This chapter discusses the effect of disability on biopsychosocial functioning throughout the lifespan, the effect of culture, race, and ethnicity on behaviors, attitudes, and identity, and the effects of discrimination and stereotypes on behaviors, attitudes, and identity. It describes the influence of sexual orientation on behaviors, attitudes, and identity, the impact of transgender and transitioning process on behaviors, attitudes, identity, and relationships, and systemic (institutionalized) discrimination (e.g., racism, sexism, ageism). The chapter then explains the principles of culturally competent social work practice, sexual orientation concepts, gender and gender identity concepts, and social and economic justice. It elaborates the effect of poverty on individuals, families, groups, organizations, and communities, the impact of social institutions on society, criminal justice systems, and the impact of globalization on clients/client systems (e.g., interrelatedness of systems, international integration, technology, environmental or financial crises, epidemics).
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With increased age comes increased likelihood of disability as people live longer and do not encounter fatal diseases. Unfortunately, this positive association between age and disability sometimes leads to a negative image of aging. Disability occurs when physical or mental health declines associated with aging, illness, or injury restrict ability to perform activities of daily living. This chapter discusses the effect of disability on biopsychosocial functioning throughout the lifespan, the effect of culture, race, and ethnicity on behaviors, attitudes, and identity, and the effects of discrimination and stereotypes on behaviors, attitudes, and identity. It describes the influence of sexual orientation on behaviors, attitudes, and identity, the impact of transgender and transitioning process on behaviors, attitudes, identity, and relationships, and the principles of culturally competent social work practice. The chapter ends with discussion of sexual orientation concepts and gender and gender identity concepts.
This chapter discusses the components of a biopsychosocial assessment, the components and function of the mental status examination, biopsychosocial responses to illness and disability, and the biopsychosocial factors related to mental health. It describes the indicators of psychosocial stress, basic medical terminology, the indicators of mental and emotional illness throughout the lifespan, and the types of information available from other sources (e.g., agency, employment, medical, psychological, legal, or school records). The chapter then explains methods to obtain sensitive information (e.g., substance abuse, sexual abuse), the indicators of addiction and substance abuse, the indicators of somatization, co-occurring disorders and conditions, and the symptoms of neurologic and organic disorders. It explores the indicators of sexual dysfunction, methods used to assess trauma, the indicators of traumatic stress and violence, and common psychotropic and non-psychotropic prescriptions and over-the-counter medications and their side effects.
- Go to chapter: Background and Demographic Profile of People Growing Older and/or People With Disabilities
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.
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 the Americans with Disabilities Act (ADA), specific components of the ADA and how the ADA provides resources to older adults and people with disabilities. The ADA, while groundbreaking, was not initially intended for people with disabilities rather than for older adults. As time progressed, however, the benefits of the ADA were much more far-reaching than originally intended, especially for aging adults with disabilities. The individual titles of the ADA have had some dramatically positive and specific impact for older adults wishing to remain in their homes or in their communities as long as possible. Although the ADA is still in its young adulthood, the benefits of the ADA have only grown as new and further linkages, such as the ADRCs, have developed in all regions of the United States.
- Go to chapter: Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
Social, Political, Economic, and Demographic Factors and Historical Landmarks Impacting Aging and Disability Public Policy
This chapter helps the reader to be familiar with the demographic and social factors that influence and shape aging and disability policy over time and to be aware of policy changes over the past century within disability and aging public policy. It explains the contrast between advances in science and technology and public policy related to people growing older and people with disabilities. Landmarks serve as essential tools to help us recall specific historical events in time. Historical landmarks, science, and technology have played significant roles in the evolution of social policies; however, aging and disability policies may not have made as many strides as other areas throughout history. The chapter briefly discusses: the role of historical landmarks in shaping social trends and public policies; the relationship between historical landmarks and aging and disability-related policies; and trends in policy, social, and political influences and landmarks in the United States.
This chapter helps the reader to understand the history of the Elder Justice Act (EJA). It provides specific components of the EJA and how programs and services flow for older adults and people with disabilities. The chapter discusses the limitations in programs and services within the EJA. The EJA requires the oversight and the appropriation of federal funding to protect people growing older and people with disabilities from abuse. It addresses legal issues with a special emphasis on the concept of a power of attorney. The chapter explores several legal issues that face older adults. It also address elder abuse, power of attorney, and a differentiation made between the types of power of attorney and the healthcare power of attorney. In addition, the chapter explores legal services provided to older adults as a result of the Older Americans Act, and outlines the challenges within the realm of legal issues.
This chapter briefly discusses the history of the Affordable Care Act (ACA) and community and presents specific components of the ACA in relationship to community prevention. The chapter deals with specific aspects of the legislation that impact older adults and people with disabilities. It presents a short review of the ten titles: Title one: quality, affordable health care for all Americans; Title two: role of public program; Title three: improving the quality and efficiency of health care; Title four: prevention of chronic disease and improving public health; Title five: health care workforce; Title six: transparency and program integrity; Title seven: improving access to innovative medical therapies; Title eight: Class Act; Title nine: revenue provision; Title ten: strengthening quality, affordable health care for all Americans. The chapter explains some of the legislative highlights, policies, and programs that have been articulated within each of the specific titles of the ACA.
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.