Journal of aging & social policy
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During the COVID-19 pandemic, justification for orders to shelter in place have emphasized the vulnerability of older people. Although other at-risk groups were sometimes mentioned, the emphasis on older people could have effects on attitudes about aging and older people for decades to come. This essay provides a comprehensive biopsychosocial description of ageism and discusses the pandemic as a "focusing event" that exemplifies the extreme social consequence of ageism for the entire older population. It suggests revisions to the Elder Justice Act and utilization of programs such as the Reframing Aging, Age-Friendly University, and Ageism First Aid initiatives to reduce ageism in the wake of the pandemic.
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Ageism, socially constructed discrimination against seniors, influences the quality of life of older adults. This study aimed to compare ageism in 15 Organization for Economic Cooperation and Development (OECD) countries using the scientifically developed Comparative Macro-Level Ageism Index (CMAI). We developed the CMAI by reviewing previous index research on the life of older people and conducting expert interviews using a Delphi method. ⋯ Yet, South Korea had the highest score for discriminating against seniors based on economic status while Spain had the lowest score in this domain. Japan had favorable conditions for economic status, health status, and social participation for older adults. Implications of this study and suggestions for further studies on developing an objective indicator of structural age discrimination are discussed.
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Health care policies for the elderly are complex, multidimensional, and contextually circumscribed. While engagement of health experts, economists, health care administrators, and political leaders is generally viewed as instrumental to the success and sustainability of eldercare programs, the elders themselves are often viewed as passive recipients of care and not included in the policy processes. Experiences and expectations from users' perspectives can be invaluable information for policy formulation and systems design. ⋯ The process was initiated by the National Health Commission Office in Thailand to explore how a citizens' jury as a model for civic deliberation can be utilized to provide sophisticated policy recommendations on long-term care policies for the elderly. The objectives of this paper are to (1) examine how public participation in health policy can be actualized through the citizens' jury as an operational model, (2) understand the strengths and weaknesses of the ways the idea was implemented, and (3) provide recommendations for further use of the model. Details of how a citizens' jury was deployed are discussed, with recommendations for further use provided at the end.
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This paper discusses Republican efforts to repeal the 2010 Patient Protection and Affordable Care Act (ACA) over President Trump's first year in office (2017) and their impact on near-elderly Americans (50-64 years old). We describe how the ACA's provisions for strengthening health care coverage were particularly advantageous for near-elderly Americans: The law shored up employer-sponsored health care, expanded Medicaid, and-most important-created conditions for a strong individual health insurance market. We then describe Republican efforts to undermine the ACA in the years immediately following its passage, followed by detailed discussion of Republican proposals to repeal and replace the ACA during 2017. We conclude by discussing factors informing the fate of Republican legislation in this area, the potential consequences of the legislation that ultimately passed, and the prospects for future attempts to repeal and replace the ACA through the legislative process.
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Comparative Study
Comparison of advance medical directive inquiry and documentation for hospital inpatients in three medical services: implications for policy changes.
Following the introduction of the Patient Self-Determination Act of 1990, the Veterans Health Administration developed its own advance medical directive (AMD) policy, which most recently states that documentation is mandatory for all hospital patients in all settings. The object of this study was to assess the effectiveness of AMD documentation at a local Veterans Affairs Medical Center. AMD documentation was compared among three inpatient services: surgery, medicine, and psychiatry. ⋯ True adherence to policy implementation may require hospital administrators to increase staff and educational efforts so that the concept of AMD communication and documentation is completely explained to all staff and patients. Policy should include an electronic record reminder that is renewed every 3 years and provisions for accommodating patients who arrive on weekends and holidays, with special awareness of the particular communication needs of minority groups. The study conclusions are that further inquiry is needed to understand these policy nuances to enable the Veterans Affairs Administration to improve its policies and performance in this important aspect of healthcare.