Elderly care
Elderly care, or simply eldercare, serves the needs of old adults. It encompasses assisted living, adult daycare, long-term care, nursing homes, hospice care, and home care.
Elderly care emphasizes the social and personal requirements of senior citizens who wish to age with dignity while needing assistance with daily activities and with healthcare. Much elderly care is unpaid.
Elderly care includes a broad range of practices and institutions, as there is a wide variety of elderly care needs and cultural perspectives on the elderly throughout the world.
Cultural and geographic differences
The form of care provided for older adults varies greatly by country and even region, and is changing rapidly. Older people worldwide consume the most health spending of any age group. There is also an increasingly large proportion of older people worldwide, especially in developing nations with continued pressure to limit fertility and shrink families.Traditionally, care for older adults has been the responsibility of family members and was provided within the extended family home. Increasingly in modern societies, care is now provided by state or charitable institutions. The reasons for this change include shrinking families, longer life expectancy and geographical dispersion of families. Although these changes have affected European and North American countries first, they are now increasingly affecting Asian countries.
In most western countries, care facilities for older adults are residential family care homes, freestanding assisted living facilities, nursing homes, and continuing care retirement communities. A family care home is a residential home with support and supervisory personnel by an agency, organization, or individual that provides room and board, personal care and habilitation services in a family environment for at least two and no more than six persons.
Due to the wide variety of elderly care needs and cultural perspectives on the elderly, there is a broad range of practices and institutions across different parts of the world. For example, in many Asian countries whereby younger generations often care for the elderly due to societal norms, government-run elderly care is seldom used in developing countries throughout Asia due to a lack of sufficient taxation necessary to provide an adequate standard of care, whilst privately-run elderly care in developing countries throughout Asia is relatively uncommon due to the stigma of exhibiting insufficient filial piety, having a relatively relaxed work–life interface and insufficient funding from family to pay for privately-run elderly care. However, institutional elderly care is increasingly adopted across various Asian societies, as the work–life interface becomes more constrained and people with increasing incomes being able to afford the cost of elderly care.
Issues in elder care
There are major discrepancies within elder care. An important issue to acknowledge is who is taking care of the elderly primarily. This task in many households comes down to members of the family. The issue that stems from the assumption that family will take care of the elderly is in many households the time spent with elder care can take away from time that would be spent providing for the family financially. This leads to larger disparities within socioeconomic class with the elderly.Gender discrepancies in caregivers
An important issue here is also gender discrepancy amongst caregivers. There is a societal assumption often that leaves women in charge of caregiving primarily. Without access to other options for elder care, this leaves many women in a position that leads to higher rates of caregiver burnout. The issue lies in the fact that for many there is simply no other option for elder care than a member of the family stepping up. This can also lead to higher rates of neglect amongst elderly because families cannot afford adequate elderly care without external support.According to Family Caregiver Alliance, the majority of family caregivers are women:
"Many studies have looked at the role of women as family caregivers. Although not all have addressed gender issues and caregiving specifically, the results are still generalizable to
- Estimates of the age of family or informal caregivers who are women range from 59% to 75%.
- The average caregiver is age 46, female, married and worked outside the home earning an annual income of $35,000.
- Although men also provide assistance, female caregivers may spend as much as 50% more time providing care than male caregivers."
Ageism
In developed nations
Australia
is designed to make sure that every Australian can contribute as much as possible towards their cost of care, depending on their individual income and assets. That means that residents pay only what they can afford, and the Commonwealth government pays what the residents cannot pay. An Australian statutory authority, the Productivity Commission, conducted a review of aged care commencing in 2010 and reporting in 2011. The review concluded that approximately 80% of care for older Australians is informal care provided by family, friends and neighbours. Around a million people received government-subsidised aged care services, most of these received low-level community care support, with 160,000 people in permanent residential care. Expenditure on aged care by all governments in 2009-10 was approximately $11 billion.The need to increase the level of care, and known weaknesses in the care system, led several reviews in the 2000s to conclude that Australia's aged care system needs reform. This culminated in the 2011 Productivity Commission report and subsequent reform proposals. In accordance with the Living Longer, Living Better amendments of 2013, assistance is provided in accordance with assessed care needs, with additional supplements available for people experiencing homelessness, dementia and veterans.
Australian Aged Care is often considered complicated due to various state and federal funding. Furthermore, there are many acronyms that customers need to be aware of, including ACAT, ACAR, NRCP, HACC, CACP, EACH, EACH-D and CDC to name a few.
In 1944 Mildred Symons, a pioneer of elderly care in Australia, started the Church of England Parish Nursing Service and The Chesalon Nursing Home.
Canada
Private for-profit and not-for-profit facilities exist in Canada, but due to cost factors, some provinces operate or subsidize public facilities run by the provincial Ministry of Health. In public care homes, elderly Canadians may pay for their care on a sliding scale, based on annual income. The scale that they are charged on depends on whether they are considered for "Long Term Care" or "Assisted Living." For example, in January 2010, seniors living in British Columbia's government-subsidized "Long Term Care" started paying 80% of their after-tax income unless their after-tax income is less than $16,500. The "Assisted Living" tariff is calculated more simply as 70% of the after-tax income. As seen in Ontario, there are waiting lists for many long-term care homes, so families may need to resort to hiring home healthcare or paying to stay in a private retirement home.United Kingdom
Care for the elderly in the UK has traditionally been funded by the state, but it is increasingly rationed, according to a joint report by the King's Fund and Nuffield Trust, as the cost of care to the nation rises. People who have minimal savings or other assets are provided with care either in their own home or by moving to a residential care home or nursing home. Larger numbers of old people need help because of an aging population and medical advances increasing life expectancy, but less is being paid out by the government to help them. A million people who need care get neither formal nor informal help.A growing number of retirement communities, retirement villages or sheltered housing in the UK also offer an alternative to care homes but only for those with simple care needs. Extra Care housing provision can be suitable for older people with more complex needs. These models allow older people to live independently in a residential community or housing complex with other older people, helping to combat problems common amongst older people such as isolation. In these communities, residents may access shared services, amenities, and access care services if required.
Overall, retirement communities are privately owned and operated, representing a shift from a 'care as service' to 'care as business' model. Some commercially operated villages have come under scrutiny for a lack of transparency over exit fees or 'event fees'. It has been noted, however, that paying less now and more later may suit 'an equity-rich, yet cash-poor, generation of British pensioners.'
Although most retirement village operators are run for profit, there are some charitable organisations in the space: for example, the ExtraCare Charitable Trust, which operates 14 retirement villages mostly in the Midlands, is a registered charity. Charities may derive additional funding from sources such as statutory agencies, charity appeals, legacies, and income from charity shops. Surplus funds are used to support residents' housing, health and well-being programmes, and for the development of new villages to meet growing national demand.
There is also an increasing market in the UK for Home Care services, where a visiting carer attends an elderly person in their own home. Similarly, there are also introductory care agencies for people who want to hire a Live-in caregiver.