Beneficiaries of the Medicare program have three rehabilitation-related benefits established by federal statute: physical therapy rehabilitation, occupational therapy, and speech-language therapy (speech-language pathology). All therapists, who must be graduates of accredited programs, must pass a national examination and be licensed, certified, or registered in their respective professions within the state in which the services are furnished. Medicare covers services that are necessary and likely to result in improvement in a reasonable period of time. Medicare does not currently regard prevention services provided by therapists as falling under therapy benefits and will not cover services intended to maintain a current level of function. (more…)

Older Person Care

• Older persons should benefit from family and community based care and protection in accordance with each society’s system of cultural values.
• Older persons should have access to health care to help them to maintain or regain the optimum level of physical, mental, and emotional well-being and to prevent or delay the onset of illness.
• Older persons should have access to social and legal services to enhance their autonomy, protection, and care.
• Older persons should be able to utilize appropriate levels of institutional care providing protection, rehabilitation, and social and mental stimulation in a humane and secure environment.
• Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care, or treatment facility, including full respect for their dignity, beliefs, needs, and privacy, and for the right to make decisions about their care and the quality of their lives.

Older Person Independence

• Older persons should have access to adequate food, water, shelter, clothing, and health care through the provision of income, family and community support, and self-help.
• Older persons should have the opportunity to work or to have access to other income-generating opportunities.
• Older persons should be able to participate in determining when and at what pace aging work withdrawal from the labor force takes place. (more…)

Over the past 60 years, many documents, including the 1948 Universal Declaration of Human Rights, have addressed the rights of all persons. But it was not until the Declaration on Social Progress and Development in 1969 that the human rights of the elderly were specifically mentioned in an international rights document (Office of the United Nations High Commissioner for Human Rights). The United Nations adopted the first International Plan of Action on Ageing in 1987 and the General Assembly of the United Nations adopted the Principles for Older Persons in 1991. (more…)

Elder maltreatment and abuse of the elderly is found in almost all countries of the world. According to the World Health Organization, elderly abuse is expected to continue to increase, particularly as many countries experience rapidly aging populations. Throughout the world, both elderly men and women are at high risk of abuse, neglect, and exploitation. Although older men are at risk of abuse in about the same proportion as women, elderly women are at higher risk of abuse, neglect, and exploitation in cultures where women are devalued. (more…)

To meet the needs of older people most countries have moved toward community-based care as a means of providing adequate and cost-effective care. Community-based care focuses around an integrated and more comprehensive approach to the special needs of older persons, their families, and the community. This type of model involves and requires inter-organizational collaboration and interdisciplinary cooperation. A community-based approach in social services and in health care is a strategic approach to meet the mounting demands for integrated health and social services for the elderly. Community health care usually includes both the health and social services sectors. (more…)

Gay elders may also have particular care and caregiving needs. Since most caregiving in the United States is provided by biological children, and since gays and lesbians are less likely to have children and appear more likely to live alone in old age than heterosexual elders, an urgent question presents itself: Who will care for gay, lesbian, bisexual, and transgender elders? In general, the state fails to recognize same-sex relationships. Some studies indicate that gay, lesbian, bisexual, and transgender elders may be more likely to live alone, making innovative support networks critical. Often, gay seniors are estranged from their families of origin due to homophobia and/or fear of rejection. (more…)

There are now several gay senior housing projects in various stages of development in Seattle, Boston, and Florida. While such developments are welcome, most units will only be accessible to upper-income people. The housing needs of rural, poor and middle-income gay, lesbian, bisexual, and transgender elders can best be addressed by making senior housing gay-friendly and either adding sexual orientation and gender identity to the Fair Housing Act of 1968 or passing a federal nondiscrimination law that covers housing as well as employment. (more…)

In better facilities, the design of the building reflects the philosophy of promoting independence. Residents usually live either in private rooms with baths, individual temperature controls, and doors that lock or in small apartments with kitchenettes. They often bring their own furniture. The decor and scale are homelike throughout the building, often with one or more small sitting rooms that encourage residents to visit with each other and entertain guests. Many assisted living home facilities explicitly avoid fluorescent lighting, long corridors, tile floors, and the nursing stations that are associated with nursing homes residents. (more…)

Activities of Daily Living (ADLs) is the core daily personal care activities that are necessary in order for people to be able to live independently. Loss of mental functioning is measured by other standardized tests and referred to as cognitive impairment. Activities of Daily Livings are particularly important because along with cognitive impairment, and in some cases “medical necessity,” they are the mechanism used by the insurance industry to determine qualification for long-term care benefits and may also be used to determine qualification for admission to a nursing or assisted living home facility. (more…)

Heterosexism and homophobia are widespread in nursing homes and are symptomatic of a larger sexphobia often associated with those providing services to seniors. In a mid-1990s survey of nursing home social workers, more than half said their coworkers were intolerant or condemning of homosexuality among residents, while most other respondents avoided answering the question. The staff in one nursing home refused to bathe a resident because they did not want to touch “the lesbian,” and a home care assistant threatened to “out” a gay client if he reported her negligent care (Cook-Daniels 1997). (more…)