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Elder Care Issues



Abstract

This paper explores elder care issues that affect the aging population in modern society. The presence of baby boomers is likely to see the elderly population grow in number from the current 47 million people in the US to more than 80 million by 2030 (Kelly, 2016). Therefore, most probably, this population is going to experience a healthcare staff shortage more than today because, in the workforce, the percentage of the aging population is much higher than of those that are joining the system.

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Furthermore, the growing population of older people is going to worsen the care provider to the elderly patient ratio, which will impact the delivery of quality geriatric care. Mature policies should be in place in order to enhance staff retention, prevent an early retirement, and increase the number of those who enter the system. Moreover, the chronic disease burden is enormous in this population. 68.4% of the elderly population suffers from multiple chronic conditions at some point in life (Sambamoorthi, Tan, & Deb, 2015). Most of these conditions are preventable through certain lifestyle modifications.

Moreover, policies should be developed in order to enhance the prevention of such problems through the adoption of effective strategies. Finally, 10% of the elderly experience abuse with about 23% of the cases being unreported (CDC, 2015). Sexual, physical, psychological, and financial neglect are a few of the most common types of elder abuse. The prevention and mitigation of this menace should target both an abuser and victims through implementing effective measures and ensuring the legal protection of the elders.

Keywords: Elder care issues, healthcare staff shortage, chronic disease burden, elder abuse

Elder Care Meaning

No standard definition for the elderly has been in place, while most definitions follow legal requirements for the retirement age (Oluwabamide & Eghafona, 2012). However, the Institute of Medicine [IOM] (2008) explains that a person should be a minimum of 65 years of age, to be called an elderly. The U.S. Census Bureau asserts that the older population is likely to grow by 17% in the period between 2015 and 2020; this growth rate significantly outpaces the national population growth rate of 3.9% (Kelly, 2016).

The baby boomers (people who were born shortly after the Second World War) will have a great influence on the growth of this population. The government expects 76 million baby boomers to age on Medicare in the coming five years. Even after factoring deaths for this period, the program is likely to grow from the current 47 million people, to include more than 80 million in 2030 (Kelly, 2016). Therefore, the aging population is going to grow greatly. This research paper looks forward to discussing some elder care issues that affect the increasing aging population.

Aging Workforce and Healthcare Staff Shortage

The aging population is likely to face serious problems as, while its number is predicted to grow, resources for supporting this population are limited. In the United States, the elderly population is going to double that of 2005 (IOM, 2008). Unfortunately, the country is not prepared to meet their social and healthcare needs. This phenomenon is going to affect not only the aging healthcare system but also many other areas that contribute to the economic growth and development of the country. The U.S. Census Bureau predicts that more than 19.6 million American workers are going to reach at least 65 years of age; this number accounts for about 19% of the entire workforce (Harrington & Heidkamp, 2013).

Moreover, the number of people in the labor force of a minimum of 65 years of age is expected to rise by 75%, while those of 25 to 54 years of age will grow by only 2% (Harrington & Heidkamp, 2013). In other words, the young population in the workforce is going to grow at a smaller rate than that of the older population. Heidkamp, Mabe, and DeGraaf (2012) explain that by the end of 2016, more than a third of the U.S. working population will have at least 50 years of age. These people can increase the group to about 115 million by 2020. The issue is further complicated by the ever-growing number of professionals, especially in the nursing fraternity, who retire before the required time. In the healthcare system, it is going to be a considerable challenge because the working population that can take good care of the aged will be inadequate in number.

The US will need more healthcare professionals in order to curb the current and projected shortage that is going to impact the health of both the aged and other population groups. According to the American Society on Aging (2011), it is expected that the country will have required additional 3.5 million health service providers by 2030 in order to sustain the current ratio of care providers to the population. Moreover, the need for geriatric specialists is higher in all professions.

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The IOM (2008) explains that more than two-thirds of the aged population is going to require long-term care at one point in life, and the traditional providers of this care have been mostly informal caregivers that comprise friends and relatives. Unfortunately, the coming generations of older people may not rely on informal caregivers because of having some children and increased divorce rates. This phenomenon further worsens the demand for professional healthcare workers, who are supposed to provide geriatric services.

Health policies, legislations, and adjustments in the health care working conditions can help limit the probability of having professionals retire before their retirement time. The IOM (2008) found out that implementing strategies with the view to improving working conditions for nurses can help prevent early retirement. For instance, Robert Wood Johnson University Hospital has implemented a set of changes such as repositioning floor refrigerators, which accommodate medications to countertops, to manage the frequency of nurses bending to retrieve medications (Harrington & Heidkamp, 2013). The hospital has also purchased anti-fatigue mats for nurses, to rest in shifts, and assigned human resource personnel to counsel the nursing staff.

As a result, the hospital was among the best places to work for nurses, who registered a dramatic reduction in work-related injuries and early retirement. Therefore, improving the hospital working environment can result in the low early retirement rates and motivate the upcoming workers to choose clinical nursing jobs. Furthermore, the increased training of health care professionals, including geriatric specialists, will likely address the staff shortage. It shows that appropriate policies and measures should be in place in order to increase the training of new providers and improve working conditions with the view to curbing the shortage of workers.

Chronic Disease Burden and Dependence

The elderly population is the most affected group with chronic diseases. Prince et al. (2015) explain that globally, the leading causes of the chronic disease burden are cardiovascular conditions (30.3%) and cancers (15.1%), which are followed by chronic respiratory diseases (9.5%), musculoskeletal diseases, which account for 7.5% of cases, and mental disorders (6.6%). In the US, about 117 million people suffer from chronic conditions and 25% of adults have multiple chronic conditions (MCC) with 68.4% of the elderly having at least two chronic conditions and 36.4% having at least four (Sambamoorthi, Tan, & Deb, 2015). The US-registered an increase in the prevalence of MCC from 21.8% in 2001 to 26.0% in 2010 (Ward, 2013). This increase is likely to grow with the predicted rise in the number of the aging population. Therefore, chronic disease conditions are a serious threat to the health of the elderly given the fact that they are the ones who bear the largest burden.

Other than the impact of chronic diseases on the health of the elderly, its impact on the cost of health care is significant, as well. In the US, 86% of the 2010 healthcare spending was provided to people, who suffered from at least one chronic condition (Gerteis et al., 2014). The same year, $315.4 billion was attributed to patients with heart diseases and stroke, including $193.4 billion catering for direct medical care without the inclusion of the cost of nursing home care, while cancer consumed a whole of $157 billion (Centers for Disease Prevention and Control [CDC], 2016).

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Other diseases that took huge amounts of money include diabetes, obesity and overweight, arthritis, and smoke-related conditions, for example, lung cancer, and many others. Among the top ten American causes of death in 2010, there were chronic diseases with heart diseases and cancer accounting for around 48% of all deaths (CDC, 2016). Therefore, these conditions are a huge loss to the U.S. economy because it accounts for most of the healthcare spending, meaning that the failure to address the problem as soon as possible will increase health costs with the concurrent increase in the number of aging people.

In a precise analysis, the conditions that contribute to the disease burden are preventable through certain lifestyle modifications such as the performance of physical exercises, cessation of smoking, weight control, and healthy diets among others. Sousa et al. (2010) assert that chronic disease prevention strategies that target the older dependent people should be a priority; they include healthy aging and healthy lifestyles that postpone the development of chronic conditions and disabilities. Eldercare laws should create an avenue, through which the elderly can receive information on their own health and provide necessary resources for fighting chronic diseases.

For instance, elders need resources and knowledge on the importance of regular physical exercises. With the predicted growth of the aging population, the primary prevention in adults younger than 50 years of age is going to enhance the health of older people because it will set a stage for improved health of the aged in the coming years (Prince et al., 2015). The performance of regular physical exercises by this population can significantly improve their physical wellbeing and prevent such diseases as type 2 Diabetes mellitus and obesity.

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Elder Abuse

Elder abuse is a common thing that affects elder care both in the community and healthcare facilities. It is the repeated lack of appropriate action or behavior that causes distress in older people in relationships that create expectations of trust (World Health Organization [WHO], 2016). The elderly are the most affected population because they cannot protect themselves from sexual, physical, and many other types of assaults because most of them are mentally or physically unable to communicate with their professional providers of care or families (Kelly, 2016). Some older people have fear because they depend on abusers, who may face devastating consequences if the truth is revealed.

Globally, 10% of the older people experience different types of abuse monthly; those in institutions suffer the most as compared to those in the community. Meanwhile, hidden cases of the abuse account for more than 23% of all instances (CDC, 2015). The WHO (2016) explains that since the population of the elderly will have increased to about 2 billion by 2050 from 900 million in 2015, the number of abused adults will equally increase. This trend can be mitigated if correct measures are in place.

On the same line, substantial evidence suggests different types of abuse against older people in both developed and developing nations. The middle and low-income countries experience the worst levels of the elder abuse with physical, sexual, psychological, financial abuse, and neglect is among the most prevalent forms (Acierno et al., 2010). The WHO (2016) asserts that the rates are high because 36% of the staff have witnessed at least one physical abuse incident with the elder; 10% have committed at least one of such abuses to their elderly patients, and 40% admitted to having abused these patients psychologically.

This data prove that social and health care facilities are not a safe place for this population. The abuse of the elderly causes a negative influence on their physical and psychological health. In elder care institutions, abusive acts include depriving patients their choice concerning daily affairs and dignity through such acts as leaving them in dirty and soiled clothes, physically restraining them, neglecting them by intentionally delivering inadequate care, emotionally abusing, and neglecting, as well as providing inappropriate medication or withholding the one (WHO, 2016). Families and friends can also abuse the old; it means that neither homes nor care facilities are safe to these people.

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However, several measures can help prevent and curb the menace of elder abuse. Recruiting, keeping, and training professional care providers on elder abuse is the major step in mitigating this challenge in care facilities (Kelly, 2016). The WHO (2016) adds that the public and public awareness, screening potential abusers and victims, supporting caregivers via such interventions as the stress management, and residential care policies that improve and assert that standards of care are equally important in addressing the challenge. Furthermore, mandatory reporting of elder abusers both from the community and care facilities can curb the menace. Most importantly, self-help groups, provision of safe houses, psychological programs for potential abusers, and caregiver support interventions can further prevent the abuse. The law is useful in punishing abusers, as well.

The aging population is increasing in number; in the coming decades, the healthcare sector is going to face serious concerns. First, the aging population will suffer the adverse consequences of the healthcare shortage of staff. The shortage is already existing, and the future will be worse given that this aging population is going to increase, while the number of informal caregivers is going to reduce due to the increase in rates of divorce and a small number of children of the baby boomers and other coming generations. Secondly, chronic disease burden impacts the elderly because they account for most of these conditions in the population with some individuals having MCC. Finally, the elder abuse that includes physical and emotional abuse impact this population significantly. However, there are measures for enhancing the mitigation and elimination of these eldercare issues.

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