CHAPTER FOURTEEN CHAPTER FOURTEEN Successful Aging

Demographic Trends: 2030 Potential for intergenerational conflict exists. –Controversy over the rate and growth of Medicare and Social Security –Future issues when the last baby boomer reaches 65 (2030) The proportion of older adults will have nearly doubled. Older adults will be politically sophisticated and organized. Will want to keep their affluent lifestyle, Social Security benefits, health care, comfortable retirement Ratio of workers to retirees will fall from 3:1 to 2:1. Lowered sense of obligation toward elderly parents Rapid increase of ethnic minority older adults

Demographic Trends and Social Policy Social Security and Medicare Political Landscape –1970s: older adults began to be portrayed as scapegoats concerning government resources Because of tremendous growth of federal dollars expended on them Older adults portrayed as highly politically active, fiscally conservative, and selfish. –1983: Congress made considerable changes in the name of intergenerational fairness. Changes in Social Security, Medicare, the Older Americans Act, and other programs and policies

Social Security 1935: initiative by FDR to “frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty- ridden old age.” Revisions to the law have changed SS so it now represents the primary financial support after retirement to many Americans. In the 21 ST century, other plans, 401(k), 403(b), 457, mutual funds, IRAs, savings option, may change SS back to being the supplement it was supposed to be. Primary challenge to SS is the large cohort of baby boomers drawing benefits and a smaller generation paying into the system.

Medicare 40 million U.S. citizens depend on Medicare for medical insurance. Eligibility for Medicare –Over 65 –Be disabled –Have permanent kidney failure Consists of three parts –Part A – inpatient hospital services, etc. –Part B – outpatient services, etc. –Part D – some coverage for prescription medications

Health Promotion and Quality of Life Little research on health programs specifically for the elderly, however: –Taking possibility of injury into account, exercise is key to health –Health education programs minimize effects of emotional stress –Health screening programs are effective in identifying chronic diseases that impact quality of life –Change unhealthy habits and increase functional capability Quality of Life – One’s subjective assessment of well-being and life satisfaction –State of health has major influence –Best studied from the point of view of the person

Health Promotion and Disease Prevention U. S. Department of Health and Human Services created a national initiative to improve health of all Americans. –U.S Government allocates funds appropriated by the Older Americans Act through the Administration on Aging (AoA) to support programs such as: Health risk assessments and screening Nutrition screening and education Physical fitness Health promotion programs on chronic disabling conditions Counseling regarding social services Follow-up health services

Health Promotion and Disease Prevention Issues in Prevention –Primary prevention Intervention that prevents a disease or condition from occurring –Secondary prevention Instituted after a condition has begun –Tertiary Prevention Efforts to avoid complications or secondary chronic conditions –Quaternary prevention Aimed at improving functional capacities of people with chronic conditions

Exercise and Nutrition Exercise –Aerobic exercise: places moderate stress on the heart by maintaining a pulse rate between 60 and 90% of the person’s maximum heart rate Nutrition –Metabolism: how much energy the body needs Metabolism and digestive process slow down with age. –Low-density lipoproteins (LDL): cause fatty deposits to accumulate in arteries –High-density lipoproteins (HDL): help keep arteries clear by breaking down LDLs

Body mass index (BMI): ratio of body weight to height BMI = w/h 2

Rowe and Kahn’s 3 criteria for successful aging (1998): 1. avoidance of disease and disability 2. maintenance of cognitive and physical function 3. sustained engagement with life

Vaillant’s 6 criteria for successful aging (2002) There are 3 criteria related to health: 1.No physical disability at age 75 2.Good subjective health 3.Length of undisabled life And 3 related to social and productive activity: 1. Good mental health 2. Objective social support 3.Self-rated life satisfaction in eight domains…

Successful Aging Vaillant’s eight domains of life satisfaction: 1.Marriage 2.Income-producing work 3.Children 4.Friendship and social contacts 5.Hobbies 6.Community service activities 7.Religion 8.Recreation/sports

Successful Aging The selection, optimization, and compensation (SOC) model Successful aging requires that people: –Have the resources to live a healthy life –Have access to health care –Have life experiences that support individual decision making Negatives –Poverty, widowhood, differential social expectations based on gender influence

Successful Aging The Meaning of Life Cartoon Best wishes for a happy, healthy life!