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Demographic trends: 2030
Future issues when the last baby boomers reach 65 (2030)
the proportion of older adults will have nearly doubled
older adults will be politically sophisticated and organized
will want to keep their affluent lifestyle, social security benefits, health cre, comfortable retirement
ratio of workers to retirees will fall from 3:1 to 2:1
lowered sense of obligation toward elderly parents
rapid increase of ethnic minority older adults
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Potential intergenerational conflicts in 2030
- Adolescents and parents
- Young/middle adults and older adults: Medicare and social security, for example, as older peopel are going to be unable to retire making the availability of jobs a lot lower for younger people
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Dependency ratio
reflects the number of people under the age of 15 and older than 64
will fall from 3:1 to 2:1
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Divorce in 2030
will be increased
could lead to lowered sense of obligation on the part of middle-aged adults towards parents or step parents
fewer older adults will have family available to care for them
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In 2030, there will be a reconsideration of issues like
discrimination and access to health care, goods, and services
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Social Security and Medicare
1) Political Landscape: (1970)?
1970s: older adults began to be portrayed as scapegoats concerning government resources (tremendous growth of federal dollars expended on them; portrayed as highly politically active, fiscally conservative, and selfish
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1983
congress made considerable changes n the name of intergenerational fairness--changes in social security, medicar, etc.
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Changes in social security and Medicare
reduce benefits to wealthy older adults
changed eligibility rules (age); ex: retirement goes higher
targeted certain benefits for older adults
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What was social security initially?
a law which gave some measure of protection to the average citizen and his family against the loss of a job an against poverty-ridden old age
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Changes to SS
revisions: it now represents the primary financial support after retirement to many Americans
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Primary challenge to SS
is the large cohort of baby boomers drawing benefits
- - smaller generation paying into the system
- - it is a revenue in-payment out system; people do not build a SS savings
- - payments not exceed revenue
- - changes need to be made by 2021 and especially by 2033
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Medicare
- 52 million US citizens depend on Medicare for medical insurance.
What is the eligibility for this?
- over 65
- be disabled
- have permanent kidney failure
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What are the three parts of medicare?
A: inpatient hospital services, skilled nursing facilities, home health services, hospice
B: outpatient services, medical equipment and supplies, etc.
D: some coverage for prescription meds
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Medicare
- funded by __
- worst than SS issues because __
- Controversy surrounding hte __
- pay roll tax
- of aging Baby boomers and the rapid increase in health care
- Affordable care act
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Medicaid
- US gov't program aimed at __
- out of pocket expenses associated with __ are paid by __
- the poor
- co-payments
- Medigap policies
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Quality of life
one's well-being and life satisfaction
- - state of health is a major influence
- - best studied from the point of view of the person
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Healthy People 20/20
sets targets for a healthier population based on three goals:
- 1) increase the length of healthy life
- 2) reduce health disparities among Americans
- 3) achieve access to preventative services for all
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tpyes of prevention
- primary
- secondary
- tertiary
- quaternary
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Primary preention
trying to prevent things from ever hapening
intervention that prevents a disease or condition from occurring
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secondary prevention
instituted after a condition has begun
occurs between pathology and impairment
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tertiary prevention
- efforts to avoid complications or secondary chronic conditions
- minimizing the functional limitations and disability
- avoiding additional medical problems and sustaining life
aka: if we ID'ed it, we need to monitor it so it doesn't get worse; if you don't do this, you won't make it
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Quaternary prevention
rehabilitation; when you say that enough is enough
- Aimed at improving functional capacities of people with chronic conditions
- avoid unnecessary or excessive medical interventions, especially invasive ones
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What is successful aging?
it is a combination of all three:
- - avoiding disease and disability
- - maintaining cognitive and physical function
- - sustained engagement with life
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What does Vaillant propose about successful aging
- 1) no physical disability at 75
- 2) good subjective health
- 3) length of undisabled life
- 1) good mental health
- 2) objective social support
- 3) self-rated life satisfaction in eight domains
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The selection, optomization, and compensation model (SOC)
- choosing goals
- application and refinement of goal-relevant means or actions
- Subbing of means when no longer available
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Aging seems more successful with higher levels of __(3)__
- education
- household income
- personal income
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