GERN 280- Controversy 5 – Flashcards
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Who provides most care for frail older adults?
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80%= families and private individuals
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Is the image of lonely and abandoned old people correct?
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NO- INACCURATE
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What percentage of women 65+ are married?
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42%
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What percentage of men 65+ are married?
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72%
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What are most American families for elders like?
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-most have adult children or at least a sibling -75% are grandparents
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What percentage of elders are grandparents?
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75%
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Describe the exchange theory of aging
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parents care for children and spouses care for one another because they are motivated by moral obligation and the knowledge they can count on reciprocal help in times of difficulty
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What theory suggests the idea that interaction in social groups is based on reciprocal balance?
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Exchange theory of aging
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Who provides the majority of care for aged relatives?
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Women- balance burden of care, employment and their own families
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Define Sandwich Generation.
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describes impact such caregiving responsibilities on middle-aged women
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Define Respite Care
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temporary care for dependent older people to allow the caregiver some time off
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Who is often considered the hidden victim?
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family caregivers- stress and increase their own risk of illness and death
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How can burden of caregiving effect elders?
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family members may burn out because of exhaustion which can lead to elder abuse and neglect
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What 2 types of help can a caregiver receive?
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1. social support 2. formal support
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What is considered social support?
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informal family and friends
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What is considered formal support?
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home health agencies, mutual aid groups, national and state organizations
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What percentage of children live 30 minutes from their child?
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2/3
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What percentage of children are expected to live in proximity?
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over 1/2
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What percentage of children have daily contact with their elder parent?
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40%
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What percentage of children talk on the phone at least once a week with their parent?
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3/4
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Has there been an increase or a decrease in the sharing or households? (1960-1984)
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decrease (40%-22%)
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Has there been an increase or decrease in multigenerational households? What caused this?
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increase- economic recession- trend is likely to continue
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What is explained in the "world-we-have-lost" myth?
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multigenerational living arrangements were never common -the idea of living under one roof is a myth
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Describe a nuclear family.
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only parents and children
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Do a majority of people live with others today?
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yes- 1/2 with spouse 14% with other relatives and other living situations
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What statistic refers to the amount of elders that become isolated? Explain.
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1 in 20 -the only reason they may be isolated is if they have lived that way their entire life
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Explain this urban legend: "only 4% of older people live in nursing homes"
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-4% only applies to single point in time -life span basis=40% or more will spend some time in a long-term care facility before they die
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What does the term intimacy at a distance refer to?
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the ability of families to remain in close contact through internet and social media
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What country has a unique Maintenance of Parents Act?
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Singapore
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Describe the Maintenance of Parents Act
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1. family rather than govt should care for older people 2. children should provide the financial means to support 3. older people want more direct care from their families
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True or False. Long-term care has remained largely a family responsibility in the US
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TRUE
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What has made health care and income of elders a societal responsibility?
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social welfare programs such as Social Security and Medicare
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What type of coverage does the US health care system provide for acute diseases among the old?
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near-universal coverage
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How much money is spent on long term care in nursing homes from Medicaid?
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1/2
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What percentage of nursing home residents us Medicaid as their primary payer?
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2/3
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What do 2/3 of nursing home residents rely on as their primary payer?
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Medicaid
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What shift has occured in the use of Medicaid funds?
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-created for health care for poor -today a primary use of nursing home coverage for middle-class older adults
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What demographic makes up 3/4 of Medicaid recipients?
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low-income parents with children
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How much of the dollar do families receiving Medicare get?
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1/4
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What is an estimated cost of nursing home living for one year?
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$75,000
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How long does it take for those using private-pay in nursing homes to enter poverty levels?
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3 months- 70%
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What a year of private pay what percentage are considered impoverish?
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90%
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Do those who dont qualify for Medicaid have enough money to afford long term care?
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NO- either provide home based care or do what is necessary to become eligible for Medicaid
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Explain the term spend down
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purposefully use up assets to become impoverish and then eligible for Medicaid
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What is a MAJOR problem with Medicaid financing?
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introduces inequities across families, age groups, and social classes
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What has become the public program of last resort to pay for nursing home costs?
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Medicaid
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What is considered to be the fastest growing component of state budgets?
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Medicaid
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Explain the urban legend: "home care is cheaper than nursing home"
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home care may be preferable to many, but it is certainly not cheaper- especially looking at full time care
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When do most people decide to go into nursing homes?
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act of desperation, need of older adult has exceeded abilities of family care giver- no other alternative
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What is divestment planning?
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appearing to be poor by taking advantage of legal loopholes to avoid the "Medicaid trap"
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How can you avoid the Medicaid trap?
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divestment planning- spend down can have harsh requirements
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List 5 key strategies in divestment planning.
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1. transfer assets at least 30 months ahead of time 2. transfer assets between husband and wife 3. seek protection through a court order 4. keep assets in a form exempt from Medicaid 5. set up a trust account
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What populations of attorneys is currently growing?
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elder law attorneys
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Why do many insist that Medicaid planning is socially irresponsible?
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because it is protecting the inheritance wealth of affluent families at the expense of taxpayers
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What do critics describe as cheating the government and using public money?
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when Medicaid spend down is used as a form of Estate planning
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Who typcially buys long-term care insurance?
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55+
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True or False. There has been a decline in privately paid long-term care services.
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FALSE- increase- especially in assisted living and home and community based long term care
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Do most privately owned long term care insurance companies pay for nursing homes?
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YES- some only for one year, others for lifetime, others have a maximum coverage
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What percentage of the elder population is covered by long term care insurance?
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less than 4%
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What are 2 reasons why long term care insurance is not more popularly used?
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1. many assume Medicaid will cover these costs- not true 2. too expensive later in life
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What makes comparing long term care insurance options difficult?
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-many exclusions and limitations
