This chapter highlights some of the current health programs and policies in place and changes in demographic trends for older adults living within American society. In addition, substantial changes within the social, political, and cultural expectations of communities over the past century pose challenges for policies and programs serving older adults. The chapter presents several issues emerge as realities within the context of policy development and program planning for older adults. These issues include changes in living arrangements, education levels, economic well-being, and rural population settings; trends in morbidity and mortality; and changes within the social, political, and cultural expectations of communities. Despite the availability of programs and services resulting from health policies, many programs have focused upon “medically necessary” services and have lacked a health promotion, health education, or community-based focus.
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- Go to chapter: Background and Demographic Profile of People Growing Older and/or People With Disabilities
Policy and Program Planning for Older Adults and People With Disabilities, 2nd Edition:Practice Realities and Visions
This book attempts to build students’ understanding of policy development through a critical analysis and review of policy frameworks, and the policy implementation process. The book is organized into four parts comprising twenty-one chapters. Part one of this book lays out a background as to the current and future demographic trends of older adults and makes the case for the reader that there are a variety of philosophical, political, economic, and social factors that affect public policy development. The chapters help the reader to explore a range of perspectives that define, shape, and impact the development and implementation of public policy. It intends to prepare the reader to critically analyze public policies related to aging. Part two provides an overview to major federal policies and programs that impact older adults and people with disabilities. It examines some historical developments leading up to the actual development and implementation of the policies. Policies include social security, medicare, the Older Americans Act, and the Americans with Disabilities Act, the Community Mental Health Centers Act, and Freedom Initiative. The last part of the book outlines specific programmatic areas that flow from aging policies, and specific components that flow from federally mandated policies. Each chapter contains same basic outline: an overview of the programs, specific features and strengths of the programs, gaps and areas for development, and challenges for the future.
This chapter focuses on sources of evidence for evidence-based policy development. It explores some of the dilemmas with developing an evidence base and provides a range of empirical sources within the aging and disabilities arenas that can be used in building an evidence-based approach to policy development. The journey, however, will not be without struggle—since philosophical paradigms, and social and economic factors will interface and play a role in the development of evidence-based policy. The chapter helps the reader to be aware of healthy people 2020 benchmarks that are used to guide program planning and policy development. Benchmarks currently have been established in order to identify where health goals for the nation and individual states should be, and the program is evaluated routinely by local and state health departments. Healthy people 2020 is also used to gauge the impact of health policy.
This chapter discusses the history of the Medicare in the United States; specific components of Medicare Parts A, B, C, and D; and how Medicare provides healthcare resources to older adults and people with disabilities. Medicare, a healthcare program perceived to be a universal program rather than one based upon a needs test, currently provides healthcare to people who reach the age of 64. Comprised of four parts, it can provide hospital care, general healthcare, hospice care, home healthcare, and prescription drug coverage. The chapter provides an overview of the Medicare program, its various components, and aspects of healthcare that are covered through its component parts. Although there are currently no needs tests or limitations as to who qualifies for services, the chapter concludes with some dilemmas for the future of healthcare coverage, including “an empty pot at the end of the rainbow” and rationing of healthcare services and procedures.
- Go to chapter: Challenges for Policy and Program Planning for the Future: Realities and Visions for the Future
This chapter address a number of areas that will affect the lives of people as they age or people who are older adults. Philosophical paradigms, statistics, evidence-based approaches, dealing with the media, making people aware of new technologies, and preparing for communities to best deal with issues of aging are all major issues of concern. It provides a range of issues; however, the chapter provides an overview of the most significant ones to be addressed or to require intervention. It cites 10 major challenges that the future will bring, in reality, policy advocates will have to be prepared to address and deal with these challenges by using innovative strategies for policy development and policy change. The chapter addresses policy development and program design to meet the needs of an aging and ability-challenged society are unique challenges.
This chapter helps the reader to be familiar with the role coalitions play in advocacy and policy development and to understand the various types of coalitions that affect the policy landscape. It also helps the reader to be familiar with the various roles that exist within groups and coalitions that contribute to the success or non-success of the group process. A number of strategies can be used to develop initiatives to impact one’s advocacy efforts. These strategies can be used to promote the development of new programs and services and can include the use of and/or development of coalitions, the media and media advocacy, and consumer advocates. The chapter addresses each of these strategies in greater depth. It outlines a variety of issues related to coalitions, group development, and coalition building for aging policies and programs.
This chapter briefly discusses the history of the Caregiver Support Act and its specific components and explains how the Caregiver Support Act provides resources to older adults and people with disabilities. It provides an overview of the current status of family members serving as caregivers, with special attention to grandparents raising grandchildren. It then discusses a current profile of relative caregivers raising children in the United States; reasons for the increase in relative caregiving; and issues facing grandparents raising grandchildren. It also provides some background into the literature and promotes an awareness of issues that grandparents face as primary caregivers. A literature review examines some of the current issues and services needed. The chapter discusses resources and services designed to meet the needs of grandparents raising grandchildren, and reviews programmatic responses through the national resources. Finally, the chapter outlines some best practice interventions for review in the text.
This chapter provides a backdrop to our current social security program and an overview of some models for social security programs in Europe and Canada. It explores the genesis of the social program in the United States. The chapter also explores contents of the original social security act (SSA) and compares the titles and programs mandated through the current SSA. It offers some guidelines for the current administration of the program, examines the debate around current proposals for revision, and reviews why these proposals are current issues for consideration. The chapter then presents the current social security system, which provides for older adults, but has also grown to cover dependent women and children. Although many people have argued for their vision to privatize the system, the reality is that there is much more political support to maintain the program as a safety net program rather than a means-tested program.