The Challenges of Disability & Aging

Much of my education in human services education deals with the challenges of becoming disabled as one ages, particularly over 65 years old. The goal should be to prepare as best as we can to be in the best health possible for as long as possible. The term for this is morbidity compression. Below is a recent class from me about common issues affecting the elderly. Feel free to comment.Grandma's (Mom's) 90th 001

Giving up a driving license is often a very difficult moment in life. What can be done to elderly adult to prevent their feeling of depression, isolation or even uselessness? What could be offered to elderly adults so they remain connected with to the world.

As of 2012, 36 million people still drive as an older adult. over 65.  A health decline usually precipitates the decision to give up driving. The irony is that giving up the car tends to make them health decline even faster. I would be angry if I had to give up my power chair, the closest I have come to driving. I think the subject should be brought up ahead of time before it becomes necessary. A good idea is to limit driving, no night or rush hour driving, This is the kindest way to do it. That way it should not come as a complete shock to give it up. Most decent sized counties or cities have paratransit systems. It is good to stress the positives, like stress free riding. There may be a friend or a family member that has errands to do. They can make it a movie or a lunch date too! The key is to make them important and keep them involved in life. That cuts down on depression, isolation and keeps their mind active.

Norton, A. (2016) HealthDay- When older seniors stop driving, poorer health may be a passenger

Retrieved from https://consumer.healthday.com/senior-citizen-information-31/misc-aging-news-10/when-seniors-stop-driving-poorer-health-may-follow-707454.html

 

  1. Are issues of addiction to alcohol and/or drugs among elderly adults given enough attention? Why or why not? How would you address them?

There are many reasons elderly people may turn to alcohol or drugs in later life. Children grow up and leave home. It becomes necessary to give up a job that he or she put great value on or move to a smaller home. Friends die or move away. Physical health fails, and there is more pain and stiffness. A spouse or partner of many years gets ill or dies. The very real difficulties of aging can easily pile up and seniors can easily turn toward alcohol or drugs, even without realizing it. Abuse among older people is often hidden, overlooked and misdiagnosed, and it is more dangerous for them since they are more likely to be on meds for other conditions. They probably won’t be honest with their doctors about it either. My husband tried to address it with his father and was told to mind his own ——– business. I would phone the primary care provider.

National Council on Alcohol and Drug Addiction (2015) Alcohol, drug dependence and seniors Retrieved

From https://www.ncadd.org/about-addiction/seniors/alcohol-drug-dependence-and-seniors

 

  1. How could you use your knowledge of health behavior concepts to help an elderly person change their unhealthy lifestyle? Use at least two theories to present a plan for this person. Explain your answer.

I would find an exercise that is facilitated by and for older people. I think many people, not just older people, operate under the Cognitive Dissonance Theory. For example, they know that exercise is good for them but because it isn’t fun, takes work and causes pain, people tell themselves that it is not good for them in order to resolve the conflict they. It is uncomfortable to hold two opposing points of view. If I understand the Theory of Planned Action correctly, this theory posits that our attitude about something determines our behavior toward it. This is why I feel that signing up for a class with an older facilitator and class members. They would understand and be empathetic, so the people would not feel so out of place, and would be on a more an equal footing (McCloud, 2014).

McCloud S. (2014) Simply Psychology – Cognitive Dissonance Retrieved from

http://www.simplypsychology.org/cognitive-dissonance.html

 

 

 

  1. Your neighbor’s parents or grandparents are going to move-in with them. They know that you are working with elderly population and taking courses in health and aging, so they asked you for help with making their house ready. Describe what you could discuss them to make them realize how to make their house safer for their aging relative.

Lighting is very important; you probably need to install more lighting. In the kitchen, place lighting over the sink, stove and other work areas and be sure your stove’s controls are easy for you to see Do not forget the closets too. Have a ground floor bedroom and bathroom if possible. Stairs present a fall risk. Keep a magnifying glass in the kitchen area to read cooking labels that use small font. Use full-spectrum bulbs that simulate daylight. Open blinds or curtains to let in natural light. Remove rugs and runners to avoid tripping. Replace round doorknobs with easier-to-use lever-style door handles. Install a walk-in or no-threshold shower, a bath seat or bench and an adjustable, hand-held showerhead. The special tubs are nice, but they are very costly.  Keep all cords up off the floors. A smart idea is to ask the primary care provider to give you a referral for a home safety evaluation, and the occupational therapist can also do an equipment evaluation. Insurance may well cover some of the needed aides. The Area Agency on Aging may be of help too. Keep a cell phone on you, or install a telephone in multiple rooms (including the bathroom) so you’re never too far from being able to call for help. Another option would be to install a medical alert system would be helpful. There are even Life Alert systems with fall detection alerts so that it will get help for you if you collapse.

AARP (2016) Home fitness for specific needs Retrieved from

http://www.aarp.org/livable-communities/info-2014/make-your-home-a-safe-home.html?intcmp=AE-HF-IL

 

 

 

 

 

 

What is your definition of social support for elderly people? How social support or lack of it can impact issues that we discuss so far this quarter?

Support from others can be important in reducing stress, increasing physical health and defeating psychological problems such as depression and anxiety.

When considering who provides social support for an elderly individual our first thoughts are of family members. While it is true that most support does come from family members, there are many circumstances in which family members cannot be supportive (stress due to responsibilities, illness, death, financial problems, job relocation). In the United States the fastest growing age group of individuals are those 85 years and older. Due to this fact, family and cohort supports will unavoidably shrink for these older folks. A need for community-based services is more important now than ever before. For example, my grandmother outlived all of her 3 husbands. 2 of the 3 left her due to long illnesses that caused death. Most of her cohorts and 1 daughter proceeded her in death as well, so her social circle became smaller and smaller until it was no longer there. It became a vicious cycle. As people died, she became more isolated and her health went downhill. It becomes like chicken vs. egg question; which caused which?

In my opinion, churches should do more to fulfill this need. Nursing and assisted living homes need to do better. I have not been able to attend services for health reasons, have requested visits and none have come. I have seen with my own eyes that music and pet therapies can create sparks of life in older people. 1 local nursing home is a block away from a middle school. A group of students came regularly for a few months. It was great for both age groups. Yet, this same place cut down the recreational and dietary budgets, two of the few opportunities to be social during the day. When there are not meaningful activities, people of all ages get depressed and anxious more easily, not just older people. All of these interventions would help to reduce these conditions.

Planning for Eldercare (2011) Social support activities lead to better quality of life as one ages

Retrieved from https://www.longtermcarelink.net/article-2011-08-8.htm

 

  1. Do you think there is more social isolation in America than in the past? Why or why not? Explain your position.

I do not think that the great majority of older people choose to be alone and isolated. For the most part, I believe that people either choose to be that way because people die, divorce or move too far away from the person to be closely socially tied with them. It hurts very much to lose connections to those that we love and care about; some may think it easier to put up a wall to protect themselves from the pain of the loss Older people are not usually as tech savvy as the younger generations.  Younger generation on down, we have been largely forced to deal with computers – even if we don’t own one. For proof of this, think of how many buttons we have to press before we have the right to speak to a live person.  For example, Grandma never would get a pc, but dad would send me emails often. He died before Facebook, Skype etc. became popular to use, unfortunately. In my opinion, these programs have become the poor substitute for personal contact Mom was convinced that the pc would ruin the intelligence of society. She was somewhat correct; my spelling has become terrible. Technology scared her. I have to admit, there was a lovely charm to her long letters, written in her graceful, cursive writing as opposed to a quickly typed instant message.

With this new technology, we have greatly diminished the human contact that used to be a part of nearly every social contact. It started to disappear, to a large extent, with the industrial revolution. The Sunday morning church services and the church socials/potlucks were a major means of social contact and fun for an entire community. As was talked about in the book Another Country, the couple from Nebraska spent their whole lives just a short distance from where they were born. Everyone in the small town knew everybody else. That is not how it is today. Small towns and cities are increasingly becoming absorbed by the much larger cities that are somewhat close to them. Oceanside used to have a distinct character that was very different from San Diego. Nowadays, as more land is swallowed in favor of condos, apartments and office spaces, the people lose their sense of being unique and special along with it. When I was a child, the home my brother and I were raised in was considered to be out in country, rural area. About 5 miles away, there were orange groves, owned by Sunkist. Just beyond it was a farm where we would buy our pumpkins and our fruit and vegetables. About 15 years later, I was living in apartment where those once upon a time. This causes the people in them to become strangers as they lose connections.

 

  1. In her book, Mary Pipher compares old people to victims of post-traumatic stress disorder (PTSD). Do you agree with her? Why or why not.

I would not be considered an older person just yet; I was not born until the very the end of the baby boom. However, I have already most of those closest to me: my parents, my grandparents and half of all my aunts and uncles. Death and grief get us prepared until we have or nothing left to lose. For example, my Grandma passed just died in February. My uncle called and seemed to expect me to break down in tears. I did not. I told my Uncle Rudy that I was resigned to it because my grandmother was as a 92. I was already experienced at it also; the circle becomes so small that you more easily accept death.

Little is really known about PTSD in older people because there have been few studies done about it. Older tend to be less likely to talk about their emotional state too. It is accepted as a normal event. Again, I feel that it could be compared to the chicken or the egg question. Several things can contribute to it: chronic pain, less mobility, lack of independence. However, it is also a myth that it cannot be successfully treated.U.S. Department of Veterans Affairs/Department of Defense. (2010).VA/DoD clinical practice guideline for management of post-traumatic stress. Retrieved from http://www.healthquality.va.gov/ptsd/ptsd-sum_2010a.pdf

 

 

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