Week 7 Part A & B - Psychology
Be sure to follow directions for both sections. Answer 6/9 of the questions in part A and 2/3 of the questions in part B. Be sure to indicate which question you are answering. Answers should be typed into a Word document in complete sentences with appropriate spelling and grammar. Save and attach your answer document here in this assignment as a .doc, .docx, or .rtf.    Textbook  Quadagno, Jill, Aging and the Life Course:  An Introduction to Social Gerontology, (Seventh Edition).  New York, NY: McGraw-Hill, 2018. Week 5: Overview Introduction This week we'll cover four topics: minority issues, women's issues, family relationships, and long-term care. Learning Outcomes · Define "double jeopardy" and describe how it affects various elderly minority groups · Describe cycle of insular poverty · Identify issues particular to older women and their longer life expectancy · Chart the pattern of marital satisfaction over the average life span · Describe how caregiving affects the "sandwich generation" · Identify the five types of grandparenting from the study by Neugarten and Weinstein · Compare and contrast the advantages and disadvantages of various forms of long-term care · Week 5: Lecture · Minority Issues · You likely will become familiar with some of the discriminatory practices toward various minorities through the reports of your classmates and your own research. Here we will briefly address “double jeopardy,” a somewhat controversial concept that has general application to various minorities. Double jeopardy is the tendency for a member of a minority to be discriminated against, first by virtue of being a member of a racial or ethnic minority, and to be further disadvantaged by being older. Some would add that being female is a third dimension of jeopardy. Women's issues will be discussed shortly. · Although some researchers have viewed the concept of double jeopardy as being overemphasized, many more have maintained its significance.  Clearly, most minorities experience hardships (lower income, substandard housing, etc.) that are less prevalent among native born, White Anglo-Saxon Protestants, or even among most Whites in general. · One of my objectives in this course is to urge you to become more sensitive to the additional hardships faced by the majority of minority elderly. In his book titled The Other America, Frank Harrington asserts that most poverty in the United States is insular poverty, i.e., pockets of poverty in which one generation of poverty begets another. As an example, a poor Hispanic child grows up in a neighborhood where education is not emphasized, attends a substandard school, ends up with a relatively low-paying job, and retires with relatively low retirement income. One’s offspring continues the cycle and has the additional burden of helping provide for aging parents that may need financial and other assistance. If you say that there are many exceptions to my example, you are absolutely right. However, Harrington and others would likely say that we may hear too much of the Horatio Alger stories and lose sight of the norm. · Week 5: Lecture · Women's Issues · Robert Butler, geriatrician and former Director of the National Institute on Aging, and Myrna Lewis have written extensively about the plight of the older woman. In recent decades the life expectancy of older women has been 5 – 7 years longer than that of older men. This fact alone presents many additional problems for older women, even though most of us value a longer life. · Whereas over the past 20 years plus, generally more than 70% of older men (65 and older) are married and living with their spouses at any given point in time, less than half of older women are married and living with their spouses. This underscores the likelihood that most older females will spend a substantial part of their later years living alone. Older men are likely to have a spouse as a caregiver in later life but older women likely will have to find a different source of assistance. Living alone also has significant implications related to income, housing (especially upkeep), social life, etc. Butler once asked why the women’s movement focused so little attention on the plight of the older woman. It appears that little headway has been made in this area since Butler drew so much attention to it in the 1970’s. Issues of older women remain an area that lends itself to discussion and creative improvement. · Week 5: Lecture · Family Relationships · In discussing family life and aging, four areas will be discussed briefly: spousal relationships, caregiving, grandparenting, and intergenerational equity. As anyone might expect, family life is a primary factor related to happy and successful aging for most. · Roger Gould, a University of California at Los Angeles researcher, noted an inverted bell shape (or u-shaped) pattern of marital satisfaction. According to him, marriage tends to be very happy in the early years, begins gradually declining into the early middle years and then begins to increase again sometime in the middle years through later life. It appears that for those who survive the challenges of the middle years (roughly ages 35-55), marriage is very satisfying. · There does not appear to be widespread consensus on what gender role patterns lend themselves best to happy and successful marriages. However, Robert Atchley, a noted author in gerontology, stated that egalitarian marriages tend to fare best. By this he meant that marriages that have flexible, rather than rigid, male and female roles tend to be most satisfying. · Another major factor related to happiness in later life is the health of one’s spouse. The Rand Corporation conducted a study of what tended to contribute most to high morale and life satisfaction among older persons. Of the three factors that were concluded to contribute most, not surprisingly, one’s good health and adequate finances were identified. The third factor, and what may be sometimes overlooked, is the health of one’s spouse. One may tend to have somewhat more control over one’s own health and finances than on the health of one’s spouse. Week 5: Lecture Caregiving The family remains the greatest single source of caregiving for older adults. Often to provide optimal care, there needs to be coordination between primary caregivers (family) and the aging network (the system of community resources for older adults such as homecare agencies, day care centers, senior centers, health clinics, etc.). Of course, sometimes caregiving for older persons falls on the shoulders of the children of older persons, the so-called "sandwich generation" that may have the dual role of raising their own children while caring for their aging parents. The Health and Retirement Study that began in 1990 and has continued into this century reported that as many as two-thirds of the middle-aged sample had parents or parents-in-law in need of some form of caregiving. Many researchers have emphasized the importance of what is referred to as a “continuum of care,” the provision of vital services as they are needed. Older people usually do not go from a state of full independence to a state of complete dependence. More frequently, there is a gradual need for increased services. Most researchers advocate facilitating the older person to remain as autonomous and independent as possible. Transitioning from the role of child to parenting one's own aging parents can be done too abruptly and completely. Some researchers also caution observers from concluding that the offspring of older persons are usually the “givers” and older persons are usually the "takers." This point is made quite clear in the attached, titled " Intergenerational Equity or the New Ageism? Actions ". In the article, the Commonwealth Fund reported in its study that older persons are four times more likely to provide assistance to their children than vice versa. And Thou Shalt Honor Now watch the film, "And Thou Shalt Honor." Again, use the  form Actions  provided to record the important points in the film for your own use. · Click here to open the video "And Thou Shalt Honor" Actions Another area that is replete with misconceptions is related to older adults and their grandchildren. Before we go on to discuss grandparenting in the next section, take a few minutes to complete the Older Adults and Grandchildren discussion.   Week 5: Lecture Grandparenting Below are important data from one of the most widely reported studies on grandparenting and aging (Neugarten and Weinstein, 1968). Five types of grandparenting are reported in the study: 1. Formal:  Grandparents of this style usually enjoy getting together with their grandchildren on holidays and other special occasions.  They are careful not to encroach on parenting which they leave to the parents. 2. Fun Seeker:  A key characteristic of this style is mutuality.  The grandparents actually enjoy very much doing activities with their grandchildren and often are younger grandparents. 3. Surrogate Parent:  These grandparents, usually females, actually take over the parenting role much of the time for their grandchildren. 4. Reservoir-of-family-wisdom:  Often the grandfather, these grandparents pride themselves in being a resource to their grandchildren, passing on both family and educational  information. 5. Distant-figure:  These grandparents are very atypical of the stereotype that most people have of grandparenting:  They don't particularly value their time with their grandchildren.   The study probably helps us to counter the tendency to stereotype the role of grandparent. There are many different approaches to implementing the grandparenting role, and there also are many different sources of significance for being a grandparent. See some of the original data from the Neugarten and Weinstein study below. Study on Grandparenting and Aging Grandmothers (N = 70) Grandfathers (N=70) Significance of Grandparenting Role     Biological Renewal 42% 23% Emotional Self-Fulfillment 19% 27% Resource Person to Child 4% 11% Vicarious Achievement 4% 4% Remote 27% 29% Insufficient Data 4% 6% Style of Grandparenting     Formal 31% 33% Fun-Seeking 29% 24% Parent Surrogate 14% 0% Reservoir of Family Wisdom 1% 6% Distant Figure 19% 29% Insufficient Data 6% 8% Ease of Role Performance     Comfortable / Pleasant 59% 61% Difficult / Discomfort 36% 29% Insufficient Data 5% 10% Source: Neugarten and Weinstein, 1968 One of the major changes between the original Neugarten and Weinstein study and the more recent Health and Retirement Study is the percent of grandparents who are implementing the “parent surrogate” role. The Health and Retirement Study reports that more than 40 percent of the grandmothers in their 50’s and early 60’s are devoting 15 or more hours per week caring for their grandchildren. Even if this number of hours may not technically qualify as a “surrogate parent,” it does seem very substantial. Week 5: Lecture Long Term Care In the previous textbook for this class, Diana Harris (The Sociology of Aging, 2007) defines long-term care as follows: “Long-term care refers to an array of health-care, personal care, and social services provided over a sustained period of time to persons with chronic conditions and functional limitations.” Harris adds that there are three major providers of long-term care: assisted living facilities, home health care, and nursing homes. Harris compares and contrasts the advantages and disadvantages of the various forms of long-term care. Note that the bulk of community-based long-term care is provided by families or friends. We have already observed that is the preference of older persons. Even when health care is needed, older persons would prefer to receive it in their own homes. However, many older persons will reach a time when chronic conditions and functional limitations are so extensive that assisted living or nursing home care may be the most appropriate setting for care. Three laws have done much to shape long-term care in the U.S. 1. The Social Security Act of 1935 helped provide the income for older persons to pay for private long-term care. 2. OBRA 87 helped to reform nursing homes by establishing provisions aimed at improving their quality of care standards. 3. Medicare / Medicaid laws of 1965 helped fund nursing home care. It is very important to remember that Medicare provides very limited funding for nursing home care following hospitalization; Medicaid is a major source of funding for nursing home care, but it is means-tested and kicks in only after depleting most of one’s assets and having very limited income. You'll learn more about the major government programs and provisions in a later class. Harris emphasizes that although nursing homes are often viewed very negatively, they may be very positive and the best setting for some older persons. For example, on the negative side, Dr. Robert Butler and others have observed that many older persons view nursing homes as a place where one goes to die. However, Harris’ example in Chapter 13 of an older couple who fared well in a nursing home and a number of examples from the videos shown in class (e.g. Eden Alternative) help show the positive side of nursing homes. On a more personal note, your instructor heaps much praise on those who work in nursing homes. He too has heard the common complaint of nursing home staff mentioned by Harris: “overworked, underpaid, and under-appreciated.” Many of the staff in nursing homes are doing what so many of us are unwilling or unable to do and are paid very little in return. The ones who are dedicated and who provide quality care are clearly heroes to me. Keep these issues in mind when we discuss careers in aging later in the course. Week 5: Activities Readings · Aging and the Life Course:  Chapters 8, 12, and 15 · Handouts · Intergenerational Equity or the New Ageism? Actions · Video Viewing Form Actions Discussions During this week, you should participate in the following discussions: · Older Adults and Grandchildren · Minority Reports · Annual Editions Presentations To receive participation points, you must post at least one substantive comment or reply for each discussion question in the week it's assigned. Substantive comments do not include simple statements of agreement or disagreement. Support your statements with references to class materials. Comments must be in complete sentences with correct grammar and spelling. Just as you would in person, participating in online discussion requires you to read and respond to your classmates' comments. Assignments Assignments are due at the end of week 5: · Retirement Plan · When I Grow Old Survey Week 7: Overview Introduction This week you will learn about political, educational, and religious aspects of aging. You'll learn about elderly involvement in the political system. We'll cover the educational needs of older adults, and the programs and services that fulfill those needs. We'll also discuss the religious beliefs and involvement of the elderly. You'll have access to some great resources that outline program benefits and eligibility requirements. Review all of the information from this class before taking the second exam. Learning Outcomes · Recall the goals and resources provided by the organizations discussed: AARP, Silver Haired Legislation, Elderhostel · Describe voting trends for elderly, addressing both cross-sectional and longitudinal data · Describe education participation rates among elderly in relation to personal and practical barriers · Relate trends in religious participation among the elderly to historical trends among all groups and the study conducted by your professor · Describe the difference between legislation and implementation in elder care in the U.S. · In regard to major U.S. federal programs to assist the elderly mentioned in the lecture, recall sources of administration and funding, services provided, and the target population · Week 7: Lecture · Political Aspects of Aging · Comprising approximately 14 percent of the total U.S. population, older persons could be a major factor in determining the outcomes of local, state, and national elections.  However, gerontologists for nearly a half century have reported the same observation:  Rarely do older persons vote as a bloc in any election.  Older adults tend to maintain their party affiliation, whether Republican or Democrat.  The political clout of older persons tends to manifest itself in ways other than regular elections, including participation in national organizations like the American Association of Retired Persons (AARP) and involvement in state lobbying and legislative efforts. · AARP is comprised of more than 40 million members aged 50 (yes 50!!) and over.  The organization regularly supports and /or conducts research aimed at improving the lives of individuals roughly 50 and over.  Publications that are free or very low cost are made available; services (e.g., various forms of insurance) are offered; and policy positions related to older adulthood are advocated regarding issues and legislation affecting that age group.  AARP also has state affiliates who are kept abreast of national AARP advocacy.  I urge you to visit the AARP website (Links to an external site.)  and learn more about the extensive offerings of this organization.  It is likely that several gerontology courses could be taught beneficially just relying on AARP resources alone! · Another example of older adult participation in the political process relates to a program that began in Missouri in 1972 (see the Silver Haired Legislature handout · Actions · ).  Missouri started a Silver Haired Legislature in 1972 to provide an opportunity for older persons to actively advocate for legislation primarily for older adults in that state.  Older adult delegates are elected through area agencies on aging (agencies that will be addressed in Class Eight of this course).  The delegates are expected to become familiar with some of the major interests of their constituents and then to convene each year in the state capitol to actually develop mock legislation.  At the end of the legislative session, delegates prioritize five bills that they would like to see enacted into law.  As you can see in the attachment, many of the bills prioritized by the Silver Haired Legislature have been made into laws in Missouri. · The discussion above is significant in part because most states reportedly have developed their own versions of a silver-haired legislature.  This has resulted in older persons exercising an active and direct role in the political process. · In the 2008 presidential and congressional campaigns the state of the U.S. economy and concerns related to the wars in both Iraq and Afghanistan likely resulted in older adult issues being pushed far into the background of political priorities.  And, major funding challenges remain in regard to Social Security, Medicare, Medicaid, and other programs that greatly impact the older adult population. Week 7: Lecture Education and Aging Few gerontologists have found ways to attract older persons to participate in regular educational offerings.  In 1974, a study supported by the National Council on Aging reported that only 2 percent of the U.S. population 65 and over were participating in organized and systematic educational programs at that time.  By 1981 the participation level had grown to 5 percent, but the comparison is fallacious because the questions about participation had changed (from “current participation” to “participation during the past year”).  “Lack of interest” was the major reason for not participating, but it was followed by the rationale of “…I’m too old…” to participate.  Even in the presence of very low cost and free educational programs for older persons at many different venues (churches, adult educational programs, colleges and universities, senior centers, hospitals, etc.), a relatively small percentage of older eligibles participate. As early as 1971, Howard McClusky asserted at the White House Conference on Aging that older persons needed not only practical information (e.g., Social Security and Medicare benefits, how to access programs and services, financial guidance, healthcare updates, etc.) but also education aimed at personal growth and development.  Harris (Sociology of Aging, 2007) describes the five categories of McClusky’s hierarchical needs theory and their meanings: 1. Coping Needs 2. Expressive Needs 3. Contributive Needs 4. Influence Needs 5. The Need for Transcendence Harris provides a rationale regarding the importance of lifelong learning.  Clearly, each stage of life confronts individuals with new challenges related to adjustment to that stage and to living a rich and full life in general.  Much more could be done to attract older persons to potentially beneficial programs aimed at problem-solving, adult development, and life enrichment.  One of the most successful educational programs for people 55 and over, from the standpoint of percentage increase in participation in recent years, is the Road Scholar program (formerly Elderhostel program).  Started in 1975 as the Elderhostel program, the program has  provided educational offerings in more than 90 countries.  Go to the  Elderhostel web site (Links to an external site.)  and review the nuts and bolts of this approach to educating older persons.  If you have any interest in this topic, I urge you to get on the Road Scholar mailing list to review the extensive sessions available each quarter of the year. View the video below on services that were provided by Elderhostel.  Many of these same programs are provided by Road Scholar.  Is there a difference between the way one should attempt to educate adults as opposed to teaching youth?  Malcolm Knowles, a prolific writer on adult education, points out some major differences.  Keep in mind his emphasis is on adults, not necessarily older adults. Knowles differentiates pedagogy (methodology for teaching children) from andragogy (methodology for teaching adult learners).  He says there are three major differences.  1. Adults have a “crystallized self-concept,” which indicates that less “discovery of self” focus is needed.  2. Adults tend to be more “problem-centered,” as opposed to “subject-centered”; practical information tends to be more valued.  3. Adult learners have “broad experiences” from which they can draw to enrich a learning situation.  I urge you to at least reflect on Knowles observations as you present information to your peers in this class.  Especially emphasizing practical information and sharing your rich experiences with one another are important. Again, it should be emphasized that older persons have abundant opportunities for free or very low cost education.  One very significant example that underscores this point is the opportunities available in Missouri.  The Missouri legislature enacted a “Senior Citizens’ Tuition Exemption” law that permits a resident of that state who is at least sixty-five years of age or older to be awarded a scholarship to most public post-secondary educational institutions in Missouri.  Individuals age 65 and older may attend classes free on a space available, non-credit basis.  See the handout titled “ Senior Citizens’ Tuition Exemption Actions ." Week 7: Lecture Religion and Aging Harris (Sociology of Aging, 2007) quotes sociologist Johnstone’s (1988) definition of religion as “a system of beliefs and practices by which a group of people interprets and responds to what they feel is sacred and usually supernatural as well…” Harris adds that “… studying and measuring religiosity – interest and involvement in religious activities – are difficult to do scientifically.” Also, the ideological and ritualistic dimensions of religion may not be closely related, as Harris notes. You may recall the item on religiosity on the “Facts on Aging Quiz” that you took as a part of Session One. Gerontologists regularly have refuted the commonsense notion that people become more religious as they age. Review the tables below and the accompanying narrative on religious trends and aging in your text. You likely would draw the same conclusion. Do you see how research methodology might be a major factor contributing to the belief in one’s becoming more religious as s/he ages? According to the research reported in these tables, a higher percentage of older persons compared to adults under age 65 report a belief in God and more frequent church attendance. However, these data are primarily from cross-sectional data; older persons today grew up in a period when organized religion was more highly emphasized; often, they have been more religious throughout their lives. (Both tables from: Harris, Diana K., The Sociology of Aging (Third Edition).  Lanham, Maryland:  Rowman and Littlefield, 2007. Tables 11.3 and 11.4)  Notice the section on “Religion and Personal Well Being” in your text (p. 54).  A consistent finding in the literature on aging is that religiosity tends to contribute to a sense of well-being. Your instructor did a study on group counseling and aging as a part of his doctoral thesis. One of the six counseling groups in the study were retired Catholic sisters at St. Mary of the Woods College in Terre Haute, Indiana. Interestingly, the sisters had higher mean scores on life satisfaction and adjustment scales than any of the other five groups who participated. Belief in God, 1998 Ages Believe and have no doubts Believe but have doubts 18 - 24 54% 17% 45 - 54 62% 1% 65 and older 71% 9% Source: National Opinion Research Center (1998) Attendance at Religious Services, 1998 Ages At least weekly At least monthly Less than once a year or never 18 - 24 16% 19% 39% 45 - 54 35% 16% 28% 65 and older 50% 13% 25% Source: National Opinion Research Center (1998) (Both tables from: Harris, Diana K., The Sociology of Aging (Third Edition). Lanham, Maryland: Rowman and Littlefield, 2007. Tables 11.3 and 11.4) A consistent finding in the literature on aging is that religiosity TENDS to contribute to a sense of well-being.   Week 7: Lecture Social Policy According to Wikipedia, The Malcolm Wiener Center for Social Policy at Harvard University describes social policy as “public policy and practice” in the areas of health care, human services, criminal justice, inequality, education, and labor.  If one accepts Wikipedia’s definition of “policy” as a “deliberate plan of action to guide decisions and achieve rational outcome(s),” one might conclude social policy as it relates to aging is murky at best.  If one focuses on federal laws (e.g., Social Security Act, Medicare, and Medicaid) and the stated objectives of the Older Americans Act, one likely would conclude that older adults are a top priority of the U.S. government and the people of this country.  If one focuses on the implementation of programs, including funding levels, one may question whether older persons are a priority.  Nonetheless, older persons in the U.S. have made significant progress in their health and welfare since 1935. Week 7: Lecture Programs and Services The twentieth century in the United States might someday be viewed as a golden age of aging in this country.  Supportive legislation for older persons, especially at the federal level, and expanded services characterized the last two-thirds of the century.  Virtually everyone would agree that the passage of the Social Security Act of 1935 was the most important legislation in U.S. history towards the improvement of older adult lives.  In Class Six, we noted the significance of Social Security in providing the major source of income for older persons. The Great Society programs of the 1960’s also greatly benefited older persons in this country.  Three laws in particular helped older persons:  1. Medicare 2. Medicaid 3. The Older Americans Act.  Medicare has provided basic health care coverage for most people aged 65 and over.  Review the material on Medicare in your text, as well as the section on healthcare in the Profiles of the Administration on Aging (AOA). It is Medicaid, rather than Medicare, that is a primary funding source for nursing home care.  However, Medicaid is a “mean-tested” program, meaning that eligibility is determined by some combination of income and/or assets.  To qualify for Medicaid funded nursing home care, older persons must “spend down” most of their assets and have a limited income.  Learning the basic Medicaid provisions in your state can enhance your value as a resource working in the field of aging. A third major program for older persons that was launched in the 1960’s stemmed from the Older Americans Act (OAA) of 1965.  The significance of that law does not relate so much to its funding level but rather to its mission.  The major charge of the OAA is to develop a system of coordinated services for older adults at the federal, state, and local levels.  At the federal level the Administration on Aging (AOA) oversees the OAA program.  To obtain OAA funding, each state is required to develop a plan under AOA guidelines to utilize the funds.  In each state further subdivisions, called Area Agencies on Aging, devise plans to use OAA funds. The diagram below, titled "The Formal Aging Network," depicts the organization of the OAA. Area Agencies on Aging were created for the purpose of coordinating aging services in their geographical region and providing information on older persons. The Area Agencies on Aging sometimes provide direct services to older persons but more often develop contracts with various local providers of services such as meals, transportation, and social programs.  The single most important item of information that I would like for you to remember from this course is this: The information and referral component of Area Agencies on Aging may be the most important resource available to you. There are more than 600 such agencies in the country that service almost every geographical area in the U.S. See the " Active Aging Resource Guide Actions " published by the Mid-East Area Agency on Aging for examples of services provided. Go to the  United States Code, Title 42, Chapter 35 (Links to an external site.)  (The Public Health and Welfare: Programs for Older Americans) for more information on federal provisions for the elderly. Another important program for the poor elderly is the Supplemental Security Income (SSI) program.  The program is means tested and targets the blind, disabled, and/or aged.  See the attachment titled “ Social Security, Supplemental Security Income, and Medicare Actions ," which was prepared in 2007 by Bill Hunot, a former Public Affairs Specialist for the Social Security Administration. Week 7: Lecture Program Provisions The following are basic provisions of the Social Security, SSI, Medicare, and Medicaid programs that you are responsible for remembering: Social Security: · Administered at the federal level by the Social Security Administration · Funded primarily by OADSI payroll taxes · Targeted primarily to retired individuals with at least 40 quarters of relevant work and who are at least 62 years old (Note: After "regular" or "full" retirement age between ages 65-67, one no longer has to be retired to receive benefits.) Supplemental Security Income · Administered by the Social Security Administration · Funded primarily by general revenue (taxes) · Targeted (eligibles) to the aged, blind, and/or disabled who meet income and asset guidelines (means-tested) Medicare · Administered at the federal level by the Centers for Medicare and Medicaid Services; administered at the local level by contractors · Part A funded by payroll taxes, general revenue, and other sources Part B funded by monthly premiums and other sources Other parts funded by a combination of premiums, co-pays, and general revenues. · Targeted (eligibles) primarily to individuals 65 and over plus qualified disabled of any age Medicaid · Administered at the federal level by the Centers for Medicare and Medicaid Services; funded at the state level by state designated agency · Funded by federal general revenue funds matched by state funds · Targeted (eligibles) to the poor of all ages who meet income and asset guidelines The programs reviewed above are fundamental to the health and welfare of the majority of older persons. Becoming familiar with the basics of the programs likely will enable you better to advocate for and/or provide assistance to older persons. Previous Next 2009 SILVER HAIRED LEGISLATURE PRIORITIES � SUPPORT OF THE AREA AGENCIES ON AGING AS MISSOURI’S COMPREHENSIVE ENTRY POINT FOR LONG TERM CARE SERVICES FOR SENIORS � SUPPORT INCREASED FUNDING FOR HOME DELIVERED AND CONGREGATE MEALS � SUPPORT STRENGTHENING REGULATIONS OF PAY DAY LOANS � SUPPORT INCREASING PERSONAL NEEDS ALLOWANCE FOR MEDICAID RESIDENTS IN LTC FACILITIES � SUPPORT RAISING ASSET LEVELS FOR MEDICAID ELIGIBILITY SILVER HAIRED LEGISLATURE BOARD PRESIDENT- JO WALKER (Speaker Pro Tem of the House) 607 N. Pine St., Marshfield 65706 (417) 859-4496 [email protected] 1st VICE PRESIDENT – BRUCE YAMPOLSKY (President Pro Tem of the Senate) 4522 Maryland Ave., St. Louis 63108 (314) 454-1863 [email protected] 2nd VICE PRESIDENT - VESTA GRINDSTAFF (Speaker of the House) 2824 W. 23rd, Joplin 64804 (417) 623-0817 SECRETARY – PEGGY WILSON (STL Chair) 5547 Waterman Rd., 2E, St. Louis 63112 (314) 367-0576 [email protected] TREASURER – WRIGHT BOGART (Senate Majority Leader) PO Box 61, Mansfield 65704 (417) 924-8369 [email protected] Bill Trimm, (Senate Minority Leader) 1101 Jobe Dr., Jefferson City 65101 (573) 634-2781 Mary Ellen Greer, (House Majority Leader) 2901 Massachusetts, Joplin 64804 (417) 623-3844 [email protected] Jim Crenshaw, (House Minority Leader) PO Box 4, Lathrop 64465 (816) 616-7484 [email protected] Dale Johnson, (SW) PO Box 363, Alton 65606 (417) 778-6589 [email protected] Loretta Schneider, (SE) 3215 Lakewood Dr., Cape Girardeau 63701 (573) 335-3546 [email protected] Nancy Maxwell, (Care Connection for Aging Services) 1240 NW 450 Rd., Holden 64040 (816) 732-6706 [email protected] Dale Faulkner, (NW) 19049 State Hwy O, Tarkio 64491 (660) 736-5398 [email protected] Lillian Metzger, (NE) 30 Heritage Lane, Troy 63379 (636) 462-4214 [email protected] Pat Donehue, (CM) 4701 Woods Crossing, Jefferson City, 65109 (573) 893-3428 [email protected] G.L. Mendenhall, (MARC) 1379 White Oak, Harrisonville 64701(816) 318-1506 [email protected] Jack Anderson, (ME) 1418 Ticonderoga Dr., St. Peters 63376 (636) 441-5614 [email protected] Karen Fritchey, (Region X) 3621 Norman Dr, Joplin 64804 (417) 781-7562 [email protected] 10/2008 2009 SILVER HAIRED LEGISLATURE PRIORITIES, ISSUES AND OFFICERS The Silver Haired Legislature is supported by the Missouri Department of Health and Senior Services and Area Agencies on Aging Email: [email protected] http://www.dhss.mo.gov/SilverHaired WHAT IS THE SILVER SHL WILL ALSO SUPPORT LEGISLATIVE ACTION FOR THE FOLLOWING ISSUES: Pre-Need Funeral Contract Regulations Tax Credits for Senior Center Donations Increased AAA Network Funding Heightened Background Check Requirements for Anyone Working with Seniors Senior Center Kitchen Equipment Funds A “Silver Alert” for the Elderly and Disabled The Missouri Elder Justice Act Consumer Protection and Identity Theft Laws Safe Driver Insurance Discounts STATE COORDINATORS Diane Wehrle: 573/526-0713 [email protected] AAA COORDINATORS SOUTHWEST Starr Kohler SOUTHEAST Ruth Dockins CARE CONNECTION Diana Hoemann NORTHWEST Bonnie Stigall NORTHEAST Pam Windtberg CENTRAL MO Kate King MARC Jacqui Moore MID-EAST Becky Marvin REGION X Helen Hahn ST. LOUIS Anneliese Stoever THE MISSOURI SILVER HAIRED LEGISLATURE HISTORY/FACTS The Missouri Silver Haired Legislature was the FIRST to be organized in the United States after Congress amended the Older Americans Act to include advocacy groups. The Silver Haired Legislature, or SHL as it is often called, is a formally elected body of citizens, age 60 or older that promote conscientious leg- islative advocacy for Missouri's older adults. The delegates are elected from each of the 10 Area Agencies on Ag- ing (AAAs). Each AAA delegation con- sists of 3 senators and 12 representa- tives for a total of 150 legislators. These elected legislators volunteer their time and serve without pay. Pro- posals are then drawn up and pre- pared following Regional meetings for presentation at the statewide session in October. The entire elected group of delegates meets for three days and conducts a model legislative session at the Capitol. At that time, SHL legis- lators present, debate and vote upon the proposals. Five priorities are chosen from the list of proposals. The members return to their districts and talk with their state legislators about their issues. They encourage support and sponsorship of these issues. Silver Haired Legislators continue to advocate by testifying and speaking to groups, regarding is- sues related to Missouri's seniors. PROPOSALS PASSED INTO LAW Over the years, SHL has grown in visibility and esteem. Through their advocacy efforts, many proposals supported by SHL are now state statute, such as: � Durable Power of Attorney � Financial Exploitation of the Elderly � Deletion of Sales Tax on Pharmaceuticals � Protection of the Elderly � Elder Abuse Laws � Reduced Sales Tax on Groceries � CLAIM Funding � Circuit Breaker Law � Creation of the Homestead Preservation Act � Pharmaceutical Tax Credits � Creation of the Missouri Senior Rx Program � Senior Tax Justice Act << /ASCII85EncodePages false /AllowTransparency false /AutoPositionEPSFiles true /AutoRotatePages /None /Binding /Left /CalGrayProfile (Dot Gain 20%) /CalRGBProfile (sRGB IEC61966-2.1) /CalCMYKProfile (U.S. Web Coated \050SWOP\051 v2) /sRGBProfile (sRGB IEC61966-2.1) /CannotEmbedFontPolicy /Warning /CompatibilityLevel 1.4 /CompressObjects /Off /CompressPages true /ConvertImagesToIndexed true /PassThroughJPEGImages true /CreateJobTicket false /DefaultRenderingIntent /Default /DetectBlends true /DetectCurves 0.0000 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Created PDF documents can be opened with Acrobat and Adobe Reader 5.0 and later.) >> /Namespace [ (Adobe) (Common) (1.0) ] /OtherNamespaces [ << /AsReaderSpreads false /CropImagesToFrames true /ErrorControl /WarnAndContinue /FlattenerIgnoreSpreadOverrides false /IncludeGuidesGrids false /IncludeNonPrinting false /IncludeSlug false /Namespace [ (Adobe) (InDesign) (4.0) ] /OmitPlacedBitmaps false /OmitPlacedEPS false /OmitPlacedPDF false /SimulateOverprint /Legacy >> << /AddBleedMarks false /AddColorBars false /AddCropMarks false /AddPageInfo false /AddRegMarks false /ConvertColors /ConvertToCMYK /DestinationProfileName () /DestinationProfileSelector /DocumentCMYK /Downsample16BitImages true /FlattenerPreset << /PresetSelector /MediumResolution >> /FormElements false /GenerateStructure false /IncludeBookmarks false /IncludeHyperlinks false /IncludeInteractive false /IncludeLayers false /IncludeProfiles false /MultimediaHandling /UseObjectSettings /Namespace [ (Adobe) (CreativeSuite) (2.0) ] /PDFXOutputIntentProfileSelector /DocumentCMYK /PreserveEditing true /UntaggedCMYKHandling /LeaveUntagged /UntaggedRGBHandling /UseDocumentProfile /UseDocumentBleed false >> ] >> setdistillerparams << /HWResolution [2400 2400] /PageSize [2448.000 1152.000] >> setpagedevice Social Security Social Insurance: no income/asset limits (49 million beneficiaries) Supplemental Security Income Public Assistance: income/asset limits (73 million recipients) Medicare Social Insurance: no income/asset limits (42 million patients) Financing: payroll tax, income tax on Social Security benefits, and interest earned by Social Security’s trust funds. Financing: general revenues of federal government. Financing: payroll tax, income tax on Social Security benefits, interest earned by Medicare’s trust funds, and general revenues of federal government. Retirement Insurance (34 million beneficiaries) retired workers 62 or older (31 million) plus benefits for family members: spouses & ex-spouses (2.5 mm) • Spouses 62+, or child-in-care • ex-spouses 62+ children (1.7 million) • < age 18 or • 18-19 in high school or • Adult, disabled since childhood Three Requirements 1. Aged, blind, or disabled 2. U.S. citizen & U.S. resident 3. Must not exceed income and asset limits Part A Hospital Insurance • Inpatient hospital care • Skilled nursing benefit • Skilled care for home-bound • Hospice Part B Medical Insurance • Doctor bills • Out-patient hospital • Durable medical equipment • Medical supplies Part C Medicare Advantage • HMOs, PPOs, PFFs, MSAs Part D Medicare Rx • Prescription drug coverage Medicare does not cover long-term care. Aged 65+ (2 million) Blind (120,000) Disabled (5.3 million) Adults age 18+ (4.2 million) Children < age 18 (1.1 million) Disability Insurance (8.6 million) disabled workers (6.8 million) plus benefits for family members: spouses & exes (153,000) • Spouses 62+ or child-in-care • Ex-spouses 62+ children (1.7 million) • < age 18 or • 18-19 in high school or • Adult, disabled since childhood Important Notes About SSI • Spouses are considered dependent on each other. • Children (< 18 years) are considered dependent on their parents. • A few states supplement federal SSI payments. • About 2.6 million Americans receive both SSI and Social Security. Qualifying for Medicare • Age 65+ (35 million) • Kidney disease (86,000) • Social Security disability for two years (6.7 million) • Social Security disability due to ALS Survivor Insurance (6.6 million) spouses & ex-spouses (4.7 million) • Age 60+ (4.3 million) or • Child-in-care (171,000) or • Disabled at age 50+ (214,000) children (1.9 million) • < age 18 or • 18-19 in high school or (65,000) • Adult, disabled since childhood (500,000) parents 62+ (1889) Medicare Supplements • Medicaid or QMB • Medicare Advantage • Insurance from former employer • TRICARE-for-Life • Medigap insurance (A-L) Medicare is not Medicaid *Figures are from 2008-2009. 1 GERN 5000: Gerontology Exam 2 Short Essay Exam, Part A Answer six of the nine questions below. Answer each question as directly and completely as you can. (10 points each) 1. In what ways does social class membership affect life chances and adjustment in later life? List and describe four areas (listed and described in handout) of later life affected by social class membership. Compare and contrast class membership as it relates to the areas cited. 2. Describe at least three major discriminatory practices against a minority group (described text) and state how these practices impact upon older persons of that minority group. Comment on some steps that you believe could be taken to improve the situation. 3. Discuss grandparenting and aging. Describe at least three grandparenting styles identified by Neugarten and Weinstein. What are at least two sources of significance of grandparenting? 4. Discuss education and aging. Include at least two principles of andragogy. Comment on the level of older adult participation in educational programs. What are appropriate settings and content for such programs? 5. Are the aged a “favored constituency”? Present a pro and con position answering the question. What is your position? How does “intergenerational equity” relate to the question? 6. Compare and contrast Medicare and Medicaid. Address different eligibility requirements, funding sources, overseers, and other aspects of the two programs that you view as significant. 7. Compare and contrast Social Security and Supplemental Security Income (SSI). Address different eligibility requirements, funding sources, overseers, and other aspects of the two programs that you view as significant. 8. List and describe at least three major practical benefits that you have gotten from this class so far. You may focus on changes in attitude, information learned, ideas that might be incorporated into your career, or anything else meaningful to you. 9. List and describe at least four major points from videos viewed in class since the first exam. 2 Short Essay Exam, Part B Answer two of the three questions below. Answer each question as directly and completely as you can. (10 points each). 1. Drawing from any information or other learning experience since the first examination, describe and explain in what ways you are now more likely to be more effective in your career in relating to and/or serving the older adult population. 2. In your family relationships and/or other personal relationships involving older persons, in what specific ways can you use what you have learned to reinforce or improve conditions for those older persons? 3. Describe and explain suggestions for improving each of the following: a. Social Security b. Medicare c. Government caregiving policies regarding older persons
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Develop a community-wide intervention to reduce elevated blood pressure and hypertension in the State of Alabama that in in body of the report Conclusions References (8 References Minimum) *** Words count = 2000 words. *** In-Text Citations and References using Harvard style. *** In Task section I’ve chose (Economic issues in overseas contracting)" Electromagnetism w or quality improvement; it was just all part of good nursing care.  The goal for quality improvement is to monitor patient outcomes using statistics for comparison to standards of care for different diseases e a 1 to 2 slide Microsoft PowerPoint presentation on the different models of case management.  Include speaker notes... .....Describe three different models of case management. visual representations of information. They can include numbers SSAY ame workbook for all 3 milestones. You do not need to download a new copy for Milestones 2 or 3. When you submit Milestone 3 pages): Provide a description of an existing intervention in Canada making the appropriate buying decisions in an ethical and professional manner. Topic: Purchasing and Technology You read about blockchain ledger technology. Now do some additional research out on the Internet and share your URL with the rest of the class be aware of which features their competitors are opting to include so the product development teams can design similar or enhanced features to attract more of the market. The more unique low (The Top Health Industry Trends to Watch in 2015) to assist you with this discussion.         https://youtu.be/fRym_jyuBc0 Next year the $2.8 trillion U.S. healthcare industry will   finally begin to look and feel more like the rest of the business wo evidence-based primary care curriculum. Throughout your nurse practitioner program Vignette Understanding Gender Fluidity Providing Inclusive Quality Care Affirming Clinical Encounters Conclusion References Nurse Practitioner Knowledge Mechanics and word limit is unit as a guide only. The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su Trigonometry Article writing Other 5. June 29 After the components sending to the manufacturing house 1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard.  While developing a relationship with client it is important to clarify that if danger or Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business No matter which type of health care organization With a direct sale During the pandemic Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record 3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015).  Making sure we do not disclose information without consent ev 4. Identify two examples of real world problems that you have observed in your personal Summary & Evaluation: Reference & 188. Academic Search Ultimate Ethics We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities *DDB is used for the first three years For example The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case 4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972) With covid coming into place In my opinion with Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be · By Day 1 of this week While you must form your answers to the questions below from our assigned reading material CliftonLarsonAllen LLP (2013) 5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda Urien The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle From a similar but larger point of view 4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open When seeking to identify a patient’s health condition After viewing the you tube videos on prayer Your paper must be at least two pages in length (not counting the title and reference pages) The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough Data collection Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an I would start off with Linda on repeating her options for the child and going over what she is feeling with each option.  I would want to find out what she is afraid of.  I would avoid asking her any “why” questions because I want her to be in the here an Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych Identify the type of research used in a chosen study Compose a 1 Optics effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. Clients often implement recommended inte I think knowing more about you will allow you to be able to choose the right resources Be 4 pages in length soft MB-920 dumps review and documentation and high-quality listing pdf MB-920 braindumps also recommended and approved by Microsoft experts. The practical test g One thing you will need to do in college is learn how to find and use references. References support your ideas. College-level work must be supported by research. You are expected to do that for this paper. You will research Elaborate on any potential confounds or ethical concerns while participating in the psychological study 20.0\% Elaboration on any potential confounds or ethical concerns while participating in the psychological study is missing. Elaboration on any potenti 3 The first thing I would do in the family’s first session is develop a genogram of the family to get an idea of all the individuals who play a major role in Linda’s life. After establishing where each member is in relation to the family A Health in All Policies approach Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum Chen Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change Read Reflections on Cultural Humility Read A Basic Guide to ABCD Community Organizing Use the bolded black section and sub-section titles below to organize your paper. For each section Losinski forwarded the article on a priority basis to Mary Scott Losinksi wanted details on use of the ED at CGH. He asked the administrative resident