Posted: March 23rd, 2023

Stopping Elder Abuse in the United States

Introduction

Elder abuse is one of the country’s most serious policy problems today, especially during the COVID-19 pandemic. Statistics and current evidence from research indicate that the challenge keeps worsening, revealing that more elders experience the problem now than ever before. The aging population has also increased in recent years, creating even more significant challenges and exposing them to abuse and violation of their rights. According to the Census Bureau, there has been a sharp increase in American citizens living up to 90 years. As a result, the number of aged people experiencing abuse has increased in the past three decades. Such abuses occur in many forms, including physical, emotional, and psychological. Unfortunately, most perpetrators are the same people expected to take care of these people, including family members, healthcare providers, and those paid to protect them. Considering the underlying challenges experienced by this group of individuals, comprehensive policy analysis is necessary because elders are an essential part of the American population, who need protection in their rights and personal needs.

The Health Policy

Policymakers in the United States have historically been concerned about the need to protect elders from abuse. However, the country has never implemented effective community social policies or programs to prevent the problem and promote the welfare of the aged. Nonetheless, a national policy has been in force since 1965, popularly known as the Older Americans Act. Policymakers in the country created the policy and related programs to meet the needs of social services targeting older persons. Notably, the original policy focused on providing grants to states to promote community planning and social services, train personnel working with the elderly, and advance research and development to improve this area. The policy led the Administration on Aging in the Department of Health, Education, and Welfare (DHEW) to support the grants program as well as the national efforts to improve the welfare of the elderly (Lepore & Rochford, 2019). Although the policy has been in force for decades, it is still useful today in providing social, nutritional, and other services to the elderly.

Considering that elder abuse is widely experienced, the analysis focuses on one crucial area, providing nutrition services. For instance, the policy focuses on health and social needs and refocuses their care from institutionalized care to community-based services by ensuring their nutritional needs are met. The Administration for Community Living of the U.S. Department of Health and Human Services (DHHS) maintains the Older Americans Act (OAA)’s Title III-C Nutrition Services Program (NSP) (Mabli et al., 2017). The program increases the availability of nutritious meals, education on nutritional needs, and nutrition counseling. The policy also focuses on health promotion to meet the health needs of the elderly while receiving care within the community. Nutrition is one area of elder abuse in the community because many aged individuals cannot afford their meals and do not have anyone to provide for them. Thus, the policy is intended to improve this area related to the welfare of the elderly.

Policy Analysis and Evaluation

Various studies have evaluated the effect of the Older Americans Act Title III-C Nutrition Services Program on addressing elder abuse related to nutrition. Mabli et al. (2017) used data from Medicare claims and comprehensive surveys to establish the impact of the program and related policies in protecting the needs of the elderly in society. The surveys focused on congregate and home-delivered meal participation among the elderly to establish the program’s impact. A comparative study between participants and non-participants provided adequate data to demonstrate the effect of the policy on meeting the needs and improving the welfare of the elderly. In addition, Medicare claims data provided information about the health status of the elderly receiving care under the program. Hence, an effective policy or program would reduce the number of elderly seeking medical care for nutrition-related conditions. Notably, the evaluation focused on the impact of the program on participants instead of the entire population.

The analysis and evaluation results indicate that healthcare outcomes improved for the elderly who participated in the Older Americans Act Title III-C Nutrition Services Program. Besides, the policy proved effective in reducing healthcare utilization among the elderly because of the health promotion element of the policy (Lloyd, 2019). In addition, the elderly participating in the program were less likely to be hospitalized for diverse medical conditions because nutrition plays a crucial role in disease prevention. However, according to Sadarangani et al. (2020), the effect of the policy is limited because of the low number of elderly who comply with the program requirements and apply for benefits. In addition, the study revealed that not all eligible individuals apply for participation in the program, suggesting that many elderly persons continue to experience abuse and neglect. Thus, while the policy is effective for the elderly who participate in the program, many other needy individuals remain unserved. Thus, the policy has failed to support participation among elderly persons. The challenge emanates from a lack of awareness of the importance of participation among the elderly and their caregivers.

Policy Recommendations

Based on the analysis, the lack of effectiveness of the Older Americans Act Title III-C Nutrition Services Program is based on inadequate awareness among the elderly and caregivers, giving room for continued abuse and neglect. Thus, the beginning step should be to create awareness among the elderly and their caregivers about the need for participation in the program. Education for caregivers and competent elderly individuals is necessary to increase their enrolment in the program and improve their access to a proper diet and knowledge about the kind of nutrients they require to improve their health and reduce the possibility of a disease that could cause early death or disability (Sadarangani et al., 2020). Since most caregivers do not understand what they are expected to do about their nutritional needs, educating them will improve the efficacy of the Older Americans Act Title III-C Nutrition Services Program. Education and awareness creation will also reduce the chances of elder abuse by ensuring that caregivers understand what to do and aspects to avoid to maintain their health.

Application of the Health Policy into Clinical Practice

Healthcare providers can play a crucial role in educating the elderly and their primary caregivers about the Older Americans Act Title III-C Nutrition Services Program to improve their participation. The effectiveness of the policy will lessen the burden of healthcare providers in clinical practice by reducing the rate of illness resulting from a lack of proper nutrition. Health promotion is essential to primary healthcare since it educates people about steps to improve their health outcomes and reduce their medical utilization (Menne & Thomas, 2018). Thus, instead of treating elderly individuals when they are unwell, they can promote knowledge about preventing illness and reducing care costs. For example, educating the elderly will reduce the burden of diseases, such as diabetes and hypertension, which become common when people begin aging. Thus, the policy will be adequate if accompanied by a health promotion component implemented by health care providers to improve health and reduce disease burden. Besides, the program will reduce hospitalization rates by providing care and meeting their needs within the community.

Conclusion

Caring for the elderly in the community is a complicated activity and becomes overwhelming even to the well-meaning caregivers. As a result, the elderly face the challenges of abuse, which has become a significant challenge in modern society, primarily because of the burden of the COVID-19 pandemic. While the elder abuse problem is multifaceted, it has numerous elements, such as inadequate and proper nutrition. Thus, the current analysis focuses on the Older Americans Act Title III-C Nutrition Services Program, which emphasizes providing adequate diet and related education within the community to improve the health of the elderly. The policy is effective for the participants who enroll in the program and receive the nutrition information and proper diet, but poor participation limits its efficacy. Thus, the solution requires health promotion and awareness creation for the elderly and their caregivers to promote participation and increase the benefit of the policy. Furthermore, treatment for abused elders consumes a significant part of medical resources, suggesting that implementation at the community level will improve health and reduce costs.

References

Lepore, M. J., & Rochford, H. (2019). Addressing food insecurity and malnourishment among older adults: the critical role of Older Americans Act Nutrition Programs. Public Policy & Aging Report, 29(2), 56-61.

Lloyd, J. L. (2019). From farms to food deserts: food insecurity and older rural Americans. Generations, 43(2), 24-32.

Mabli, J., Gearan, E., Cohen, R., Niland, K., Redel, N., Panzarella, E., & Carlson, B. (2017). Evaluation of the effect of the Older Americans Act Title III-C Nutrition Services Program on participants’ food security, socialization, and diet quality. Washington, DC: U.S. Department of Health and Human Services, Administration for Community Living, April, 1, 2017-07.

Menne, H. L., & Thomas, K. S. (2018). Interest Group Session-Nutrition: Evaluation Of OAA Title Iii-C Nutrition Services Program: Food Security, Dietary Intake, And Healthcare Utilization. Innovation in Aging, 2(suppl_1), 20-20.

Sadarangani, T. R., Beasley, J. M., Stella, S. Y., & Chodosh, J. (2020). Enriching nutrition programs to better serve the needs of a diversifying aging population. Family & community health, 43(2), 100-105.