The recent growth of "assisted living" facilities and programs has shaken the foundations of the system of long-term care for the elderly in the United States. Fueled by consumer frustrations with the available options, notably nursing homes, the assisted living model emerged during the 1990s to promise shelter, health care, control of one's own life, less government involvement, and a "real home." But how well have the advocates and developers of assisted living delivered on such promises? And what are the model's implications for public policy and the future of caregiving?

In "Reinventing Care," David Barton Smith offers brilliant insights into those questions by examining the realities of assisted living in New York City. Encompassing the largest, most concentrated population of elderly in the United States, New York spends more per person caring for its seniors than any other urban center. Yet, while the size of the city's care system boggles the mind, it nevertheless contains the same elements that exist in other metropolitan areas and thus provides valuable lessons for the nation as a whole.

Smith's study draws on twenty-five years of research, including hundreds of interviews and visits to representative facilities. He provides a succinct overview of how care is presently organized for New York's aging population and traces the history of the system up to the present. Among the key issues he addresses are the role of market forces and government regulation, the impact of class differences on access to quality care, and the ways in which perceptions of community affect the creation and management of assisted living programs. At the heart of the book are ten fascinating case studies, half of them focused on private-pay facilities and the other half on public-pay institutions.

While finding that the actualities of assisted living rarely match the rhetoric of its proponents, Smith sees much to admire in its goals. He suggests tactics and strategies--such as promoting family- and community-based models of assisted living and adopting a standard of licensure for certain facilities--that could point the way to a better future.

TThe recent growth of "assisted living" facilities and programs has shaken the foundations of the system of long-term care for the elderly in the United States. Fueled by consumer frustrations with the available options, notably nursing homes, the assisted living model emerged during the 1990s to promise shelter, health care, control of one's own life, less government involvement, and a "real home." But how well have the advocates and developers of assisted living delivered on such promises? And what are the model's implications for public policy and the future of caregiving?

In "Reinventing Care," David Barton Smith offers brilliant insights into those questions by examining the realities of assisted living in New York City. Encompassing the largest, most concentrated population of elderly in the United States, New York spends more per person caring for its seniors than any other urban center. Yet, while the size of the city's care system boggles the mind, it nevertheless contains the same elements that exist in other metropolitan areas and thus provides valuable lessons for the nation as a whole.

Smith's study draws on twenty-five years of research, including hundreds of interviews and visits to representative facilities. He provides a succinct overview of how care is presently organized for New York's aging population and traces the history of the system up to the present. Among the key issues he addresses are the role of market forces and government regulation, the impact of class differences on access to quality care, and the ways in which perceptions of community affect the creation and management of assisted living programs. At the heart of the book are ten fascinating case studies, half of them focused on private-pay facilities and the other half on public-pay institutions.

While finding that the actualities of assisted living rarely match the rhetoric of its proponents, Smith sees much to admire in its goals. He suggests tactics and strategies--such as promoting family- and community-based models of assisted living and adopting a standard of licensure for certain facilities--that could point the way to a better future.

Given the impact that good nutrition and keeping fit have on health and well-being in later life, WHO, in collaboration with the Tufts University USDA Human Nutrition Research Center on Aging, organized a consultation to review the scientific evidence linking diet and other factors - especially exercise - affecting nutritional status, disease prevention and health promotion for older persons. The consultation focused primarily on practical issues, including the establishment of explicit recommendations to improve the health and nutritional status of older persons in a wide variety of socioeconomic and cultural settings. During the production of a comprehensive report, representing the outcome both of the preparatory work and of the consultation itself, it was recognized that new information emerging in several key areas should also be included. The combined results presented here are intended as an authoritative source of information for nutritionists, general practitioners, gerontologists, medical faculties, nurses, care providers, schools of public health and social workers.The specific recommendations concerning nutrient intakes, food-based dietary guidelines, and exercise and physical activity should also interest a larger audience, including the general reader. The main body discusses the epidemiological and social aspects of ageing, health and functional changes experienced with ageing, the impact of physical activity, assessment of the nutritional status of older persons, and nutritional guidelines for healthy ageing. Additional material covers food-based dietary guidelines for older adults - with particular emphasis on healthy ageing and prevention of chronic noncommunicable diseases - and guidelines for promoting physical activity among older persons. "...This report is significant, representing an authoritative consensus related to the epidemiological and social aspects of ageing, health and functional changes experienced with age, and the impact of physical activity. This valuable source of information is relevant to a wide range of health professionals; the clear and specific recommendations concerning food/nutrient consumption and physical activity for older adults should also interest a larger audience."- The Journal of the Royal Society for the Promotion of Health "...The book is a timely publication, which provides an exhaustive review of studies...This publication will certainly serve as a reference manual for all those involved in nutrition, gerontology and geriatrics. " - Indian Journal of Medical Research

Elderly Americans - Issues & Programs

What are the issues underpinning the trend towards innovation in the community care of older people? What is the nature of the innovation: how is it experienced by older people and their carers? "Changing services for older people" sets out to address these pressing questions. It presents the findings of a major research project evaluating the outcomes of the Neighbourhood Support Units innovation in Sheffield. Key issues raised include the goal to create more flexible 'tailor made' services and the promotion of user-and carer-responsive forms of provision, shifts which are occurring in many other European countries.;The aims of the book are two-fold. First, it reports on the outcomes of the initiative for older people and their carers placing these findings in the context of current debates about community care. Second, it discusses the process of innovation in the social services, drawing on evidence gathered from policy-makers, managers and front-line workers to illustrate both the barriers to change and the ways in which successful innovation can be accomplished.; "Changing services for older people" will be invaluable to personnel in the health and social services who are consi

* If most older people want to remain in their own homes, then why does residential care persist? The authors of this timely book set out to answer this pressing question and offer an explanation as to what makes older people give up their homes. Residential care homes provide accommodation for over 300,000 older people in the UK, the majority of whom are in their mid eighties. More than a quarter of the population over eighty five live in institutional settings, most of them in residential care homes. This book offers readers a comprehensive review of the history of residential care, current provision, current practice and an analysis of its future role. Re-Evaluating Residential Care will be invaluable to a wide range of practitioners involved in residential care, as well as students of nursing, social work, gerontology and social policy.

OVER 1,000 SOURCES OF FREE DOLLARS AND ASSISTANCE FOR SENIORS

Millions of dollars of services are available to help seniors and their caregivers get the top quality care they need for free or at a minimal cost. Many people with needs just like yours are already receiving free money and services for medical treatment, meals, long-term specialized care, and at-home assistance. But in order to get these benefits, you have to locate and tap into the government, community, and private agencies that offer them.

Leading free money expert Laurie Blum shows you how to navigate the bureaucratic maze. She provides:

• Over 1,000 sources of free financial aid, complete with contact names, addresses, and phone and fax numbers
• Listings of hundreds of government, community, and private organizations that provide nonfinancial assistance
• Clear step-by-step instructions for assessing your needs, evaluating services, working with caregivers, and making legal arrangements
• Smart ways to choose at-home and alternative housing for self-sufficient seniors or those needing special care

Given medical advances and greater understanding of healthful living habits, people are living longer lives. Proportionally speaking, a greater percentage of the population is elderly. Despite medical advances, there is still no cure for dementia, and as elderly individuals succumb to Alzheimer's Disease or related dementia, more and more people are having to care their elderly parents and /or siblings. Profiles in Caregiving is practical source of information for anyone who teaches caregiving, acts as a caregiver, or studies caregiving.
This book discusses recent research on stress factors associated with caregiving, and what factors impact on successful versus non-successful adaptation to the care-giving role. This is an expanding field in gerontology, and is also of interest to personality and social psychologists studying stress and interpersonal relations. Although there are many books on the cause and treatment of dementia, there has been a book that provides a research investigation into the factors associated with effective caregiving to dementia patients.
Key Features
* Conceptualizes caregiving as a multistage career whose impact on the caregiver continues to be felt after in-home care has ceased
* Based upon a longitudinal survey of a demographically diverse sample of principal caregivers over a three-year period
* Identifies caregivers who are most at-risk for adverse adaptation to the role
* Describes preventative and clinical intervention strategies
* Identifies post-care risk and issues
* Identifies antecedents to successful adaptation
* State of the art analytic techniques
* Graphic presentation of empirical findings
* Renowned multidisciplinary research team

Empowerment refers to the ability to make informed choices, exercise influence, make continuing contributions to society, and take advantage of services. These privileges are taken for granted by most working-age adults, but often are not available to older persons for a variety of reasons, including poverty, poor health, low educational levels, lack of transportation and access to services, negative stereotypes about aging, and overt or subtle age discrimination. Yet empowerment is vital to the quality of life of older persons and the health of society on the whole if seniors are engaged and involved members of it. This book takes an international approach by presenting the work of 17 experts in aging. Countries represented by the contributors include Denmark, the Dominican Republic, Ireland, India, Japan, Mexico, Pakistan, South Africa, the United Kingdom, and the United States. While many works address the issue of empowerment, the aging perspective is relatively rare and the international perspective entirely lacking until now.

Empowering Older People presents views and research written by experts in aging from around the world. Contributions look at the need to ensure older people have control over their own lives and discuss any positive measures which are being taken to provide real opportunities and resources for the older populations. Empowerment is vital to older people's quality of life and to the health of any society, and an international perspective on the issue will inform all who work with older people. In this edited volume, the countries represented by contributors include Denmark, the Dominican Republic, Ireland, India, Japan, Mexico, Pakistan, South Africa, the United Kingdom, and the U.S.

*Why do many older people rate their health as good when 'objective' evidence suggests that old age is a time of inevitable decline and disease? *How do different perspectives on health inform our understanding of health in old age? *What are the policy implications for ensuring a healthy future for old age? This book addresses important questions which existing literature on health and old age has largely ignored. By juxtaposing detailed case histories and first person accounts from older people with 'official statistics' on the health of 'the elderly' it explores the myths and tries to unpick the mysteries which surround the subject of health in later life. It goes on to explore the implications of these myths and mysteries for the way individual older people manage their health. It looks at the resources and social support available to them as well as the implications for public policy provision. The book ends by exploring the problems and possibilities of ensuring a healthy future for old age. It will be essential reading for reflective practitioners and for anyone concerned with new developments in the fields of ageing, social policy and health.

In the first geographic and environmental analysis of the recreational and retirement community industry, Hubert B. Stroud shows how and why certain communities had positive impacts on the surrounding region while others did not. Focusing on well-known developments in Arizona, New Mexico, Florida, Arkansas, and Tennessee, he finds that most developments were poorly planned, resulting in environmental damage, overtaxing of public services, and social and economic problems. Yet Stroud acknowledges that future development is inevitable, as recreational and retirement communities continue to lure urban America with the promise of paradise.

Many older people, indeed the majority, have many years of relatively good health after the usual retirement age. Contrary to widely accepted stereotypes, evidence indicates that those who wish to use their skills and abilities for productive contributions may encounter significant barriers.

Bass, Caro, and Chen and the experts who contributed to the volume provide an original reassessment of the current options available to older people. The authors argue that polices, practices, and societal messages help determine what choices are realistically open to older individuals. The attitudes and policies of family, workplace, and government as well as those of educational and religious institutions all contribute to defining what opportunities really are available for older people. The authors show, too, that considerations of gender and ethnicity are powerful in their impact on what those in the later years of life may or may not do. Although leisure is attractive to many in their elder years, the authors stress that it is but one of the number of choices that should be available. Employment, volunteering, and other new productive roles should not be denied to those who want to continue them and who, in the process, enrich their own and society's well-being. The authors provide authoritative analysis and new perspectives on aging.

By offering a comparative, institutional analysis of how state-supported pensions for the elderly developed in Britain, Canada and the United States, Anna Shola Orloff aims to make a contribution to understanding the growth of modern social welfare policies. It is not enough, Orloff demonstrates, to simply examine socioeconomic factors in the growth of the welfare state. She argues that welfare policies are also shaped by the political institutions and processes that are the legacy of state formation and expansion in particular nations. Orloff explains why, when and how poor relief was replaced by modern social insurance legislation and pensions for the elderly in the first three decades of the 20th century. She analyses the long-term social and political transformation that laid the basis for modern social politics: the spread of waged work, the development of new liberal ideologies and the expansion and transformation of state administrative capacities. Combining original historical research with the analysis of secondary sources, Orloff's work is an example of the use of comparative and historical methods in answering questions about macropolitical transformation, such as the origin of the welfare state. ""The Politics of Pensions"" outlines an original, interdisciplinary approach that should appeal to a wide variety of readers: political sociologists interested in the state, social workers and specialists in old age policy, and comparative researchers of all disciplines engaged in research on the welfare state.

This thoughtful collection based on a highly successful conference held in Calgary, Alberta, combines the views of professional gerontologists, educators, health-care specialists, and policy makers to confront the issues affecting health care for older adults in both Canada and the United States. The contributors seek not only to inform but to inspire innovative responses from the private as well as the public sector. Experts in government, ageing, medicine, public administration, social service, counselling, and consulting focus their attention on vital areas of concern to elders who are in need of assistance, to the providers of these services, and to a public who seeks assurance that its resources are cost-effectively allocated to meet present and future demand. Included are essays on the current status of health-care policy in the United States and Canada, daily money management, caring for the non-compliant elder, long-term care as an emerging women's issue, lobbying government agencies and political leaders, the role of gerontology in resolving the crisis of long-term care, and "geroethics".

A lively account of life in a decent American nursing home, this book offers an in-depth look at American geriatric facilities. Using six years of anthropological research, Joel Savishinsky analyzes the lives and experiences of residents, staff members, and volunteers. He addresses the contradictory attitudes American society has shown towards geriatric facilities and the aging process itself: the tensions between caring and curing, morality and mortality, privacy and supervision, home and institution, and selfishness and altruism.

Savishinsky portrays the strengths and weaknesses of the nursing home in a humanistic way, emphasizing how the nursing home affects the individuals who live and work there. He also discusses inventive recreation programs, such as pet therapy, suggesting they can alleviate loneliness and provide meaningful opportunities for residents. Savishinsky challenges the stereotypic view of aging and institutional life, concluding that not all nursing homes are warehouses for the dying; he offers several recommendations for improving the quality of life and work in geriatric institutions. This book is presented in nontechnical language and is valuable to the general reader as well as to professionals in health, social science, social work, and gerontology.

America urgently needs innovative housing and care solutions for our growing population of older persons. For those who do not require or cannot afford costly, full-time nursing care, yet find it increasingly difficult to live alone, board and care residential facilities may be the most practical and attractive alternative. What are board and care homes, and how do they operate? How are they managed and regulated? How can older persons, caregivers, and family members decide which are the best facilities?"Between Home and Nursing Home" suggests what to look for when choosing a facility, how to monitor the care offered, and the kinds of supervision and services that should be available. For residents and caregivers alike, the authors offer valuable suggestions and illustrate activities that contribute to total mental and physical well-being. This book includes valuable appendices that feature important facts about retirement facilities and tips on how to evaluate a residential care facility. Families and professionals will find this book to be a valuable guide to one of the fastest-growing housing and health care options available to the aged.

Human Services for Older Adults provides a broad overview of the conditions and context in which today's older adults live, as well as practical information on how to work with them given today's circumstances. Information is provided on the demographic characteristics of older people in America, discussing social, economic, and health problems confronting them and the needs of subgroups among the elderly population such as minority elderly, rural elderly, and older women. The book also provides information on various methods of working with older adults, and social programs available through the government, as well as other sources for meeting the needs of the elderly. The revised edition of a popular text, it is geared toward nurses, social workers, psychologists, gerontologists, counselors, and others who work in senior adult positions and settings.

A groundbreaking exploration of the sociology of dementia with contributions from distinguished international scholars and practitioners. * Organised around the four themes of personhood, care, social representations and social differentiation * Provides a critical look at dementia and demonstrates how sociology and other disciplines can help us understand its social context as well as the challenges it poses * Contributing authors explore the social terrain, responding in part, to Paul Higgs and Chris Gilleard s highly influential work on ageing * Breaks new ground in giving specific attention to the social and cultural dimensions of responses to dementia

This volume presents important findings on conflict and abuse in families of the aged. A valuable resource for those in sociology, psychology, gerontology, and social work as well as psychotherapists who work with the aged, the staff of elder abuse programs, adult protective service workers, and legislators. the authors provide a fresh, historically balanced, empirical and theoretical framework for the view that elder abuse and neglect is an extreme manifestation of family conflict.

"Lisa P. Gwyther, Journal of Gernontology"

This volume presents important findings on conflict and abuse in families of the aged. A valuable resource for those in sociology, psychology, gerontology, and social work as well as psychotherapists who work with the aged, the staff of elder abuse programs, adult protective service workers, and legislators.

People with dementia need increasingly specialised support as they approach the end of life, and so too do their families and the professionals working with them. This book describes not only what can be done to ensure maximum quality of life for those in the final stages of the illness, but also how best to support those involved in caring for them. Emphasising the importance of being attuned to the experiences and needs of the person with dementia, the authors explain why and how they should be included in decisions relating to their end of life care. Practical strategies for ensuring physical and emotional wellbeing are provided, drawing on useful examples from practice and providing solutions to potential challenges that carers and family members will face. Dilemmas surrounding end of life care are explored in detail, including the moral dilemma of medical intervention, and the authors suggest ways of supporting family members through the process in terms of providing information, helping them adjust to change and loss, and involving them in their relative's care, and at how care staff can be supported through appropriate education and training, team building and information-giving. This is an essential resource for anyone who wishes to provide compassionate, person-centred care for a person with dementia as they approach the end of life, including care staff, nurses, social workers and related professionals.

Presenting clergy and chaplains with unique therapeutic tools for helping senior adults enrich their later years, this book gives advice on how to strengthen relationships, find meaning in life and feel comfortable approaching life's final chapter. It guides clergy and chaplains through how to effectively conduct "Soul Legacy" projects, in which older people reflect on what they want to leave behind for their loved ones and how they want to be remembered after they die. It enables older people to pay loved ones personal tributes and show them how important they are. By focusing on others rather than the self, it provides comfort for loved ones as well as the senior adult, prevents loneliness and negative feelings about ageing, and helps adults gradually become comfortable with the challenges of approaching the end of life.

'Blisteringly well written, deeply humane and very funny' Daily Telegraph 'Enough to make you die laughing' Daily Mail 'Funny and moving' Daily Express Whether he's initiating a coup d'etat against new regulations with the residents, or forging a bond with the 98-year old who once called him a fat slut, Pope Lonergan's work is infinitely varied. This no-holds-barred account shows what life inside a care home is really like, for both residents and carers. Featuring night-time drama, incontinence pads and the uniquely dark humour of one double-amputee Alzheimer's patient, here you can learn everything you ever wanted to know (and a few things you probably really didn't) about Britain's care system. This important memoir challenges us all to think differently about the value of our elderly, and also the carers who look after them.

Proven to enhance wellbeing, posture, breathing and sleep, and reduce anxiety and agitation, this programme shows how yoga can be adapted to benefit people with dementia. Based on the findings of a pilot therapeutic yoga programme for people with dementia in care homes, this book offers substantial yoga sequences, breathing exercises, meditations and mindfulness exercises for improving symptoms associated with dementia. It offers an innovative Reminiscence Yoga approach, which uses sounds, music, guided imagery and familiar actions to stimulate memories. The book demonstrates the many benefits of yoga for people with dementia, and describes the ways that each yoga exercise can be adapted for people of different abilities.