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The number of elderly and disabled adults who require assistance with day-to-day activities is expected to double over the next twenty-five years. As a result, direct care workers such as home care aides and certified nursing assistants (CNAs) will become essential to many more families. Yet these workers tend to be low-paid, poorly trained, and receive little respect. Is such a workforce capable of addressing the needs of our aging population? In Who Will Care for Us? economist Paul Osterman assesses the challenges facing the long-term care industry. He presents an innovative policy agenda that reconceives direct care workers’ work roles and would improve both the quality of their jobs and the quality of elder care. Using national surveys, administrative data, and nearly 120 original interviews with workers, employers, advocates, and policymakers, Osterman finds that direct care workers are marginalized and often invisible in the health care system. While doctors and families alike agree that good home care aides and CNAs are crucial to the well-being of their patients, the workers report poverty-level wages, erratic schedules, exclusion from care teams, and frequent incidences of physical injury on the job. Direct care workers are also highly constrained by policies that specify what they are allowed to do on the job, and in some states are even prevented from simple tasks such as administering eye drops. Osterman concludes that broadening the scope of care workers’ duties will simultaneously boost the quality of care for patients and lead to better jobs and higher wages. He proposes integrating home care aides and CNAs into larger medical teams and training them as “health coaches” who educate patients on concerns such as managing chronic conditions and transitioning out of hospitals. Osterman shows that restructuring direct care workers’ jobs, and providing the appropriate training, could lower health spending in the long term by reducing unnecessary emergency room and hospital visits, limiting the use of nursing homes, and lowering the rate of turnover among care workers. As the Baby Boom generation ages, Who Will Care for Us? demonstrates the importance of restructuring the long-term care industry and establishing a new relationship between direct care workers, patients, and the medical system.
"Published in 2018 by arrangement with Da Capo Press, a subsidiary of Hachette Book Group, Inc."--Title page verso.
"Who Will Take Care of Mom?" is a must-read for anyone who expects they will have to provide or coordinate long-term care for a parent, disabled or terminally ill relative. This life-changing experience happened to Cynthia Wilson when she was 34, single and poised to enter her peak earning years. Odds are that you or someone you know will have to take care of a parent sooner than expected because people are living longer, but not necessarily healthier. The trend is threatening America's economic prosperity and consuming individual wealth because Americans are spending more of their tax dollars, personal savings and time away from work on elder care. In "Who Will Take Care of Mom, A Guide for Family-Managed Senior Care," Cynthia examines the political debate surrounding senior care, along with some economic and employee trends that are affecting elder care, family life and the work place in America. She explains why family-managed care is the better solution for families and shows caregivers how to implement a family-managed care plan that provides safe, loving care for a relative, without forfeiting the family's wealth.
It is amazing to realize that much of the Western medical community is in a love/hate relationship with the economics of medicine. Quality-Adjusted Life Years (QALYs) is one of the primary methods of guiding many medical decision-makers in the allocation of limited medical resources. Herein lies the problem of medicine and economics. It seems that deciding who will receive limited medical resources is a task filled with moral and ethical difficulties, even for those depending on the information obtained from QALY calculations. These moral and ethical difficulties are beyond the scope of sound bites that tout the benefits of "universal health care," "affordable insurance," or the safety of the "free-market economy." The breadth of the difficulty is found in the widespread disagreement concerning how the health-care system should be distributed or "fixed," since most will agree that there is a problem with distributing medical resources. It seemed obvious that some difficult decisions will need to be made that few are both willing and able to make. This difficulty is particularly true in decisions about health-care allocation, and that is where QALYs have been found useful and problematic. Limiting medical care for the elderly based upon their age did not occur until the mid-twentieth century possibly because the elderly held a unique position of respect in the Western community. It is no longer the case that the elderly are given a unique position of respect and dignity. Rather, it seems that with the increased use of QALY calculations, the elderly are in danger of receiving less medical care than they are warranted. It is imperative that Christians respond to the ethical implications of significant models of resource allocation that currently assist decision-makers in the allocation process, such as QALYs.
To care can feel good, or it can feel bad. It can do good, it can oppress. But what is care? A moral obligation? A burden? A joy? Is it only human? In Matters of Care, María Puig de la Bellacasa presents a powerful challenge to conventional notions of care, exploring its significance as an ethical and political obligation for thinking in the more than human worlds of technoscience and naturecultures. Matters of Care contests the view that care is something only humans do, and argues for extending to non-humans the consideration of agencies and communities that make the living web of care by considering how care circulates in the natural world. The first of the book’s two parts, “Knowledge Politics,” defines the motivations for expanding the ethico-political meanings of care, focusing on discussions in science and technology that engage with sociotechnical assemblages and objects as lively, politically charged “things.” The second part, “Speculative Ethics in Antiecological Times,” considers everyday ecologies of sustaining and perpetuating life for their potential to transform our entrenched relations to natural worlds as “resources.” From the ethics and politics of care to experiential research on care to feminist science and technology studies, Matters of Care is a singular contribution to an emerging interdisciplinary debate that expands agency beyond the human to ask how our understandings of care must shift if we broaden the world.
Raising kids to be socially conscious and embrace strong values can be difficult in today's world. In Raising Kids Who Will Make a Difference, mother, counselor, and family-life educator Susan Vogt sets out to inspire, equip, and comfort parents in the awesome task of raising Catholic kids who will make positive contributions to our world. Using a delightful blend of honesty and humor, Vogt offers successful parenting strategies and straightforward discussions on important issues such as sexuality, substance abuse, materialism, racism, global awareness, and death.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
"An important contribution to the on-going national dialogue concerning the need for planning for an increasingly aged population and its impact on our social, political, medical, economic institutions." --Wisconsin Bookwatch "Based on their assessments of the levels of need for the long-term care among African-American, Latino, and non-Latino white older persons, the authors offer viable and attractive possible alternatives to institutionalization in the long-term care of the elderly." --Nurse Practitioner "A major contribution. Should be a part of every course on social gerontology, long-term care, the demography of aging, or formal/informal support networks of the elderly." --Robert Joseph Taylor, Institute for Social Research, University of Michigan America is getting older. By the year 2010, almost one in five Americans will be 65 years of age or older.The combined forces of low fertility and longer life spans among all racial and ethnic groups have resulted in a disproportionate increase in the number of individuals over 65 and an even faster increase in the proportion of those individuals over eighty-five. As a result, the nation faces an unprecedented challenge in addressing the economic, medical, and long-term care needs of this older population at the same time that it assures the welfare of the young. The growth of the cost of the long-term care of the elderly is one of the major forces behind recent increases in Medicaid expenditures, and any reformed health care financing system will have to find ways of providing high quality long-term care to older Americans at a reasonable cost. In a racially and culturally diverse nation like the United States, official policy regarding the care of the elderly simply cannot be based on the assumption that the elderly are a culturally and socially monolithic population. The cultural, social, and economic situations of the elderly simply differ too greatly and the family's role in their care is affected by important cultural and social factors. In Who Will Care for Us? Ronald J. and Jacqueline L. Angel argue that policies based on the assumption of a homogenous population will fail to take advantage of the opportunities that ethnic and cultural diversity offer for the long-term care of the elderly. The authors examine the great racial and ethnic diversity among the elderly in the contemporary U.S. in terms of living arrangements, economic well-being, and reliance on formal and family-based sources of support. Based on their assessments of the levels of need for long-term care among black, Hispanic, and non-Hispanic white older persons, they offer viable and attractive possible alternatives to institutionalization in the long-term care of the elderly.
Approximately 100,000 deaths per year in the United States result from preventable medical errors. This figure is about twice the number of people who die in car accidents and five times the number of murder victims annually, and twenty times the number of servicemen and women killed in Iraq and Afghanistan since the start of hostilities in 2001. If you think Americans have the best health-care system in the world, think again. In this deeply researched and controversial book, Dr. Stephen Schimpff explains why our health-care delivery system serves us so poorly, why it costs so much, and why government policy over many decades has not only failed to improve care delivery but has actually made it worse. In the process, he dispels common misconceptions about medicine and health care. The Future of Health-Care Delivery provides timely information and a road map to achieve world-class care delivery, putting health care where it belongs--in the hands of the patient and medical professionals instead of the insurance companies and government.