Elderly Forced to Move Due to Corporate Greed

Elderly Forced to Move Due to Corporate Greed

This story headlined my Seattle CBS news affiliate. Ballard is a suburb of Seattle. We must remember that a society is judged by how well it treats its elderly, disabled and children, its most needy and vulnerable population. This is an example of how terrible we are doing; 48 seniors have to find a new, affordable place to live March 31st because the owner wants to convert these assisted living apartments into regular apartments.  I would appreciate your thoughts on this important issue. Here is the link to the full story:

http://www.kiro7.com/news/local/seattle-assisted-living-residents-told-to-move-because-of-apartment-conversion/490393054

 

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About Another Country

I had to read this book for 1 of my final assignments for my BA. Since there are readers and writers here, I thought that you may enjoy it.

 

 

A Book Review of Another Country

It is interesting to note that from a historical perspective, growing old is a relatively recent phenomenon. In the 17th century, it was rare that someone lived beyond thirty years. He or she probably did not have wrinkles and gray hair. There were huge advances in medical care in the late 19th and early 20th century and going forward. For example, doctors began learning about germs and started washing their hands.  In spite of these advances, there is no doubt that the oldest in our country were born and grew up in a very different era than in present day. In the 1920’s and 1930’s. Automobiles were not parked at everyone’s home, telephones did not inhabit everybody’s’ kitchen, the family gathered around the radio, and not the television.

If someone had told them that there would be personal computers and mobile smart phones in sixty to seventy years, they may have thought that that person had been into the whiskey or the moonshine too much. The thought of flying across the country or the world would have been a terrifying prospect to most people. Many grew the majority of their own food, unless they lived in the big cities. Although the demographics began to change dramatically in the 1920’s and ‘30’s, more people began to live in cities, as opposed to small farming communities. In order for an area had to contain one to two thousand people. While more people lived on the farm, there tended to be big families with multiple generations needed to work the farm (U.S. Census Bureau, n.d.).

More Historical Context

However, history tells that it started many decades before when pioneers left their extended families to travel westward. This coincided with the growth of the industrial revolution. Many men took jobs, largely away from home on the railroads and other places. Farming has always been a hard way to make a living. It is worth noting that the places described in Another Country could also describe small town Wisconsin, or any small Midwestern town. It almost seems like time stands still – there is still a sense of community and neighbor helping neighbor. Most people have moved to the big city these days; only about sixteen percent of the U.S. population lives in a rural area versus thirty percent in 1973 (Haber, 2013). The smaller families, who more often tend to work outside the home, have led to fewer family caregivers over time. In the early 20th century, an urban area meant that the population was greater than 1,000 persons (U.S. Census Bureau, n.d.).

How is Old Age Defined?

            Age is usually understood and defined by the numbers, especially when we are young. However, as we turn forty, it starts to become murky. People as young as forty are legally protected against age discrimination. Haber defines young-old as between sixty-five and seventy-five. Old-age is loosely defined as over seventy-five, possibly even eighty-five (Haber, 2013). Conversely, Pipher has two definitions that make an impression on the reader, and both have to do with life circumstances, the death of spouses and the loss of health. It is surprising that finances were not mentioned here as well. Income loss can also play a huge part in older people’s quality of life. If they lost a spouse, got divorced or were never married, women especially tend to have less disposable income. Therefore, they may not have money for leisure activities, regular doctor visits etc. After all, there is still a pay gender gap that persists today. Loss of health or finances can also mean that older persons have to move away from their beloved home (Pipher, 2000).

 

 

Pros and Cons of City Life for the Older Adult

There are undeniable advantages to bigger city life, especially for older people. The biggest one is probably easier access to goods, services and medical care. Larger places have senior activity centers that offer a variety of things to do. The one in Bellingham allow people to participate as young as fifty. They offer a number of health/wellness and other programs: immunizations, dance, exercise, computer skills, current events, and playing games/cards etc. (Bellingham Senior Center, 2016). As pointed out in the book with Gladys and Roger, loneliness can cause as many problems as physical, chronic illness. It definitely often leads to severe depression. Like Roger, Gladys also missed Nell’s companionship. Several things happened to improve her quality of life: a nice girl came in to work as a caregiver, Gladys began to participate in social activities outside the home and Roger along with his new girlfriend began to spend more enjoyable, quality time with her. Another thing that was so important to Gladys was that she was able to cook with her caregiver, and she wanted and needed to pass on years of cooking advice, recipes, and some wisdom along the way.

There is usually at least one hospital and a complex of different medical offices nearby In tiny in a larger city, towns, one may have to travel hundreds of miles for specialty medical care. For example, Bellingham has a hospital, but any acute or specialized care is done in Seattle. That is about ninety miles away. An older person, who may not be able to drive anymore, may have a particularly hard time getting there. In addition, if she/he needs to use assistive equipment, wheelchairs, power chairs or walkers, this makes traveling great distances even more difficult.

In cities, there are more housing options. Caregivers can be hired so that the person can remain in the place that s/he is most familiar and comfortable with – home.  There are assisted living homes: these are a hybrid between living in a skilled nursing facility, nursing home, and living independently. Both of these options are very costly and not covered by Medicare. Nursing homes are often thought as the option of last resort. They can be rather unpleasant places, and as illustrated in the book, the resident has little autonomy; she may not even be able to open a curtain without disturbing the resident on the other side of the room. There are few private rooms, and those that are available are reserved for those few who can afford them. Some of them are trying to do better, making them more like home and less like a hospital. They also need pleasant areas outdoors with trees and flowers. People with carpentry skills can make plant or flower boxes up high enough so that people that use wheelchairs can help with the gardening. There is something almost spiritual and healing about getting the hands into the soil that gives life to flowers and plants; it is very therapeutic for many people. Yet, is possible to be alone in a crowd.

However, a sense of community may well be lost. A rural setting offers opportunities for solitude allows for reflection and life review. There is also something to be said for the rural country life and its far slower pace. The noisy hustle and bustle does not exist. Housing tends to be cheaper as well, so it may be worth it to be farther away.

What is Cohousing?

            As more baby boomers age, there is a need to come up with innovative ideas to take care of them in the future. Cohousing is a possible answer. These home communities are designed to provide both privacy and community. Each resident may own or share a home, but they have common areas. One such area may be a community house. All the residents share chores like housework, laundry, lawn mowing, driving and cooking. Cohousing developments usually have a communal garden. The cohousing option in Bellingham is quite a bit costlier than the average cost of housing for the area. The median cost of a home today is $330,000 in Bellingham (Zillow, 2016). The cohousing option in Bellingham ranges from $350,000-$560,000. It also makes very clear that it is not a housing option for people who need “therapeutic care.” However, this neighborhood is for all ages, not only the elders (Bellingham Cohousing, 2016). There is also a requirement to devote twenty hours per month to community activities and committee meetings. It is also necessary to give up some level of autonomy because the majority rules when it comes to decisions involving the community. For example, should pesticides be used on the garden? The idea behind cohousing is good, but it is expensive to get old – too expensive like the other options for many older people.

The Gift of Hospice

            It is not an overstatement to say that that hospice is a blessing. It is very difficult to make wise decisions in the midst of grief. The hospice program gives comfort, palliative care for the person in the last six months, (as estimated by a physician) of life. It is not uncommon for family members to disagree about how care should be handled. The hospice nurse will act as an advocate for the ill person. The physician and the nurse collaborate together for the care of the patient. The wonderful thing about hospice is that the person does not have to go to the doctor’s office or to the hospital nearly as often. The hospice team will guide the family through the most difficult choices that involve the end of life. It is especially hard to know what the loved wants if he or she does not express the wishes in an advance directive, living will or last will and testament (Haber, 2013). Hospice was involved with the care of my grandparents and my mother. It was a blessing each time because it takes some of the burden of decision making away while giving comfort to my loved ones.

 

The More Personal Side – Relationships

The heart and soul of the book, however, is its personal stories – poignant, heartwarming and Kleenex worthy stories. It is impossible to read the book without being flooded with this author’s own personal memories. The guilt and the uncertainty are all very real. When away from the loved one, it is easy to feel guilty for not doing enough to help.  It is a heart breaking agony to watch a once vibrant person leave this earth inch by inch. The book begins with Mary Pipher talking about the mixed feelings she experienced when her own mother was going through the last days of her life. It was a wonderful, touching and difficult time for her. Every moment became more precious than the last because it may be the last one, at least for a long time, (if one believes in an afterlife). Most everyone who has lost loved ones can relate to her experience, and/or relate to someone in the book (Pipher, 2000).

The end of life can be something quite different in some families Fractures in relationships that have existed and have been strained for years between family members can crumble with the stress of a sick and needy loved one. This was illustrated in the case of Granny Zella Mae, daughter Beverly and her teenage daughter Abby. Beverly had a lot of stress in her work environment, and she has been in the middle of her aging, head strong mother and her equally stubborn daughter. It is clear that this three generational living arrangement is not working out well for anyone in the home.

Zella and Abby did not even come to the next therapy session; they were so angry about it. However, Beverly and Ms. Pipher came up with a plan to find a nice assisted living situation for Zella. This turned out to be a win-win situation for all three of them because Beverly did not have the stress of being a caregiver to her aging and critical mother, yet she visited her daily. Abby even visited her Grandma. Zella was in a situation where she was getting better care and not complaining as much (Pipher, 2000).

Another example is the older father dying of tongue cancer. The mother needed help, but none of the adult children had the free time to devote to his care, except the gay daughter who was a freelance writer. Her family had made her an outcast after she came out as gay, but she did keep in touch with one or two of her sisters. When she learned of her father’s cancer, she returned home to help her parents and care for her dad. It took some time for all of the family members to come around, but they saw the love and compassion she showed to their father. The fact that she was gay no longer mattered. Her father said that he was glad that cancer had brought them together again. It is tragic that it took cancer and the father’s impending passing to bring the family back together once again, but it would have been even more tragic if the chance for the family to mend its hurts had ever come at all. The daughter/sister had a great capacity for empathy and forgiveness (Pipher, 2000).

Concluding and Personal Thoughts

            This book was a beautiful one, but it was very hard to get through it. There are parts that reminded me of my Grandfather who was taken by cancer in 1985 when he was only sixty years old. He did not even make to the young-old stage. He faced it with grace, dignity and courage. Ironically, Grandma was a nurse in the oncology unit. I do not know how she was able to manage dealing with cancer, illness and death both at work and at home. Grandpa made sure to tell us how much he loved us. Just as Pipher talked about, Grandma felt guilty about going to work yet she had to keep the insurance going to pay for his care and medicine, otherwise, she would have taken a leave of absence. This was an impossible choice. Mom and her sister took turns caring for him.

There were sections that reminded me of Dad. He was taken in 2010 by COPD. I wish that he and my step-mother had wanted hospice to come, but I do not think Dad could face his own mortality. He made no end of life plans. My step-mother made all of the decisions; she did not allow my brother or I to be a part of the decision making process, even though I offered my help in the past. Like some in the book, I was uncertain as to what to do. He and my mother were both in the young-old category. Neither of them made it seventy.

Mom was the only one who did not pass away at home, but she died alone in a nursing home. She was debilitated by strokes, diabetes and vascular dementia. This made her even more stubborn and irritable than she was before her chronic conditions. She would not listen to anybody, unless that person agreed with her. Like Dad, she had made no type of will, although she did have an advance directive. It was up to my brother and I to make after death decisions for her. I was angry with her for leaving it to us. Grandma died this year; she was the only one to make it to old-old age, ninety-one years old, and die of natural causes. Aunt Rose lived with her.

However, Pipher gives me and every other reader permission to have our feelings because I and most everyone else are doing the best we can under very trying circumstances. As long as we handle old-age and its pitfalls with love and empathy, we should not beat ourselves about it. She poses interesting different definitions regarding old age. Does a death of a spouse or disease make a person age? It depends on a person’s perspective. I have always had Cerebral Palsy, CP. It and other comorbidities have always been a part of my daily life. Lack of mobility is something that is usually associated with older age, but I have always had to ask for help with ADL’s, Activities of Daily Living. I am used to it. Now, it is time to answer the question that this paper began with; what happens that transforms anyone from the young-old to the old-old? Losing health is serious, but losing people that I love is worse. However, reasonable minds may disagree.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Bellingham Cohousing (2014) Aging in cohousing Retrieved from

http://www.cohousing.org/aging

 

Bellingham Senior Activities Center (2016) Health & wellness Retrieved from

http://wccoa.org/index.php/Home/

 

Haber, D. (2013). Health promotion and aging: Practical applications for health

professionals (6th ed.). New York: Springer Pub.

 

Pipher, M. B. (2000). Another country: Navigating the emotional terrain of our elders. New

York: Riverhead Books.

 

  1. S. Census Bureau, (n.d.) Urban and rural areas Retrieved from

https://www.census.gov/history/www/programs/geography/urban_and_rural_areas.html

 

Zillow (2016) Bellingham home prices & values Retrie

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