policy considerations in the development and implementation of an aging-related service program. What specific aging-related factors of an older client need to be considered in offering such services? Give 2 examples of such situations that may occur in the "real world" service with an aging population.

Policy considerations in the development as well as implementation of aging-related service program are numerous. In this section we use the work of Niles-Yokum and Wagner (2011) and other related materials in the description of five policy considerations in the development as well as implementation of an effective aging-related service program. A review of the work of Niles-Yokum and Wagner (2011) indicates that there are several policy considerations. They include the following;

Cultural background

Health status

Living arrangements

Education level

Employment and Income

These are discussed into details in this section.

The first policy consideration is accurate cultural background information of the aging population (Niles-Yokum and Wagner,2011,p.6). Even though several advocacy groups shun stereotyping, there is a general tendency to consider the elderly as a single, homogenous group whose cultural beliefs and values are similar and defined by their designated age group. The reality however is that cultural backgrounds of these elderly citizens are varied and dissimilar. According to Niles-Yokum and Wagner (2011), a U.S. census report indicated that close to thirty million elderly citizens were born outside the U.S.

Actually, only about two demographic characteristics of this given population are important. These are; the median age of any foreign-born person who is more than 52 years old and the fact that the foreign-born population is too diverse to ignore. This includes a large number of Latinos from South and Central America, Asians from India, Korea, Cambodia, Vietnam and Laos, Caribbean islanders and Haitians as noted by Gelfard (2003). The differences in the cultural attitudes towards the elderly and aging population is an important policy considerations in the development and implementation of an effective aging-related service program. This is because it has a direct influence on the mode of communication with the aging population and helps in the easy implementation of aging-related programs.

The health status of the elderly is the second policy consideration in the development and implementation of an aging-related service program (Niles-Yokum and Wagner,2011,p.7).It is a fact that the main health problem affecting the elderly is not acute illnesses but rather the chronic conditions that adversely affect their functioning. The problems that are associated with the functioning of an individual are assessed on the basis of the individual's relative inability to perform the basic Activities of Daily Living (ADLs such as bathing, feeding oneself, dressing, using the toilet as well as transferring between bed and a chair). The Instrumental Activities of Daily Living (IADLs) refers to the ability to perform household tasks like meal preparation, cleaning the house, managing money, shopping, strolling and participating in the community as well as using the telephone. The work of Siegel (1996) for instance projected that the total number of disabled elderly population would triple by the time we reach 2040. Disability is therefore a common feature in the American society as indicated in the 1977 study that indicated that more that 50% of the older Americans reported having at least one nonphysical or physical disability as noted by AoA (2005).

While developing age-related service programs, it is critical for the policy makers to understand the number of older population who have chronic conditions. Chronic conditions are noted to be a case of functioning problems in a large number of the older population. The most common ones are hypertension (49percent), arthritis (36percent), heart disease (31percent), sinusitis (15.1percent), and diabetes (15percent). Other than pain which is associated with some of the chronic conditions like arthritis, the older persons may experience a lot of difficulty in cooking, feeding themselves, walking and even taking medication. The chronic conditions therefore negatively impact the older population's quality of life.

The third policy consideration in the development and implementation of an aging-related service program is the living arrangement that are preferred by the older population (Niles-Yokum and Wagner,2011,p.7). There are close to one and half million nursing home beds in the U.S. However, older population with more than 65 years represents not more than 5% of the total number of the older adults in America. Aging in place is noted to be one of the most striking method that has statistically been noted to be experiencing a growth as a preference of the older population who are keen in maintaining their individual households in their elderly state. The proportion of older persons who live alone is however noted to vary by both age and gender. For instance in 2007, close to 73% of older men were reported to live with their spouses while close to 42% of the women population aged over seventy five years also lived with their spouses as indicated by the Federal Interagency Forum on Aging-Related Statistics (2008).In addition to this, close to 56% of all the noninstitutionalized older people lived alone in 2007.However, variations by ethnicity and race exists among the older persons who lived alone. In the U.S. The non-Hispanic White as well as black women were most probably be the ones who live alone. According to Niles-Yokum and Wagner (2011,p.8), the number of elderly persons who are living alone is a reflection of the dispersal of their families over a wide geographical area. The poorer families are noted to often live closer to their elderly adult population/relatives. It has also been indicated that the level of family income bears a positive correlation with the use of long-term care homes/residences for the elderly population/parents/relatives. The poorer families who are not in a financial position that can support the stay in care homes are therefore most likely to resort to living with their older family member (s).

In the U.S. rural states like Missouri, Iowa and Arkansas are noted to have very high proportions of the elderly. This is because the younger population has moved to other regions that are more urbanized and have not been sufficiently replaced by any new population. Even though a large number of the elderly populations have joined in the rural-urban migration, several suburban residents have aged in place (grown old in their homes). As a consequence of this aging in place phenomenon, a large number of the elderly persons are living in their own homes as opposed to care homes. Close to 23% of the elderly population in the U.S. have according to AoA (2003) lived in various nonmetropolitan areas.

The fourth policy consideration in the development and implementation of an aging-related service program is the education level of the older population (Niles-Yokum and Wagner,2011,p.8). This is because of the fact that the insufficient educational background of several present-day older persons is a cause of problems for the service providers. This is due to the fact that most of these elderly persons have very limited reading, writing and verbal skills. The implication of this is that programs that require very extensive discussions and reading may not be practical for a large number of the elderly population. It is also worth noting that at even a more basic level, this population may find a lot of difficulty in comprehending as well as following instructions on care and medication use. This would therefore lead to the improper use of medication and lack of appropriate skills for taking care of themselves. These problems seem to abate as the differentials in the educational levels of the elderly population and the general pollution reduces.

It is useful to point out that an improvement in the educational levels of the elderly population would automatically lead to an improvement in the type and complexity of programs to be used in helping them in realizing good health and self-care.

The fifth policy consideration in the development and implementation of an aging-related service program is the employment and income of the older population (Niles-Yokum and Wagner,2011,p.9). These recent changes in the work patterns in America are noted to have not been of great benefit to several American as well as foreign-born older persons. The inability of majority of the elderly persons to obtain basic higher education in the 1900s meant that they would automatically be destined for blue-collar jobs. Older persons with low-paying jobs have very limited financial resources that translate to lower Social Security benefits as well as nonexistent or inadequate pension funds. Intermittent work as well as part-time jobs has also prevented several women from getting adequate "quarters" to help them qualify for Social Security.

Most of the American elderly population who are being served by the existing programs has a very limited ability to pay for the rather costly services. For instance, Income maintenance programs like Supplementary Security Income (SSI), food stamps, Medicare as well as housing subsidies have in way helped in raising the income ceiling of the older population. Ethnic and cultural factors and variations however also affect this domain.

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