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
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 helps the reader to understand the history of housing and long-term care for older adults and people with disabilities and specific components of the Long-Term Care Reconciliation Act. The chapter discusses how legislation related to housing and long-term care provides resources to older adults and people with disabilities. It explains community-based care options such as home health, seniors congregate living, assisted living options, skilled nursing facilities, and long-term care facilities. Although differences may exist from state to state relative to who qualifies for these options and when they qualify, these will be discussed in some detail specifically providing an overview of these as options for care management of older adults. The chapter describes different residential models of care for people as they require community-based settings or settings with supports and examines issues that will face the long-term and community-based care settings in the future.
This chapter presents a brief overview of some legislative efforts within the mental health (MH) arena and examined their limitations and application with respect to older adults and people living with mental illness. The chapter also takes us through a journey to examine the current status of MH and older adults, with a particular emphasis on depression, anxiety, and schizophrenia. It discusses and reviews the programs, services and issues still outstanding within the MH arena. The chapter helps the reader to understand specific components of the Community Mental Health Act and other MH-related legislation. Many of the community day hospital programs and community MH programs administered through the Community Mental Health Act are based on the deinstitutionalization paradigm since the goal is to treat people outside the institution and within community settings. It concludes with laying out some challenges for the future in the area of MH and older adults.
This chapter helps the reader to understand what a needs assessment is and be acquainted with a framework within which to conduct a needs assessment. and to be familiar with the core concepts of a needs assessment. It helps the reader to be familiar with strategies that encompass a needs assessment. Needs assessments can be carried out by a wide cast of people. Social workers and public health workers, as well as city planners, can carry out needs assessments, as can government organizations. Local citizens or groups of people can also be responsible for carrying out a needs assessment. The chapter provides an overview of strategies to develop a needs assessment. When used in combination with a health behavior framework, a needs assessment can help one determine the needs of a community and attempt to build community support for this resource or policy change through media advocacy and coalition building.