Study Guide Exam 3 1 What is the definition of a migratory stream Migratory Stream the movement of older people to the Sun Belt Sun Belt Florida Arizona Nevada New Mexico North Carolina places with a warm climate and reasonably priced retirement housing Rust Belt Corn Belt and Great Plains also have a high proportion of older people but only because the lack of job opportunities have chased younger people away 2 What are assisted living facilities How do they differ from nursing homes Assisted living philosophy is the idea of aging in place aging in place staying in own home as one grows old Not a permanent home for most people but a step along the continuum of long term care Most ALFs provide meals personal care limited medical assistance housekeeping utilities social activities transportation and security provide higher care than that typically provided at home but less than the care provided at a nursing home 3 What are continuing care retirement communities Grew out of the life care concept developed by religious groups for the care of aging lay people and clergy Independent living community geared toward a healthier and younger crowd Most CCRCs ask residents to pay an up front fee and a continuing monthly fee 4 What are some of the advantages and disadvantages of continuing care retirement communities Advantages They know their needs will be met if they require intensive medical care May have come to feel isolated in their own homes As health declines residents can move from an independent unit to a unit that offers more services without leaving the community A variety of structured and unstructured activities provide opportunities for residents of CCRCs to form friendship networks Disadvantages Adjusting may lose friends community and familiar surroundings reduced living space have to give up many accumulated possessions Costly fewer than half of older people can find one that they can afford 5 What is the compression of morbidity thesis Two premises to theory 1 Human life span is fixed and finite 2 Improvements in health care and prevention will compress years of disability and improve quality of life for an individual Term coined by James Fries in 1980 As a results demand for health care resources will decline the quality of life for the aged will improve and increased life expectancy will not bring about increased illness and disability On the other side of the debate are those who are pessimistic about what the increase in life expectancy portends They assert that people will gain no active healthy years but simply spend more time ill and disabled Consequently costs will rise and resources may be strained BUT the evidence increasingly supports the compression of morbidity thesis 6 What is the effect of exercise on health After smoking exercise is the next more important lifestyle influence on health With advancing age people who exercise are more fit more able to keep their weight under control and more likely to have fewer backaches and joint problems People who exercise regularly also show improved cardiovascular function better long term and short term memory and less disability 7 How do alcohol consumption and smoking affect health Be specific Alcohol Consumption can have positive and negative effects on health Heavy drinkers 14 or more drinks week more likely to suffer with liver problems cancers and hypertension Those who drink an occasional glass of wine with dinner have a lower risk of mortality than nondrinkers All three major causes of death heart attack cancer and stroke are linked to smoking Smoking is the major cause of chronic obstructive pulmonary disease COPD Also associated with disability Older smokers typically have a longer history of smoking They are usually heavier smokers They often have other health problems The number of older people who smokes has been steadily declining since the 1980s Older people are less likely to smoke than younger people but the effects are more severe for older people Rates of smoking among women initially increased but then began to decline for both men and women There has been a decline in smoking among all groups Currently white men and women smoke less than do black men and women and Hispanic women are least likely to smoke 8 Over the past several decades what has been the trend in regard to obesity Increased risk of joint problems disability diabetes and heart disease Less able to perform ADLs Less physical strength Less upper body mobility the prevalence of obesity among older men and women has increased significantly over the past 40 years 9 What is the theory of cumulative disadvantage Theory of Cumulative Disadvantage People who begin life with greater resources continue to have opportunities to accumulate more Those who begin with few resources fall further behind According to this perspective the gap in health status should increase with age Research supports the theory of cumulative disadvantage Convergence Theory old age is a great leveler inequality is reduced later in life this theory would predict that the gap in health between rich and poor narrows with age 10 Which racial ethnic groups have the best health Which have the worst health Whites have best health African Americans Hispanics and Native Americans have worst health With age they are more likely to develop a serious illness and to rate their health as poor Racial ethnic gap due to social factors including lifestyle employment history and access to health care 11 What are health maintenance organizations HMOs Health Maintenance Organizations Health insurance plans run by financial officers Control costs through capitation where reimbursements to health care providers are set in advance Fee for service This is a payment system where physicians set the fees and people or their insurance company pays It grants doctors a great deal of autonomy It contains financial incentives for doctors to perform many services and procedures 12 What is the trend in regard to retiree health insurance offered by employers Decreased These policies have become increasingly expensive as health care costs have increased The aging of the workforce has increased the ratio of retired to active workers The federal government now requires firms to report all the costs and liabilities associated with retiree health plans 13 What are the trends in labor force participation among older men and older women There is a gradual decline in work as men age The most important trend is