Ch.12, Social Support/Dying

Question 1

Serial Exchange of Resources:

Answer 1

generally involve a downward flow of assistance from the older generation to a younger generation because of a sense of responsibility and affection.

Question 2

Reciprocal Exchange of Resources:

Answer 2

reciprocal exchange, or a two-way flow, is most common between the members of the middle and oldest generations. This process of exchange usually involves services (babysitting, giving advice, shopping, and household maintenance); gifts of money or goods; or companionship through visits, telephone calls, or while helping an older person with an ADL or IADL.

Question 3

Informal Social Support

Answer 3

Informal support is provided in the home or community by family, friends, neighbours, or volunteers.
For elderly women living alone, these fictive kin play instrumental and emo- tional roles in later life that would normally be played by family members.

Question 4

Subjective component of informal support/objective component

Answer 4

Subjective Component: t involves the quality (i.e., access to people one can trust, able to share intimacies with, and able confide in), mean- ing (the importance or value of contact with kin and friends for well-being), and satisfaction with the support that is received
Objective Component: The objective component refers to the quantity of relation- ships (number of available kin, friends, and neighbours), the availability of assistance when needed, and the degree to which the available support is used (the amount, frequency, and intensity of interaction).

Question 5

How is informal support a gendered process?

Answer 5

Gender roles tend to place greater expectations on women to be caregivers, although this has been changing in recent decades.
Women are more likely to be comfortable with both giving and receiving in expres- sive, nurturing relationships.
Mother–daughter relationships are stronger and more intimate.
Ethnocultural norms support gendered care of elderly.
Women are more likely to maintain family connections.
Women are more likely to live close to members of the family and therefore to visit

Question 6

Hidden costs of caregiving

Answer 6

HIDDEN: The emotional, psychological, and financial costs of informal caregiving are diffi- cult to estimate and are often hidden from the public

Question 7

Unhidden costs of caregiving

Answer 7

Unhidden: The financial costs for a caregiver may be considerable, especially if the parent is impoverished and must be supported by his or her children. These costs include loss of wages for time away from work, transportation to and from the recipient’s home, long-distance telephone calls, home renovations, drugs and other medical supplies, and food. The cost of caregiving can create financial hardship for a caregiver who strives to keep a parent out of a residential institution.

Question 8

Formal Care, Social Support

Answer 8

Formal support is provided to dependent and frail adults by public and private agencies in the home or in an institution by trained volunteers or professional health- and social-care workers.
Public-sector programs are created by laws, policies, or regulations across different levels of government

Question 9

Home Care Services

Answer 9

Health Canada defines home care as “an array of services enabling Canadians, incapacitated with a disability or a chronic health problem, in whole or in part, to live at home, often with the effect of preventing, delaying or substituting for long-term care or acute care alternatives”

Question 10

THERAPEUTIC AND COMPENSATORY GOALS OF IN HOME CARE:

Answer 10

The therapeutic goal, for example, may be to help the older person recover from an accident or illness or to prevent further deterioration from a medical or disease condition. The compensatory goal may be to promote comfortable and meaningful daily living despite the onset of dependence created by disabilities or frailties.

Question 11

3 General Methods of Helping Older Persons/Their Caregivers

Answer 11

First, to relieve the caregiver’s stress and improve the quality of care for the recipient, programs should provide educational, emotional, and social support for the caregiver.
A second type of assistance consists of financial incentives or reimbursements for the caregiver through tax credits or a subsidy to offset lost income or to purchase needed services.
A third source of assistance involves private or publicly supported care (with or without a subsidy/user fee) provided within or outside the home.

Question 12

Respite Care

Answer 12

Respite care provides temporary supervision or care by professionals so that a primary caregiver can take a daily, weekend, or vacation break from the routine, responsibility, and burden of caregiving.
Ideally, respite care is used before any family crisis arises. Respite care is underused, however, perhaps because people may not know it exists.

Question 13

Substitution Hypothesis, Complementary Hypothesis of Informal Care

Answer 13

The substitution hypothesis argues that the public sector must provide a formal safety net when families are unavailable, unable, or unwilling to help; when older adults are isolated or abandoned; or when informal caregivers can no longer provide adequate support.
In contrast, the complementarity hypothesis argues that a coordinated system of informal support (by the family) and formal support (by government or the private sector) is essential to enhance the quality of life of both older people and their caregivers

Question 14

Why do older persons often not report abuse?

Answer 14

• fear that disclosing abuse will be seen as a sign of incompetence and frailty. In most cases, abused and abusive people are family members and/or caregivers, although one of the fastest-growing types of abuse is financial abuse, especially telephone, mail, and Internet fraud
  -do not know what abuse is
  -no access/cognitive ability to report it

Question 15

3 Methods to identifying elder abuse

Answer 15

interviews with older people by professional care workers to identify victims
classification schemes to indicate types of abuse
survey instruments with lists of abusive behaviour to identify incidents of abuse or attitudes around whether such behaviour is abusive and, if so, how prevalent it is

Question 16

Elder Neglect

Answer 16

Elder neglect, which may be intentional or unintentional, is the failure or refusal to perform necessary caregiving or monitoring responsibilities for an older adult, especially one who is cognitively or physically impaired.

Question 17

How is self-neglect hidden in elders?

Answer 17

Self-neglect may involve self-abuse, such as malnutrition or drug or alcohol abuse, which results in physical or mental injury. This type of abuse is “hidden” and is often undetected unless care workers or emergency department personnel are called to the home.

Question 18

Situational Stress Model:, Explaining Elder Abuse/Neglect

Answer 18

Early explanations for abuse were based on a situational stress model. It was argued that caring for a dependent elderly person, especially one who is cognitively impaired and prone to behavioural problems, leads to significant stress for the caregiver, who reacts by engaging in abuse or negligence.

Question 19

Life Course Approach to Abuse:

Answer 19

A life-course approach emphasizes timing and sequencing of events embedded in the aging process, linked lives, and agency. Thus, some incidents of spousal elder abuse are a continuation of lifelong spousal abuse, whereas other cases appear as new forms of abuse unique to old age: for instance, an adult child “pays back” an abusive parent and uses physical force, verbal abuse, or neglect to control the parent

Question 20

Durable power of attorney

Answer 20

A “durable” power of attorney authorizes an agent (usually the spouse or one or more children) to act on behalf of an individual with regard to financial matters.

Question 21

Eligibility for Medically Assisted Dying, Bill C-14

Answer 21

be a mentally competent adult (18 years or older);
make a voluntary request and give informed consent to receive medical assistance
in dying;
have a serious and incurable illness, disease, or disability;
be in an advanced state of irreversible decline in capability;
experience enduring and intolerable suffering as a result of their medical condition; and,
be on a course toward the end of life.
Death would have to be reasonably foreseeable in all of the circumstances of a person’s health, but there would not have to be a specific prognosis or prospected time period before death.

Question 22

Palliative Care/ Hospice Care

Answer 22

Palliative care, sometimes called hospice care, is designed for those with a terminal illness who need relief from pain and other symptoms, such as loss of appetite, nausea, incontinence, and breathing difficulties.
The goal is to improve the quality, not the quantity of life, through physical, social, emotional, and spiritual support for the dying person, as well as provide education, training, and support for his or her caregivers

Question 23

Reactive vs. Proactive Policies

Answer 23

Many policies are developed in response to a problem, such as poverty, homelessness, or lack of access to appropriate care, and are therefore reactive policies. However, the goal of policies should be to delay or prevent the problems from arising in the first place; in other words, they should be proactive.

Question 24

Problems with privitizing services

Answer 24

An emerging issue in health and home care is whether services that were previously the responsibility of the public sector should be privatized. Since many older adults do not need or use most public services, advocates of privatization argue that if certain programs or services were privatized, it would ease the public financial burden.
For governments, privatization is a way to reduce spending and demonstrate fiscal restraint to the voting public