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These grants were to provide community planning and services and for training through research, development or training projects. Its 10 objectives were aligned with the major areas of federal programming. These were an adequate income in retirement according to the American standards of living; the best physical and mental health; suitable housing; full restorative care for those who would require institutional care; employment opportunities without discrimination; health, honor and dignity in retirement; pursuit of meaningful activity at the widest range; efficient community services; immediate benefit from reliable research knowledge; and freedom, independence and the free exercise of individual initiative. Title III of this Act provided grants for community planning, services and training. Amendments made in 1971 and 1974 provided the basis for establishing and operating a nationwide network, the Administration on Aging or AoA. The first implementation strategy of the AoA was to sponsor many small direct service programs nationwide. The purpose was to create demand for additional services. In 1973, Strategy II was implemented to delineate State and sub-State units on aging. This also succeeded and was followed by the current strategy to negotiate cooperative agreements with agencies on a federal level. This step was intended to maximize resources needed for area agencies. Keeping the agreements at the national level was to devise a national framework in serving the needs of seniors throughout the country (Baumhover & Jones).
The Senior Benefits Program
The State of Alaska under Governor Sarah Palin established the Senior Benefits Program for lower-income older Alaskans (Orr, 2007; Gelfand, 2003; Gillespie & Sloan, 1990; Palin & Jackson, 2011). These would provide seniors and their caregivers with comprehensive assistance from nursing home placement to heating equipment, nutrition, transportation, and support services. Businesses also began to provide benefits assistance to cover the cost of hiring in-home assistance so that employees can return to work. The Program, signed on July 28, 2007, provides payments at $125-250 per month, according to the senior's income level. It replaced former Governor Frank Murkowski's Senior Care Program and the State's Longevity Bonus Program. Congress removed these two programs from the operating budget of fiscal year 2008. Governor Palin swore that seniors would not go hungry under her rule. She said she would work on this with the Alaska Legislature (Orr, Gelfand, Gillespie & Sloan, Palin & Jackson).
State Services for Senior Alaskans
In 2007, the 25th Alaska Legislature passed operating and capital budget bills to provide more than $300 million to programs for older Alaskans (Orr, 2007; Gelfand, 2003; Gillespie & Sloan, 1990; Palin & Jackson, 2011). House Rule Committee Chairman John Coghill remarked that many of the services provided by the State are non-existent in other States. He said that all that was needed was to identify the programs, which addressed seniors' specific needs and provide funding for these. Estimated funding for senior programs within the Department of Health and Social Services includes $54.3 million for pioneer homes; 3.3 million for heating assistance; $5.7 million for nutrition, transportation and support service; $18.7 million for adult public assistance; $3.5 million for home-and-community-based services; $173 million for Medicaid for seniors; $14 million for disabled persons aged 65 and older; $3.2 million in food stamps; and $6 million for assisted living. Further, more than $9 million was appropriated to projects, purchase and programs for seniors, such as grants, property tax exemptions for homeowners among them and free hunting and finishing licenses for residents. Senior and Disabilities Services deputy director Rebecca Hilgendorf said that more than 14,000 senior Alaskans received personal care services, nursing home services, home and community-based waiver services and senior grants from their programs in 2006. She also said that their goal is to promote the health and independence of senior individuals and their families. They serve seniors, physically disabled adults, and seniors on Medicaid waivers, those with developmental disabilities, vulnerable adults and assisted-living providers. Hilgendorf added that they have four Aging and Disability Resource Centers in the State and sustaining as well as developing more. SDS signed a formal agreement with private entities to continue serving as "one-stop shopping" center for long-term support for seniors and disabled persons (Orr, Gelfand, Gillespie & Sloan and Palin & Jackson). As of 2008, these were financial safety net programs, personal safety and long-term care supports, information resources, senior housing supports, and home and community-based services (Palin & Jackson, 2008).
Native American Families
The popular assumption is that Native American families primarily depend on family support networks (Glefand, 2003). Such networks, however, cannot be further assumed to have developed from the European mold of kinship. They may have derived from a larger one similar to a village. Some experts have argued on the appropriateness of measuring family extension from the household concept, although some households are included within the family network. There are other social support networks in reservations as well as among Native American families in the urban and rural areas. The intergenerational Native American household has been stereotyped and is inapplicable in urban Native American communities. These changes in social networks very probably increased or decreased the amount of formal care provided by the support network. The individuals who provided that care may have also changed. Those living in urban areas may have been separated from their family members in reservations. A study conducted in Oregon and Washington reservations found that 75% of those interviewed in the city and 89% in the reservations perceived the family members as the most important persons. Older Native Americans living in the city were reported to obtain fewer resources. They and other members of the family in the urban areas rely more on the formal service-delivery system more than their counterparts at reservations. Nonetheless, the family presented as a crucial provider of assistance in both groups. And even with the support and commitment of the family, assistance extended to older Native American persons was not optimal. They viewed the family as extending to non-kin and other individuals in the community with whom they related (Gelsfand).
Home Health Care
This is a new term, which refers to caring for the frail and the sick (Gillespie & Sloan, 1990). It implies the provision of healthcare services right at home instead of in institutions and facilities. Modern home health care has recently expanded to include skilled nursing care, acute care, and care requiring technologically advanced equipment and procedures. Recent statistics disclose that disabled older adults in the community receive care from relatives at 84% for males who provide 89% of days of care. Older disabled females receive care from relatives at 79%, who provide 84% of days of care. Almost all of those aged 65 or older have at least one chronic disease condition. Multiple diseases are common among them. The most common among these conditions in 1987 were arthritis, hypertensive disease, heart disease, and hearing problems. Approximately 1.1 million of them receive formal home health care and 600,000 of them pay for part of that care. They spend an average of $165 a month from their own money. In 1987 alone, Medicare beneficiaries obtained 35 million home health visits. This translates into an average of 1,068 per thousand enrollees (Gillespie & Sloan).
Home health care consists of diagnosis, treatment, rehabilitation, monitoring, and/or supportive care given and received at home (Gillespie & Sloan, 1990). It was a flourishing business on account of the aging of the population, shorter hospital stays, and the growing preference for home health care to nursing facilities and hospitals. Home health care agencies or organizations provide a gamut of services from skilled nursing, therapy to nutrition. Their services may also include personal care, therapy, medical equipment and diagnostic aids and high-technology treatments. Home health care is likely to be appropriate for an older adult who is chronically ill and requires a high level of care. He or she may also need frequent or ongoing monitoring, such as a heart condition or kidney disease. It may be a sound alternative to a terminally ill senior. If he or she needs care for a physical or emotional problem and must remain home, home health care may be the proper choice (Gillespie & Sloan).
2011 Legislative Priorities
The Alaska Commission on Aging (2011) listed these as the reauthorization of the Senior Benefits Program, the Senior Hunger Abatement: Grant-Funded Nutrition Services, Enhanced Services for Older Alaskans and Unpaid Family Caregivers, Community Transportation for Seniors and Persons with Disabilities, Adequate Funding to Build Appropriate, Accessible and Affordable Housing for Older Alaskans Where They Live, and Aging and Disability Resource Centers. Enhanced services focus on seniors with Alzheimer's disease and other forms of dementia and unpaid caregivers. These services will provide long-term support service to seniors living at home for as long as possible. These services will delay or avoid the need to move seniors to nursing homes. The funds will be spent to build…[continue]
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