Similar to many heterosexual elders, the lack of coverage for long-term care for most gay, lesbian, bisexual, and transgender elders constitutes a crisis in their care as well as personal finances. Often, seniors who enter nursing homes spend all of their assets on their care, then simply apply for Medicaid when they have next to nothing left, a phenomenon known as the “Medicaid spend-down.” (more…)

Several efforts, both public and private, are helping assisted living become more affordable by lowering the cost of constructing assisted living facilities. The Department of Housing and Urban Development (HUD) has two programs that subsidize developers of affordable assisted living, allowing them to provide assisted living at a lower cost to consumers. Under the first program, the Assisted Living Conversion Program, HUD allocated $50 million per year from fiscal years 2000 to 2002 to provide grants to help owners of nonprofit low-income senior housing apartments to convert dwelling units into assisted living apartments (HUD 2001). (more…)

Developers have built and marketed assisted living primarily for middle- to upper-income older persons—those able to pay $2,000 a month or more—a cost prohibitive for many older persons. According to a survey of 300 assisted living facilities in 1998, only 20% of facilities charged a single rate. The other 80% charged varying rates, depending upon room sizes or apartments or for assistance beyond the facility’s standard package of services. Most of the basic monthly rates ranged between $1,100 and $2,900 per month (Hawes, Phillips, and Rose 2000). Only 7% of the residents surveyed by the National Investment Center (NIC) and the Assisted Living Federation of America (ALFA) (1998) received public assistance for services (provided through Medicaid), and only 9% received public assistance for shelter costs (provided through the federal Supplemental Security Income program). (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…)

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…)

Complications of Adverse Drug Reactions may include hospitalization, increased hospital stays and health care expenditures, morbidity, and death. The incidence of Adverse Drug Reactions varies by type of health care setting (e.g., ambulatory clinic, hospital, nursing home). In a cohort of older Medicare enrollees, the rate of Adverse Drug Reactions was 50.1 per 1,000 person years. In long-term care facilities, the rates of Adverse Drug Reactions were reported as 1.9 to 9.8 per 100 resident-months. Adverse Drug Reactions are a common cause of hospital admission of older adults and were responsible for 6% to 24% of all hospital admissions. Of all Adverse Drug Reactions, 23% to 28% were categorized as serious.

Approximately one quarter to one half of Adverse Drug Reactions are considered to be preventable. Errors are most likely to occur at the time of prescribing a medication or during monitoring of therapy. Prescribing errors include choosing an inappropriate medication, prescribing a medication that interacts with another medication in the individual’s regimen, and prescribing a drug in the face of an established drug allergy. Errors in monitoring of therapy may include failing to obtain necessary laboratory values to monitor drug therapy and not responding promptly to signs, symptoms, or laboratory evidence of drug toxicity.

Many researchers have attempted to identify risk factors for Adverse Drug Reactions, an endeavor that has been disappointing. The most persistent risk factor for Adverse Drug Reactions is use of multiple medications; thus, it is important that patients be maintained on the fewest number of medications needed to manage their health conditions. Researchers have not found Adverse Drug Reactions to vary substantially according to age or sex. Several factors are important to keep in consideration to minimize Adverse Drug Reactions, even though they have not been identified as independent risk factors. (more…)

Australia’s health policy is funded and delivered by several levels of government and is supported by private health insurance arrangements. In place are systems for the delivery of health, income support, and housing and community services to support aging people. Medicare, the national health insurance scheme, is funded and administered by the Australian (commonwealth) government and provides coverage for a range of primary care services, including visits to medical practitioners. (more…)

Though much psychological research traditionally has focused on problems and maladjustment, recently there has been more interest in positive psychology, qualities that promote personal well-being across the life span. In this section, several of the positive aspects of later life social cognition that have received attention within personality psychology are briefly discussed. These include generativity, ego integrity and coping, optimism and perceived control, and wisdom. (more…)

My job is to plan for catastrophe, yet Jane’s story was an echo of my own. My mother, a fiercely seniors independent and proud woman, worked until she was 86 years old; but after she was forced into a senior nursing home care at age 93, she died within weeks. Ethel enjoyed a long life. Its end was certainly not a direct result of the loss of independence and personal dignity she experienced in the nursing home. But if I had helped her plan for her very old age, she might have spent her last months surrounded by neighbors and friends, instead of professional caretakers. (more…)

Parents are always conscious about their kid’s health related matter, thus they take children’s immunization as a serious issue. Children, particularly babies should be protected by taking immunization due to their bodies are easily infected with virus. However, parents often forgot that they also should take adult immunization shot. Grown up adults also need immunizations and keep it up-to-date to hinder any adult diseases or chronic disease which may be caught by their body. It is thus important that adult immunization should not take lightly and it necessary to always keep up-to-date. (more…)