for ___ or more of their income

A

~25%; 90%

223
Q

___ of older adults would be poor without SS

A

35%

224
Q

42.5 mil retired people received SS in 2017, how much money?

A

60$ bil

225
Q

Average retirement benefits are ___/year or ___/month; maximum in 2013 was ___/year

A

$16,848; $1404; $30,000

226
Q

who is most likely to rely solely on SS as their only source of income

A

Women, elders of color and oldest-old

- they also tend to receive less than the average monthly SS benefit

227
Q

income sources for older adults: assets

A

Interest-bearing saving and checking accounts that typically generate low earnings

  • investments
  • home equity
  • personal property
228
Q

What is arguable the most important asset?

A

home equity –> “financial safety belt” if not longer paying a mortgage (or owe more than what its worth)

229
Q

Compared to current elder cohort, boomers are less likely to have ____ and more likely to have ____.

A

paid off mortgages; refinanced

230
Q

Many older adults report what for asset income?

A

no asset income

231
Q

Who is more likely to report no asset income?

A

women, oldest-old, and persons of color

232
Q

60% of workers report that they have saved less than _____ for retirement

A

$25,000

233
Q

Income sources for older adults: pensions

A
  • Tied to a specific job and administered by an employer, union, or private insurance company
  • Generally based on earnings/combination of earnings and years of services
  • Intended to supplement social security income
234
Q

what percent of employees receive pensions

A

~28%

235
Q

what are the 2 types of pensions?

A
  1. Defined benefit pension plan:
    a. employees pension payment is calculated according to length of service and earnings history
    - Fixed/specified amount of guaranteed by the employer/company as a lifetime
    - annuity
    - IPERS
  2. Defined contribution plan:
    a. specifies how much money will go into a pension plan; employers, employees, or both contribute to plan
    - 401K
236
Q

Income sources for older adults: public assistance

A

Supplemental Security Income (SSI)

237
Q

Supplemental Security Income (SSI)

A

income supplement program for elders, visually impaired, and disabled living on little or no income/resources

238
Q

SSI does not require what

A

history of covered employment contributions

–> instead, must meet income and resource eligibility requirements

239
Q

Maximum monthly SSI benefits (2018): eligible individual / couple

A

Eligible individual = 750$/mo

Eligible couple = $1125/mo

240
Q

can supplement income through SS?

A

yes as long as they meet eligibility

241
Q

SSI recipients may qualify for

A

food stamps and medicaid

242
Q

why do many people not apply or participate in public assistance programs?

A

difficult and time consuming application processes

243
Q

Many states have reduced SSI, as well as?

A

food assistance, and Medicaid benefits

244
Q

who may be denied public assistance programs

A

immigrants

245
Q

Summarize the gist of SSI

A

SSI helps get one to the lowest standard of living

246
Q

Social class in old age is largely influenced by what

A

larger economy, past and current employment patterns, and resulting retirement income and benefits

247
Q

Social class shapes what

A

shapes what is possible in old age and how to spend ones time in work or retirement

248
Q

Social class is related to what

A

every measure of health, illness and disability

249
Q

social class affects access to what?

A

medical and dental care, out-of-pocket health care costs, living situations, and social networks, transportation, and opportunities to experience productive activities

250
Q

Income we have across the life course profoundly affects what

A

our choices in old age

251
Q

Older adults are benefited from policies designed to give a minimum standard of income and health care such as…?

A

Social security and Medicare

252
Q

older adults are more likely to own what

A

their own homes and have other assets like savings and retirement

253
Q

Describe older adults net worth compared to those younger then 35

A

net worth tends to be greater than for those under 35

254
Q

networth

A

all sources of income/assets

- However, those assets do not necessarily translate to liquid or disposable income, or money they can spend

255
Q

Overall, proportion of poor adults is ___ than children and people aged 18-64

A

lower

256
Q

Percent of poor elders ___ in past decade for the first time since the 1950s

A

increased

257
Q

percent of poor elders may continue to increase, why?

A

if SS benefits don’t include costs of living increases

258
Q

Around ___ of adults 65+ currently live at or below federal poverty level

A

9%

259
Q

what was the federal poverty level in 2018?

A

$12,140 for one person; $16,460 for two people

260
Q

what % of elders are considered “economically insecure”?

A

36%

  • Living at or below 250% of poverty level; at risk for being poor
  • A crisis or price spike could push them into poverty
261
Q

Statistics for poor elders do not include who? what does this mean?

A

hidden poor; those living with relative or in long term care facilities

262
Q

older adults are at _____ and _____ than those 18-64

A

marginal levels of income and greater risk of poverty

263
Q

factors that increase the risk for economic insecurity in old age

A
  • female
  • over age 85
  • living along
  • LGBT
  • AA, Latino, American Indian or Alaskan Native
  • living in south
  • housing costs exceeds 30% of income
264
Q

cumulative disadvantage

A

argues that inequality is a cumulative process over the life course

  • Inequalities experienced in old age are piled onto disparities faced as early as childhood; intensifies gap between rich and poor
  • Inequalities typically become worse and are hard to reverse
265
Q

___ of elders experience food insecurity

A

8%

266
Q

food insecurity

A

Households that do not have enough food for every person to live an active, healthy life

267
Q

Elders often forced to choose between paying for what

A

medications, healthcare, and putting food on table

268
Q

People struggling to eat are almost 3 times more likely to what

A

skip pills, delay refilling prescriptions, or stop taking meds entirely

269
Q

Older adults who face hunger are more likely to report what?

A

poor health, vitamin deficiencies, hospitalizations, and limitations in ADLs

270
Q

What are the 2 primary insurance policies?

A

medicaid

medicare

271
Q

medicaid

A
  • state and federal funded program
  • income and specific eligibility based
  • Managed Care Organization (MCO)
  • different for each state
272
Q

how many medicaid programs in iowa?

A

26

273
Q

medicare

A
  • federally funded program

- age based eligibility

274
Q

What are the 4 parts of medicare?

A

Part A: hospital care (not LTC)

Part B: doctors, medical tests, procedures, etc (anything you have had done to you; monthly premium)

Part C: Medicare advantage –> administered by private insurance companies

Part D: Prescription drug coverage; monthly premium

275
Q

explain how medicare is not a comprehensive health insurance plan

A

there are “gaps” in coverage

ex. medicare does not cover LTC

276
Q

Social security

A

A benefit available to individuals who are retired or disabled –> 3 main programs of the SS administration that can be accessed

277
Q

Describe how social security has to do with retirement

A
  • SS based on retirement age
  • -> Begins at age 62
  • ->Full at 66
  • ->Based on your ss credits
  • ->Spousal programs
278
Q

SSI - Supplemental Security Income

A

Program that is strictly needs based according to income and assets

  • disability or age controlled
  • solely based on need
279
Q

What is SSI (Supplemental Security Income) funded by

A

general fund taxes

280
Q

Why is SSI (Supplemental Security Income) called a “means tested” program?

A

it has nothing to do with work history but strictly involved in financial needs

281
Q

what do you need to meet the requirements for SSI (Supplemental Security Income)

A

you must have less than 2000$ in assets (3000$ for couple)

282
Q

people who receive SSI (Supplemental Security Income) benefits are receiving what?

A

receiving enough money to bring them up to poverty level

283
Q

SSDI (Social Security Disability Insurance)

A
  • payment based on work history
  • spousal and developmental support
  • under age 65
284
Q

how is SSDI (Social Security Disability Insurance) funded

A

through payroll taxes

285
Q

SSDI (Social Security Disability Insurance) candidate requirements

A

must be younger than 65 and have earned a certain number of work credits (the amount of time they spend in the workforce directly impacts the money they receive and the eligibility for the program)

286
Q

what happens when you have received SSDI (Social Security Disability Insurance) for 2 years

A

you become eligible for Medicare

287
Q

A disabled person spouse, children, or dependents are able to receive partial depend benefits called…?

A

auxiliary benefits —> only ppl 18+ are able to receive the actual benefit

288
Q

Supplemental Nutrition Assistance Program (SNAP)

A
  • “food stamps”
  • Food assistance program that provides and electronic benefit transfer (EBT) card that can be used to buy food at supermarkets, grocery stores, farmers markets, CVS
  • Must meet requirements
  • Children are still eligible is their parents are not citizens
289
Q

what do policies typically result from?

A

legislation –> then translate into regulations, programs and services that determine how funds are allocated among different groups

– >Who should receive what benefits, from which sources, and on what basis

290
Q

What shapes policy

A

Values, beliefs, and ideology

291
Q

What are two contrasting core values reflected in many debates

A
  1. Individual welfare is essentially a person’s responsibility within a free-market economy unrestrained by government control
    - -> Individualism, self-determination, personal choice and privacy
  2. Individual welfare is the responsibility of both the individual and the larger community
    - -> Government intervention (like Medicaid) is required to protect its citizens and to compensate for free market’s failure to distribute resources equitably
292
Q

From the 1930s to the 1980s, public perception of older people was what?

A

more “deserving” than other age groups converged to create the universal categories of Social Security, Older Americans Act, and Medicare

293
Q

means-tested policies determine what?

A

if a person is “deserving” of services reflect societies bias toward productivity and economic self-sufficiency

  • Argue that state/local governments, private sector and individuals are responsible for own well-being
  • Encompass self-help, family caregiving, private retirement investments, faith-based organizations, and volunteerism
294
Q

Over the past 5 decades, programs for older adults shifted from government ensuring adequacy and protection to what?

A

cutting budgets, reducing government size, and increasing revenues

295
Q

Our society has emphasis on individual responsibility with government playing what kind of role?

A

a residual or “backup” role

–> Government only intervenes when economy, family, or individual fail to provide for themselves or relatives

296
Q

Western european countries have health and welfare policies representing a collective national responsibility that all citizens are entitled to have basic needs met by government –> what are some examples of this policies

A

Cradle to grave policies

Free healthcare for all

297
Q

an ongoing debate is whether services should be delivered on the basis of ___ or ___.

A

age or need

298
Q

What are the arguments for the entitlement programs based on age

A
  • Efficient way to set a minimum floor of protection and transfer resources to older population
  • Less stigmatizing
299
Q

Critics of age-based programs argue what?

A
  • No longer economically feasible; too many people
  • Some people are relatively healthy and have enough income/resources to pay for services
  • Reinforce the perception of “the old” as a problem
  • Eligibility should be selectively determined on basis of income and functional ability to provide safety net for most vulnerable elders
300
Q

Intergeneration inequity perspective

A

Emerged when fiscally conservative groups claimed that older citizens are “greedy geezers,” thriving at expense of younger age groups, and selfishly concerned only about retirement benefits.

  • contend that SS is jeopardizing future generations and lowering responsibility for own retirements
301
Q

Interdependence of generations framework

A
  • Argues that younger and older generations support each other across the life course
  • Address income inequalities among older adults
  • Recognizes that many age-based programs often benefit younger generations
302
Q

Facts about age-based policies

A

a. Age-based policies are often at center of various proposals to reduce government spending
b. Federal expenditures for older adults are growing as life expectancy and older population increases

303
Q

Spending for SS, Medicare and Medicaid is estimated to outpace economic growth by___ times by 2030

A

2-3x

  • not only drivers of growing deficit
  • tax cuts
  • Escalating defense spending and healthcare costs
304
Q

Current reserves in Social Security Trust Fund help pay for what?

A

other federal expenditures as government borrow from these to cover other expenses

305
Q

Since 2001, funding for defense has grown much faster than average growth rate for what?

A

Social Security, Medicare, and Medicaid combined

306
Q

Age-based entitlement programs

A

most adults are automatically entitled to receive benefits based on their age, not on financial or health needs

  • SS and Medicare
  • Based on lifetime contributions into these public insurance/pension systems
307
Q

Universal and categorical benefits

A

available as a social right to all persons belonging to a designated category

  • Including age-based programs
  • Older Americans Act
308
Q

Need based or means-tested programs

A

decide eligibility by financial need

- Medicaid, Elderly Waiver, Supplemental Security Income (SSI), food assistance

309
Q

Age-based policy approaches evolved in a very different historical period - explain how it was different

A
  • Life expectancy was shorter
  • Chronic diseases relatively rare
    Poverty of elders higher than older age groups
  • Federal deficits less concerning
  • Lower percentage of older adults in US (5% of population)
310
Q

First Policies to Benefit Older Americans: 1930s-1950s –> what was the primary cause for increased government responsibility for older adults

A

economic factors

311
Q

First Policies to Benefit Older Americans (1930s-1950s) was fueled by what

A

great depression

312
Q

when was SS implemented

A

1935; it was assumed to cost less than reliance on local poorhouses

313
Q

by encouraging retirement, SS was a strategy to reduce what?

A

unemployment, and create job for the young

314
Q

First Policies to Benefit Older Americans (1930s-1950s) –> what did no one predict

A

Nobody predicted medical advances, longer life expectancies, and fewer young people paying into SS system

315
Q

Expansion of programs in the 1960s and 1970s:

A
  • Periods of economic growth can also be conductive to new policies
  • Time of economic progress and increased social consciousness about needs of vulnerable populations
316
Q
  • Medicare, Medicaid, and Older Americans Act passed what
A

1960s and 1970s

317
Q

Expansion of programs in the 1960s and 1970s: “graying” of the federal budget

A
  • Creation of a wide array of major federal programs and interest groups
  • directed toward older persons
318
Q

Cost Efficiency and Program Reduction (1980s and 1990s) –> what are different factors that influenced policies

A
  • A growing federal deficit and pressures to reduce government costs
  • An anti-tax mentality
  • Increasing concern about younger groups economic well-being
319
Q

Cost Efficiency and Program Reduction (1980s and 1990s): what happened to public support for universal age-based benefits

A

began to deteriorate

320
Q

Cost Efficiency and Program Reduction (1980s and 1990s) –> explain how economic diversity among the older population occurred

A
  • Generous private pension and personal savings increased
  • Became more apparent that chronological age is not accurate marker of financial status or functional ability
  • Old age no longer considered sufficient ground for public benefits
321
Q

Cost Efficiency and Program Reduction (1980s and 1990s) –> major societal shift in attitudes toward older population resulted in cuts across what?

A

the political spectrum
- Social security, medicare, and medicaid were drastically curtailed

  • Belief increased that older adults should finance their own retirements
322
Q

reduced government spending: Market and personal responsibility (since 2000)

A

Age-based entitlement programs were further challenged by Republican administration and Republican majority in Congress
- cost and intergenerational inequity issues that surfaced in 1980s are still salient

323
Q

reduced government spending: Market and personal responsibility (since 2000) –> with democratic administration and congress in 2008, value stance was to what?

A

increase policy and supports for vulnerable populations of all ages
- was found difficult to act on values due to recession, record high number of unemployment and deficit, and Republican congressional victories in 2010

324
Q

Factors influencing where elders live

A
  • health status
  • functional ability
  • geographic location
  • activity interests
  • finances/income
  • families/support
325
Q

what percent of older Americans live in urban and suburban areas

A

80%

326
Q

What percent of older Americans live in rural areas with fewer than 2500 residents

A

5%

  • Often have lower income and poorer health
  • More limitations in mobility and activity
  • Lower availability of services, healthcare and transportation
  • More interactions with friends and neighbors; robust informal support systems
327
Q

Graying of the suburbs

A

significant proportion of people who moved into suburban developments in 1960s and 1970s remained there after retirement; fewer young people/families moving into these areas

  • -> Designed around automobile
  • -> Lower density of housing, greater distance to services, fewer mass transit options
328
Q

Urban elders

A
  • More public transportation
  • Sidewalks conductive to walking
  • Better and closer access to social and health services
  • Higher risk and fear of victimization and crime
329
Q

age with lowest victimization of crime

A

65+

330
Q

generally, relocation is in response to major changes in lives such as what

A

Retirement, poor health, loss of partner

Existing home environment no longer fits their needs or is unsafe

Often time relocation is met with resistance

331
Q

what percent of those 65+ live in traditional housing

A

90%

332
Q

Over 23 million elder households

–> __ are homeowners and __ are renters

A

80%;20%

- Single-family homes, condominiums, mobile homes, cohousing/cooperatives, and apartments

333
Q

Aging in place

A

The desire and ability to live in the home of your choice independently and safely for as long as possible

334
Q

aging in place is associated with what

A

better health, life satisfaction and self-esteem - “home is where the heart is”

335
Q

Age-friendly/Livable Communities

A
  • Strategy that supports “livable” or “lifelong” communities
  • Recognizes importance of physical design, environment, and accessibility as well as transportation, recreational activities, civic engagement, and social engagement
336
Q

home and community based services

A

Help older adults age in place in the least restrictive environment possible

337
Q

How have home and community based services evolved

A

evolved from emphasis on institutional care to home/community-based care

338
Q

home and community based services include

A
  • Adult day services
  • Home delivered meals
  • Respite care
  • Home repair and modifications
  • Homemaker services to assist with IADLs
  • Personal care/aides to help with ADLs
  • Chore services to assist with home/yard maintenance (lawn mowing, snow removal)
  • Caregiver reimbursements
  • Assistive devices
  • Transportation
  • Case management
  • Various funding streams and eligibility criteria
339
Q

home healthcare

A

home care services have increased dramatically as Medicare/insurance companies seeks to reduce hospital and nursing home costs

340
Q

__ of older adults go online (~__ in 2012)

A

67%; ~50%

341
Q

__ own computer/tablet

A

32%

342
Q

__ have smartphones

A

42% –> Older smartphone owners are more likely to make 75K more

343
Q

why will usage of information and community technologies continue to increase?

A

many boomers used ICTs in workplace

344
Q

Ownership and usage of information and community technologies drops off considerably among what age

A

older-old (75+)

345
Q

More places offering classes/trainings to computer w internet such as…

A

Library, community centers, senior centers, AARP, other nonprofit organizations

346
Q

More older adults live in a home with internet access –> __ have high speed internet at home (__ in 2013)

A

51%; 47%

347
Q

Assistive technologies

A

products, devices, or equipment that people with physical or mental limitations use to perform functions that might otherwise be difficult or impossible

  • Walkers, WC, BR equipment, transfer equipment
  • LifeAlert, Lifeline
  • Hearing and visual aids, medication reminders
348
Q

Telehealth

A

health information is transmitted electronically from the patients home to physicians office or ambulatory care setting (health clinic, specialist’s office, etc.); can also be transmitted to family members for surveillance

  • Can increase compliance with meds/recommendation
  • Improve patient’s perceived control or self-efficacy over their health
  • Reduced hospitalizations and ER visits
349
Q

what group is at the forefront of using telehealth

A

VA –> More than 35,000 veterans enrolled in telehealth

Patients with chronic diseases monitor and transmit vital signs via phone line to secure central site, which is reviewed by clinics

350
Q

Gerontechnology

A

recent field of research and practice aimed at using technology to improve older adults’ autonomy (and likelihood of aging in place)

  • -> Portable keypads or remote controls for operating thermostats, windows and their coverings
  • -> Systems that make a room light up through sensors in the floor can help prevent falls
351
Q

Robotics

A

being developed and used to help elders perform routine housework and personal services; and provide companionship

352
Q

Smart homes

A

residences equipped with technology that connects all the devices and appliances in a home to communicate the residents

  • -> Residents can use their voice, a remote control, or a computer to command their home network to open doors, light a path, turn on exterior lights, regulate room temp.,
  • ->Can help monitor elders with care needs and reduce caregiver burden by allowing technology to help with some aspects of personal care and support
353
Q

MedReady

A

automatically dispenses medications up to 4 times a day; is med is not taken within a certain amount of time then data/call center notifies family, contracts person, etc.

  • Some are locked and set up by a nurse
  • Automated system to call person after the scheduled med time and ask if the pill has been taken; if no response or older person does not recall taking meds, then phone alerts are sent to family member or other contact person
  • Software to call and remind them when it is time to take meds
  • Some devices/technology covered by insurance/Medicare/Medicaid
354
Q

What are some examples of medical alert systems

A

Necklace or bracelet that can help elders who have fallen or have another emergency

Connects to emergency personnel or a designated individual is pushed

Some detects falls and alert people without being pushed

355
Q

Government-subsidized housing for low-income elders AND age segregated housing such as assisted living is often geared to who?

A

middle and upper-income older adults

356
Q

Active adult or lifestyle communities

A

offer wide range of activities and programming

357
Q

Service-enriched housing

A

packages housing and care; different levels or care on-site; easy access to services and assistance

358
Q

Continuing Care Retirement Communities (CCRC)

A

broadcast type of service-enriched housing recognizing that residents may need increasing levels of care over time

359
Q

Continuing Care Retirement Communities (CCRC) –> Multilevel of care

A

offers range of housing, social, and health services on same campus

—> Independent apartments, assisted living, skilled nursing care, intermediate nursing care

—> remain in same CCRC but move into various levels of care as needed

—> expensive

360
Q

Continuing Care Retirement Communities (CCRC) –> Assisted Living Facilities (ALF)

A

housing option for people not needing 24 hour medical care but needing some assistance

—> Private apartments with supportive services

—> Provided at least one meal a day, basic health care, minor ADL and IADL assistance, 24 hour security

361
Q

how are Assisted Living Facilities funded?

A

Some accept Medicaid (usually through elderly waiver) funding but costs can still be prohibitive

362
Q

what are the types of nursing facility care?

A
  1. Skilled care (SNF)
  2. Intermediate Care (ICF)
  3. Custodial Care (RCF)
363
Q

Skilled Care (SNF)

A

Continuous “around-the-clock” care designed to treat a medical condition.

This care is ordered by a physician and performed by skilled medical personnel, such as RN or professional therapists. A treatment plan is established

364
Q

Intermediate Care (ICF)

A

intermittent nursing and rehabilitative care provided by RN, licensed practical nurses, and nurse’s aides under the supervision of a physician

365
Q

Custodial care (RCF)

A

care designed to assist with one’s activities of daily living. It can be provided by someone without professional medical skills but is supervised by a physician.

366
Q

How is nursing home care paid for?

A

generally paid through Medicare, private pay, long-term care insurance or Medicaid

  • Long-Term Care Insurance
  • Private Pay - average $5,833 per month
  • Medicaid - income/asset restrictions
367
Q

Medicare pays for up to ____ days in a skilled nursing facility with caveats

A

100

368
Q

Private Pay averages how much money for nursing homes per month?

A

Private Pay - average $5,833 per month

369
Q

loss = deprivation which means

A

we no longer have something

370
Q

unresolved grief

A

earlier generations told to “be strong” and not express painful thoughts/feelings

371
Q

Anticipatory grief

A

grief reaction that occurs before and impending loss

Ex. Impending death of a loved one due to illness

Start imagining life without that person/thing

372
Q

Disenfranchised grief

A

a loss that is not opening acknowledged by others, publicly mourned or socially supported

373
Q

instrumental grief

A

grief experienced in more physical/cognitive/behavioral ways; more thinking and action than feeling; focus on doing and actively responding to grief

374
Q

intuitive grief

A

grief experienced in waves of emotion; grief expression mirrors inner feelings and emotions; more feeling and thinking/action

375
Q

3 stages of life review

A

Introspection
Self-reflection
Reminiscence

376
Q

What percent of wives outlive husbands?

A

85%

377
Q

what percent of both women and men over 65 are widowed?

A

40% women and 13% men

378
Q

what percent of both women and men over 85 are widowed?

A

73% women and 36% men

379
Q

elder of color are ___ higher proportion of widowhood than white peers

A

2x

380
Q

most adults do not lose a sibling to death till about what age?

A

70

381
Q

Kubler Ross Stages of grief

A 
sock or denial
anger
bargaining
depression
acceptance/hope
382
Q

5 wishes

A

type of living will/AD; designed to encourage conversations about broader questions related to health care decisions and preferences; meets legal requirements for AD in 42 states

383
Q

honoring your wishes

A

initiated by Iowa City Hospice; 11 page healthcare directive

Includes Health Care POA, religious preferences, healthcare wishes/desires, CPR/DNR preferences, life support preferences, organ/body donation preferences, etc.

Gerontology (2 decks)

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