The aged

Characteristics of the aged

Figure 1

e aged are a fast-growing group in our society

Issues relating to the aged are discussed in detail below. See chapter 5 (Researching community groups, pages 161 162) for an explanation of the headings used in this section.

Legal and social denitions of the aged

Legal de nition: e Australian Bureau of Statistics tends to refer to the aged as those individuals who are 65 years and over, whereas the National Seniors Association refers to the aged as persons over 50 years. Social de nition: When people become old or elderly, society o en sets them apart from the rest of the community. Some view the aged as bored, having abundant spare time, isolated, lacking mobility, burdening the health system, o ering wisdom and experience, usually retired, pensioners, frail and vulnerable, volunteers and playing a role in providing free childcare to their grandchildren.

Think it through
1 What parts of the social denition are positive? 2 What parts of the social denition are negative? 3 What else could you add to the social denition?

e proportion of the aged population in paid labour has decreased. erefore, the aged have more leisure time. Most people have decreased income in retirement, relying on government bene ts, superannuation and savings. However those who own their own house may have higher levels of discretionary income. e aged require and use more public services such as public transport and hospitals. e aged have increased susceptibility to illness and disability. One in ve people over 80 years have dementia while osteoporosis and arthritis both increase in incidence. While 80 per cent of the aged continue to live in their own homes, they may require help to maintain independence through a combination of formal and informal means of support. These include Home and Community Care, family, community nurses and Meals on Wheels. Aged people may become lonely and detached from society when their partner dies. Due to decreased mobility and increased frailty, the aged may be targets for violence.

e aged population is increasing. Life expectancy has increased and is now 76.6 years for men and 82.1 years for women. Centenarians are one of the fastest growing age groups. e aged contribute wisdom and experience to society in relation to employment and raising children. ey are oral and written historians of past events, places and technology.

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Figure 2 Many aged people use their increased leisure time to improve their health

Specic needs of the aged

Areas that are a high priority for the aged include health, access to services, and housing.

Access to services
e aged require access to services that maintain and increase their independence. ese include health services provided by professionals such as GPs, hospitals, optometrists and psychologists, and access to breast scans, bowel scans and hearing tests. Transport services can help the aged participate in the community and ensure that their needs are met. ese services include public transport, taxi vouchers, community buses and transport to medical appointments or to hospital. Aged people are required to undergo driving tests in order to keep their licences and can obtain help from driving schools to maintain and improve their skills. Many aged people require assistance to live independently in their home. Home Care and a variety of other providers, such as Catholic Care of the Aged, assist the aged with meal preparation, shopping, laundry, hygiene needs and basic home maintenance. Meals on Wheels can be a valuable service, providing nutritional meals and regular social contact. Many aged people are concerned about nancial matters. ey may use government agencies such as Centrelink to access the Age Pension, or the Department of Housing to access a ordable housing. Independent retirees may use nancial planners and accountants to plan the most e ective way to manage their money.

O en, access to services is a ected by lack of knowledge. Friends and extended families need to assist the aged to become aware of, locate and utilise these services. Language and other cultural barriers can also a ect a persons ability to obtain support.

Education
Education involves both formal and informal experiences. e aged require education in technology so they can maintain communication, seek information and improve their access to goods and services. e University of the ird Age (U3A) speci cally targets retired people. TAFE, the Workers Educational Association (WEA), community colleges and some universities also operate courses aimed at this age group. Many aged people seek to learn about computers and the internet. ey may want to engage in a new leisure activity or take up a musical instrument or learn to play bridge. Educational needs may also be achieved by asking a friend or family member for assistance. Education not only meets intellectual needs but also has valuable social and self-esteem bene ts. Research suggests that intellectual stimulation may help to reduce the impact of dementia. According to Board of Studies press releases, there have been people over 80 years of age who have studied subjects for the HSC!

Employment
George Bilbie, a lawyer in Newcastle, New South Wales, was still practicing part-time at the age of 100. However, many aged people are no longer in

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full-time work or may be phasing into retirement by accessing part-time work or job sharing. Some have retired altogether from paid employment, and this may cause a change in their sense of identity and self-esteem. Sometimes aged people take on a mentoring role on a part-time basis to younger colleagues. Advances in technology may make it di cult for some of the aged to obtain a job. Many aged people contribute through voluntary work; for example, by assisting as a Pink Lady at a hospital or minding grandchildren while their adult children are at work.

Health
Many people experience increasing levels of sickness and disability as they become older, so health needs become increasingly important. e health costs for the aged are higher than those for other age groups. e growing specialty of geriatric medicine allows medical practitioners to specialise in the problems of the aged. e ageing process brings increased health problems due to decreases in bone density and muscle mass. As coordination decreases and re exes slow, aged people may experience falls. A broken hip or femur can lead to a long period of rehabilitation and loss of independence. e aged also have higher rates of heart disease and cancer in comparison to the rest of the population. ose who have a chronic illness, such as asthma or arthritis, may experience increased levels of impairment. Mature onset diabetes brings with it a number of related medical complications. It is important for individuals to have access to a GP who supports them e ectively. Many GPs will bulk-bill senior citizens so that they do not have to pay the gap between the doctors scheduled fee and the Medicare rebate. Some of the aged may require regular services by allied health professionals, such as physiotherapy to help enhance mobility. Other health issues include increased levels of sensory disability as vision and hearing deteriorate.

Think it through
1 Read about George Bilbie, who died in
October 2008.

2 Describe three specic needs met by

his work.

Newspaper article

Financial support

Many aged people rely on government assistance such as the Age Pension or the Newstart Allowance for mature-aged people (50 years or over). However, this age group includes a large number of nancially independent people who do not require government assistance. ey may use their superannuation or have private assets. Centrelink is the Federal Government agency that provides nancial assistance to aged people who are not nancially independent. Other forms of nancial help include the Pharmaceutical Allowance, Pensioner Concession Card and Health Care Card, Rent Assistance and assistance from volunteer organisations such as the War Widows Guild. Stringent regulations and means testing ensure that the most needy people are provided with assistance. Families sometimes assist the aged, but it is also important to recognise Figure 3 Many aged people have chronic illnesses that that the aged people o en assist family require them to take a variety of medications daily members nancially.

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e aged are more likely to su er from eye problems such as glaucoma, where increasing pressure in the eye can cause blindness, and cataracts, where the lens of the eye becomes opaque. With a cataract operation, the patients vision is usually restored to a functional level once more. Some of the aged experience depression and may require psychological help and medication to assist them. ere is also a higher risk of dementia. e associated memory loss and confusion may result in a loss of ability to communicate and live independently. In many cases, nursing home care is eventually required. Health care needs to be a ordable, accessible and age-appropriate.

Check for understanding

1 Outline the role of a geriatrician. 2 What is Alzheimers disease? Who is at
risk? Identify the signs of this disease. Assess the role of the family and formal support in coping with a family member with this illness.

Housing
Many aged people live independently in their own home or with family members. Sometimes, modi cations may be needed to the family home. Home and Community Care (HACC) operates a home service that includes changes such as adding handrails in toilets and bathrooms and building ramps. Housing needs may change due to the changing physical health of the aged person and their current family structure. It is likely that they may be living only with their partner as adult children would be living independently. If, as people age, it becomes harder for them to shop, cook and clean, assistance through HACC and Meals on Wheels can be organised. Some aged people move to retirement homes where a variety of

social activities are organised for the residents. As disability and frailty increases, a person can move to a hostel or nursing home where meals, personal care and medical care are provided. Housing needs to be a ordable and accessible to services. Another factor that in uences housing is location. If an aged person experiences loss of independence through relinquishing their drivers licence, their housing needs to be accessible to public transport, local shops and their GP, if possible. An aged person with decreasing mobility may need to move to an accessible house where all rooms are on one level. e aged may choose to downsize to a smaller house or unit or move in with other family members. Granny ats built on to family dwellings o er the aged some independence while keeping them close to people who can provide assistance. Over the years, the private sector has developed an increased amount of housing aimed at independent retirees who are nancially secure. Retirement villages o er accommodation, independence from gardening and home maintenance. ere is usually a variety of communal facilities such as a swimming pool, bowling green, hall and a bus to take residents into the wider community for outings. Aged people whose health deteriorates may require accommodation in a hostel where more support is available. Initially, this may be o ered as respite care for other family members. ere may be communal meals, laundry services and,

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once again, a variety of programs to stimulate the residents physically, socially and mentally. e next step is nursing home accommodation where greater support is o ered, including medication, feeding and personal hygiene needs.

Think it through
1 Develop a list of government and nongovernment organisations that assist the aged to remain in their home. Identify the services that are provided. Describe the ways in which the needs of the aged are met. Figure 5 Centrelink is a valuable source of nancial support for many of the aged

Security and safety

e aged can be vulnerable because of their deteriorating strength and mobility. ere is increasing evidence of elder abuse in the community, where the aged are exploited nancially or harmed physically by relatives or nursing-home sta . Additionally, as partners and friends die, the aged may become lonely and isolated. With increased support from resources such as Home and Community Care (HACC) and Meals on Wheels, the aged may be able to stay longer in their homes. is can lead to security and safety issues such as falls or robberies.

Government policies and regulations for the aged

Self-esteem
Self-esteem can be an issue for older people if they feel little sense of achievement in daily life. Isolated and lonely people may have low self-esteem. rough participating in voluntary work and assisting family members, the aged can feel wanted and useful.

Sense of identity
A person who has contributed signi cantly in the workforce, but is now too old to do so, may experience depression because they feel they are no longer needed. A widower with busy adult children, who rarely visit, may feel a sense of loss of their role in the family. By maintaining links with family and the community, an aged persons sense of identity can be enhanced.

e Age Pension is designed to meet basic needs of food, clothing and shelter. Access is determined by income, assets and age. Men can access this bene t at 65 years. Women born before June 1944 must be 63 years, but by 2014, they will need to be 65 to receive this bene t. At 1 July 2009, a single person received $569.80 per fortnight and a married couple received $475.90 each. e amount is adjusted twice a year in line with the Consumer Price Index (CPI). Recipients must have lived in Australia for more than 10 years to receive this support. For some aged people, the pension is insu cient and their nal years are lled with insecurity because of their limited means. People currently under 50 years of age will not receive the Age Pension until they are 67. Compulsory superannuation was introduced in 1992. is increases the likelihood that, in the future, more aged people will be independent nancially and will not need to receive an Age Pension. Under the Superannuation Guarantee, employers are required to contribute to each employees superannuation fund. Currently, the minimum contribution is 9 per cent of ordinary income. Concession cards provide discounts on services such as telephone, health, transport, electricity

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Figure 6 Many aged people must review their driving skills in order to keep their licence

and entertainment. ese cards increase access to a variety of goods and services, and help to improve the standard of living of aged people. Most cards are means-tested. One exception is the Seniors Card, which is available to all retired people over the age of 60 years. e Aged Care Act 1997 sets out the funding of aged care and the standards that must be reached by owners and operators of aged-care accommodation. According to the Act, residential care needs to be a ordable and of good quality, with appropriate outcomes for recipients of care. e Act also outlines the rights of aged-care recipients to privacy and con dentiality, to be informed and consulted about their care, to make a complaint, and to have a person of their choice act as their advocate. e Carer Payment and Carer Allowance are payable to a person who provides constant care and attention. Many of the aged have carers who are also aged persons. e National Falls Prevention Project provides strategies aimed at reducing the incidence of the aged being involved in falls. e project includes dietary advice, visits by an occupational therapist to assess the safety of the home, and advice

about safe furnishings. A er a fall, an aged person may require hospital care, surgery and a long period of rehabilitation, at considerable cost to the government. It is far better for both the aged and the government to prevent falls. e aged receive a free annual GP visit and free in uenza vaccinations. e Pharmaceutical Bene ts Scheme (PBS) Safety Net may allow the purchase of approved medications at a reduced cost. e aged may experience discrimination in relation to employment, housing and other areas. e Anti-Discrimination Act 1977 covers age-related discrimination. e Home and Community Care Act 1985 provides government funding for home and community care services that allow people to stay in their own house for as long as possible. ere are certain driving restrictions on the aged. (See the following question.)

Think it through
1 Investigate the driving restrictions on the
aged. At what age must they undergo a yearly medical examination? At what age must they have a yearly driving test? 2 Select three of the above points and identify the government department or agency responsible for the policy.

Community responsibility
Individual citizens have a responsibility to act in their own best interests; for example, by eating nutritious food, exercising regularly, taking prescribed medication and following the basic norms of society. Family and friends o er assistance to the aged. is may include providing companionship, accommodation, transport, assistance with domestic tasks and nancial support. Home and Community Care (HACC) is supported by the government and provides basic home maintenance and support for the aged. It enables the aged to have a measure of independence, security and quality of life living in their home. Local churches may provide fellowship and activities for the aged.

Think it through
1 Investigate how Home and Community Care (HACC) assists the
aged to remain in their home. What tasks can be carried out? Identify the government department responsible for funding this service.

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Rights of the aged

All individuals have basic rights but some rights are more relevant to the aged. e aged have a right to: adequate health services adequate income safe and secure housing that is a ordable and suitable, for example, a single-storey, compact house with railings, which is close to public facilities adequate, accessible and a ordable transport personal safety, especially in the home information about services, including education, transport and recreation education about technological advancements and new forms of communication

contribute to the organisation for a long period of time.

Disability
As age increases, so does disability due to causes such as arthritis and osteoporosis. Some aged people may be eligible for the Disability Support Pension or a Mobility Parking Scheme sticker. e aged may access community transport to attend appointments and activities in the community.

Education
As previously mentioned, the aged need education so that they can use new technologies in communication and information. is can include learning about ATMs and computer applications such as email and word processing. An aged person who is competent and con dent in using the internet has an increased access to a wider range of goods, services and information. ere is a wealth of supportive resources for the aged at the Federal Governments seniors website, and some seniors groups o er training in computers in their programs. e aged need information on new driving regulations; for example, how to negotiate roundabouts so they can pass their driving test and keep their licence. Education about health issues and support groups are other needs for the aged.

active participation in the community; for example, through a church or as a member of a club like Rotary, Apex, Lions or Probus. e Aged-care Rights Service Incorporated (TARS) is a community legal service that operates in New South Wales. It provides an advocacy service for older residents in nursing homes, hostels and retirement villages, and assists disadvantaged and distressed people in protecting, advancing and representing their interests. e National Aged Care Advocacy Program provides a Charter of Residents Rights and Responsibilities for people in community aged-care facilities. Many government-funded nursing homes operate a community visitors scheme. is helps meet the rights of residents to continue having relationships with people outside the nursing home, and is particularly important for residents who have limited family, or who may be isolated by a language barrier or other cultural reasons.

Federal Government Seniors website

Ethnicity/culture
A person from an ethnic background will be able to access support from their own cultural group and use the services of a cultural centre. Some nursing homes support a speci c ethnic group; for example, there are homes for the aged run by the Greek, Italian and Jewish communities. Language barriers may a ect an aged persons access to friendships or health resources in their community.

Factors affecting access to resources

Age
Age is a factor that determines access to superannuation, pensions and drivers licence tests. Signi cantly, it may also impact on other peoples attitudes towards the aged. It may be di cult for a 62-year-old man to nd employment because employers o en want employees who can

Gender
Women are generally better at maintaining relationships and may have better developed social networks. erefore, a er the death of their spouse, men may be lonelier than women. Overall, there are more aged women than men, as they have a longer life expectancy.

Location
An aged person in an urban community may have greater access to resources such as health, education CAFS Student CD The aged
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and government departments than a person living in a rural community. However, an aged person in a rural community may have closer family and community ties.

Issues of concern for the aged

e special needs of the aged have been identi ed above. Issues of particular concern for this age group may include: where to live whether they can stay at home or whether they need to move in with family or to a nursing home separation from their partner, who may have a di erent health status and require a di erent level of care loneliness as partner, friends and siblings die health issues such as illness and increasing levels of disability mental health issues such as depression and dementia

Socioeconomic status
Socioeconomic status has a signi cant e ect on the wellbeing of the aged. An aged person with high socioeconomic status may have private health insurance and money for entertainment and travel. An aged person with lower socioeconomic status may not be able to a ord a car. To obtain nonelective surgery, they may be forced to wait on a public hospital waiting list.

Societal attitudes towards the aged

People in the community hold many di erent types of attitudes towards the aged. Some of these attitudes tend to be stereotypes that may or may not be true for individuals or the group as a whole. Some attitudes are positive and some are negative, as the following examples show. Aged people are bad drivers. ey are stubborn. ey are technophobic. e aged are much healthier and more active than aged people in the past. ey live longer and play a valuable role in caring for grandchildren. ey become disengaged from their community and socially isolated. ey receive less respect than they deserve. e aged require special help and consideration from family, members of the community and the government.

ey are a burden on society, especially because of the amount of government funding required for pensions and the health budget. ey are valuable sources of oral history.

Think it through
1 Which of these attitudes are positive? 2 Which of these attitudes are negative? 3 Can you add to the list?

mobility issues that a ect independence and opportunities to participate in the community feeling that are a burden on family members safety issues, including feeling physically unsafe in the wider community and the risk of physical, mental or nancial abuse by carers and family members within the home or residence loss of their sense of identity as their role within the family, workforce and community changes worry that the Age Pension is insu cient to meet the basic needs of food, clothing, shelter and health care. As a result of the rising cost of medications, some aged people choose between their prescribed medications, as they cannot a ord to pay for all of them. Aged migrants o en have additional concerns. Language may be a barrier that prevents them receiving informal support from neighbours and community members. Nursing-home residents who do not speak English may feel isolated and frustrated if they cannot be understood by the sta and other residents. Many people look forward to retirement, when they will have the time and money to access a range of leisure and other activities. In 2008, however, world economic forces put extensive pressure on shares, and many peoples superannuation portfolios were a ected. For many retired people, this has lead to a decrease in their income, while some aged people in the workforce have rescheduled the date of their retirement.

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Conict between the aged and community interests

e aged may feel threatened by young people and physically unsafe in the community. e aged may feel a lack of respect from younger generations. Although the aged may wish to remain in employment, younger workers may feel they should they move aside and retire, increasing the number of jobs available for youth. e aged may feel that they are expected to look a er their grandchildren at a time they would prefer to enjoy their own interests instead. Some people may feel that aged people are no longer safe drivers and shouldnt be on the road. Some people may have aged neighbours who they feel make unreasonable complaints about noise and so on. e aged are responsible for approximately 35 per cent of the heath budget. Some people may see them as a burden on the health system and feel that this money could be better spent on younger people. Other costs to the government, such as pensions and aged-care services, may also cause people to think that the aged are a nancial burden to society.

Some people may resent having to adapt their lifestyles to care for aged parents or other relatives; for example, some people may need to change their work hours or their job so that they have more time to care for an aged family member. ey may feel that their responsibilities to the aged make it di cult to balance work, family and social life. In some areas, the building of a granny at may be seen as a negative environmental factor that decreases the value of a property. Alternatively, a granny at may increase the economic value of the property.

Resolving conict
e following suggestions relate to three of the points above. Many aged people want to continue driving for as long as they can to maintain their independence and social contacts, and to attend appointments. However, elderly drivers may pose a danger to the community. To resolve the con ict requires strategies to ensure the needs of the aged such as health and self-esteem are met. One strategy is for the local community to fundraise for a bus to pick up aged people. Another is for the state government to fund taxi vouchers. Many aged people appreciate peace and quiet in the community and like to go to bed early. By o ering housing in an estate speci cally designed for aged residents, there is less likelihood of them being annoyed by noisy parties, band rehearsals or loud motor bikes.

Figure 7 Some younger workers feel that older workers should move aside for them

Some young people feel that the aged have had their life and should be less of a priority in terms of health resources. One solution could be o ering the aged exercise classes and food preparation courses to keep them healthy and out of hospital. Encouraging young people to study and work in the aged-care sector will also enhance their understanding and tolerance for this group.

CAFS Student CD The aged

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Think it through
1 Find a newspaper article that
demonstrates a conict between the needs of the aged and the community. Identify any solution that is offered. Propose other strategies to solve the conict.

Think it through
1 Select two of these points and nd out
more about how the aged use power within the community.

Power within the group and the community

As a group, the aged hold considerable power at the polls and are actively courted by politicians. e Federal Government has a Department of Health and Aging. At state level, there is a Minister for Aging. is group will continue to increase in size, which will give the aged greater political power. e Council of the Aging (COTA) was formed in 1951 and serves the interests of older Australians. Its mission is to mobilise older people and those who work with them to age well in a just society. e Council provides information to seniors and lobbies governments on their behalf. Grey Power began as a lobby group in 1983 and lobbies the government for the needs of the matureaged citizen. e group has no political a liation. It is concerned with issues such as health, transport and law and order. Senior Citizens Associations encourage participation in society and can lobby on behalf of their members. e current group of aged people have contributed signi cantly to Australias economic prosperity and high levels of employment. Marketers have begun to recognise their purchasing power. Many retirees have discretionary income and some marketers speci cally target this group, advertising vacations for seniors, specialised products and tailored accommodation. A variety of magazines that cater to this age group advertise products such as mobility aids, moving stairs and retirement living options. e aged have the power to make a signi cant contribution to the community as role models to younger family members, workers and school students. ey are volunteers in schools, hospitals, church, welfare organisations and museums.
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Positive contributions aged people make to the community

Aged people have made, and continue to make, many di erent positive contributions to the community. In the past, they may have produced children, worked, contributed to economic growth and paid taxes for many years. Many aged people continue to: educate the younger generation pass on a wealth of experience do volunteer work for organisations such as Pink Ladies, the CWA and Meals on Wheels

work in part-time or casual roles, for example, as HSC examination supervisors enrich their family relationships. take on full- or part-time care of their grandchildren provide a positive role model by living a healthy, happy and productive life provide employment for those in elds such as health, housing, welfare, government departments and travel agencies!

Extent to which community service groups meet the needs of the aged

Community transport schemes allow the aged to access shops, travel to medical appointments and recreational activities. Local clubs may o er activities for the aged such as bridge games, cra activities and discounts on meals. Home and Community Care (HACC) provides a range of services to help the aged to continue living in their homes. Meals on Wheels deliver nutritious meals to the aged. Senior citizens centres, U3A and groups such as Probus provide activities and outings. Community groups and nursing homes may o er respite care.

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Rights, responsibilities and attitudes of aged people to the wider community

Relationships between societal structures and the needs of the aged

e following examples critically analyse the relationships between societal structures and the ability to satisfy needs. Access to nursing homes may help to meet the needs of the aged for housing and health. However, an aged persons sense of identity and self-esteem may be threatened through such institutionalised living arrangements. Although nursing homes provide a valuable service, they are a heavy burden on Australias health system. Additionally, there have been a number of reports of elder abuse, where residents have been physically injured or sexual abused by nursing-home employees. e family can be an excellent source of support for the aged. Family members can provide companionship and may o er assistance with nancial support and housing. Being a respected and loved senior family member can enhance an aged persons self-esteem and sense of identity. However, the decreasing birth rate may result in fewer family members who are able to assist an aged person, causing increased demand on government and community services. ere can also be elder abuse within the family, and there are examples of the aged being exploited nancially by family members.

e rights of the aged include the right to: respect and dignity safety in the home and community a basic standard of health care housing that is suitable to their needs opportunities and su cient nancial means to participate in society opportunities for involvement in recreational and spiritual activities opportunities to participate in education make decisions about their lifestyle and their medical treatment. However, as the aged become more frail, their mental state can deteriorate and family members may need to make decisions on their behalf. If other people manage their nancial a airs and make decisions about their accommodation, the aged may feel they have no rights. Some aged people sign legal documents that give family members access to bank accounts and the right to sell their house. In some cases, they sign their rights away and are exploited by family members who do not show integrity towards them. e responsibilities of the aged can include: cooperating with other family members and carers following their doctors advice on treatment and medication being a positive role model for the family and the community looking a er grandchildren, if they are in sound health and are willing to help with childcare. Community attitudes towards people from other cultures and towards gay and lesbian people have changed signi cantly during the lifetime of the aged. erefore, some people would claim that the aged are more likely to be more prejudiced against such people, or that they are intolerant of young people. However, the attitudes of individual members within any group are, of course, quite varied.

Figure 9 Meals on wheels provides valuable support for the aged

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TABLE 1

Societal structures that meet the needs of the aged

Structure Government

Examples Superannuation Guarantee Act 1992 Aged Care Complaints Resolution Scheme Age Pension

Specic needs met Financial support Safety and security Financial support

Non-government

Red Cross, CWA Clubs, interest groups Probus

Charity

Salvation Army St Vincent de Paul

Self-esteem, socioemotional, physical, spiritual

Family

Clothing, food Empathy

Individual

Companionship Safety, security

Think it through
1 Copy the above table and complete it by
identifying other needs met by the societal structures.

2 Visit your local senior citizens centre and

assess its ability to satisfy needs of the aged. Identify what needs are met, assess how well the needs are met and propose what could be improved.

Modications to the social environment

e social environment is where a person works, rests and plays in other words, their home, workplace and where they interact in the
TABLE 2

community. e examples in the following table address the question: What must be changed so that aged people are better able to meet their needs?

Modications to the social environment for the aged

Social environment Home

Modications Install ramps, railings to keep independence and allow self-care. Use HACC to assist with cooking, cleaning and shopping. Move to a nursing home or hostel.

Specic needs met Self-esteem, sense of identity, health Self-esteem, sense of identity, health Housing, health (Continued)

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TABLE 2

Modications to the social environment for the aged (Continued)

Social environment Work

Modications Increase access to part-time work or jobsharing and meaningful voluntary work. Provide training in the use of technology such as computers to increase workplace skills.

Specic needs met Financial support, self-esteem, sense of identity Self-esteem

Community

Provide accessible recreational facilities such as a senior citizens centre on a bus route. Provide community transport or public transport. Provide affordable recreation such as concessions on theatre tickets. Ensure access to affordable medical treatment through Medicare, PBS and Medicare Safety Net. Teach the aged about ATMs and mobile phones. Increase opportunities for satisfying volunteer work. Acknowledge the nancial and social benets of the work of carers.

Self-esteem, sense of identity

Access to services Access to services Health

Education, safety and security Self-esteem, sense of identity Self-esteem, nancial support

Modi cations may include: legal changes: for example, the AntiDiscrimination Act 1977 and Equal Employment Opportunity Act 1977 can help the aged meet needs of education, employment, nancial support and housing physical changes: for example, kerb cuts and ramps enable frail aged people to access shops (access to services, self-esteem) educational intervention: for example, school students who complete courses in aged care or interact with the aged at nursing homes will generally have an increased tolerance, understanding and respect for this group (selfesteem, sense of identity) vocational changes: for example, changes in work patterns may allow the aged to meet employment, nancial support and self-esteem needs.

Management strategies to address equity issues faced by the aged

Areas of inequity that impact on the aged include: socioeconomic ( nancial) inequities. Many of the aged may require welfare payments such as the Age Pension. health inequities. Many aged people have increasing problems with illness and disability and may have poorer health outcomes due to their location, education or socioeconomic status. social inequities (social stigma and negative stereotypes). e aged are o en viewed negatively by other groups. educational inequities. Many of the aged lack education in technology. Additionally,

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Figure 10 Education in technology can increase access to information, goods and services for the aged

self-esteem or mobility issues could make them less inclined to participate in a course that could assist them. discrimination due to age. is can be an attitudinal barrier of employers. To address health inequities, the government o ers a free GP visit annually as well as an in uenza vaccination. Another management strategy could be to increase the number of

community nurses available to help the aged and detect health issues before they becomes a major problem.

Think it through
1 Propose management strategies for two
of the other inequities discussed in this section.

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