Among the most critical issues facing society today is the
provision of community support for people of all ages who require
assistance in performing daily living tasks. Researchers have
documented the support systems and needs of older persons, children
with special health care needs, and young persons transitioning
into adulthood. While the United States may not yet have solved
many of the challenges of providing adequate supports to these
populations, researchers at least have a good sense of the nature
of those challenges and are working toward that end. Somewhat
surprising, then, is the nearly complete lack of knowledge about
the support systems and needs of a rapidly growing population of
adults who are not yet considered old but who nevertheless need
help due to traumatic injury, the congenital illnesses of childhood
and young adulthood, and/or the early onset of chronic diseases
typically associated with later life (e.g., arthritis, heart
disease and cancer). Specifically, researchers know little about
the millions of Americans who require assistance during the period
of late middle age, a transition phase between middle age and the
older years, when activity limitations associated with a chronic
condition escalate sharply. The largest generation in American
history to date--the baby boom generation--has begun to enter late
middle age, the oldest of whom turned sixty in 2006. While the
research community looks ahead to the likely strains this
generation will place on the formal long-term care system,
Medicare, and the Social Security system in the near future, those
who find themselves in need of personal care in late middle age
must first pass through a particularly vulnerabletime before they
are eligible to benefit from the safety net these systems afford.
Because late-middle-aged adults are often considered the "carers"
of society (many caring for dependent children or aging parents,
and often both), we do not often think of this group as vulnerable
and in need of help themselves. They, more than others, are left to
rely on their own financial and family support systems to get
through their difficult time, while at the same time planning and
preparing for the possibility of living another 20 years or more
with chronic illnesses and conditions. Up until now, we have known
very little about how, and how well, they manage. In this first
critical study of the availability and receipt of care for
late-middle-aged adults, Julie Lima and Susan Allen uncover a host
of vulnerabilities that challenge the wellbeing of those who find
themselves in need of personal assistance at a critical point in
their lives. Using a lifecourse approach, they outline the care
needs of older adults in various stages of life, as well as the
sociodemographic and policy trends that influence the amounts and
types of care that are available, and that will likely be available
in the near future. Since so little was known about the care needs
of this group prior to this work, this book is largely descriptive
in nature, and the authors intend for it to lay the groundwork for
future work in this area. This is an important book for all
gerontology, disability, and lifecourse collections.
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