Critical Perspectives
Issues Faced by Community Health Nurses Encountering Cases of Elder Abuse
Paper Presentation in a Themed Session Sepali Guruge, Mohamed Mohamed
With the increase in aging populations, community health nurses (CHN) are increasingly encountering situations of elder abuse. Their ability to advocate for systemic solutions is often hindered by the unfamiliar legal, financial, and institutional contexts. This study provides a scoping review of thirty-two qualitative studies that were published between 2012 and 2017 and conducted in consultation with community and professional experts to develop an algorithm of flow of actions for addressing identified or suspicious cases of elder abuse in the metropolitan city of Toronto, Canada. The algorithm helped authors make the following observations: a lack of appropriate community resources; a disconnect between the healthcare and other social services; a lack of up-to-date sources of guidance for community health nurses dealing with cases of elder abuse; the communication breakdown between hospital and community health settings; poor collaboration between public guardianship and law enforcement; a lack of clear policy for financial institutions to share information with external organizations in suspected cases of financial abuse; and a lack of training for police, healthcare professionals and community workers to assess and report suspected abuse. Community health nurses’ efforts to intervene in cases of elder abuse in a timely and effective manner could be enhanced by addressing these systemic and policy level issues. Further research using an in-depth algorithm may help uncover solutions to these intertwined issues.
Social Networks and Long-term Care amongst Older LGBT* People: The Project "AgedLGBT*"
Paper Presentation in a Themed Session Ralf Lottmann
This paper discuss findings of the AgedLGBT* project, which compares and synthesizes data from three research projects conducted in Germany and the UK concerning lesbian, gay, bisexual, and trans* (LGBT*) people, housing, and care, later in life. This paper focuses on two main questions from the project that have been examined so far. Firstly, in what ways, if at all, do older LGBT* people’s life course experiences, such as their experiences of discrimination, prejudice, and/or resilience, appear in their choices and expectations regarding housing and long-term care facilities later in life? Secondly, how reliable are social networks of older LGBT* people, who are more likely to be childless, single, and to live alone than their heterosexual peers, in terms of social support and personal care in old age? The specific projects used to answer these questions are GLESA, which examined the needs and expectations of a LGBT* housing project in Berlin, Germany, based on interviews with experts and older LGBT* tenants, GLEPA, which investigated the needs of older LGBT* people in long-term care facilities, using narrative interviews with older LGBT* people in need of care and interviews and focus groups with experts in the field, and SAFE, which used a mixed methods design of focus groups and a survey to produce the largest study of older LGBT* housing experiences, preferences, and concerns in the UK.
Economic Status of Older Persons and Their Participation in National Health Insurance
Paper Presentation in a Themed Session Lilis Heri Miscicih
Indonesia is the fourth largest population in the world and there is rapidly aging. According to Statistics Indonesia, forty-eight million people or 15.8 percent will be 60 years and older by 2035, more than triple the number in 2000. This demographic change has major implications for the economic development, with rising in health-care costs, a shrinking workforce, and higher pension costs. This paper aims to present the economic status of older persons and their participation in National Health Insurance (NHI), especially in informal sector. Findings will contribute to the current efforts in the promotion of prepayment schemes for health. Using the 2016 National Socio-economic Survey data, we analyzed associations between selected variables of interest, also using the Logistic regression model. In this study, we selected respondents who are informal workers 55 years old and above, divided into 55-64 years, and 65 years and above. A total sample of respondents are 73,191 persons, or 22.49 percent of total number of informal workers. There are 48.1% of respondents living with the low economic status, and only 12.3 percent of them have high economic status. Most of respondents or 42.2 percent not included in NHIs participants. Only 20.2 percent of respondents including in prepayment participants of NHI. The characteristics of respondents who not NHI participants are low education, and most of them have economic status below quintile four. Sample with higher education had two times the odds of being aware of the NHI than they with less than primary education.
