Notes For Exam 4
Notes For Exam 4 GERO 2000-005
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This 0 page Class Notes was uploaded by Kerrigan Flynn on Sunday November 22, 2015. The Class Notes belongs to GERO 2000-005 at University of Nebraska at Omaha taught by Professor Zoe Baumel in Fall 2015. Since its upload, it has received 20 views. For similar materials see Introduction to Gerontology in Human Development at University of Nebraska at Omaha.
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Date Created: 11/22/15
11415 Crime Abuse Fraud Fears Older Adults amp Crime 0 Elders are victimized at a lower rate overall but many crimes unreported 0 Older victims may be Unable to identify attackers Unwilling to report crimes especially by a family member 0 Overall older adults are victimized at a lower rate than younger age groups 0 Violent crime robbery rape assault etc older adults are victimized at a lower rate than younger age groups Age 65 and over 4 per 1000 Age 12 to 24 82 per 1000 0 Overall older adults victimized at a lower rate 0 Property crimes are most common 0 Examples Personal larceny Home burglary Auto theft Fear of Crime 0 Psychological state that is highest among older adults 0 May lead to avoidance of leaving home 0 Most violent crimes against older adults occur in or near their homes Fear of Crime pg 324 0 The literature consistently reports that a Women are more fearful than men b African Americans are more fearful than whites c Those with less money are more afraid of crime than those with more money d Residents of large cities are more fearful than people in smaller towns and rural areas Paradoxes of Fear of Crime 0 Older women fear crime more than older men but are less likely to be victims 0 Older people are more fearful than younger people but are less likely to be victims Risk Factors for Crime Higher for elders who 0 Live on fixed incomes 0 Are physically 0 Live in highcrime areas Vulnerabilities of Older Adults 0 Older adults are sometimes 1 Poor living on fixed incomes 2 May live in old or changing neighborhoods 3 May not be strong enough to defend selves 4 Often unable to defend themselves 5 May me unable or unwilling to identify attackers Efforts to Reduce Crime 0 Grass Roots efforts to reduce crime examples Neighborhood Watch Granny Squads Heaven39s Angels and Gray Squads Preventing Crime against Elders Local amp state efforts 0 Special training for police units 0 Neighborhood Watch quotGranny Squadsquot 0 Escort services Problems for Law Enforcement Older adults are often 0 Unable to identify attackers 0 UnWilling to report crimes especially by a family member Elder Abuse 0 Reported among 210 of older adults incidence is probably higher 0 Most common abuser is a family member including caregivers 0 Can be reported by anyone anonymously to Adult Protective Services APS 11415 11415 Elder Abuse is Dif cult to Quantify 0 Definitions of elder abuse vary 0 State statistics vary Widely no uniform reporting system 0 Comprehensive national data not collected Many Types of Elder Abuse 0 Physical Abuse use of force to in ict pain amp injury 0 Psychological Abuse use of threats amp intimidations Financial Abuse amp Fraud 0 Improper use of an elder39s funds property or assets 0 Includes fraud Telemarketing scams Doortodoor sales Estate ripoffs Con games Medicare fraud SCAMS 0 Telemarketing Insurance companies quotcontrast Winnersquot 0 Door to door high pressure sales tactics 0 Estate ripoffs living trusts 0 Con games tricking older victim into giving up voluntarily 0 Medical quackery misrepresentation of health or cosmetic benefits Examples include Medicines and Medical devices Youth restorers Cancer cures Arthritis cures Medicare Fraud 0 Abuse of Medicare system by doctors amp pharmacists 0 Exaggerated claims for reimbursement unnecessary procedures Overbilling Fraudulent claims Other Types of Elder Abuse 0 Violation of rights taking away rights voting due process etc 0 Neglect caregiver39s failure to provide adequate care for an older person 0 SelfNeglect Failure to provide for one39s own care Drug Abuse among Older Adults Mostlv legal drugs 0 Prescription drugs 0 Overthecounter drugs 0 Alcohol Problems with Drugs amp Elders 0 Adverse drug reactions amp drug abuse 0 Medication errors 1 Not prescribing a drug correctly 2 Prescription more or less of a drug than necessary 0 Nursing homes valium etc use of quotchemical restraintsquot Alcoholism 0 Lower of elders than other age groups 0 Strain on body greater in older drinkers 0 Risk factors in later life include Family or personal history Pain amp insomnia Depression 11415 11915 Ethnic Minority Groups Minority groups in numbers and status 0 Groups that experience discrimination due to physical or cultural characteristics 0 Cumulative disadvantage unequal treatment throughout the life course Ethnicity o Involves a culture and an internalized heritage Results in social status 0 In uence the composition and function of support systems 0 Differences exist between ethnic groups but also much variation within groups Minorities Identi ed by language physical characteristics or cultural characteristics 0 Have experienced unequal treatment based on those characteristics in certain segment based on those characteristics in certain segments of society Aging amp Diversity 0 Older adults are nota homogeneous group 0 Until recently the study of aging focused on older white Americans African American Elders 81 are age 65 28 million 0 Have less adequate income housing and healthcare 0 Less likely to use formal longterm care services Hispanic Elders 49 are age 65 17 million 0 Higher of elders below poverty level and with poor health care 0 Use fewer public services language barriers are a factor African American Elders 11925 Older Americans are admitted to nursing homes at between 12 and 34 of the rate of whites Pg355 Asian American Elders Differences of culture language and religion make each group unique Asian American refers in the broadest sense to people of Chinese Korean Japanese Filipino East lndian Asian American Elders 78 are 65 800000 Less likely to use formal longterm care and public services Language and cultural barriers few bilingual staff also stronger m my The bulk of Asian immigration occurred between 1870 and 1924 and many were instrumental in developing the railway system they laid the track The immigration law of 1924 halted Asian immigration it forbade Chinese males from bringing their foreignborn wives to the US so many in the US could not marry Laws Discriminating Against Asians are Numerous pg364 Executive Order of 1942 resulted in the internment of 110000 people ofJapanese ancestry Public Law 95507 excluded Asians as a protected minority under the de nition of quotsocially and economically disadvantagedquot 111115 Health Care and Life Expectancy The most common health issues faced by older African Americans are hypertension arthritis and heart disease 0 More African Americans are now covered by health insurance which should help their health statuses in the future 0 Older African Americans are less likely than their white counterparts to reach out for help Filial Piety A customtradition demanding that family members respect and care for elders Some Asian groups have kept to this custom more closely than others 0 As children and grandchildren become more acculturated intergenerational tensions result Native American Elders 56 are age 65 138000 0 More likely to suffer from chronic illness amp disability 0 Access to health care amp longterm care is insuf cient Native Americans Suffer higher rates of death due to diabetes alcoholism in uenza pneumonia suicide homicides and death due to accidents Lower income results in poor nutrition and health care and is associated with lower education levels pg 369 Groups Assisting Minority Elders National Caucus amp Center on Black Aged National Indian Council on Aging 0 Association National Pro Personal Mayores National Paci cAsian Resource Center on Aging Older Adults in the United States 0 During 20th century wellbeing has improved 0 Social Security Medicare Older Americans Act 0 Not everyone bene ts equally End of Chapter 13 111125 Minority Groups Elders identi ed by physicalamp culturecharacteristics Elders who have received unequal treatment across the life course Includes older women Women are considered a minority group because of unequal treatment Elderly Women Sexism is compounded by ageism Women still don t have equality in work politics or romance Roles for older women have been historically narrow but are broadening Women are more comfortable reaching out and accepting help from each other books and seminars and counseling services Women39s Financial Status Poverty among unmarried women is three to four times higher than that of their married counterparts Over 50 of 65 women would live in poverty if it weren39t for Social Security Among unmarried older women 48 of their total income comes from Social Security compared to 30 of couples39 income Reasons Older Women are More Likely to be Poor Lower wage histories Women earn on average 76 might be closer to 78 today of what men earn which leaves less money to invest for retirement Lower retirement income Women are less likely to be vested in retirement plans vested based on how long you39ve been working there Vulnerability of divorced women Likelihood of remarriage is lower for women than for men Lack of nancial planning skills Managing money was traditionally left to men Reasons Older Women are More Likely to be Poor cont Longevity of women Women live longer than men and need more retirement money 111135 0 Need for public bene ts Women are more likely to need public services 0 Caregiving responsibilities Women are more likely to leave employment to perform caregiving Inadequate housing Affordable housing is difficult for women to nd MiddleAged Boomer Women 0 Gender pay gaps lead to lower retirement incomes Divorce rates are higher for the Boomer generation 0 Women are less likely to remarry so a cohort of divorced women is now entering later life Single Widowed and Divorced Older Women 0 More than 25 of women aged 65 and older who live alone or with nonrelatives live below the poverty level 0 Only 8 of those living with their husbands are in poverty 0 Nevermarried women tend to have greater retirement incomes than divorced or widowed women Double Standard of Aging 0 The double standard of aging for women emphasizes beauty and youth dictating their selfworth while the standard for a man is much less strict Our culture sees older women as sexually invisible and as objects of pity The youth culture exerts an intense social pressure for women to remain young Exploitation of Women39s Fears Late midlife astonishment a developmental crisis in which women aged 50 to 60 work through society39s devaluation of their physical appearance 0 For women who do not transition well from midlife to old age low self esteem poor body image and depression can result Aging amp Diversity 0 Older adults are nota homogeneous group 111145 0 Until recently the study of aging focused on older white Americans Special Problems for Older Adults Suicide 0 Crime Older adults as victims Older criminals Alcoholism amp drug abuse Suicide Among Older Adults 0 Rates of attempted amp successful suicides increase among the oldest M 0 Women are more likely to attempt suicide men are more likely to be successful Suicide rates higher among whites than among nonwhites Risk Factors for Suicide Suffering and loss leading to depression 0 Physical illness pain amp disability 0 Alcohol amp drugs including medication Risk becomes greater with an increase in factors Gerontology 111615 Double Standard of Aging 0 The double standard of aging for women emphasizes beauty and youth dictating their selfworth while the standard for a man is much less strict Our culture sees older women as sexually invisible and as objects of pity The youth culture exerts an intense social pressure for women to remain young Medical Ethics 0 Are medical professionals allows to assist in the death of a patient 0 OR WA MT they can prescribe meds but not administer them 0 Several alternatives legal consequences and physicians attitudes vary 0 Passive Euthanasia vs Physician assisted suicide Passive Euthanasia o Allowing persons to die without using quotextraordinary meansquot to save them Noneuse of feeding tubes respirators medication 0 Legal for physicians with informed consent of patient or under advance directive Gerontology 112015 Care of the Dying at Home Primarily through palliative care 0 Pain control through prescription drugs physical therapy etc 0 Less costythan hospital care Hospice 0 Palliative care for the dying Medicare pays for hospice services Living Arrangements 0 More than half of 85 live in their own home 0 For some supportive services may become necessary 0 Families provide most of this support Philosophy of Hospice Care Controlling m and symptoms not treating underlying cause 0 Addressing psychological emotional and spiritual needs of patient and their families 0Providing care in a homelike setting Hospice Care in the US 0 Interdisciplinary team including 0 Doctors and nurses Therapists Nutritionists Chaplains Volunteers FOCUS on Providing Comfort OOOOO Patient SelfDetermination Act 0 Passed in 1991 0 Medicare and Medicaid providers must honor advance directives Applies to doctors hospitals longterm care etc Legal Rights of the Dying 0 Until late 20th century physicians made all informed decisions for patients 0 Today patients have the right to choose and accept or reject treatment options 0 Informed consent patients share in decisionmaking 0 Patients are competent 0 Patients give consent freely 0 Patients understand their options Advance Directives Legal documents signed by an individual about future treatment choices 0 State your wishes if you are in a coma or persistent vegetative state 0 Give instructions on whether to acceptor refuse treatment Legal documents signed by an individual about future treatment choices 0 Give instructions on whether to accept or refuse treatment 0 Examples 0 Usenonuse of lifesustaining procedures Feeding tubes Respirators Medication o Usenonuse of health care facilities 0 Instructions 0 Health Care Power of Attorney HCPA A document that appoints a person to be your advocate This person makes your treatment choices when you are incapacitated This person decides for you whether to acceptor refuse treatment 0 Living Will If you do not want to appoint a person to be your advocate A document stating your treatment choices in case you become incapacitated This document states your choice to accept or refuse treatment 0 DoNotResuscitate DNR Order A living will for a speci c treatment choice A document that states quotif my heart and breathing stop no person can attempt to resuscitate mequot Extraordinary lifesaving measures are avoided Gerontology 112315 Patient SelfDetermination Act 0 Passed in 1991 0 Medicare and Medicaid providers M honor advance directives Applies to doctors hospitals longterm care etc Physicians and Terminally Ill Patients 0 Physicians are bound by law and ethics to sustain life and when a patient approaches death it is a sad time for o The patient 0 The patients family and loved ones 0 Medical staff and caregivers Rational Suicide 0 The idea that suicide can be a decision based on good mental health although the relationship between suicide and mental health is not as clearcut to some as to others Pg 405 Medical Ethics 0 Are medical professionals allowed to assist in the death of a patient OR WA MT 0 Several alternatives legal consequences and physicians attitudes vary 0 Passive Euthanasia vs Physician Assisted Suicide Passive Euthanasia o Allowing persons to die without using quotextraordinary meansquot to save them Nonuse of feeding tubes respirators medication etc 0 Legal for physicians with INFORMED CONSENT consent of patient OR under advance directive PhysicianAssisted Suicide 0 ln states where Physicianassisted suicide is legal law does NOT allow the doctor to administer or perform euthanasia They can legally prescribe medications but these must be SELF ADMINISTERED Facing and Preparing for Death 0 Financial and legal arrangements 0 Advanced directives 0 Last will and testament 0 Life insurance Autopsy organ and tissue donation Funerals and burial Funerals and Burials Majority of Americans who die are buried increasing number are cremated Funeral cemetery costs can be high Preplanning can lower costs and reduce family con ict Preplanning Average funeral cost is over 7000 Preplanning lowers costs 0 Funeral expenses 0 Caskets o Burial or cremation Speci c instructions made in advance to ease the burden on families Bereavement v Mourning Bereavement is the experienced loss the fact and some employers provide bereavement time off for individual for whom death has occurred in their immediate family Mourning is not the feelings but the behavioral responses to grief How do we behaviorally express our grief different customs or traditions may suggest different behaviors Bereavement The experienced loss the fact some employers provide bereavement time off for individuals for whom death has occurred in their immediate family Mourning Mourning is no the feelings but the behavioral responses to grief How do we behaviorally express our grief Grief 5 stages of grief o Denial o Anger o Bargaining 0 Depression 0 Acceptance Some suffer chronic serious problems Majority are resilient within 2 years Complicated Grief Responses Complicated grief a cognitive disorganization and emotional chaos that can lead to some DEPRESSION Types of complicated grief include 0 Chronic Grief Reactions results in longterm sorrow lasting for years 0 Masked Grief Reactions result in avoidance of grief accompanied by substitute psychosomatic complaints headaches insomnia pain etc o Exaggerated Grief Reactions result if avoidance of grief that can erupt in the future as phobias Psychiatric disorders etc Groups Assisting Minority Elders National Caucus amp Center on Black Aged National Indian Council on Aging Asociacion Nacional Pro Personas Mayores National Paci cAsian Resource Center on Aging Other Adults in the United States During 20th century wellbeing has improved Social Security Medicare Older Americans Act Not everyone bene ts equally Key Decades for Aging Policy 19305 Great Depression Social Security 19605 Civil Rights Era Medicare amp Medicaid Older Americans Act 20105 Demographic Changes Baby Boomers turning Age 65 Political Power for Older Adults Increasing in terms of Voting Of ce Holding Interest Groups Myths about Older Voters Older voters Are always more conservative Agree on aging policy Vote as a single bloc Reality about Older Voters Diverse in political party membership Republican Democratic Independent Diverse views on public policy Aging issues Social Security Medicare etc Aging issues 113015 113015 0 Do not vote as a single bloc Of ce Holding Political power 0 President 0 Congress 0 Supreme court President 0 Minimum age is 39 no maximum age why Limited to two terms 0 2 elected at age 65 William Henry Harrison 9th President 1841 Ronald Reagan 40th President 1981 Age Discrimination Act Amendments of 1986 Eliminated the BFOQs which allowed mandatory retirement at age 65 for certain occupations for example Police Of cers Airport Traf c Controllers Fire Fighters Recent Presidents Baby Boomers 0 Bill Clinton Born 1946 0 George W Bush Born 1946 0 Barack Obama Born 1961 12215 Political Power for Older Adults 0 Increasing due to aging of baby boomers Highest voter turnout in recent elections has been among age 6574 0 Older adults do notvote as a single bloc Political Power cont 0 President Most recent are all Boomers Congress No term limits many serve into old age 0 Supreme Court Lifetime appointments many already in 70s Changing Status of Older Adults Also due in part to 0 Interest Groups 0 Education Programs 0 Volunteer Programs Interest Groups 0 Organizations that advocate for groups or individuals Interests groups quotlobbyquot policymakers on behalf of their members 0 Aging interest groups represent older adults at the national and state level Gerontology 124 Changing Status of Older Adults 0 Also due in part to 0 Interest groups Organizations that advocate for groups or individuals lnterest groups lobby policymakers on the behalf of their members Aging interest groups represent older adults at the national and state level 0 Education programs OLL Lifelong learning for persons age 50 0 120 colleges in the US including UNL Elderhostel now Road Scholar Education and travel for persons age 55 0 All 50 states 90 countries 0 Volunteer programs Senior Corps established in 2002 as a part of USA Freedom Corps Foster Grandparents o Volunteers age 60 0 Provide mentorship for disadvantaged or disabled youth 0 Support children with exceptional needs 0 Senior Companions o Volunteers age 60 0 Provide assistance and companionship to other seniors 0 Support for frail elders and for caregivers RSVP o Volunteers age 55 0 Work in community service opportunities in public and private sector 0 Examples Building homes planting gardens Neighborhood watch programs Disaster relief services Volunteer program for Americans age 55 seniors get small stipend Older adults serve 1540 hours per week Aging Interest Groups 0 Older adults join for different reasons 0 Political activity 0 Social networking 0 Membership bene ts 0 quotGray lobbyquot includes 0 AARP 0 Gray Panthers AARP Founded in 1947 by Ethel Percy Andrus 0 Today 47 million members many join for the bene ts 0 Members are age 50 Gray Panthers Founded in 1970 by Maggie Kuhn Small group more focused on political issues 0 Members are ages
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