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14 HUS 133 Successful Aging


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14 HUS 133 Successful Aging

  1. 1. Adulthood and Aging, 6eJohn C. CavanaughFredda Blanchard-Fields CHAPTER FOURTEEN Successful Aging 1 of 21
  2. 2. Demographic Trends and Social PolicyLearning Objectives• What key demographic changes will occur by 2030?• What are the challenges facing Social Security and Medicare? 2 of 21
  3. 3. Demographic Trends and Social PolicyDemographic Trends: 2030• Potential for intergenerational conflict exists. – Controversy over the rate and growth of Medicare and Social Security – Future issues when the last baby boomer reaches 65 (2030) • The proportion of older adults will have nearly doubled. • Older adults will be politically sophisticated and organized. • Will want to keep their affluent lifestyle, Social Security benefits, health care, comfortable retirement • Ratio of workers to retirees will fall from 3:1 to 2:1. • Lowered sense of obligation toward elderly parents • Rapid increase of ethnic minority older adults 3 of 21
  4. 4. Demographic Trends and Social PolicySocial Security and Medicare• Political Landscape – 1970s: older adults began to be portrayed as scapegoats concerning government resources • Because of tremendous growth of federal dollars expended on them • Older adults portrayed as highly politically active, fiscally conservative, and selfish. – 1983: Congress made considerable changes in the name of intergenerational fairness. • Changes in Social Security, Medicare, the Older Americans Act, and other programs and policies 4 of 21
  5. 5. Poverty Rates 5 of 21
  6. 6. Social Security & Medicare 6 of 21
  7. 7. Demographic Trends and Social PolicySocial Security and MedicareSocial Security – 1935: initiative by FDR to “frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age.” – Revisions to the law have changed SS so it now represents the primary financial support after retirement to many Americans. – In the 21ST century, other plans, 401(k), 403(b), 457, mutual funds, IRAs, savings option, may change SS back to being the supplement it was supposed to be. – Primary challenge to SS is the large cohort of baby boomers drawing benefits and a smaller generation paying into the system. 7 of 21
  8. 8. Demographic Trends and Social PolicySocial Security and MedicareMedicare – 40 million U.S. citizens depend on Medicare for medical insurance. – Eligibility for Medicare • Over 65 • Be disabled • Have permanent kidney failure – Consists of three parts • Part A – inpatient hospital services, etc. • Part B – outpatient services, etc. • Part D – some coverage for prescription medications 8 of 21
  9. 9. Health Issues and Quality of LifeLearning Objectives• What are the key issues in health promotion and quality of life?• What are the major strategies for maintaining and enhancing competence?• What are the primary considerations in designing health promotion and disease prevention programs?• What are the principle lifestyle factors that influence competence? 9 of 21
  10. 10. Health Promotion and Quality of LifeChanging Unhealthy Habits Increase Functional Capability• Little research on health programs specifically for the elderly, however: – Taking possibility of injury into account, exercise is key to health – Health education programs minimize effects of emotional stress – Health screening programs are effective in identifying chronic diseases that impact quality of life• Quality of Life – One’s well-being and life satisfaction – State of health has major influence – Best studied from the point of view of the person 10 of 21
  11. 11. Health Promotion and Quality of LifeA Framework for Maintaining and Enhancing Competence• Use of computers is one way in which technology can enhance competence of older adults. – Websites dedicated to older persons. – Email as a way to keep in touch with friends and family.• Considering the life-span perspective, changes occur with age result from: – Multiple biological, psychological, sociocultural, and life-cycle forces• Mastering tasks of daily living contributes to a sense of competence. – Key is to apply the three adaptive mechanisms for aging: • Selection – Optimization – Compensation (SOC) – Differentiate usual or typical aging from successful aging. 11 of 21
  12. 12. Health Promotion and Quality of LifeHealth Promotion and Disease Prevention• No magic potion or set of steps to successful aging but table 14.1 suggests a strategy. 12 of 21
  13. 13. Health Promotion and Quality of LifeHealth Promotion and Disease PreventionU. S. Department of Health and Human Services created a national initiative to improve health of all Americans. – U.S Government allocates funds appropriated by the Older Americans Act through the Administration on Aging (AoA) to support programs such as: • Health risk assessments and • Health promotion programs on chronic disabling conditions • screening Nutrition screening and education • Counseling regarding social • Physical fitness services • Home injury control services • Follow-up health services 13 of 21
  14. 14. Health Promotion and Quality of LifeHealth Promotion and Disease Prevention (cont.)Issues in Prevention – Primary prevention Intervention that prevents a disease or condition from occurring – Secondary prevention Instituted after a condition has begun – Tertiary Prevention Efforts to avoid complications or secondary chronic conditions – Quaternary prevention Aimed at improving functional capacities of people with chronic conditions 14 of 21
  15. 15. Health Promotion and Quality of LifeLifestyle Factors• Exercise – Aerobic exercise: places moderate stress on the heart by maintaining a pulse rate between 60 and 90% of the person’s maximum heart rate• Nutrition – Metabolism: how much energy the body needs Metabolism and digestive process slow down with age. – Low-density lipoproteins (LDL): cause fatty deposits to accumulate in arteries – High-density lipoproteins (HDL): help keep arteries clear by breaking down LDLs – Body mass index (BMI): ratio of body weight and height (w/h2) 15 of 21
  16. 16. Overweight & Obesity 16 of 21
  17. 17. Successful AgingLearning Objectives• What is successful aging? 17 of 21
  18. 18. What is “Successful Aging?” The absence of disease and disability makes it easier to maintain mental and physical function. And maintenance of mental and physical function, in turn, enables (but does not guarantee) active engagement with life.It is the combination of all three—avoidance of disease and disability, maintenance of cognitive and physical function, and sustained engagement with life—that represents the concept of successful aging most fully(Rowe & Kahn, 1998, p. 39). 18 of 21
  19. 19. Successful AgingVaillant (2002) proposes three criteria related to health: 1. No physical disability at age 75 2. Good subjective health 3. Length of undisabled lifeand three related to social and productive activity: – Good mental health – Objective social support – Self-rated life satisfaction in eight domains 19 of 21
  20. 20. Successful AgingVaillant’s eight domains of life satisfaction: 1. Marriage 2. Income-producing work 3. Children 4. Friendship and social contacts 5. Hobbies 6. Community service activities 7. Religion 8. Recreation/sports 20 of 21
  21. 21. Successful AgingSuccessful Aging TheoriesThe Selection, Optimization, and Compensation (SOC) modelSelection The choosing and developing goalsOptimization The refinement of goal-related actionsCompensation the substitution of means when previous ones are no longer available 21 of 21
  22. 22. Successful AgingSuccessful Aging Theories• Successful aging requires that people: – Have the resources to live a healthy life – Have access to health care – Have life experiences that support individual decision making• Negatives – Poverty, widowhood, differential social expectations based on gender influence 22 of 21
  23. 23. Successful AgingWhen you are old, will you be able tolook back and say, “I lived long and prospered” 23 of 21