Old and Homeless in Australia: It Can Happen to Anyone

In Australia, on any given night, 1 in 200 people are homeless.” One fifth of all people who are older than 55 years of age are homeless; many more live in unsecured housing.

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What is homelessness and what may cause someone to become homeless? A person is considered homeless when he or she does not have a conventional home and lives on the streets or in a park. Someone may be at risk of homelessness when living in unsecured housing. There are certain reasons that can cause homelessness which may include lack of social bonding and support from family or friends. What if you are in a crisis and cannot receive help from the closest people in your life—your family and friends? What would you do? You may think it can never happen to you but that may not be the case. Homelessness can happen to anybody. Young, old, women, and men.

Today, Australia and most other developed nations face more issues with divorces, family breakdown, and higher rent for affordable housing. Due to the growing aging population, homelessness will become a rising issue because of the lack of money to build affordable housing or lack of space for seniors in existing homeless shelters.

ABC Australia reports that Australian older women outnumber the men in homeless shelters. In fact, 9% of single women over the age of 45 are in crisis accommodation and that number will continue to rise. The woman being interviewed by ABC makes it clear that it can happen to anybody. She notes that “there is a fine line between having a roof over your head and having nothing.” Imagine if you, from one day to another, lost everything and couldn’t turn to anyone.

The report “Homelessness and older Australians: Scoping the Issues” reports that there are systems in place in Australia that give the homeless population access to certain services. However, the homeless believe that their complex needs are not addressed. In addition, they have difficulties to access those services and obtain the needed information because the service system in itself is too complex. There needs to be an increased collaboration and integration of existing service departments.

Australia must think of sustainable ideas and strategies to increase and invest in the affordable housing stock. The government, non-governmental organizations and service providers also need to step up and create strategies to reduce the bureaucracy and make easier access to the services the homeless population needs easier.

Martina Lesperance
is a Health Educator and Screening Technician in El Paso, Texas.

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Alzheimer’s and Parkinson’s: A Great Threat to the U.S. National Budget

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Since the last Presidential Election, the national budget has been a sore spot for Republicans and Democrats, the two major political parties in the U.S. While government programs such as the Affordable Care Act (ACA) are leading debates on reducing the national budget, politicians are oblivious of a looming threat to the budget. People with Alzheimer’s and Parkinson’s diseases require constant and very expensive care. Also, these debilitating illnesses can prevent affected persons from working, which may have a devastating long-term impact on the budget.

Alzheimer’s disease (AD) is the sixth leading cause of death in the U.S. and an estimated 5.4 million Americans currently suffer from AD. If current population trends continue, the number of people with Alzheimer’s disease will increase significantly unless the disease can be effectively treated or prevented. The U.S. population is aging and the risk of Alzheimer’s increases with age. For instance, Alzheimer’s usually begins after age 60 and the number of people with the disease doubles for every five-year interval beyond age 65. About five percent of men and women ages 65 to 74 have Alzheimer’s disease and it is estimated that nearly half of those age 85 and older may have the disease. Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease and affects one million people in the United States. Symptoms of PD include muscle rigidity, tremors, and changes in speech and gait that worsen as the illness progresses over time. PD is more common in the elderly and most often develops after age 50. Sometimes, Parkinson’s disease occurs in younger adults. When a young person is affected with PD, it is usually because of a form of the disease that runs in families.

With strong research investment, heart disease deaths in the U.S. fell by 13 percent in the past decade. Alzheimer’s deaths rose by 68 percent from 2000 to 2010 and continue to increase. The issue is not how, but why we cannot increase our investment in research into fighting these diseases that have a tremendous impact on both the individual and society. Alzheimer’s and Parkinson’s get comparatively less funding than other top diseases because they are more common in the elderly and largely ignored. Stigma is another reason why it is hard to raise money since people with Alzheimer’s and Parkinson’s rarely talk about the disease. Also, Alzheimer’s is different from other diseases because Alzheimer’s patients rarely lead marches to fight for more funding since their memory is impacted. It is important to our nation’s economic future to reduce the deficit, but we cannot ignore the importance of investing in Alzheimer’s and Parkinson’s research. As the nation’s older populations grow, the cost of care for these diseases will rise dramatically. In fact, Alzheimer’s is expected to cost the U.S. more than $1 trillion annually and persons who leave the workforce to care for an affected family member impact economic productivity. Increasing funding for Alzheimer’s and Parkinson’s will require difficult choices and shared sacrifice in spending reductions and increased revenues.

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As the U.S. Congress continues to agree or disagree on the best way to fix Medicare, a government health program, the national budget will likely increase if there is no dramatic increased investment in research into fighting Alzheimer’s and Parkinson’s disease. The devastating statistics continue to increase and rising health care costs pose a great problem to the U.S. economy.

Sophie Okolo is the Founder of Global Health Aging.

Fighting Loneliness – Pet Therapy for the Elderly

For many, retirement and old age is a welcome stage of life with few responsibilities, and a lot of time to pursue interests. To others, it brings on that dreaded feeling which no amount of pills and doctor appointments can cure – loneliness. According to AARP, over a third of Americans over 45 years are lonely. Retirement, decreased mobility and income source are all contributing factors to increased social isolation. Studies show that loneliness puts the individual in greater risk of diseases and illness, and greatly impacts their well-being and quality of life.

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A variety of interventions are in place to combat loneliness in the geriatric population. They focus on various high risk groups and employ various individual and group approaches. There are also several programs in place, including social and cultural outings, health promotion, community engagement and group support. However, few show direct improvement in reducing loneliness among the elderly. A study comparing eighteen different interventions in Netherlands concluded that only two of them significantly reduced loneliness – one, an individual, at-home intervention for the elderly with chronic disease, and two, a group intervention in a residential home that included discussion and coffee breaks. There is limited success in identifying and employing interventions that significantly reduce loneliness

Another lesser known intervention to battle loneliness is the use of companion animals. Pet ownership and interaction positively contribute to the overall wellbeing of elderly citizens as pets can instil a sense of responsibility and purpose in the elderly, and provide much solace from loneliness. The role of Animal-assisted therapy (AAT) is increasingly being explored in elderly care. AAT is a formal, documented process with scheduled sessions and a treatment goal. AAT most commonly uses dogs, but is not restricted to fish, rabbits, cats, horses and dolphins. AAT should not be confused with service animals, and animal-assisted activities (AAA). Service animals and AAA are more spontaneous and do not necessarily have a treatment goal. Both AAT and AAA can help in increasing social behaviors, interaction with people as well and decreasing loneliness among the elderly.

In addition to temporary animal companionship, several organizations also look to provide seniors with the opportunity of pet ownership. The ‘Seniors for Seniors’ program is employed among many non-profits and animal shelters across the United States. This program looks to place adult dogs and cats with willing and able senior citizens. Since older dogs are usually house-broken, trained, and come with a fully developed personality, they can serve as great companions to the elderly.Several animal welfare organizations such as SAVE, Paws and the North Shore Animal League America successfully run such a program, often providing financial and other support to senior adopters. Pets for the Elderly Foundation, is a non-profit solely focused to this cause. It provides financial support to adoption centers around the United States that place dogs and cats with senior citizens.

Animal therapy, in all its forms, is a burgeoning field of study in geriatric care. There are only a handful of scientific studies documenting the efficacy of AAT on loneliness, but current research shows positive trends. Despite the challenges of working with animals, the therapeutic role companion animals can play in fighting loneliness is promising.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.

The Threat of Food Insecurity Among the Elderly in the U.S. and Beyond

In 2012, 1.1 million (9.1 percent) U.S. senior citizens living independently were considered food insecure. This number is expected to increase by 50 percent in 2025 as the U.S. population continues to age. Data reported by American Association of Retired Persons (AARP) described increases in the number of older adults experiencing food insecurity since 2007. It was shown that food insecurity rose by 25 percent among individuals aged 60 and older between 2007-2009. According to AARP, individuals were more likely to report food insecurity if they were non-white, Hispanic, renters, widowed, divorced or separated, high school dropouts, unemployed and with a disability, had an income below the federal poverty line, and those with grandchildren living in the household.

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Defined as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”, food insecurity is directly related to a household’s ability to acquire the foods that are necessary for daily living. Among vulnerable and dependent populations such as the elderly, food insecurity can be particularly pronounced.

Individuals who are considered food insecure are at risk for experiencing poor health due to malnutrition. Health risks of particular relevance to the elderly include impaired cognition, diminished immune function, and the potential decrease in life expectancy. In addition to physical health concerns, mental health risks may also accompany malnutrition including feelings of powerlessness and isolation as well as stress and anxiety. Among the elderly, feelings of anxiety related to food insecurity are more pronounced than among young people. For the elderly living with chronic diseases (a number that has grown exponentially worldwide) such as cancer, heart disease, and diabetes, having access to a nutritious diet is a key factor in their ability to manage their condition.

While food insecurity is closely tied to having the financial resources necessary to purchase food, among the elderly, additional barriers may impact their access. In a series of interviews conducted with 46 elderly households in New York state, additional barriers to food access that participants reported were: transportation limitations, mobility limitations, lack of motivation/ability to prepare meals, financial compromises (purchasing food vs. other expenses), and food compromises (quality vs. quantity).

From a global perspective, ensuring that the aging population has adequate access to the resources necessary for healthy living (including safe, nutritious, and affordable food options) should be a priority. Advocating for such resources requires concerted efforts locally, regionally, and nationally. This is particularly important as our global society continues to confront multidimensional problems that threaten environmental, economic, and social stability.

Diana Kingsbury
is a PhD student and graduate assistant in prevention science at Kent State University College of Public Health.

Sweden: A Role Model for Elderly Care

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As mentioned in previous blog entries, worldwide, countries are facing challenges due to aging. By 2050, the elderly will outnumber children under the age of 15, mostly in developing countries. So, reforms for more cost-effective health care systems for elderly’s long-term care are becoming more and more important. Sweden is known for its universal and comprehensive social and health care programs. Most care is funded by citizen’s taxes. In fact, Sweden allocates 3.6% of its GDP on long-term care and also provides the highest number of health care workers for the elderly over the age of 65. As a result, it is not surprising that in 2013, Sweden was ranked first for treatment of elderly in a United Nations (UN) supported global study, The Global AgeWatch Index (BBC).

Sweden is one of the nations that established reforms which focus on and encourage high quality long-term care for elderly in institutions as well as in home care. In Sweden, municipalities are responsible for elderly care and provide funding for in home assistance as well as manage the needs of accessible housing. 94% of the elderly over the age of 65 live at home and are given the opportunity to live an independent life, even if someone is in need of supported assistance. If an older person needs assistance from a health care worker, he or she can apply for this assistance. In addition, most regions offer ready-cooked meals which are even delivered to the elderly’s home.

Sweden’s approach of taking care of the elderly in their own home is unique and allows them to keep their independence. In addition, their families are at ease knowing that their loved ones are in good care. Is this a system that can be adopted by other countries? Who wouldn’t wish to live at home until the end of life? Don’t the elderly have a right to decide where they want to live? It is great to see that the Swedish local governments give them the option to either live at home or in accessible housing. The seniors contributed to their communities all their lives. They have worked, raised a family, and paid taxes, therefore securing care for their countrymen and women. They deserve to receive the same high quality of care. In addition to the care the elderly receive, health care workers are needed and appreciated. So it is a win-win situation for everybody: the elderly, their families, as well as all current and futures citizens of Sweden.

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.

 

Women in India – Longevity, Health Disparities and Empowerment

Being over 65 years and living in India is an increasingly common phenomenon. The Indian population over 65 years is steadily on the rise, totaling to a whopping 90 million people in 2011. Estimates suggest that this number will exceed 227 million by 2050. Within this giant aging population, there is a unique sub-section of disadvantaged people who are women. Women in India live longer than men, but consistently report poor health, higher disabilities, lower cognitive function and lower utilization of health services.

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A study in 2008 showed wide health disparities between elderly men and women. Even after controlling for demographics, medical conditions and known risk factors, the gap still existed. Controlling for economic independence, however, reduced the gaps significantly. This emphasizes the necessity for financial empowerment among older women for them to enjoy a healthier life. Financial empowerment may be the key to improving health outcomes of elderly women. However, the barriers of gender discrimination and poor education are hard to overcome.

The Longitudinal Aging Study in India (LASI), the first of its kind in the country, found that elderly women have lower cognitive function than elderly men, and linked this discrepancy to gender discrimination. This study was conducted in two southern states, Karnataka and Kerala, and two northern states, Rajasthan and Punjab. In the southern states, the gender difference was accounted for by poorer education, health and social engagements. However, the disparity in the two northern states existed even after controlling for these known risk factors, indicating a high level of discrimination against women.

Gender bias is evident in all life stages of a woman – female infanticide, poor education facilities, dowry practices, stereotypical roles of women as home-makers and discrimination against widows. It is exceptionally hard for elderly women to have good health and quality of life. Stigma needs to the fought at the grassroots level. The existing government initiatives for the girl child are commendable, but they do little for the current generation of elderly women who continue to face discrimination, poor health, poor education and economic dependence. While the ongoing LASI study will continue to provide a comprehensive understanding of geriatric health in India, targeting elderly women will go a long way in improving health outcomes among the elderly population. The provision of medical, financial and social support for elderly women is empowering, and can improve their overall health and quality of life.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health. 

A Comparative View of Elder Abuse in Israel and the United States

Photo Credit: Hamed Masoumi

I spend every Tuesday morning visiting a dear friend at a local nursing home. My friend is a Holocaust survivor and at 90 years old, her mind is sharp since she easily recounts the story of her life – from the horrors of the camps to the beauty of Israel and finally to the hard work, freedom, and challenges of America. As I am ready to leave her and return to school each week, a look of loneliness washes over the smile on her face and I am reminded that her only other visitors are nurses and her daughter who can visit once a week.

The elderly comprise a significant amount of the U.S. population and statistics indicate that 10,000 baby boomers will turn 65 each day for the next 15 years. As the U.S. population ages, older adults are often viewed in a negative light, and hence a target group for all kinds of abuse: physical, sexual, verbal and financial exploitation. It is estimated that a shocking 500,000 older adults are abused each year in the United States, with family members as the overwhelming majority of abusers (mainly partners and children of the individual). Most of these cases go unreported because the victim does not have the physical capability or mental capacity to inform an official of the mistreatment.

Elder abuse is a major issue currently plaguing Israel as well. A report by the University of Haifa indicated that 18 percent of elderly participants were subject to some form of abuse. The most common form is verbal abuse, indicating a potential problem in interpersonal relationships as people age. Verbal abuse may also be used as a method to instill terror and power in a relationship, lending the way to more types of abuse.

Many religions teach people to respect and revere the elderly. In short, an individual’s exterior does not properly convey the depth of its contents. My dear friend appears to be a frail old woman with a failing body but her mind is very active. The elderly are people above all else and they deserve to be treated as such.

It is impossible to ignore the fact that everyone will grow old one day. With this in mind, I urge you to take some time and think about giving back by volunteering with a senior in your area. You may be the only contact the person has with the outside world beside the caregiver, and can advocate on their behalf if you suspect abuse. For U.S. residents, visit Give Back to Seniors to search for volunteer opportunities in your community.

Linda Nakagawa is a rising senior at Brandeis University. She is a double major in Psychology and Politics with a minor in Social Justice Social Policy. Linda is originally from Newburgh, New York and is a member of Temple Beth Jacob. As a Machon Kaplan participant, Linda was a public policy intern at the National Association of States United for Aging and Disability.

Aging, Health, and Social Networks

Across the globe, nearly every country of the world is experiencing population aging. According to the United Nations, the number of people aged 60 years or older is expected to increase to more than 2 billion by 2050. While this shift in demographics carries implications for the social and economic makeup of our global society, it is important to also consider the unique health needs of the aging population.

Included among the most pressing health needs for the aged are managing chronic disease, preventing falls, maintaining cognitive function, and ensuring improved quality of life throughout the life span. Of additional importance to healthy aging, particularly in terms of health related quality of life, is the social support older adults receive from their family, friends, and communities. A known contributor to health related quality of life (HRQOL) is the strength of one’s social networks. It has been shown that individuals who report close bonds with family and friends are more likely to positively self-report their health. This was shown to remain true among elderly in the U.S., who reported improved health if they felt satisfied with the support available to them from family members, friends, and their communities.

From the perspective of the elderly, however, changes that occur late in the lifespan also translate to changes in their social networks and their social support. Social networks have been defined to include family members, friends and acquaintances, work and school connections, and relationships built in formal and informal organizations. Among the elderly, connections may be lost for a variety of reasons throughout the aging process, including retirement, limited mobility that prevents participation in previous activities, as well as the aging and death of close connections. Such changes to the social fabric, that a person formerly engaged with, carries implications for the health related quality of life an individual experiences.

For the elderly, a strong social network often translates into diminished feelings of loneliness, support for mental and physical health needs, as well as improved cognitive functioning. The elderly who feel supported by their community are less likely to report feelings of isolation and report better health than those who do not feel supported. With global population aging, ensuring that all individuals age with dignity, respect, and support should be of paramount importance.

The lengthening of the lifespan should also come as an increase in the number of years lived in high quality health. To protect the health of the aging population, concerted efforts should be made on the part of health care providers, communities, governments, families, and friends to ensure that all individuals enter into the late stages of life with the support that is necessary to live positively and healthfully.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Quality of Life for Elders: Lessons from South Africa and Bolivia

Photo Credit: Pixabay
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Last year, the Global AgeWatch Index published a report on the quality of life for elders in 91 nations. The report included several factors such as income security, health and well-being, employment and education. African nations did not fare well. South Africa was the highest ranked African nation at number 65 while Ghana, Morocco, Nigeria, Malawi, Rwanda and Tanzania came in at numbers 69, 81, 85, 86, 87 and 90 respectively. Other African nations were not included in the report because there was not sufficient data. With South Africa leading the pack in elderly well-being, it helps to decipher the various ways South Africa deals with its senior citizens.

South Africa has the second largest and most developed economy in Africa with the old age pension reaching 72% of the older population. The pension system is the second most distributed of the African countries that are in the Index. Namibia is the first at a whopping 167.3% although there was not enough data in other areas to include the nation in the report. While South Africa performed moderately well in income security, the nation ranked low in elderly health status. There are only eight registered geriatric doctors to serve an older population of 4 million in South Africa. Since 1994, dramatic changes have taken place in the structure of health services. The government prioritized maternal and child healthcare because of the HIV/AIDS pandemic in the 90’s.

Although South Africa was ranked at number 65, Bolivia, one of the poorest countries on the list was ranked at number 46. This shows that higher-income does not always correlate with better quality of life. In fact, some lower-income countries that invested in aging saw positive impacts. Bolivia, for instance, implemented a national plan on aging and free health care for older people, which vastly improved quality of life.

The rankings illustrate that limited resources need not be a barrier to countries providing for their older citizens, that a history of progressive social welfare policies makes a difference, and that it is never too soon to prepare for population aging. This is important for African nations because the elderly are a significant boon. African nations can do better by learning from each other as well as non-African nations. The outcomes may vary but the collective goal is to improve the elders’ quality of life for present and future generations.

Sophie Okolo is the Founder of Global Health Aging. 

Singapore: Prevention is Better Than Cure

As we all know, in today’s world, people have longer life expectancies. In fact, 75% of the world’s population is older than 60 years of age (WHO). We live longer but the fact is the fact is that we are not aging very well. Once we reach a certain age, chronic diseases occur and hinder us from living a healthy long life; two out of three global deaths are due to chronic diseases such as heart disease or stroke. Due to the aging population, these chronic diseases and necessary expensive treatments put a financial burden on nations’ healthcare systems. As Dr. Lim states in the video, “the healthcare system in Singapore has worked well the last few decades, but was not built for such an aging population and a population that struggles with chronic diseases.”

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Singapore has responded to the trend and puts emphasis on preventative health strategies rather than on just treating or curing the diseases. In Singapore, many fitness parks with workout stations have been built, which not only help the elderly to get active and stay physically healthy, but also to meet and get to know one another. With the increasing aging population possibly living alone, the social aspect of these fitness parks is important and improves the mental state of the elderly.

Public Health professionals can only hope that such preventative initiatives towards healthy living situations for the elderly, or better yet all age groups, will be continued not only in Asia. If we can persuade the entire family to get involved in these types of physical activities, we will have healthier children, adults, and elderly and can lessen the financial burden on the healthcare system. Other community organizations may get involved by offering exercise classes and promoting fitness among seniors.

In addition, local governments need to be convinced that building fitness parks has a positive impact not only on the elderly, but all residents’ physical and mental health. Governments overall need to rethink and focus on disease prevention, and not only treatment and cure.

What else can WE do to improve the health of our community members?

Martina Lesperance is a Health Educator and Screening Technician in El Paso, Texas.