Week 10 Discussion: Ethical Issues With an Aging Population – NURS 6050
Week 10 Discussion: Ethical Issues With an Aging Population – NURS 6050
Week 10 Discussion: Ethical Issues With an Aging Population – NURS 6050
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According to the CDC, “in the United States, the proportion of the population aged >65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030,” (CDC, 2003, para. 2). Caring for this aging population is going to be one of the greatest challenges facing the health care industry. Not only will the number of individuals requiring care rise, but so will the cost. As poignantly stated by Crippen and Barnato, “unless we change the practice of medicine and reduce future costs, and explicitly address the ethical dilemmas we face, there may come a time when our kids simply cannot afford us” (2011, p. 128).
Old age is associated with increased risk of development of chronic conditions, hypertension, heart diseases and respiratory illnesses being among the variety of diseases. With the increase in the comorbidities, it therefore means increased need for specialized care. On the other hand, there is increased expenditure to sustain life and sustain a better quality of life. The US has seen an increased expenditure as a result of the large aging population. The aging population has the potential to present a challenge to the macroeconomic and fiscal stability of the society. The end result would lead to a hurting economy and an overall reduced quality of services by different governments. This essay therefore seeks to address the issue of increasing expenditure, footed by public funds and some of the policies that have been put in place to address the increasing expenditure.
Resolution of the increased public expenditure
Phased retirement for the sake of fiscal sustainability
There has been a phased-in retirement for the sake of fiscal sustainability and well-being of the elderly. The elderly people have been encouraged to remain longer in the work force in order to reduce the fiscal pressures and the economic challenges associated with the aging population. Some of the attempts in this case include encouraging the elderly people to remain at work but being given fewer hours instead of being forced to retire. The gradual retirement process many be beneficial in a number of ways.
At first, the phased retirement makes it possible for continuity in the collection of revenues from taxes and this reduces the expenditures on pensions which are then crucial for both macroeconomic and fiscal stability. Secondly, the older workers can be considered to be of great value when working along the younger colleagues because of the knowledge and skills they are capable of imparting (JOHNSON, n.d.). The late life work has also been shown to have long term positive effects which have been shown to have positive effects on the long term.
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Promotion and reward of volunteering
Whenever the individuals are unable to utilize the phased retirement as a result of health challenges, mismatch of skills and probably family obligations, the governments could reward and promote volunteering by the seniors. Some of the elderly persons could do artistic work and care work which are usually unpaid for but goes a long way to improve the social fabric. Besides, the engagement makes it possible for the elderly to improve well-being as they make contributions to the economy while reducing the healthcare and welfare expenditures.
Over the years, volunteering has been shown to be one of the most essential pro-social activities that possess individual and social benefits. Research has established that about 25% of the residents in the US volunteer and this provides about 7.9 billion hours towards service and this contributes about $184 billion towards service (Gil-Lacruz, Saz-Gil, & Gil-Lacruz, 2019). In addition, the late life volunteers have been shown to witness lower rates of mental and even physical health deterioration which then leads to delayed mortality.
Part of the care work that has been undertaken by the elderly include cleaning, childcare, preparation of meals and providing assistance to the elderly and the disabled. The contribution of the elderly has therefore been shown to be of value and rewarding financially. Incentives can also be provided to the elderly by encouraging them to participate in social activities like painting, creative writing and music. The activities therefore limits the possibilities of social isolation, which is associated with deterioration of elderly ailments. The governments can promote such activities by funding arts and crafts in the community centers and social hubs.
Attempts to incorporate the solution into public policy
Phased retirement
The U.S. Office of Personnel Management (OPM) has made huge strides in ensuring phased retirement for the elderly. The policy makes a provision to allow human resources, especially the full time workers to work on a part-time basis. Through the policy, it is possible for the administrations to continue with the efforts of delivering the government which is effective, supportive and efficient in terms of economic growth (Office of Personnel Management, 2019). The regulations are currently available on the website of the federal register effective August 8, 2014.
Through the policy, agencies are supposed to send applications to the OPM for the processing of the phased retirement. In 2019, there was an update of the standard form for the phased retirement status election. In the update, the employees must elect to enter into phased retirement and when on the phased retirement, the employees may make elections or opt from the phased retirement or even move to another agency. The decision elect must be documented on the form: SF 3116.
Some of the rules in place include provision that the working percentage for phased retirement is about 50% and this equates to about 40 hours for the pay period. The capped 50% of working is depicted to be half of the full-time scheduled workers of about 80 hours per the pay period. The regulations also provide that agencies have no obligation or authority to approve the working percentage besides the 50%. Similarly, the working percentage for the phased employee may not be altered during the phased retirement period.
Volunteerism for the elderly
There are federal policies that have played a role in creating and then supporting the services of the elderly when they volunteer. For instance, the Domestic Volunteer Service Act of 1973 is in place and the National and Community Service Act of 1990. The Domestic Volunteer Act has made mandatory a number of programs for the older adults (Volunteers of America Mid-States, n.d.). The programs include the Foster Grandparents Programs, The Retired Senior Volunteer Programs and the Senior Companions Programs.
The Retired and Senior Volunteer Program is the largest of all the three and it was brought into force in 1971 and caters for the elderly above 55 years. The volunteer program enlists opportunities for the elderly and through these, a number of organizations have been able to impart the seniors with skills through the opportunities. In order to ease the burden of the volunteer program, there are a number of organizations that have provided sponsorship programs and most of the support has been drawn from nonprofit organizations. The support by the private sector players has therefore helped ease the burden by the government on such programs.
Barriers to implementation of solutions of increased public expenditure on adults
There are few employees who have been able to establish formal programs since this often complicates the delivery of the benefits and this has a consequence of violating the antidiscrimination regulations. For instance, the federal laws put a limit to the retirement plan since only a few older people are capable of affording to reduce the working hours, unless they can still receive similar retirement benefits. In addition, many employers are not willing to give fringe benefits to their part-time employees and therefore giving the elderly patients some exception also violates antidiscrimination rules.
The seniors are also at very high risk of complications and their rights may be violated or abused. It is possible that some people may be unaware that the senior people have particular rights regarding the care in the nursing homes, their homes and the facilities within which they live. In addition, the elderly caregivers and volunteers are bound to suffer severe illnesses and when these are in sight, stress would also be on the rise. When stressed, the elderly volunteers are unlikely to deliver optimally and provide care as expected.
Private and Public Funding for the elderly persons
There is an established Volunteer Generation Fund which is a program that is mandated by the Edward M. Kennedy Serve America Act, established to give support to the voluntary organizations and the state service commissions to boost the impact of the volunteers to deal with the critical community needs. The fund also participates in increasing volunteer recruitment as well as retention in the community service (Successful Strategies for Recruiting, Training, and Utilizing Volunteers, n.d.). The funding of the volunteer service would make it important to accrue benefits to the individuals who serve. There are also non-profit organizations which have dedicated funds towards the support of the volunteer programs.
Personal recommendations
There is need for the employers and government to engage on a platform which enables them to reach an agreement on the phase retirement for the elderly employees. I would recommend increased lobbying by both government and non-government agencies towards funding of the volunteer programs in order to improve healthcare for the elderly.
References
Gil-Lacruz, M., Saz-Gil, M. I., & Gil-Lacruz, A. I. (2019). Benefits of Older Volunteering on Wellbeing: An International Comparison. Frontiers in Psychology, 10, 2647. https://doi.org/10.3389/fpsyg.2019.02647
JOHNSON, R. W. (n.d.). Phased Retirement and Workplace Flexibility for Older Adults: Opportunities and Challenges. The Annals of the American Academy of Political and Social Science, Vol. 638, pp. 68–85. https://doi.org/10.2307/41328579
Office of Personnel Management, U. (2019). Office of Personnel Management The Federal Government’s Human Resources Agency Benefits Administration Letter Subject: Additional Guidance on Phased Retirement.
Successful Strategies for Recruiting, Training, and Utilizing Volunteers A Guide for Faith-and Community-Based Service Providers Substance Abuse and Mental Health Services Administration Faith-Based and Community Initiative. (n.d.). Retrieved from www.samhsa.gov.
Volunteers of America Mid-States. (n.d.).
Respond to at least two of your colleagues on two different days in one or more of the following ways:
References:
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions. Journal of Law, Medicine & Ethics, 39(2), 121–129. doi:10.1111/j.1748-720X.2011.00582.x
Public health and aging: Trends in aging—United States and worldwide. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5206a2.htm
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