Well-being Of Older Americans Research Articles

Perspectives of Productive Aging: How Occupations Affect Health and Well-Being of Older Adults in Retirement

A predicted surge in the aging population presents a major challenge for public health in the USA. As occupational therapy researchers, we wondered how continued engagement in productive occupations affected the health and well-being of older Americans. Today’s retirees already understand the basics of successful aging, such as maintaining physical and mental fitness, and continuing an active lifestyle. Productive aging represents the next step: choosing roles and occupations that keep them engaged with others and their communities. As suggested by Clark (Jackson, Carlson, et al., 2012), occupations have the potential to provide a protective barrier to declining health, thereby lowering health care costs for the older population. Our Productive Aging qualitative studies (1 & 2) explore the lived experiences of life transitions, challenges, and adaptive skills implemented by participants (ages 65-80) in their own productive occupations. The findings of this follow-up study confirm and enhance themes of our first study (Cole & Macdonald, 2015): 1) prominence of the self-manager role, 2) intentionally maintaining social connections, and 3) engaging in self-fulfilling activities. Additional findings reflect current technology effects and elaborate how participants have met health challenges by adapting activities and environments (self-management), and using social resources (connections) to help them remain engaged in the occupations that give their lives meaning. Cole, M., & Macdonald, K. (2015). Productive aging: An occupational perspective. Thorofare, NJ: Slack, Inc. Clark, F., Jackson, Carlson, et al. (2012). Effectiveness of Lifestyle Intervention in promoting well-being of independently living older adults. Journal of Epidemiology and Community health.

DEVELOPMENTS IN UNDERSTANDING AND COMBATING SENIOR FINANCIAL EXPLOITATION

Financial exploitation of older adults has been called the “Crime of the 21st Century,” and continues to be a pervasive threat to the health and well-being of older Americans. With 10,000 people turning 65 every day in the United States, the time to act to combat senior financial exploitation is now. As even otherwise high-functioning older individuals can be vulnerable to financial exploitation due to the normal aging process (and the excessive rate at which they’re targeted), it is vital that we understand the root causes of senior financial exploitation and know what steps we can take to fight it – and to give those on the front lines the tools to detect and prevent exploitation. This symposium will: Examine the cognitive changes that occur in older adults that can create this vulnerability; Explain how these changes contribute to poor financial decision making; Provide an overview of changing state and federal laws which can help better protect seniors from financial exploitation; Discuss what participants and financial institutions can do to help combat financial exploitation; Address the financial challenges often faced by caregivers; and Understand how financial institutions can be a helpful partner for caregivers.

Public health imperative of the 21st century: innovations in palliative care systems, services, and supports to improve health and well-being of older americans.

A primary aim of federal aging and health policy must be promoting innovations in palliative care systems, services, and supports that improve the experience of growing old in America. Older adults must contend today with increasing burden over the life course often as the result of life-limiting chronic pain and chronic illnesses as well as social and economic factors beyond their control. These burdens are frequently shared with unpaid family caregivers who provide significant uncompensated medical care and social support to their loved ones. Enjoyment of the highest attainable standard of physical and mental health, recognized as a fundamental human right under international law, remains a goal for all older adults and encompasses the right to palliative care. For many older Americans, especially vulnerable subgroups who face health and pain disparities, however, this goal remains elusive. A public health strategy for implementing palliative care policy interventions will help to build age-friendly environments, assure the availability and accessibility of palliative systems of care, essential medicines, and an adequate generalist-level workforce, and sustain diffusion of innovation across all levels of health and social provision. The 2015 White House Conference on Aging must make these realignments a policy priority in order to foster social and economic development for all older Americans.

Medication (Re)fill Adherence Measures Derived from Pharmacy Claims Data in Older Americans: A Review of the Literature

Medication nonadherence is a significant public health problem that affects the health and well-being of older Americans while burdening the US healthcare system. Pharmacy claims data have gained importance in deriving objective medication (re)fill adherence measures; however, little is known about application of such measures in older Americans. The objective of this study was to assess the types and characteristics of pharmacy claims-derived medication (re)fill adherence measures used in older Americans. A comprehensive literature search strategy was employed to identify all articles using pharmacy claims data to measure (re)fill adherence to prescription medications in older Americans aged 65+ years. Included were articles reporting original research studies conducted and published in the USA in English between 1 January 2000 and 1 November 2012. The basic search used multiple key terms indicating adherence, combined with the term "medication" and the term "pharmacy claims or administrative claims." Due to the variety of measure names used in the literature, a more specific search was added to repeat the basic search for 29 previously used medication (re)fill adherence measure names. Articles identified through the database search were manually reviewed to select only articles meeting the inclusion criteria. The search resulted in a total of 36 articles. Information on medication (re)fill measurements were extracted and summarized. The 36 articles used 20 differently named measures under the three main concepts: medication adherence, persistence, and discontinuation. Measures of medication adherence cumulatively assessed the proportion of time at which medications were (not) filled over a predefined observation period (e.g., medication possession ratio). Measures of medication persistence assessed the continuity of medication filling over a specified time period, while medication discontinuation measures focused on termination of medication (re)fills. Overall, almost two thirds of all identified articles used a single medication (re)fill adherence measure. Among them, 77 % used a medication possession measure. The term "medication possession ratio" (MPR) was used most frequently (65 %), followed by the "proportion of days covered" (PDC; 30 %). No single measure can be generally recommended for the use in older Americans. The challenges in using pharmacy claims-based medication (re)fill adherence measures in older Americans include a lack of consensus terminology and algorithms among measures of the same concepts, insufficient transparency of individual measure operationalization, and inadequate consideration of unique characteristics of the older population, such as temporary nursing home care. Although medication (re)fill adherence measures may be well suited for measuring medication adherence in older Americans, little guidance is available on how to use them in this population. Further efforts need to be given to the development and standardization of pharmacy claims-based medication (re)fill measures that are specifically tailored toward use in older Americans.

News from NIH: translational research for an aging population

The National Institute on Aging (NIA) has long been the primary sponsor of research in the basic social and behavioral sciences on the processes of aging. These investments have generated a large body of knowledge about change in physical health, social and psychological function, and economic behavior over the adult life course; on the inter-relationships between older people and social institutions; and on the economic impact of both changing age-composition of the population and public/private programs that serve older populations. (For more information visit the Division of Behavioral and Social Research (BSR) website at: http://www.nia.nih.gov/research/dbsr.). As recent years have seen an explosion of fundamental insights in the basic social and behavioral sciences, translating this knowledge into practical advances to benefit the health and well-being of older Americans has increasingly become a priority for the NIA. Of particular interest are approaches that apply these evidence-based insights to (1) translation into state/federal/international public policy; (2) adoption by agencies or firms (e.g., government agencies, insurance companies, employers, nursing homes); (3) translation into public health practice; (4) development of new technologies and; (5) development of behavior change/behavior maintenance programs.

The Effects of the Financial Crisis on the Well-Being of Older Americans: Evidence from the Cognitive Economics Study

This paper uses the Cognitive Economics Study (CogEcon) to assess the effect of the financial crisis on the well-being of older Americans. Financial wealth fell by about 15 percent for the median household. These financial losses were concentrated among households with high levels of wealth and high cognitive capacities, who tend to have higher exposure to the stock market. Nonetheless, households with little financial wealth suffered declines in well-being-measured by declines in consumption-as large on average as households with substantial exposure to the stock market. Tight credit market conditions and adverse labor market outcomes account for much of the effect of the financial crisis on the consumption of these low-wealth households.

Trends in health of older adults in the United States: Past, present, future

The decline in late-life disability prevalence in the United States was one of the most important developments in the well-being of older Americans in the 1980s and 1990s, but there is no guarantee that it will continue into the future. We review the past literature on trends in disability and other health indicators and then estimate the most recent trends in biomarkers and limitations for both the population aged 65 and older and those aged 40 to 64, the future elderly. We then investigate the extent to which trends in education, smoking, and obesity can account for recent trends in limitations and discuss how these three factors might influence future prospects for late-life health. We find that improvements in the health of the older population generally have continued into the first decade of the twenty-first century. The recent increase in the proportion of the younger population needing help with activities of daily living is concerning, as is the doubling of obesity in the last few decades. However the increase in obesity has recently paused, and favorable trends in education and smoking are encouraging.

Understanding Expenditure Patterns in Retirement

Understanding the consumption needs of retirees is critical to assessing the adequacy of retirement income and the possible impact of Social Security reform on the well-being of older Americans. This study uses data from the Health and Retirement Study, including a recent supplemental expenditure survey, to analyze spending patterns and consumption needs for adults ages 65 and older. Results indicate that typical older married adults spend 84 percent of after-tax household income, and nonmarried adults spend 92 percent of after-tax income. Even at older ages individuals devote a larger share of their expenditures and income to housing than any other category of goods and services, including health care. Fully 8 percent of married adults report after-tax incomes that fall short of our estimated basic-needs threshold, consisting of housing, health care, food, and clothing. By comparison, only 3 percent of married adults have incomes below the official poverty level.

The Economic Well-being of Older Americans and the Persistent Divide

The Economic Well-being of Older Americans and the Persistent Divide

"I Would Weave a Song for You"

When the Music Therapy for Older Americans Act was signed in 1992, public recognition was given to the power of music to increase cognitive and psycho-social functioning and wellbeing in older Americans. Music therapy services can be provided only under the direction of accredited music therapists. Yet the benefits of music therapy are profound, and the need for therapeutic treatment for dementia residents so great that ways must be found to disseminate selected therapeutic goals that nurturing music and milieu can promote. Strategies suggested in this paper are among those that have been used successfully with dementia residents and can be facilitated by activity professionals, motivated caregivers and health care professionals to improve quality of life.