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How Do We Ethically and Morally Influence the Dignity and Decision-Making of our Aging Population?

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"Aging in Place" is simply a matter of preserving the ability for seniors to remain in our homes, neighborhoods, and communities for as long as possible. The U.S. Centers for Disease Control and Prevention defines aging in place as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level". At age 67, married to the love of my life for 44+ years this is a concern of mine as well as our fellow Baby Boomers: (April 2014) Data from the U.S. Census Bureau show that there are 76.4 million baby boomers. There were actually a total of 76 million births in the United States from 1946 to 1964, the 19 years usually called the "baby boom."

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Joe Tufo (L.I.O.N.)
33 months ago

8 answers

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By respecting the sanctity of life and offering no structural impediments (e.g., restrictive building codes and permits related to necessary home modifications) or economic barriers to family decision-making in this area, individuals and families will enjoy the freedom to make the best personal decisions and allocation of resources in this vital season to finish strong, with dignity, in this life. To help facilitate this, medical providers and free enterprise should be unencumbered in offering home-based solutions in the form of visitation/delivery services, innovative residential and self-help equipment/devices, etc. Any long-term care insurance or funded government-managed benefits related to retirement living (disability, Medicare/Medicaid, etc.) should also be redesigned to offer (and even encourage) home-based alternatives for those who are healthy and sentient enough to navigate this way with the help of their spouses, families, and other caregivers. Easy processing of reverse mortgages and the elimination of any death taxes could also help to economically facilitate this process to provide a "soft landing" for those involved. Anything regulated by federal/state/local government that constrains the individual, couples, or families from making preferred decisions (aligned with personal and public safety) should be revised or eliminated. A move toward family responsibility and away from governmental oversight of personal "quality of life" matters would be a step in the right direction, as this is the way our Creator has instructed us to live.

Don Barefoot
33 months ago
Thank you for providing insight that will benefit many seniors like me. - Joe 33 months ago
LTCI has been a disaster? - Dr. David E. 22 months ago
The only LTCI approach I trust is the one offered by Northwestern Mutual which has fairly well stood the test of time and generally enables aging in place home services under the allowable daily cap. Earlier offerings by lesser insurers (in my book and according to their credit and peer industry ratings) like NYLife, MassMutual, etc. Sadly, they weren't able to sustain/honor their offerings. - Don 22 months ago
Agreed; a catastrophe as the actuary folks misjudged medical progress. - Dr. David E. 22 months ago
It should be behavior to take care of seniors. - Er. Jangyadutta 20 months ago
OK - Dr. David E. 20 months ago
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Maintaining both the dignity and respect of our aging population to make decisions ultimately is based on the simple fact of how much does their immediate family wants them around-bottom line. Let me explain...

The reason why aging adults go the 'homes' and senior care is simply because their sons & daughter just don't want to have that obligation to care for them, watch over livelihood, cook and feed them, ect.- same as caring for little ones except aging adult aren't that cute and can be a pain for the caregivers. In life, we make time for we really care about and if someone truly cares about their aging parent, then that aging parent is either at home with them or in an apartment or private housing and not part of a senior living community. The fact is unless the aging person actually buys into a community as a resident living in their own private house, then being committed to a senior care facility is just a place to keep the senior, out of sight and out of mind till they pass away.

We can spend all day talking about government programs, outreaches, senior programs, ect. which are just fine when the aging senior has no family support and such is really needed. I am addressing the issue involving aging seniors with a family support base that really doesn't want to deal with their aging parents. Therefore, the aging parents are shuffled off to a senior care facility where their children can ease the guilt feeling in their minds by rationalizing that at least their parents are being cared for by a staff and among peers for a better quality of life. As long as a senior is able body and of sound mind but without financing, they would almost always want to be in their own apartment or housing than to be thrown in a senior care facility where life seems to end in their minds. As if they are so ill or mentally not sound, then obviously a care facility would be needed in some cases but either way, the aging parent wouldn't know the difference and if they did, it would be best that the aging parent at least could live out his last few days at home-which we all would want.

So it all goes back to how much we are willing to care for our aging parents, those without any family would have very little choice obviously unless they have the finances and the aging parents who do have family support would love to stay at home or be put in their own place. I guess if you substitute the word 'aging parents' for 'our children', then its a no-brainer, they stay with us at home. Again, we make time and do what we really care about.

ANTHONY MICHAEL SESMA
33 months ago
“Etc.” is an abbreviation for the Latin phrase et cetera, meaning “and the rest.” (Et means “and” in French too.) Just say “et cetera” out loud to yourself to remind yourself of the correct order of the “T” and “C.” Thank you for sharing. - Joe 33 months ago
Well said. - Dr. David E. 22 months ago
MY FAVORITE: Ceteris paribus is a Latin phrase meaning "with other things the same" or "all or other things being equal or held constant" or "all other things being equal" or "all else being equal". - Dr. David E. 22 months ago
It is our duty to take care of aged. - Er. Jangyadutta 20 months ago
Agreed - Dr. David E. 20 months ago
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From a city planning perspective, it is important that cities become "communities for all ages" by embracing development projects and reinvestment initiatives that aim to "level the playing field" for all users. This is not just a baby boomer issue, but also a youth issue and an accessibility issue for those with disabilities. We need to get away from the mindset that conventional zoning, super highways, McMansions, and shopping malls are how our communities should develop. Instead, we should be encouraging traditional neighborhood development, open public spaces, multi-modal transportation, and a well integrated network of social service providers that can provide assistance in a variety of ways. For areas that are already fully developed, it could mean redeveloping in more intelligent ways. For example, most neighborhoods built in the 1950s through 1970s lack sidewalks, street lights, and often even curbs and gutters. As a matter of policy, cities can choose to prioritize projects that focus on establishing these amenities and ensuring that para-transit services are available.

In addition, many of the houses in these neighborhoods could benefit from small adaptations that can make a previously non-ADA compliant property fully capable of accommodating someone with a wheelchair. Cities should ensure that zoning codes allow for ramp installations, on-site mother-in-law quarters, and other changes that can enable a person to age in place, regardless if they have family and friends or are by themselves.

Finally, the social service aspect of aging in place cannot be overlooked. Cities should create registries of citizens who elect to have someone check on them during significant events. In the Midwest, this is often accomplished through "Meals on Wheels" during snowstorms and yearly courtesy inspections by a city's fire department to ensure that smoke detectors and storm sirens are adequately installed and functioning.

Nick Pappas, AICP
33 months ago
Well spoken, spot on, thank you for sharing. - Joe 33 months ago
A level playing field is boring. - Dr. David E. 22 months ago
Good description. - Er. Jangyadutta 20 months ago
Thanks - Dr. David E. 20 months ago
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We can Ethically and Morally Influence the Dignity of our elders by helping the children so they can relief themselves from the younger generation of grand chidldren and children en general.
We shall provide incentives so that in their Decision-Making, our Aging Population be more optimistic and caring of our judicial and parliamentary system.

Belize Green Independent Party
33 months ago
You may want to proofread before you enter information. This answer doesn't make sense. - Joe 33 months ago
Agree. - Dr. David E. 22 months ago
I agree. - Er. Jangyadutta 20 months ago
Thank you, too - Dr. David E. 20 months ago
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I spent last year as a member of a steering committee formed to address the issue of creating an Aging In Place Program sponsored by the Senior Center in my community. To date, it is in the beginning stages of testing the feasibility of the model that ultimately is intended to be serviced predominately by volunteers. One of the first issues that surfaced as we began talking about this issue and reviewing research that has been done by other communities was in our language as we shared our thoughts. Each person sharing led with what they thought were the most important issues those 'senior citizens' would have to face. At one point, one of the dynamic and articulate members said: "You know I am a big supporter of our Senior Center but I don't come here. Yes, I'm a busy man but the real issue is that I don't even consider getting personally involved in programs here. I've just realized those people we are talking about, as I look around the room, are US instead of them!"
I believe that one of the biggest issues is our personal awareness that aging happens to everyone and the best way to influence the dignity and decision-making of our aging population is to get involved in the issue as soon as our minds start wrapping around the fact that empathy comes from expanded identification with the issue. The statement: "Nobody cares how much you know until they know how much you care" is important to bring to the foreground. Systems can be created and implemented with some predictability but the art of relationship building has to be elevated to primary status in any program because of the myriad needs and fears that come with the loss of power and control over our lives.

Susan McNeal Velasquez
33 months ago
"one of the biggest issues is our personal awareness" REALLY - Dont we ALL get old? - Dr. David E. 22 months ago
Thanks, Really personal awareness is required. - Er. Jangyadutta 20 months ago
NOPE = you can not help to get old = no awareness needed - Dr. David E. 20 months ago
Just OBSERVE - Dr. David E. 20 months ago
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EASY ETHICS

Just follow the "Golden Rule"

Dr. David E. M
22 months ago
Amen... since Jesus taught this approach to his disciples, it is certainly something He continues to desire for us today! - Don 22 months ago
Agree; but more secular. - Dr. David E. 22 months ago
Is co-opting Christ's teaching - since it's true and effective (as God's ways always are) ever really a secular endeavor? This is what Christians like to term "general revelation" whether we choose to accept its source or not! - Don 22 months ago
Thanks. - Dr. David E. 22 months ago
Right comment. - Er. Jangyadutta 20 months ago
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Aging and Technology

My colleague. Joe Kvedar MD, released a new book last year: The New Mobile Age: How Technology will Extend the Healthspan and Optimize the Lifespan.  It covered many related themes but, in an effort to be succinct:

  • We all want to live a long healthy life: ‘long’ as in longevity and we’ve done well there, adding 25 years to the lifespan in the past century; ‘healthy’ is where we have uneven results, that is the healthspan.
  • From a societal perspective, we need to better engage older individuals, providing them with opportunities to maintain a sense of purpose, social connections and increased physical activity. Technology can help with all of these.
  • For individuals, the decisions we make that lead to a shortened healthspan are a combination of data and emotions. Technology can help us with the data part of the equation.
  • Care-giving is in need of an overhaul, going from our current one-to-one model to a one-to-many model. Technology (robotics, artificial intelligence and other digital and emerging technologies) is critical. 


Any other thoughts?

Dr. David E. M
22 months ago
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It should be responsibility of all to be self aware to take care of their seniors and aged.

Er. Jangyadutta D
20 months ago
Repeat = OK - Dr. David E. 20 months ago
Agree, Er., but since our government's career leftist politicians desire to make the state the ultimate "father" of children/families, there are often (specially in urban centers where many are dependent on the taxpayer) no descendants that have such a responsible family heritage or intention. Soft Marxism, aimed at securing lifetime Democrat voters, has lowered the "lowest common denominator.." - Don 20 months ago
OK - Dr. David E. 20 months ago

Have some input?