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Aging in Families > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What does wisdom do for older people?

A

Wisdom makes older people more skilled at working
in everyday life. This could allow older people to
play a unique role in modern society.

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2
Q

Concerning wisdom, what ability do older people have?

A

older people have a greater ability to shape

and solve a problem in a less-defined situation.

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3
Q

What did wise people do?

A
  • wise people guided others, had knowledge

and experience, and applied moral principles.

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4
Q

What is called the growth of wisdom in later life?

A

Developmental intelligence

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5
Q

What are wisdom and developmental intelligence considered?

A

An advanced style of cognition.

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6
Q

What ways can you increase or at least stabilize mental function in later life?

A

 Stimulating the Brain for Growth in Later Life

  • Mentally stimulating activities like crossword puzzles,
    taking classes, or reading might enable the brain to
    compensate for disease.

 An Effective Training Program

  • The ACTIVE study: training can delay or compensate for mental decline.

 Physical Exercise

  • exercise facilitates specific aspects of cognitive functioning.
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7
Q

What does Erikson’s stages of Psychosocial Development assume?

A
  • A fixed set of stages for the life course exists.
  • Stages unfold over time.
  • Each stage has a challenge with a positive and negative
    pole.
  • A healthy personality will achieve the positive pole and
    then have the resources to tackle the challenge of the next stage.
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8
Q

What is the last stage of Psychosocial Development?

A

Stage 8: Late Adulthood – Age 65 to death

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9
Q

Stage 8: Important events?

A

Reflecting on and accepting one’s life

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10
Q

Stage 8: Crisis?

A

Integrity vs. Despair

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11
Q

Stage 8: Description?

A

Old age is a time for reflecting upon one’s own
life and its role in the big scheme of things, and seeing it filled with pleasure and satisfaction or disappointments and failures.

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12
Q

Stage 8: Positive outcome?

A

If the adult has achieved a sense of fulfillment about life and a sense of unity within himself and with others, he will accept death with a sense of integrity. The healthy older adult will not fear death.

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13
Q

Stage 8: Negative outcome?

A

If not fulfilled a sense of achievement, the individual will despair and fear death.

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14
Q

What are some critiques of Erikson’s model?

A
  • This model (stage 8) describes old age as a time to disengage
    from life and look back. It ignores the fact that older people go
    on living.
  • Studies found many stages in the life cycle and different stages
    and patterns for men and women.
  • This model did not fit in the timing of life events or the roles of older people in developing nations.
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15
Q

What is “the self” in later life?

A

The ability to be aware of one’s own boundaries and individuality and to reflect upon these.

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16
Q

What are the two motives that shape behavior as people age?

A
  • People try to view themselves positively and to present a good
    image of themselves to others.
  • People try to maintain their sense of self in the face of a
    changing social environment.
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17
Q

What are the challenges to the Self in later life?

A
  • Societal attitudes toward older people
  • Physical decline
  • Loss of social roles
  • Ageism
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18
Q

What did Disengagement Theory show?

A

As people aged, social interaction decreased.
- This decreased interaction took place because society
withdrew from the older person

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19
Q

Decreased social interaction is the outcome of what?

A

Mutual withdrawal of society and the older person.

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20
Q

Disengagement allows what two things?

A

1) older people to naturally
withdraw from social contacts and roles as their strength
declines and 2) allows society to remove older people
from social roles before the final disengagement.

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21
Q

How does disengagement theory see withdrawal?

A

Disengagement theory sees withdrawal as
inevitable, universal, and, satisfying to the individual
and society.

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22
Q

What are some critiques of disengagement theory?

A
  • It supports the negative stereotype of older people
    as frail and unable to perform social roles.
  • It assumes that younger people perform social roles
    better than older people.
  • It assumes that all older people will respond to
    aging in the same way.
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23
Q

What does Activity Theory lead to?

A

High life satisfaction.

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24
Q

What does Activity Theory assume?

A
  • Older people have the same needs as people in
    middle age.
  • Disengagement takes place against the older
    person’s will.
  • Satisfied older people resist the shrinkage of their
    social roles and social contacts. They find substitutes
    for the roles that they lose over time.
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25
Q

Describe Continuity Theory?

A
  • People age best if they can view change in later
    life within existing pattern of thought or behavior.
  • People adapt best if they can use strategies from
    their past experience to cope with current
    challenges.
  • Emphasize continuity over the life course.
  • Ex) continuity theory suggests that mildly active
    people in their middle years will feel most satisfied
    with a mildly active old age. Very active people will
    stay very active.
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26
Q

What are the frameworks for defining minority experience in the U.S.?

A

Melting Pot

Pluralistic Society

Assimilation coninuum

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27
Q

Melting pot

A
  • Taking in people from around the world and

transforming them into typical Americans.

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28
Q

Pluralistic society

A
  • A society in which many racial and ethnic groups exist side by side.
  • People maintain their racial and ethnic heritage and still take part in the wider society.
  • More recent immigrants/even third- or fourth- generation Americans show pride in their original culture.
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29
Q

Assimilation continuum

A
  • Minority assimilation ranges from very traditional
    (Nonassimilation) to bicultural to very assimilated.
  • Ex) minority group member may be very assimilated
    in the office, but adopt a traditional worldview at
    home.
  • Points to the complexity of ethnic and racial
    identity. Individuals differ in how they identify with,
    use, and express their race and ethnicity.
  • Reflects person preference and the demands of
    U.S. society for a common public face
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30
Q

What is the dominant group of the older population?

A

White

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31
Q

What contributes to whites being the dominant group among the older population?

A

 Include a variety of ethnic groups of European
origin.
 Have a long history of settlement in USA.
 Have more formal education and lower rates of
poverty than most older minority group members.
 Make more use of formal support systems (like
government programs, community centers, and
ethnic associations).
 Most programs originally designed for this group.

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32
Q

How do minority groups differ from the white population?

A

Mortality; Fertility; Migration

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33
Q

How do subgroups differ from the white population?

A
  • Demography
  • Cultural background
  • Reasons they came to the US
  • How they came to the US
  • Relationship with American culture
  • Assess to social and economic resources
  • Ex) the Latino group has a young population due to high
    fertility and high levels of immigration.
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34
Q

Multiple Jeopardy

A
  • Societies use age, gender, social class, and minority
    group membership to classify people.
  • Young, male, upper middle-class, and white place
    a person at the upper end of North American
    society.
  • Old, female, lower class, and minority group
    membership place a person at the lower end.
  • A person with more than one of these
    characteristics will face multiple jeopardy (like a
    minority member age 65 and over).
  • A person in multiple jeopardy will face an increased
    risk of death and illness, compared with whites, as
    they age.
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35
Q

What is the critique of Multiple Jeopardy?

A
  • Most studies of multiple jeopardy use a cross-sectional design (Looking at minority group at one point in time). This makes it impossible to tell whether things have gotten worse for minority members, compared with dominant group members, as they have aged.
  • It takes a “victim-centered” approach. It shows the negative effects of discrimination on minority older people. It fails to study the strengths and coping abilities of minority members.
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36
Q

Life Course Perspective

A
  • Looks at the impact of social institutions, historical
    periods and events, personal biography, life cycle
    stage, life events, and resources on the minority
    older person.
  • Looks at differences between minority groups,
    cultural subgroups within a minority group, and age
    cohorts among minority group members.
  • Links early life experiences to actions and attitudes
    in later life.
  • Links life experiences to the minority norms for timing
    life events and entering and leaving social roles.
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37
Q

Institutional Completeness

A
  • A minority group’s institutional completeness can
    influence members’ quality of life.
  • Institutional completeness refers to the number of
    agencies, programs, family, friendship networks,
    and religious institutions in an older person’s
    environment.
  • An institutionally complete context provides strong
    support for the older person.
38
Q

Structured inequality and personal history

A
  • Structured inequality refers to inequalities built into
    the social system.
  • Personal history refers to a person’s passage
    through life.
  • The life course perspective looks at the links
    between personal history (youth, middle age, and
    old age) and a person’s social and historical
    context.
  • Ex) For many African Americans, low-paying jobs
    and low income in youth lead to low-paying jobs in
    middle age and poverty in later life.
39
Q

Cultural competence

A

an ability to understand,
communicate with, and effectively interact with
people of different cultures and socio-economic
backgrounds, particularly in the context of human
resources, non-profit organizations, and
government agencies.

40
Q

What does developing cultural competence result in?

A 
strengthening an older minority person’s ability to 
function in the wider society.
41
Q

What are the models of health care

A

The medical model, the social model, and the health promotional model.

42
Q

The medical model

A
  • Focus on diagnosis and cure of illness.
  • Define health care as sickness treatment.
  • Care takes place in hospital, doctor’s office, nursing
    home through drugs, surgery, and rehabilitation.
  • Physicians control most treatment.
  • Little focus on prevention or community-based
    care.
  • The current system of health care services and
    government financing of health care through
    Medicare and Medicaid supports the medical
    model.
43
Q

The social model

A
  • Focus on functional capacity (a person’s ability to
    function in the social world).
  • Define health care more broadly (Health is more
    than the absence of disease).
  • An older person needs medical care and other
    kinds of care.
  • Health care mostly takes place in community by
    health care professionals, social workers, counselors,
    and volunteers.
  • Family counseling, home health care, and adult
    daycare supports the social model.
44
Q

The health promotional model

A
  • Focus on disease prevention and reduced disability.
  • Assumes that some people can regain lost abilities with proper supports.
  • Define health care as improving fitness and well-being.
  • Public health measures (like flue vaccination, antismoking campaigns, diet education, and yoga classes) support the health promotion model.
45
Q

Shifts in health care for older people

A
  • Policymakers, politicians, economists, and health
    care professionals have begun to explore the social
    and health promotion models of care due to:
  • High cost for care (hospital and institutional
    care)
  • Overmedicalized service
  • The needs of an aging population
  • These models save the system money in the long
    run, and they provide the kind of care that fits older
    people’s long-term needs.
46
Q

Medicare

A

A national social insurance program, administered
by the U.S. federal government.

Medicare serves a large population of elderly and disabled individuals in the Unites States.

47
Q

How is one eligible for medicare?

A

• They are 65 years or older and U.S. citizens or have been
permanent legal residents for 5 continuous years, and they or
their spouse (or qualifying ex-spouse) have worked and paid
Medicare taxes for at least 10 years.
• They are under 65, disabled, and have been receiving either
Social Security Disability Insurance benefits or Railroad
Retirement Board Disability benefits; they must receive one of
these benefits for at least 24 months from date of entitlement
(eligibility for first disability payment) before becoming eligible
to enroll in Medicare.
• Specific medical conditions may also help people become
eligible to enroll in Medicare (ex: end stage renal disease, Lou
Gehrig’s disease).

48
Q

What are the 4 part benefits of medicare?

A
  • Part A is Hospital Insurance.
  • Part B is Supplementary Medical Insurance.
  • Part C is Medicare Advantage plans
    (“Medicare+Choice”).
  • Part D is Prescription drug plans.
  • All Medicare benefits are subject to medical
    necessity.
49
Q

Medicaid

A

“government insurance
program for persons of all ages whose income and
resources are insufficient to pay for health care.”
- People aged 65 and over make up 8% of all
Medicaid recipients in 2008.
 Medicaid is the largest source of funding for
medical and health-related services for people with
low income in the United States.
 It is a means-tested program that is jointly funded
by the state and federal governments and
managed by the states.

50
Q

How is one eligible for medicaid?

A

• Poverty alone does not necessarily qualify someone for
Medicaid. Eligibility is categorical: to enroll you must be U.S.
citizens or legal permanent residents and must be a member
of a category defined by statute.
• Some of these categories: low-income adults and their
children below a certain age, pregnant women, low-income
seniors, and people with certain disabilities.

51
Q

Other health care plans beside medicare and medicaid?

A

 Employer Sponsored Plans
 Medigap insurance
- Intended to reduce out-of-pocket costs due to
gaps in Medicare coverage.
 Long Term Care Insurance
- Vary widely in coverage and services
- Strong interest in buying LTC insurance

52
Q

LTC: Describe some significant factors for institutional care (care in a nursing home).

A

 Age: the older the person, the greater the chance
of living in a nursing home.
 Gender: Women run a greater risk than men of
entering a nursing home.
 Race: Older whites outnumber older African
Americans in nursing homes by almost nine to one.
- Reflect cultural differences (more family supports
in minority groups).
 Physical condition: cognitive impairment, functional
impairment, and recent hospital release are
significant risk factors of living in a nursing home.
 Social support: A person without community
supports faces an increased likelihood of living in a
nursing home.
 Cost problems
- Due to restrictions on reimbursements, Medicare,
Medicaid, and private supplemental health
insurance cannot provide substantial nursing home
benefits (ex: Medicare only covers skilled nursing care in a skilled nursing facility).
- Medical insurance generally pay only part of the
costs of nursing home care for older people (ex: on
average, LTC insurance covers 70%).

53
Q

What are the types of Long-term care?

A

Institutional care, community-based care, and managed care with a community focus.

54
Q

LTC: Describe Community-based cares

A

 Community LTC programs aim to:
- Keep potential patients out of nursing homes.
- Meet the social and personal care needs of older
people.
- meet health needs not covered by Medicare.
- Link medical care and social support to keep the
older person in the community.
 Community care services range from adult
daycare, to respite services, to home health care.
 Adult daycare programs
- Provides socializing, recreation, and meals for older
people outside their homes in a group setting.
 Respite services
- Give short-term relief for caregivers of chronically ill
patients.
 Home health care programs
- Deliver services to a person a home.
- Services: bathing, showering, dressing, using the
toilet, help with shopping, light housework,
medications, and meal preparation

55
Q

LTC: Describe Managed care with a community focus

A

 On Lok Lifeways
- Pioneered the model of care known as “Program of
All-inclusive Care for the Elderly (PACE)“
- Combines medical services with adult daycare,
home care, and transportation.
- Contracts with health care professionals and
institutions for services.
- Tailors its services to each family’s needs and to its
ethnicity.
- Receives monthly capitated payments from
Medicare, Medicaid, and individuals.

56
Q

What are the future issues in health care?

A

Availability, Accessibility, and Coordination

57
Q

Future issues in HC: Availability

A

 Refers to the existence of services.
 Some regions have many services for older people.
Other regions have few.
- Rural and non-metro settings offer fewer services
to older people than do metropolitan areas.
- Some parts of metropolitan areas have fewer
services (“no care zones”).

58
Q

Future issues in HC: What are ways to improve availability?

A
  • Create programs that encourage health
    professional.
  • Offer incentives.
  • Support technology.
59
Q

Future issues in HC: Accessibility

A

 Refers to whether a person can get the services
that exist.
 Barriers to services: lack of knowledge, eligibility,
money, geography, transportation, distance,
isolation, and negative experience.
- Poorer and minority group older people have less
access than whites to health care services due to
the cost of copayments, deductibles, and
dissatisfaction with services.

60
Q

Future issues in HC: What are ways to improve accessibility?

A
  • More convenient location, better office hours,

better services, and public education

61
Q

Future issues in HC: Coordination

A

 Refers to better coordination of health care

services.

62
Q

Future issues in HC: Regarding coordination, what are the 5 characteristics of an integrated service system?

A
  • It provides broad and flexible services.
  • It includes community-based care as well as
    institutional care.
  • It uses care planning methods, teams, and other
    approaches to integration.
  • It provides quality control and a single
    responsible party.
  • It offers flexible funding that rewards efficient and
    effective service.
63
Q

Agricultural society

A

settled in one place,
accumulated s surplus of food, owned(or worked)
the lands(farms) and passed their lands and
resources to their sons later in their lives, and
supported relatives.

64
Q

Industrial society

A
  • The rise of industry, factories, and wage labor
  • Urbanization
  • New risks for workers
  • Less support from traditional sources
65
Q

What are some of the effects of the Great Depression?

A

 A national economic crisis
- Left many older people and people near retirement
without any savings for their old age.
- Older people began to fill the poorhouses.
- Charities and religious groups provided help to
older people (offered mostly food and shelter, but
little cash).
 28 state had welfare programs for older people, but
no state had an old age insurance program.

66
Q

When was the Social Security Act passed?

A

8/14/1935

67
Q

What is the Social Security Act?

A

 A response to social and economic distress
 Development of a social insurance program
- Protected workers in business and industry from
unemployment and poverty in retirement.
- Moved older workers out of the labor force
- Created jobs for younger workers

68
Q

What is the Social Security Act the official title of?

A

Old-Age, Survivors, and Disability

Insurance (OASDI)

69
Q

What does the Social Security Act have to do with a retirement income system?

A

Forms part of a retirement income system that provides
an income replacement for middle-income retirees and
a safety net for the poorest older people

70
Q

What are a couple of the well known programs under the Social Security Act?

A

 Federal “Old-Age, Survivors, and Disability
Insurance”
• Supplemental Security Income (SSI)

71
Q

Fill out the US retirement income system pyramid

A

Top Level 3: Personal
Middle Level 2: Employment Pensions
Bottom Level 1: Social Security (SS) & Supplemental Security Income (SSI)

72
Q

What kind of plan is Social Security?

A

 A “Pay-as-You-Go” plan
- Benefits get paid out to retirees today from
payments made by current workers.

73
Q

What are the basic principles of the Social Security program?

A
  1. work-related benefits
  2. No means test
  3. Contributory
  4. Compulsory coverage
  5. Rights defined in law
74
Q

Who gets Social Security?

A
  • Retired workers
  • Disabled workers
  • Current spouse and divorced /former spouses
  • A surviving spouse (Widow/widower)
  • Children of a retired, disabled or deceased worker
    => Ensure that all workers and their families in the US
    will have at least a basic income in retirement.
75
Q

What is the problem with Social Security?

A

• The answer is a long-term shortfall.
- Social Security plans for solvency over 75 years, but
because of demographic pressures, the weak
economy (Recession- a retirement crisis), and
structural flaws, it is currently solvent only until 2033.
After that, without reforms, it would pay about 75
percent of promised benefits.
- If current payroll tax rates stay the same, the
shortfall will begin in 2017 and the trust fund will be
exhausted by 2037.

76
Q

How is Supplemental security income different than Social Security?

A

SSI get paid out of general revenue.

77
Q

Describe supplemental security income

A
  • The largest cash assistance program in the US for
    older people in need.
  • Help older people and others (blind, disabled
    people) in need, whose incomes fall below the
    official poverty threshold.
78
Q

Describe Employment Pensions

A

 Mostly available to middle and upper income
workers.
- Middle- and upper-income people cannot
maintain their preretirement life styles on Social
Security benefits alone.
- Employment pensions supplement Social Security.
 Benefits through specific employers.
- Defined contribution plans vs. defined benefit plans
 Some employers don’t follow through on pension
promises

79
Q

Describe Personal Assets and Other Income

A

 Younger old people (under age 74) tend to have
the most income from earnings, but older old
people tend to rely on public pension programs for
their income.
 Three major sources of asset income
- Savings and checking accounts
- Financial investments (stocks and bonds)
- Other investments (art and rare collections)
 Large differences in net worth within the older
population.
- Many old people have limited financial resources.

80
Q

What has been the impact of the retirement income system on older people’s incomes?

A

 Between 1960S – 1980s

  • Older people’s finances/incomes improved.
  • The poverty rate for older people dropped.
81
Q

Why have older people’s incomes improved?

A
  • New retirees had paid into Social Security and
    Pension plans longer than retirees in the past.
  • Congress added a cost of living increase to Social
    Security between 1968 and 1971.
  • In 1972, the government added another 20%
    increase to Social Security benefits.
82
Q

Describe the first historical event that made retirement an established social institution?

A

The development of the “retirement principal- people should leave work at a fixed age regardless of physical or mental ability” in industrial societies.
- Served an economy that valued faster, stronger,
younger workers.
- Offered seniority rights only up to the age of
retirement.
 At retirement age, companies could let older
workers go without firing them.
 Companies gave middle age workers the most job
security.

83
Q

Describe the second historical event that made retirement an established social institution?

A

 The creation of retirement wage- “Social Security”
- Made it possible for nearly everyone (even people
with very low incomes) to retire.
- Provides an income replacement for middle-income retirees and a safety net for the poorest older people.

84
Q

Describe women and retirement

A

Women, compared with men, follow more varied
career paths.
 Women, more often than men, retire because they
have family caregiving responsibilities.
 A lifetime of gender discrimination in the workplace
affects women’s retirement decisions.
 Women, more often than men, use bridge jobs
(part-time work, second career, self-employment)
to lengthen their work careers because they need
the income.
- Finances shapes single women’s retirement plan.

85
Q

Describe minorities and retirment

A

 Minority workers
- Less likely to have private pensions than white
workers.
- Less likely to have enough savings for retirement.
- Less likely to have resources than workers overall.
- More likely to have broken work careers.
- Often must work in their later years to survive.
 Due to lower education levels, lower income levels,
discrimination, and language barriers.
 Retirement options and decisions for many minority
members differ from those for the white population.

86
Q

When do people partially retire?

A

 People have partially retired if……
- They earn less than one-half their past maximum
yearly income.
- They earn less than 80% of their past maximum
monthly income.
- They work in the two-years after they begin to get
Social Security benefits.

87
Q

Describe Pre-retirement education (PRE)

A

 PRE programs
- Focused on financial planning a few years before
retirement.
- Mostly served white, middle class, professional men.
- Women and minority groups had less
opportunity to plan retirement.
- Few people get formal PRE before retirement.

88
Q

Medicare: Part A Benefits

A
  • Care in a hospital (at least overnight)
  • Care in a nursing home after a hospital stay
  • Home health care
  • Hospice care
89
Q

Medicare: Part B Benefits

A
  • Some services and products not covered by Part A, generally on an outpatient basis (ex: doctors’ services, medical equipment, laboratory tests, radiation therapy, and vaccinations)
90
Q

Medicare: Part D Benefits

A
  • Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D.
  • Offers subsidies for drug costs.
  • These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies and drug companies.

Aging in Families (2 decks)

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