SECTION 1: HEALTH CARE SERVICES

Elders represent a large segment of the population that require special needs because of the complexities of illness and aging. The high cost of health care sometimes impedes the ability of this population to have their health care needs met. The complexities also impair the ability of caregivers to provide for the needs of their aging relatives.

Institutions

Abuse

Abuse is the physical, psychologic, or sexual acts that jeopardize the individual's medical care, health status, sense of personhood, right to self-determination, personal property or income. Abuse also includes neglect and failure to perform acts that make the elder's environment safe and clean. About 4% to 10% of the older population in the United States are abused. These estimates reflect the cases that are reported. It is suggested that the numbers are actually higher due to unreported cases.

Medical Care

Medical care for elders has become specialized because of the complexities of age-related changes and illness. A consumer health movement is advocating for improvement in health care for elders and for education about taking responsibility for appropriate health care.

The current trend in health care financing is called managed care. This process purports to save money while providing quality health care. In actuality, managed care reviewers (not necessarily health care professionals) determine which health care strategies are appropriate for reimbursement. Traditional health care insurance policies reimburse treatments recommended by the physician with the exception of treatments not covered by the insurance plan. Controversy continues over the pros and cons of the different systems of health care financing.

AIDS and the Older Population

As of 1993, ten percent of all AIDS cases are of age 50 and over (CDC, 1993). Recent data suggest that the transmission of HIV in older adults is primarily from sexual contact and IV drug use (Linsk, 1994). Older adults are neglected as a population at risk for HIV/AIDS. They are more likely to be diagnosed late in the course of the disease, or misdiagnosed with Parkinson's or Alzheimer's disease (Gordon, S. & Thompson, 1994). The vague early signs in older adults such as loss of appetite, weight loss, fatigue, loss of stamina, and diminished mental ability can be commonly overlooked as related to aging (Schuerman, 1994). An HIV antibody test should be strongly considered in an elder with an opportunistic infection.

Aging and Ethnicity

The elders in the United States truly represent the melting pot. They differ in special ways because of cultural tradition, ancestry, national origin, history and religion. The impact of culture effects one's beliefs, values, customs, self-concept, behavior, language, and social interaction. Ethnicity affects aging by establishing the elder's status and facilitating membership with the group. The resources, support systems and group values among this membership will support individual coping and adjustment to older age.

Quality health care for these individuals depends upon the sensitivity to the differences among cultures. Some areas requiring special consideration include food preferences, spiritual needs, family contact and connection, and verbal and non-verbal communication. In the Asian and Native American culture there is little eye-to-eye contact, a practice very opposite from American communication. On the other hand, it is important to realize that all people are still individuals and may vary from their traditional cultural customs. Therefore, instead of assuming you know the needs and behaviors of an elder belonging to a specific ethnic background, it would be much more caring to inquire and then honor the special needs and desires of each individual.

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SECTION 2: HEALTH CARE OPTIONS FOR ELDERS

There is a general consensus now that people of all ages in the United States are seeking alternative health care. Many people are looking for health care options as an adjunct to or replacement for standard western medicine. Some of the reasons include tighter finances, lowered trust of western medicine, or just looking for something that works. Research has shown that elders as well as their younger counterparts benefit from alternative health care. There is a general trend toward more self-reliant behaviors related to health and health care. Some examples of health care options include yoga, meditation, biofeedback, acupuncture, naturopathy, homeopathy, massage, Therapeutic Touch, Tai Chi, and QiGong. 

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