Strategies for Active Ageing
The history of social work has always been the welfare of society. The 19th century ushered in the Poor Laws, relief for multitudes who were unemployed and financially distressed. Charitable Organization Groups, (COS) concerned with the distinctions being made between the deserving and the undeserving poor, chose to address the idea that relief promoted dependency, turned their focus to addressing the cycle of poverty which became the basis for their societies. The fact that COS only granted relief to recipients it deemed worthy and “improvable.”
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COS groups soon developed philanthropic organizations to aid the poor, distressed and the deviant, considering their actions God’s work. Their objective was to empower families to be self-sufficient and to take responsibility for their conditions. The organizers being from wealthy families believed they were teaching scientific principles of the value of hard work. With this model, a range of public services provided by the government, private and non-profit organizations were built promoting equality.
Settlement houses were established within neighbourhoods and became the source of information and referral and direct assistance for community members. Social reform was born. Gradually, social casework was established and social service was born. Is spite of its claims that private charities would be superior to public welfare. The COS believed that the charities improved the moral character of its recipients. Also, journals kept by the COS case workers and “friendly visitors” showed that they were not on friendly terms with the relief recipients and often referred to them in disparagingly and interacted with them in an indiscreet and meddling ways and were resented by the poor for their harshness.
Settlement houses were established within neighbourhoods and became the source of information and referral and direct assistance for community members. Social reform was born. Gradually, social casework was established and social service was born. Despite its claims that private charities would be superior to public welfare. COS believed that the charities improved the moral character of its recipients, Furthermore, journals kept by the COS case workers and “friendly visitors” indicate that they were not on friendly terms with the relief recipients but described them in disparaging terms and interacted with them in an intrusive and presumptuous way. The COS was resented by the poor for its harshness.
A clear aim is to assert the importance of this issue and to encourage the development of well trained, knowledgeable Social Workers to be the impetus moving forward for this new agenda on Active Ageing.
2) Contemporary practice issues, including the programs and resources which are avail as well as unmet needs.
3) Ethical concerns when working with this population
4) In my opinion: What changes should take place in order to ensure effective and ethical practices are maintained and continue to flourish in this field, be specific, concrete and realistic
There is a great deal of evidence that proves being active as we age allows us to live longer healthier lives. Provided we maintain some form of physical activity at least 3 times per week. This also improves an ones mental acuity. We also know that staying active maintains independence, improving our social network, community, family and friends. And ageing gracefully is a term most seniors meet with derision and irritation. Many seniors feel adopting that term is a defeatist and pushes against the implications of contributing anything to our society, therefore; accepting ” out to pasture” reference in Sussman’s,(p.145, 2017) Social Problems text, ‘ on Structural Functionalisms’ as it speaks about disengagement theory. Our attention should be on maintaining goal-focused friends who support our entry into active aging. Let’s not forget, that only about 30 percent of the way we age is biology and genetics. (1)
The World Health Organization, (WHO), British Columbia’s Ministry of Health, identify inactivity as the fourth-leading risk factor for global mortality. Claiming that activity versus inactivity in BC is troubling. Almost 64% of British Columbians’ ages 12 and over are active in their leisure time, and while British Columbians’ are more active than other provinces residents, statistics display our inactivity.
This encourages the opportunity that influences and nourishes our quality of life. Being free of illness is not a requirement for healthy aging, many older adults have these concerns and if controlled, the condition has very little influence on their overall quality of life.
The World Health Organization, (WHO) defines aging as the process of developing and maintaining the ability that enables wellbeing for persons as they age. A “Functional ability” means the capacity to do what we feel has value, such as meeting most basic needs, for example, to learn, to grow, to maintain mobility, to develop and to sustain relationships, all contribute to our society.
“Functional ability means intrinsic capacity,” (1) mental and physical capability which includes the ability to walk, think, see, hear or remember. The level of capability is influenced by many factors, such as presence of disease, injuries, age related changes, environment, home, community, society, people’s relationships, attitudes and values, social and system implemented policies. Living in an environment that addresses these intrinsic capacities and functional abilities is the key to living active longer.
Diversity: Aging is not typical! Many seniors have levels of physical and mental capacity that compare with 30 and 40 years olds. Others of the same age may require regular extensive care and support for the most basic actions like dressing or eating, so improving those functional abilities of all people, whether or not robust care must be our focus.
Inequity: The range of circumstance seen in seniors and the elderly is the impact of disadvantages across people lives. These relationships within our environment are shaped by factors such as the family, level of education, opportunities and of available resources.
The World Health Organization fosters the idea that no one will be left behind and “everyone will have equal opportunity to fulfill their potential with dignity as they age,” (3) While this is a lovely sentiment, the health issues have become more chronic as the numbers of seniors reach the age of seniority and with the age of seniority come health concerns of physical, sensory, cognitive impairment. The prevalence of chronic, complex health conditions, like frailty, urinary incontinence, risks of falls. The risk of having multiple conditions increases if not properly addressed can lead to “poly-pharmacy,” (3) leading to hospitalization or death. Numerous wellness teams are being put in place to provide care for the many senior issues as they increase in complexity.
But there is a disconnect between the existing health systems across care providers. The time available for care provided in the 41% results in health services needs that fail to meet the requirements of older people and lead to substantial unavoidable cost for the elderly and the care system. Older people find it difficult to use these services when necessary, regardless of their level of suffering and poor health. The cost of health care visits, different modes of transportation and availability to pay for transportation are real deterrents. Health care services in urban areas are usually more easily accessible. Other limitations accrue with physical capacity come with the ages, access to long queues, hearing loss, physical barriers to visual impairment.
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The ageist attitude is the factor keeping older people from seeking care and the widely held fear or aging in our society perpetuated by the media. But, Social Workers and Health Care professionals must offer service without discrimination of age.
We need to shift the singular focus (management of specific disease or condition), towards the care that optimizes seniors’ intrinsic capacity over their life course, keeping in mind their physical and mental capacity. Many people reach a point of ageing they no longer perform basic tasks without assistance. Health care systems are in place for people with serious loss of capacity and who require ongoing disease management, rehabilitation or palliative or hospice care.
With a large number of the population of Canada nearing 65, the greater of these being 85 and older, live in some form of collective living facility, it pales compared to 29% of those 85 and older who live in assisted living facilities. According to the General Sociological Survey, (GSS, p. 322, para4, 2002), only 45% of adults between 65-74 years were dependent on some form of assistance with “activities” of daily living and 21.5% of adults 85+ depended on some form of assistance with major activities.
Aging is often discussed in terms of decline and loss within the Canadian population by media, politicians and researchers. Emphasizing the anticipated projections of an over-burdened health care system, creating panic at the projected loss of our pensions. When, in fact, older adults make major contributions to society in the form of tangible assistance to spouses, children, grandchildren, friends, neighbors and volunteerism. (5) Also, older adulthood can be marked by associative gains and opportunities such as increased time for leisure and personal growth (of our younger community members.)
Institutional policies and practices function to subordinate or exclude people based on their advanced age. For example, an older (accomplished) adult seeking medical advice, accompanied by a young person. Practices are the doctor will speak directly to the young person and not the older person. WHY! Social norms dictate that subordinate to the young and exclude the older person.
Research suggests that remaining social and engaged in activities; older adults can maintain highly satisfied living in their later years. Micro-therapies look at ageing from a positive perspective. Tamara Sussman, Social Problems, (p.322, 2017) asks us to look at ageing as a “passive stage” of life rather than one of decline. The idea of replacing passive approach with “adaptive,” focusing on it as “successful” or “engaged ageing” in social roles to preserve the dignity. (1)
From Sussmans’ perspective, keeping active and positive in later life prevents illness and decline of mental health. She encourages terms like “Selective optimism with compensation,” elaborating by “applying the life span model of primary and secondary control” and “Positive coping processes” of aging, inviting this new terminology adapts to our new perspective on aging within the health care community. She believes that by applying the “life span model,” conceptualises optimisation as a higher-order process; by regulating selection and compensation. So the long-term potential for primary control is promoted. She also believes that primary and secondary control strategies give way to four types of life-management strategies: a) selection, b) optimization, c) compensation, d) measurement.
Finally, she argues that selection and compensation are not adaptive and may become dysfunctional and impair the long-term potential for primary control. (1)
The Active Ageing framework of 2015-2030, (established by WHO) is new, rolled out across many sectors of the aging population and is to remain a resource to the family, community and economy. (2)
Introduction to Social Work in Canada, Ives, Denev, Sussman
- Facts of Aging Quiz (Breytspraack, Kendall, Halperti.n.d)
- http://cas.umkc.edu/agingstudies/Aging FactsQuiz.asp
- Canadian Institute of Health Information, 2011, Echeberg, Gauthier, Leonard
World Health Organization, CANADA
- social determinants/the commission/countrywork/within/canada/en/
Government of British Columbia – Active Aging
- British Columbia’s Ministry of Health
https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health- safety/active-aging active Aging 1)
- British Columbia’s Ministry of Health
- https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health- safety/active-aging active Aging 1)
- National Advisory Council on Ageing (formerly National Seniors Council), Rosanova, 2006, top paragraph, pp326
- The State of Seniors Health Care in Canada, (September 2016)
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