chapter seven

• three basic models= medical, social, health promotion
• medical model = disease oriented
• health promotion model = wellness oriented
• social model= independent living with chronic illness
• improvements on healthcare

  • 1 out of five people find it diffcult to find healthcare
  • quality of LTC
  • quality of homecare
• healthcare prioritites

  improve access to family health and primary services

  increase number of healthcare works services
• Normalization of LTC  

  • Normal rhythm of day/ week  
  • normal amount of decision making  
  • Lead normal social life  
• [LTC] 

  • social model 
  • Formal and informal caregivers  
  • Relationship based care  
  • Nursing homes  
• [home and community-based care programs] 

  • Both social and medical model  
  • Adult daycare  
  • Meals on wheels  
  • Transport system  
  • Assisted living  
  • Day hospital  
• Types of res options  

  • Supportive housing  
  • Retirement homes  
  • LTC  
• Do seniors raise healthcare costs?  

  • Yes 
  • 75% one or more chronic issues  
  • Longer stays  
  • 45% of spending  
• Do they really rise up costs? 

  • No  
  • Modest cost drivers  
  • We have more gen info, more population, more medical tech 
• Key issues for the future  

  • Availability of services 
  • Accessibility of services  
  • Coordination of services  
  • Need to shift to social and health promotion model
• Romanow report

  • Made in 2002  
  • Report underscores Canadian commitment to its healthcare system with many proposals in regards to seniors 
• future plan [report]

  • Public uni/transport/accessibility/ and new accountability  
  • Insurance should be beyond the norm and target home care services  
  • Diagnostic services should be free  
• recommendation 7

  • Short-term government should provide 2 years of payment  
  • Access  
  • Diagnostic services  
  • Transfers  
  • Drugs  
• recommendation 26

  Help with waitlisting  
• recommendation 34

  • Home care transfer should be provided  
  • Mental health  
  • Home care 
  • Palliative home care  
• recommendation 35

  Government should allow caregivers to spend time away from work to help family  
• two types of retirement system

  1. Retirement principle  

  Leave work at fixed age regardless of mental and physical ability  

  1. Retirement wage [citizen wage] 

  Pension paid by the government to older people 
• Freedom 65 

  • Group of Canadians said they have to work longer in order to pay bills  
  • 2018; 30% of people have no retirement savings  
  • 19% have less than $50,000 saved  
• Inequality in later life  

  1. Structural barriers  

  • Lower income has least chance of having any private savings [cumulative disadvantages]  

  1. Private savings  

  • Only benefit middle – and high – income earners  
• Income inequality  

  • Senior women income is about 65% of senior men  
  • Unattached women have a higher risk of living in poverty  
  • Women earning 70%  
  • Women have part – time job  
  • Widows=no survivor pension plan  
• Future trend one  

  • Delayed retirement will be a trend  
  • If older people have a choice they will not work  
  • Why? Public pension system and personal reasons  

  Future trend two  

  • Flexible retirement  
  • Bridge jobs  
  • Job sharing  
  • Encore career  
  • Second career  
• Future direction  

  • Pension programs will increase claw back of OAS benefits becoming social assistant model  
  • Ongoing enhancing CPP to protect younger workers [2070] 
  • Fewer private employment pensions  

  1. Public pension system= lower – income people  
  2. Private pension system = for middle/higher - income group  
• origins of retirement

  • myles 1984
• At home tax credit [2022] 

  • Help lower income adults aged 70 above  
  • Offer a 25% tax break on seniors at home medical cost up to $6,000 
  • Older adult 70+ can claim up to $65,000/yr.  
  • Offer on sliding scale 
• Leisure and recreation in later life  

  • Different from other instrumental activities  
  • Path to personal growth, liberation, and freedom [giving back to others] 
  • Important source of identity and purpose of life  
• Social  

  • Decreased mortality rates and less functional decline  
• Solo  

  • Age = less time spending it with others [97-98] 
• how to leisure

  People who enjoyed athletic activity, socializing, or traveling will continue to do these things when they retire 
• Social  

  • Positive trend: 80% take up at least one social activity  
  • Helps with self – perceived health and loneliness 
  • 21% AND 27% want more social activity 
  • They can study  
  • Volunteer  
  • Media related stuff  
  • And work  
• Expanders: 

  •  people who have not stopped any activity in the past year and have added one new outdoor activity since 65 [life span development theory of aging] 
• Life span development theory of aging  

  • People can change, grow, and developed at every age in life  
• Contractor: 

  •  people who have stopped at least one outdoor activity in the past year and have not learned any activity since 65 [disengagement theory of aging]  
• Disengagement theory of aging  

  • People who want to disengage from social roles as they age  
  • Withdrawal from things lead to high life satisfaction 
  • Begins because of awareness of death  
• What are the trends of older adults’ participation in volunteering and lifelong learning activities? 

  • 96% have at least participated in one volunteering style  
  • Helps increase good mental health  
• Four styles of volunteering  

  • Charitable  
  • An organization  
  • Helping directly  
  • Membership  
• What are some personal and structural barriers / determinants to active social participation among older adults?  

  • Barriers to tend to religious things  
  • Barriers for education purposes  
• What are some of the examples of social and community-based activities in the videos shown in the class?  

  • Karate grandmas  
  • Young @ heart chorus  
  • Men's shed movement