Sunday, April 5, 2009

Caring for the Elderly

We decided to focus on the care of the elderly (our cut off point is 60 years old). We chose four countries: United States, India, England and France. Each country has very different policies and expectations but one thing that is important to recognize is that a lot more work needs to be put into the care of people during this part of life.

India:

India has a very large population, second only to China. With health care improving and birthrates rising, the percentage of elderly individuals in the country is only going to get bigger. The numbers went form 20 million in 1951 to 70 million in 2009 and a projected 326 million in 2050 (United Nations, 1995). Although India is still very family based when it comes to the care of the elderly, new policies are being put in place to help support these rising numbers of aging individuals.

Two things that India's government has done in the last decade to address this situation are: In 2000, the government declared a National Older Person's Day to raise awareness and in May of 1999, the National Council of Older Persons was constituted. The NCOP has members from various political groups, such as the National Human Rights Commission, who gather together to advocate for the elderly and try to work out the problems. Health care has become more widely available and group homes are being provided due to more and more older people no longer being able to stay with their families like they once did. The government also feels very strongly about utilizing assets and funds training for those elderly individuals who want to have something to do in their retirement.

Non-Governmental Organizations also play their part in caring for the elderly. The NGO provides services for both the individual and their family. However, due to families being unable to afford the help, the NGO really only assists a very small percentage of the population.

Family is an aging person's support system. The family provides emotional, financial and social support. Culturally, the aging members of an Indian family are treated with respect and honored for their wisdom. As opposed to America, where only 15% of older people live with their children, India has close to 75%. There is a lot of pressure on the children to take in their parents, especially the male who have greater responsibility. The elderly also have very specific roles in a household: They take care of the children, resolve conflicts and help with matchmaking.
-Grace Maskell

England:



Health care for the elderly in England seems to be very similar to care for the elderly in the states. One of the main differences is that health care is free, due to the national health system in England. Everyone in England is taxed for health care, so there is no health insurance that needs to be payed, rather, health care is free for most people, particularly for the elderly and disabled. This enables elderly people to stay in their homes for longer, allowing home health workers and doctors to come to an elderly person's home, rather than that person or their family having to spend a lot of money on trips to the hospital.

There are still residential care facilities and nursing homes in England, but they are very expensive, (500 pounds a week, or $1000) This high cost has pressured the health service to continue to subsidize health care so the elderly can live in their homes for longer.

Below is a link to an article on this subject.

Another reason why people in England view keeping elderly home longer as a better option, is the poor treatment they receive in hospitals. A BBC report has confirmed that the elderly are being neglected on hospital wards, not consulted about their care, and treated like "second class citizens." One story in the article detailed the experience of a woman with Alzheimers who was in the hospital. She was on a ward that was not equipped to deal with people with dementia. The man writing this article said that he always had to make sure that a family member was with his mother, otherwise very important things got neglected. She had trouble eating, so if a family member wasn't with her, her meal tray would remain untouched. She would wake up in the middle of the night and wander around, so someone needed to be there to make sure she wasn't hurt. The two nights she was left alone she hit her head one night, and fractured her shoulder the other. The staff dismissed these concerns. When she was finally admitted to a nursing home, she had open sores on her back, was dehydrated and with a heavy cold. This story shows the type of horrible treatment an elderly person can face while in a hospital ward not equipped to deal with their concerns.
A link to the article is below.

In conclusion, health care for the elderly in England is very similar to that in the U.S., the one difference being universal health care provided by the NHS which puts an emphasis on favoring elderly people staying in their homes longer. There also seems to be more of a danger for neglect if an elderly person stays in the hospital, than if they were at home or in a nursing home.


-Sam Nelson

Questions:

1. In the past it was up to the family to take care of their aging parents but that seems to be changing. In your opinion do you think it should be the children's responsibility to care for the elderly?

2. Out of all the countries discussed, which one has the best plan for caring for the elderly. What should they work harder on and/or do differently?

America:

America, a country so rich in history, holds much power and authority all over the world. As one of the leading nations, we have redefined luxury and set forth high expectations for ourselves. We strive to remain one of the largest and most powerful countries in the world. Our government could be thought of as the “people” business, yet we lack one of the most critical components of the “people” business. To run a country, a successful country, it must begin within its citizens. Recent evidence provides we will be facing a major healthcare massacre, especially for elderly. Healthcare is a moral, civil rights, economic and human rights issue. Health is not a mere decision of what name brand of material goods to purchase at the local mall. Healthcare is a fundamental right to all people, and especially of all ages. Lifespan is prolonging considerably past the age of sixty, and retirement age will also be increasing as life expectancy increases. Since the elderly hold a higher rate of health issues, they often face age discrimination and their healthcare costs are often some of the highest. The united states department of human health and services. Medicare, the most primary form of heath care services established for the elderly of age 65 and older, yet it does not provide full coverage, and often the costs are not nearly close to what elderly receive in Social Security income. The Center for Disease control and prevention reports findings of the U.S. department of Health and Human Services, found the number of visits to physician offices by persons age 65 and over is 229.8 million. They also report that the access to health care percent of noninstitutionalized persons without a usual place of care age 65-74 is 3.8% and age 75 and over of 2.9%. Additional findings can be found on: http://www.cdc.gov/nchs/fastats/older_americans.htm
Out of the uninsured citizens in America, 7% were found uninsured out of the total population of 7% in a study conducted in 2005 by Office of the Assistant Secretary for Planning and Evaluation: http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm

This is suggesting the increased need to provide health care to all, as many European countries have already established. Often, in many European and foreign cultures, the elderly are viewd as extended family members, often living with their children and grandchildren during old age, where as in America, elderly are often placed in very expensive nursing homes, and family members may visit only a handful of times during the month. This may also explain the high numbers of doctor patient visits.

Question:

President Barack Obama has proposed a new plan to transform and modernize Americas healthcare system, provide an example of one of his goals in this transformation, and discuss how this progressive change will effect the elderly.
You may refer to: http://www.healthreform.gov/ to support any ideas and provide findings.

-Sabina Medvinsky

10 comments:

  1. First, I would like to say thanks to an impressive series of topics so far covered on this blog! I continue to be impressed by the range of issues and depth of research associated with each blog! I do ask that while I know all of you are very busy that you get involved in the ongoing rich discussions...keep blogging! I do think the topic of caregiving, certainly relevant to this course, the demographics of the American Family, and to current trends in sociology research has important implications for both the Sociological Imagination as well as the Lived Experience of families today. I look forward to the questions posed!

    Dr. Amy R-R

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  2. I really like the health care that England provides for its' elderly. I think it is important to provide free care to all those who are too old to be working full time. It is a really good think for elderly to stay in their home doing typical routine things, since there is so much research about how elderly that go into group homes prematurely lose a lot of their independence earlier on. I wish we had some sort of system for the elderly and not just those who made more money during the working years.

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  3. In response to the first question I think there should be a balance of who should be responsible for taking care of our elderly. I think it is important to have family ties and to value our elders by taking care of them. But if we expect families to care for elders then we need to provide them with support services. It is not always realistic for elders to be able to be cared for within the family, but I think if we had better supports for them then more would be able to stay out of institutions more often. Some of the main supports that would help families caring for elders could be free health care, tax breaks, and free health services that come into the home. If we provided support for our families they could then in turn provide better support for our elders and in turn we would have to worry less about nursing homes and institutions.

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  4. #1

    I feel that the children should definitely take care of their elders regarding their health. I feel that if a child who has their health does not take care of the person who raised them or gave birth to them, they are being extremely selfish. Their mother gave birth to them, and then they feel its ok to leave them alone in a nursing home...its not ok at all. A family should be able to support each other; a parent took care of their child their entire life, why can't they do the same for their parents? I believe that the American culture is very selfish and self centered; people tend to only care about themselves, and don't open their eyes wide enough to see who truly brought them into the world and raised them to be the person they are today.

    -Rachel Badger

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  5. 1.
    I do not think there is a clear black and white answer to this question. When I think of this question in terms of my own family, on my mother's side if my (widowed) grandfather needed to move in with one of his children it would cause quite a family dilemma. My mother lives in Maine, my aunt Carol lives in Belgium, my uncle James lives in California and my grandfather lives in Nevada. One of the scenarios here includes my grandfather having to choose between his three children whom he would want to take care of him and the other scenario is the siblings deciding which one of them would take on the task (which is obviously an emotional burden as selfish as that may sound). So in each scenario there may be some tension surrounding the decision.

    Also, sometimes certain elderly people really cannot live only with the assistance of family members. In this case it would obviously be justified to put this person in a nursing home. I think children should definitely stay involved in this process, visiting as regularly as possible and conversing with doctors. I would agree to an extent that it is disrespectful and selfish to put an elderly person in a nursing home "just because" but again this issue is not black and white.

    -Rhyanna Anderson

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  6. Response to Question #1:

    I agree with many of the opinions expressed in the previous responses to this question. As Rhyanna mentioned, there really is no one right answer to the dilemma of how to adequately care for aging parents. I agree with Rachel that people certainly do have some responsibility to support their parents in their older years, but I do not think that being the sole caretaker of one’s aging parents is the right answer for every family. In some cases, people may not be financially or emotionally able to care for their parents, and attempting to do so may aggravate the situation. For example, the stress of caring for one’s parents and/or the humiliation that the aging parents may feel about needing to be cared for may compromise the parent/child relationship. It may be healthier for both parties, as well for the child’s family, if a child supports their elderly parents financially by paying for home care or placement in a high quality nursing home and then supports them emotionally by visiting them on a regular basis. In addition, the elderly may prefer to stay in their own homes for a variety of reasons, including the desire for independence and social support (which they have to give up if they are forced to move many miles away to one of their children’s houses), as well as the desire to not be a burden for their children. Therefore, the government should provide increased financial support for families and the elderly. This may allow children to be able to financially support their aging parents better or it may enable the elderly to be able to choose to live their final years in their own homes with outside support.

    -Amy Diamond

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  7. I think children should care for their aging parents, but government should provide funding for their well-being, as well. On top of keeping a job, providing help for a parent full-time could be overwhelming. Healthcare needs to be more available, and affordable, for American citizens, especially the elderly. There should be more options, other than putting a parent in an expensive, non-personalized nursing home or children caring for their parents at home. Also, as we talked about in class, not all families have harmonious relationships, which could make caring for parents even more difficult for adult children. Society also generally views the elderly as a burden, which influences the treatment people think they deserve. The elderly are as multidimensional as any other age group (if not more so) and thus one answer will not fit everyone's needs.
    Mia BloomBecker

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  8. I think that the government should provide services to care for all elderly. It is great when children can care for their parents as they age but not all elderly people are lucky enough to have children that will take care of them. This is why the government needs to provide services, tax breaks, and provide medical support to all elderly and not expect that younger generations will be there as support. For example a family friend of my family is elderly and she lives by herself. She has no family because they have all passed away and never got married or had children. She would not have anyone there to take care of her if the governemnt did not take care of her. Every elderly person deserves to be taken care of and the only way to ensure that this happens is to make it mandatory that the goverment sufficiently care for the elderly population.
    Thanks,
    Taylor Faulkner

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  9. In response to question 1:
    Yes, it is the children’s responsibility to take care of the elderly; if the elderly are beyond being capable of taking care of themselves. The simple fact that they are related should automatically make someone feel some sort of responsibility towards their care. That they are one’s parents, the people who supported the child from infancy through eighteen years of age (if not longer), should instill a sense of duty in the children during the later years of a parent’s life. I believe the statistic is something like it takes a quarter of a million dollars to raise a child, not to mention the time, hardships faced and love that would be given to the child; at least this much should be repaid, if not more. Though in certain situations, it is understandable if one does not feel they particularly owe a parent due to abuse or other reasons. With all that said, people should not have to go at it alone, support systems need to be in place, but simply dropping parents in a home and forgetting about them (even if the bills are being paid) is just immoral. Many families have more than one child, split between all children the care of the parents is no overwhelming burden. If it wasn’t for a person’s parents, they wouldn’t even exist; every child owes their parents infinitely for that reason.
    -James

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