Disabilities, Disease, and Aging; Public

Disabilities, Disease, And Aging; Public Policy

One of the major changes in the last century regarding human health and longevity is that people today have a longer life and expectancy than ever in history. Because medical science has given us what could arguably called a "gift," the general concept of aging in society has seen significant changes. Old age is no longer regarded as the harbinger of death, for example. Instead, its lasting nature has brought it to mind as an entire stage of life, during which people should be just as concerned with their health and well-being as during the younger years. It is also, however, true that extreme old age could bring with it a level of disability that may plague the individual for a far longer time before death than was the case in the past. Hence, the concept of caring for the aged has also changed to accommodate this new situation. It is not only the idea of caring for the aged that has changed, however. The entire concept of aging from an individual perspective, as well as the official perspectives of health care students, personnel and policymakers has seen significant changes over the last 100 years.

In terms of the individual, aging is conceptualized differently for every person, depending on a number of factors, including the level of age-related disability and chronic conditions. These can have significant effects on the way in which an older person experiences his or her stage of life and the level of general well-being that goes with this (Hollis-Sawyer, personal communication, 4/4/2013). Indeed, according to estimations, approximately 20% of persons over 65 have mild disability, with 4% having severe disability. In the past, this situation was accepted as part and parcel of becoming old; a predecessor to dying, with little to be done about it. Indeed, it was uncommon for many people to became so old that severe disability affected them for significant lengths of time before they ultimately died. Today, however, great importance is attached to provide old people with physical and cognitive age-related conditions with services to help them function at as high a level as possible for as long as possible.

In this regard, an increasing number of people find themselves in need of assistance with activities of daily living (ADL). These include various degrees of dressing themselves, preparing meals, visiting the bathroom, and so on. The number of people in need of such assistance is expected to be 12 million by 2020 and 17 million by 2040 (Hollis-Sawyer, personal communication, 4/4/2013). Hence, the concept of old age and the degree and type of care people expect to need in these later years of their lives differ significantly from what it was 100 years ago. A century ago would have seen many elderly people simply placed in a care home, with no alternatives. Today, the various types of care and those involved in such care, as well as longer life expectancies, has changed this. Older adults, for example, have choices between formal, informal, institutional, residential and other forms of care. Care can even be provided in a tailor made way, with the use of technology to assist the process. The general aim of care today is helping the elderly remain in their own homes for as long as possible, with the degree of assistance they need to do this.

One of the most important changes in the concept of aging today is that this stage of life is no longer assumed to automatically be synonymous with becoming an invalid. The assumption is rather that chronic illness and disability can be managed with the appropriate care, thus providing sufferers with the means to be as autonomous as possible for as long as possible.

Family members are an example of informal care providers. Siblings can play a key role in this (Chapter 13, p. 245). Even though the sibling relationship can be somewhat more distant during the young adult and adult stages as a result of moving away from each other and having families of their own, it has been found that many siblings once again become close during the later stages of their lives. This creates a platform for them to help each other with daily needs or simply to offer companionship and other forms of assistance. It is also found that, in the case of unmarried or childless older people, nieces and nephews can play an important role in care and companionship needs. Hence, the various family relationships the elderly are able to establish over time because they live longer allow them to establish a basis for informal care once his becomes necessary.

Because of longer lives, the health needs of older people have undergone great changes over the last 100 years. Modern diseases such as HIV / AIDS are at the forefront of medical professional attention today, especially as this concerns older people. Indeed, a paradigm shift has become necessary, since the common assumption has been that young people are in need of education regarding the condition (National Institute on Aging, 2013). However, since older people are sexually active for longer than was the assumption before, it has become necessary to pay attention to potential ignorance levels among them.

The various differences and dynamics of growing older today as opposed to 100 years ago has made it necessary to pay significant academic attention not only to the health needs of older people, but also to the way in which they experience and live their lives and their connections to others. Some research, for example, focus on the various interactions and dynamics among older people and their families. It has been found, for example, that older people negotiate and renegotiate their family relationship as the life span progresses (Chapter 14, p. 261). One example of this is the care giving role, which changes from a parental one to care provided for grandchildren, and finally to receiving care from children and even grandchildren. These dynamics are important in terms of policy construction. Particularly, health care reform is battling with concerns about providing an increasingly aging population with its health needs.

If one considers the value of informal care by siblings or children, however, a large amount of the current burden on the system could be alleviated. Even the burden on professional care givers could be alleviated, since this has also become an important health concern related to the aging society of today (Centers for Disease Control and Prevention, 2010).

Perhaps this is one of the greatest shifts in conceptual paradigms not only by individuals observing the elderly, but also by the elderly themselves. It is the understanding that moving to a home or retirement village is not necessarily the only option. Indeed, many prefer to remain at their homes, not only for financial reasons, but also for the emotional attachments to the home (NORCs, 2013).