Community Care For An Aging Society

Most older persons desire to remain living in the community, but those requiring care are often at risk of not having their needs met. Families may find themselves unable to care for their older relatives, while formal services are often unavailable or inaccessible. Policies and services are beginning to focus on the community rather than institutions as the primary axis for care. This book examines the many factors contributing to needs for care among older persons as well as the ways in which impairments are defined and responded to by both the individual and society. Focusing on practice and policy issues, Dr. Cox describes many of the early stage community care innovations that hold the promise of making contributions to the well-being and independence of the older population.

Sixteen chapters by scholars of social work relate the well-being of older adults to social work practice and the current model of service delivery. Chapters concentrate on issues affecting the health of older adults (depression, dementia, abuse), services to specific populations (African American women, grandparents raising grandchildren, the developmentally disabled), and professional issues (home care, case management, standardized assessment). The implications for training, research, and policy are highlighted. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com).

First published in 1989. In an aging society, however, the challenge broadens to include health care and social support at home and in the community. The major premise of this book is that cost-conscious community care and self-care will become increasingly important as the era of cost containment intensifies.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

As people age, they are at increased risk of having their basic human rights threatened or violated. When age is perceived as incompetence, it can easily lead to discrimination that impacts human rights. Based on the premise that social policy must reflect human rights principles, this graduate-level textbook views the challenges associated with aging as opportunities for policy development that stresses the rights of older adults rather than needs. The text distinguishes between “needs” and “rights” and describes those policies and services that best ensure that the rights of older adults are actually met—particularly programs that enable people to remain in their own communities so they can benefit from continued integration and participation in society. Issues and challenges surrounding such efforts, and gaps in social policies faced by specific subsets of older people, are critically examined. The book first analyzes current aging policies and rights and considers the Older Americans Act as a basic policy framework. With an eye to promoting independence, the book discusses issues of income, housing, transportation, health, and home care and what constitutes a “livable community,” along with policies that promote wellbeing and focus on preventing senior abuse and exploitation. Challenges faced by older workers are covered, as are issues particular to family caregivers, older women, and grandparents as caregivers. Gaps in social policies for LG BT seniors and older members of specific ethnic groups are discussed. Particular attention is given to global issues and aging policies in diverse countries and the ways in which they reflect human rights concerns. Each chapter concludes with probing discussion questions for classroom use. KEY FEATURES: Presents a human rights framework for aging policy Distinguishes between needs and rights of older persons Focuses on policies and programs that can help older people to remain in the community Explores the issues and challenges of specific older populations Discusses global responses and concerns with regard to older persons and human rights Carole B. Cox, MSW, PhD, is professor at the Graduate School of Social Service, Fordham University. She is a fellow of the Gerontological Society of America and a Fulbright scholar. She is the author of more than 50 journal articles and chapters dealing with various aspects of aging and caregiving, with extensive research on caregivers for persons with dementia, their needs, and their use of services. Her recent work includes a study of the impact of dementia on the workplace. Her caregiving research also includes that of grandparents raising grandchildren, leading to the development of a curriculum, Empowering Grandparents Raising Grandchildren: A Training Manual for Group Leaders (Springer Publishing Company, 2000). She is the editor of To Grandmother’s House We Go and Stay: Perspectives on Custodial Grandparents (Springer Publishing Company, 2000). Her other books include Home Care for the Elderly: An International Perspective, coauthored with Abraham Monk (1991); The Frail Elderly: Problems, Needs, and Community Responses (1993); Ethnicity and Social Work Practice, coauthored with Paul Ephross (1998); Community Care for an Aging Society: Policies and Services (Springer Publishing Company, 2005); and Dementia and Social Work Practice (Springer Publishing Company, 2007).

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

Students and practitioners will find Public Health for an Aging Society an invaluable resource both in the workplace and the classroom.

This comprehensive graduate textbook focuses on the full spectrum of long-term care settings ranging from family and community based care through supportive housing options to a variety of institutional long-term care alternatives. Integrating theory and practice, the book features the perspectives of diverse fields regarding current long-term care options and new directions for the future. Prominent scholars from history, environmental design, family caregiving, gerontology, social service delivery, clinical care, health service delivery, public policy, finance, law, and ethics explore such themes as: Relationships among independence, dependence, and interdependence Ethical considerations in the provision of long-term care Decision-making in long-term care Fluidity and transitions in long-term care The lived experience of long-term care A micro-macro perspective ranging from the individual to societal institutions The book examines future directions for long-term care, considering such factors as the interface of technology and long-term care, cultural diversity, and relationships between voluntary and paid services. Each chapter includes case examples, study questions, and exercises, additional resources, and website links. The appendices provide a glossary and a list of acronyms. Instructorís resources are also available. Key Features: Focuses on the full array of long-term care options Integrates theory and practice Incorporates the perspectives of diverse fields including history, environmental design, family caregiving, social services and public policy Includes numerous case examples, study questions, exercises, and additional resources Considers new approaches to long-term care incorporating technology and considering cultural diversity and the relationship between voluntary and paid services