Education

Part 2: Health Transitions as People Grow Older

Chapter 5: Physical Changes of Aging
Chapter 6: Chronic Conditions among Older Adults
Chapter 7: Cognitive Changes of Aging
Chapter 8: Mental and Emotional Health in Later Years
Chapter 9: Healthy and Creative Living in Aging

Description

Increasingly, older adults insist on experiencing aging as a positive stage in life. Proper nutrition, exercise, activities to express creativity and keep the mind healthy, and spiritual wellness are at the heart of successful aging. In Part 2, you learn about physical and mental health during aging, from normal physical and cognitive changes to chronic illness and dementia.

Cognitive impairment is one of the most feared possibilities associated with aging. Signs and symptoms of dementia can be confused with depression and grief. Recognize important differences between normal cognitive changes and dementia, and differences among dementia, depression, and grief.

Grieving occurs when people experience a major loss such as the death of a loved one, a career change or relocation. Contemporary views of grieving shed light on what is healthy and natural for people who have experienced a major loss.

This part gives you an invaluable context for working with your older clients. Your increased awareness and understanding of the physical, cognitive and psychological aspects of aging enables you to be more effective in many ways, including the ability to recognize when your clients need more assistance and to refer them to other qualified professionals.

Learning Objectives

Chapter 5: Physical Changes of Aging

• Tell the difference between normal biological aging and disease.
• Discuss the two groups of aging theories.
• Identify key findings from longitudinal studies on aging.
• Describe the common physical changes of aging.
• Recognize the attitudes that contribute to successful aging.

Chapter 6: Chronic Conditions among Older Adults

• Differentiate physical changes due to normal aging versus chronic conditions.
• Compare and contrast acute and chronic illness.
• Distinguish between disease and illness.
• Discuss the various effects of chronic illnesses on older adults.
• Describe traditional and nontraditional methods of managing pain.
• Identify common chronic illnesses among older adults and examples of symptoms and treatments.

Chapter 7: Cognitive Changes of Aging

• Recognize the cognitive functions most affected by normal aging.
• Contrast the cognitive changes of normal aging with dementia.
• Tell what people can do to maintain cognitive health.
• Explain what mild cognitive impairment is.
• Discuss causes and symptoms of reversible and irreversible dementias.
• Identify the stages of Alzheimer’s and guidelines for each.
• Describe ways to manage the behavioral symptoms of dementia.

Chapter 8: Mental and Emotional Health in Later Years

• Describe how older adults are resilient.
• Tell why older adults might have unmet mental health needs.
• Identify the major mental disorders that might affect older adults.
• Explain how mental health is assessed.
• Discuss mental health treatments and settings.
• Compare and contrast the symptoms of depression, dementia and grief.
• Discuss contemporary views of grieving.

Chapter 9: Healthy and Creative Living in Aging

• Identify the key health and social factors that influence healthy aging.
• Describe the health and social consequences of poor lifestyle choices.
• Discuss strategies that promote healthy aging.
• Tell how to prevent injuries from falls and driving accidents.
• Describe new and traditional forms of creativity and their lifetime benefits.

Part 3: Quality-of-Life Choices for Older Adults

Chapter 10: Housing and Services for Aging Needs
Chapter 11: Caregiving in Families
Chapter 12: Advance Care Planning and Directives
Chapter 13: Hospice and Palliative Care
Chapter 14: End-of-Life Choices and Ethics

Description

Many older adults live independently in their own homes, thanks in part to a large and dynamic network of housing options and long-term services and supports that include transportation, meals, home care and home health care.

Although paid caregiving services are available, family members are often the caregivers for their aging parents and other relatives. Informal family caregivers play a huge and growing role in older adults’ later years, and their needs are a growing issue and concern. Family caregivers account for billions of dollars each year in informal caregiving, often at the expense of their own needs.

Grieving occurs when people experience a major loss such as the death of a loved one, a career change or relocation. Contemporary views of grieving shed light on what is healthy and natural for people who have experienced a major loss.

With the knowledge from Part 3, you can guide your older clients to housing and resources that enable them to live independently for as long as possible, and provide clients who are caregivers what they need most -- information and support.

From caregiving to advance care directives and end-of-life care, this part covers the entire range of end-of-life choices, including ethical aspects of end-of-life health care decisions. Professionals need to know about the ethics of end-of-life choices because they are of concern to almost every older adult and his or her family.

Learning Objectives

Chapter 10: Housing and Services for Aging Needs

• Explain the connection between aging in place and the continuum of care.
• Discuss why housing decisions can be difficult for older adults.
• Describe difficulties that older adults face aging in place in the suburbs.
• Identify housing and services for older adults from active/independent to less active/more dependent.
• Give examples of home and community-based services.
• Recognize new approaches to housing and services for older adults.

Chapter 11: Caregiving in Families

• Explain why family-centered caregiving is vital.
• Describe major challenges caregivers face.
• Discuss tensions between care givers and receivers.
• Describe strategies for caring for difficult adults.
• Describe the key supports family caregivers need.
• Recognize professional issues related to family dynamics.

Chapter 12: Advance Care Planning and Directives

• Distinguish advance care planning from advance directives.
• Identify the focal points for end-of-life discussions.
• Discuss the role of personal values in treatment choices.
• Describe the purposes of the three most common advance directives.
• Tell how Five Wishes is used and its effect on other advance directives.
• Explain the Physician's Orders for Life-Sustaining Treatment (POLST).
• Identify questions to start conversations about advance care planning and directives.
• Discuss how to prevent advance directives from failing.
• Name the four elements that define capacity and competence.
• Explain the process and rules for tissue, organ and body donation.
• List tasks and expenses for funerals, memorials and dispositions.

Chapter 13: Hospice and Palliative Care

• Identify the four trajectories of illness.
• Define palliative care and hospice care.
• Explain how palliative and hospice care services each meet the needs of older adults.
• Discuss how to evaluate and select appropriate hospice or palliative care service.

Chapter 14: End-of-Life Choices and Ethics

• Identify basic ethical principles that inform end-of-life care.
• Explain the four categories of end-of-life choices.
• Discuss five end-of-life options and their ethical and legal status.
• Describe the nature of suffering at the end of life.
• Discuss how to respond in an ethical, constructive way to suffering and requests to hasten death.

Part 4: Financial & Estate Planning for Age 65 and Older

Chapter 15: Financial Planning for Retirement
Chapter 16: Main Sources of Retirement Income
Chapter 17: Basics of Investing for Age 65 and Older
Chapter 18: Federal Income Taxes and Older Adults
Chapter 19: Essentials of Estate Planning

Description

Financial resources affect quality of life in later years, including choices for housing, health care, and long-term care. The knowledge from Part 4 enables you to generally discuss key financial planning topics and to raise important questions that your clients should consider about their financial health.

Recognize when you should refer your clients to tax, financial, legal and other experts for an integrated, more effective approach to making the best use of their accumulated resources.

Estate plans should be done to cover the possibility of mental incapacity and to help ensure timely and proper distribution of any amount of assets after death, large or small. Use the guidelines in this part to help your clients prevent or reduce fairness issues among their heirs, and introduce your clients to ethical wills, also called legacy letters, as a way to pass on their values, learning, and other intangibles during their lives or after death.

Learning Objectives

Chapter 15: Financial Planning for Retirement

• Explain how retirement today is different than in the past.
• Describe the models and stages of retirement.
• Discuss the effect of longevity on retirement income and expenses.
• Identify financial issues of older adults by asset or income level.
• Describe how the financial planning process applies to older adults.
• Identify strategies for managing risk.
• Explain life settlements, accelerated benefits, and viaticals.

Chapter 16: Main Sources of Retirement Income

• Identify the main sources of retirement income.
• Discuss the benefits of qualified retirement plans.
• Explain two criteria for distributions from tax-deferred plans.
• Define annuities and list the types and payout options.
• Discuss the role of reverse mortgages in financial security.

Chapter 17: Basics of Investing for Age 65 and Older

• Identify the key factors in creating an investment portfolio.
• Discuss the guidelines for asset allocation.
• Name the most common types of investments.
• Tell how mutual funds are used in retirement planning.
• Identify the most common pitfalls for investors.
• Explain how to make informed investment decisions.
• Discuss how suitability applies to older adults' financial needs.

Chapter 18: Federal Income Taxes and Older Adults

• Identify frequent tax questions and errors by older taxpayers.
• Discuss specific tax issues for older adults.
• Recognize the general flow of the federal income tax return.
• Identify the advantages of both the standard deduction and itemization.
• Tell the difference among a tax adjustment, deduction, exemption, and credit.
• Explain cost basis and how it relates to capital gains tax.
• List questions to ask when selecting a qualified tax preparer.

Chapter 19: Essentials of Estate Planning

• Explain why estate planning is important and the consequences of not having an estate plan.
• Recognize the main components of an estate plan.
• Identify the issues that incapacity can cause.
• Describe the probate process and the executor's role.
• Discuss the function of beneficiaries in an estate plan.
• Identify the taxes related to estate plans.
• Discuss what fairness means in legacy decisions.
• Explain the purpose of ethical wills and how and when to create one.

Part 5: Federal & State Programs for Retirement & Health Care

Chapter 20: Medicare
Chapter 21: Medicaid and Older Adults
Chapter 22: Social Security and SSI
Chapter 23: Veterans Benefits

Description

Medicare, Medicaid, Social Security and SSI, and veterans benefits are crucial financial resources that can provide older adults with more freedom of choice about their quality of life in later years.

Older adults might not know about all the government benefits available to them. You can be of immeasurable help to your clients by informing and educating them about these programs. Share the resources in Part 5 with your clients and connect them with program experts who can help your clients identify benefits, determine their eligibility, apply for and then manage their benefits once they are receiving them.

Learning Objectives

Chapter 20: Medicare

• Explain common misperceptions about Medicare coverage.
• Identify the groups eligible for Medicare and when and how they enroll.
• Describe Medicare Parts A, B, C, and D.
• Contrast the benefits and out-of-pocket costs of Parts A and B.
• Provide examples of what Medicare covers and does not cover.
• Contrast the four main options for supplementing Medicare.
• Explain how Medigap insurance complements Original Medicare.
• Discuss how Part D works with other parts of Medicare.
• Tell where to report suspected Medicare fraud and abuse and marketing violations.
• Explain the Medicare appeals process.

Chapter 21: Medicaid and Older Adults

• Identify the main differences between Medicaid and Medicare.
• Explain Medicaid's role in providing long-term care services and supports.
• Discuss Medicaid's eligibility rules.
• Recognize the multiple meanings of spend-down.
• Describe the Medicaid application process.
• Discuss how spousal income rules affect Medicaid eligibility for married couples.
• Explain how the look-back period affects Medicaid eligibility.
• Tell how states recover the cost of Medicaid benefits.

Chapter 22: Social Security and SSI

• Identify the eligibility criteria for retirement benefits.
• Discuss the benefits available for spouses, dependents and survivors.
• Explain factors to consider when choosing the best time to retire.
• Tell how working while receiving benefits affects benefit amounts and taxes.
• Discuss the eligibility criteria for Social Security Disability Insurance.
• Identify the requirements for Supplemental Security Income.

Chapter 23: Veterans Benefits

• Recognize older adults who may be eligible for VA benefits.
• Identify the types of VA benefits programs.
• Discuss the net worth and income requirements for pension benefits.
• Identify the benefits programs based on service-connected disabilities.
• Describe burial and memorial benefits.
• Explain the claims process and required documents for VA benefits.
• Compare key aspects of VA pension and Medicaid long-term care benefits.

Part 6: Essential Ethics for Working with Older Adults

Chapter 24: Practical, Everyday Ethics in Serving Older Clients
Chapter 25: Protecting Older Adults from Financial Exploitation
Chapter 26: Finding Qualified Professional Resources

Description

Gain new insight and practical ways to apply ethical principles in your everyday interactions with older clients. Topics in Part 6 include what to do if you suspect a client is showing possible signs of cognitive impairment, how to reduce the power differential between you and your clients, and how to proactively manage the effects of magical thinking by your clients on your professional relationship.

One of today’s most critical issues is financial exploitation of older adults. There are psychological reasons behind financial abuse; recognize warning signs and symptoms of financial abuse so you can help protect your clients from becoming victims or connect them with those who can help if they have already been victimized.

Serving clients with an integrated approach – health, social and financial -- is essential to ethical conduct and requires you to have a bank of trusted professionals who display the highest levels of competence and integrity.

One of the most confusing things to many people is the ever-increasing number of professional credentials, and in particular, understanding the difference between a certification and a certificate. Learn the differences among certifications, certificates, licenses and degrees, and what accreditation means. With this knowledge, you can have increased confidence in the referrals you give your clients and in building your own professional network.

Learning Objectives

Chapter 24: Practical, Everyday Ethics in Serving Older Adults

• Identify the requirements for legitimate informed consent.
• Explain the difference between competency and capacity.
• Discuss when and why decisions are a choice between the least of two harms.
• Define personhood and explain how to preserve it.
• Describe how a power differential is created and how to minimize it.
• Explain why professional boundaries are important.
• Discuss preventive ethics as applied to serving older clients.
• Identify four steps to take when you have concerns about a client's competency.
• Give examples of ethical do's and don'ts.

Chapter 25: Protecting Older Adults from Financial Exploitation

• Define financial abuse and exploitation.
• Describe older adults who are at most risk of financial exploitation.
• Identify those who most often financially exploit older adults.
• List signs of financial exploitation among older adults.
• Describe the psychological aspects of financial exploitation among older adults.
• Discuss the most common types of financial crime against older adults.
• Explain how older adults can protect themselves from financial exploitation.
• Explain where to report financial abuse, fraud, and crime.

Chapter 26: Social Security and SSI

• Identify key issues related to professional credentials.
• Distinguish between a credential and a designation.
• Discuss differences among credentials: license, certification, certificate, and diploma or degree.
• Explain the purpose and requirements of accreditation.
• Recognize credentials that typically serve older adults.
• Give examples of interview questions when choosing providers.