Issues in Human Services (HMNS 10085)

Module 6: Issues Pertaining to

Older Adults

Defining Older Adulthood:

• Very complex

• Statistics Canada defines a senior citizen as,– “a person age 65 years or older, who is eligible

to collect full pension benefits.”

• Chronological age (years)

• Social age (social expectation for 65 year old adults to retire

Different Categories of Older Adulthood

• 3 different age groups:– “Young old” - 65 to 70 years

» 53% are women

– “Middle old” - 75 to 84 years» 60% are women

– “Old old” - 85+ years» 70% are women

Aging Population

• Means that older adults, as a group, are growing more than the growth of the population of all Canadians

• Percentage of the Canadian population that was 65 years or older:– 1981 - 9.6%– 1991 - 11.4%– 2001 - 12.5%– 2005 - 13.1%

• Projected that 18.9% of the Canadian population will be 65 years or older in 2021

Reasons for Aging Population:

• Longer life expectancy - more older adults

• The beginning of the baby boom generation have started to reach the age of 65 years (in 2011).

• Lowered birth rate - fewer babies being born

Ageism:

• “Any attitude, action or institutional structure that subordinates or oppresses a person or group on the basis of age.” (Hick, 2006, p. 252).

• Western society > aging is feared> places premium importance on productivity>when one stops working in the paid labour force, rely on fixed income>viewed as not productive but as burdensome

• Canadian Charter of Rights and Freedoms, 1982.>prohibited to discriminate based on age

Health Problems of Aging:

• 65-74 age group:– Most remain in good health

– 1/3 report some level of pain or discomfort

• 75+ years:– More likely to suffer from pain - acute pain from injury

or illness

– Chronic pain lingering months to years

– Eg. arthritic conditions, diabetes, heart disease

– May lead to depression

Health Problems of Aging:

• Over the age of 75 years, adults experience the following problems at higher rates:– Mobility – Vision– Memory

Health Problems of Aging:

• Incidence of long term, debilitating terminals illness have increased with increased life expectancy:– Cancer

– Alzheimers

• Loss of independence and the fear of it• Myth > older adults all get dementia

> only 4% of people aged 75+ have dementia

Need for Care: At Home

• Need assistance with many of the activities they do daily:– Eg. Meal preparation Everyday housework Heavy household chores Attending appointments Financial managing Moving around the house Nursing care

Need for Care: At Home

• Large proportion do not tend to receive the help they need.

• 41% of older adults 65+ either received help but needed more or received no help at all.– Mobility – 42% of those aged 65+ received no help or

received help but needed more. – Vision – 46.3% of those aged 65+ received no

help or received help but needed more.– Memory – 50.8% of those aged 65+ received no

help or received help but needed more.

Who Are Unpaid Caregivers?

• Mostly women (57%)– May be an older woman themselves (16% are 65+

years, 8% are 75+ years).

• Women provide assistance with personal care (bathing, toileting, dressing) – 60% of women vs. 30% of men > tasks inside the house– 33% of women vs. 53% of men > tasks outside the

house

• Personal care tasks and care management tasks >more frequent, daily usually

Caregivers’ Other Responsibilities:

• Many caregivers provide this care while trying to maintain other responsibilities– 43% of caregivers are between the ages of 45-54

– Children at home

– 76% are married

– 57% are employed > only 1/3rd retired

• Tends to be long term– Provide care for > 5 years

– 10% providing care for > 10 yrs

Caregiver Stress

• Higher level of symptoms of distress:– Depression -Feeling Demoralized– Anxiety -Insomnia– Headaches -Irritability

• Can be mitigated by:– Positive interpretation of caregiving – Getting some relief from caregiving, occasionally

• Considered one of the causes of Elder Abuse & Neglect.

Relocation to Long Term Care

• Due to a combination of risk factors:– Experiencing difficulty doing activities of daily

living– Having a form of dementia– Recent hospitalization/health deterioration– Being 85+– Living alone

Impacts of Move to Long Term Care

• Stress

• Loss of culture

• Loss of community – LGBTQ

• May feel relief

Impacts of Move to Long Term Care

• Change in habits and routines

• Less contact with family and friends

• Loss of clubs or organizations

• Greater difficulty doing hobbies previously enjoyed.

Rights of Older Adults:Violations

• Abuse in institutional settings

• Direct - individual resident is target of abuse or neglect

• Systemic - policies or procedures that limit the rights or result in the direct abuse or neglect of residents (eg. restraints)

Rights of Older Adults: Violations:

• Some signs or symptoms of abuse:– Dehydration/malnourishment– Untreated medical issues– Missing aids (eg. hearing aids) or property– Unexplained injuries– Use of restraints, if frequent & to replace care– Decisions made for the resident - not able to participate

in decision-making– Lack of sufficient medical reasons for medication given– Family having difficulty contacting resident

Rights of Older Adults: Long Term Care Homes Act, 2007

• To improve the quality of care in Long-Term Care:

• Steps to improve care:– The Home is “primarily the home of its residents & is to be operated so

that it is a place where they may live with dignity & in security, safety & comfort, and have their physical, psychological, social, spiritual &

cultural needs adequately met.” (Mead, 2010).

– Bill of rights which includes the right not to be neglected, to have access to their personal health records

– Goal of care -> independence to the greatest extent possible

Rights of Older Adults: Long Term Care Homes Act, 2007

• Steps to improve care:– Limits to restraints- resident safety– Respect of choices and lifestyle– Provide opportunity to have private meetings

with partners or another person– Provide social & recreational activities >

includes those who not able to leave room– Enforcement of these rights by the Ministry of

Health and Long-Term Care

Loss of Significant Relationships

• Acute grief - up to ~ 6 months– Physical symptoms - headaches

- dizziness…

– Psychological symptoms - intense sadness

- longing & yearning for deceased- Feelings of hopelessness….

--> Becomes less acute & intense - may last years

Loss of Significant Relationships

• Major disruption to the life of the surviving spouse– Finding new & positive meaning in life– Developing new social roles– Relationships with friends may change– Financial loss– Housing– Transportation– Need for increased social support

Income of Older Adults:

• Sources of income (beginning at age 65):– Old Age Security/Guaranteed Income Supplement– Canada Pension Plan– Guaranteed Annual Income Supplement (GAINS)

(Ontario)– Over two thirds of older adults rely on OAS & CPP as

main source of income – the remainder > private pension or one sponsored by an

employer. – small number of older adults also have RRSPs

Income of Older Adults

• Has improved > success of combined public & private retirement income system.– Seniors with low income: 1985 > 14.7%

2004 > 7.3%

• Due to:– More people becoming eligible for Canada Pension

Plan– Maturation of CPP - 1990s > more retirees earning full

benefits– More women in the labour force

Groups of Older Adults Vulnerable to Experiencing Poverty:

• Women:– 22% of all older adult women experience poverty vs. 10% of older

adult men (City of Hamilton)

• Recent newcomers (1991+):– 27% vs. 17% of older adults on the whole, experience poverty

• Visible minorities:– 20% & 23% (Ontario) vs. 17% of older adults experience poverty

• Aboriginal:– 25% vs. 17% of older adults experience poverty

Readings:

1. Mayo, S., Wetselaar, R., Bakht, L. & Camplin, B. (2011). Profile of Vulnerable Seniors in Hamilton: Summary Report. Hamilton: Social Planning and Research Council of Hamilton

• http://www.sprc.hamilton.on.ca/Reports/pdf/SPRC_Seniors_Report_2011_Summary.pdf

2. Walters, Joan (2012). “The Silver Tsunami”. In The Hamilton Spectator, January 14, 2012. Hamilton:

• http://www.thespec.com/news/local/article/654486--the-silver-tsunami