Introduction
Elder abuse is one of the country’s most serious policy problems today, especially since the COVID-19 pandemic hit. Statistics and current evidence from research indicate that the challenge keeps worsening, revealing that more elders experience the problem now more than ever before. The aging population has also increased in recent years, creating an even greater opportunity for them to be abused and their rights violated. According to the Census Bureau, there has been a sharp increase of Americans living up to 90 years. As a result, the number of aged people experiencing abuse has increased in the past three decades. Elder abuse occurs 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, health care providers, and those paid to take care of the victims. Comprehensive policy analysis is necessary for this area because elders are an important part of the American population and the need to protect their rights and meet their 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, the Older Americans Act. Policymakers in the country created the policy and related programs to meet the needs for social services targeting older persons. The original policy focused on providing grants to states to promote community planning and social services, train personnel working with the elderly, and advancing research and development to improve this area. The policy led to the Administration on Aging in the Department of Health, Education, and Welfare (DHEW) to support the grants program and support 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 wide, the analysis focuses on one important area, providing nutrition services. The policy focus is on the health and social needs and refocuses their care from institutionalized care to community-based services by ensuring that 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 of the aged cannot afford their meals, and those who can 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 establish the impact of the policy on meeting the needs and improving the welfare of the elderly. Medicare claims data provided information about the health status of the elderly receiving care under the program. An effective policy or program would reduce the number of the elderly seeking medical care for nutrition-related conditions. 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 health care utilization among the elderly because of the health promotion element of the policy (Lloyd, 2019). The elderly participating in the program were less likely to be hospitalized for diverse medical conditions because nutrition plays a key role in disease prevention. However, according to Sadarangani et al. (2020), the effect of the policy is limited because of the low number of the elderly who comply with the program requirements and apply for the benefits. 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, there are many others who remain unserved. Thus, the policy has failed to support participation among the 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 the lack of awareness among the elderly and caregivers, which has given room for their 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 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 the nutrition 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 things to avoid to maintain their health.
Application of the Health Policy into Clinical Practice
Healthcare providers can play a key 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 reduce the burden of health care providers in clinical practice by reducing the rate of illness resulting from a lack of proper nutrition. Health promotion is an important part of primary healthcare since it educates people about steps to improve their health outcomes and reduce their medical utilization (Menne & Thomas, 2018). Thus, instead of waiting to treat elderly individuals when they are unwell, they can promote knowledge about preventing illness and reducing the cost of care. For example, educating the elderly will reduce the burden of diseases like 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 elder abuse, which has become a major challenge in modern society, especially because of the burden of the COVID-19 pandemic. While the elder abuse problem is multifaceted, it has numerous elements, such as lacking proper nutrition. Thus, the current analysis focuses on the Older Americans Act Title III-C Nutrition Services Program, which focuses on the provision of proper 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. Treatment for the abused elders consumes many medical resources, suggesting that implementation at the community level will improve health and reduce the cost.
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: US 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.
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