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“People tell me I look good these days. I look good because I feel good. I know people who are older than I am who are twenty-five… It’s all about attitude. To me, age is just a number.”
—Rita Moreno
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
1-1. Analyze demographic characteristics of older adults and their influence on global aging.
1-2. Explain how social determinants of health and public policy affect older adults.
1-3. Compare how different physical contexts influence the aging experience.
1-4. Analyze the impact of socio-cultural factors, including attitudes on the experience of aging.
1-5. Create interventions that support positive aging.
1-6. Describe social and occupational justice efforts to support the health and wellbeing of older adults.
1-7. Explain the WHO ICF model as foundational to occupational therapy practice with older adults.
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Mini Case Study
Ms. Brown is a 72-year-old woman who had many jobs as an adult, from motel housekeeper to grocery clerk to school cafeteria cook. She retired from the school cafeteria at age 70, when being on her feet all day was too fatiguing. She has limited income from Social Security. She quit school at age 16 when she ran away from her abusive family home. She has always rented homes and currently lives in a home with her daughter, a granddaughter, and two great grandchildren who are in high school. Her daughter has mental health issues and receives Supplemental Security Income (SSI). Her granddaughter works in a local meat packing plant in their semirural community. Ms. Brown has diabetes, peripheral neuropathy, high blood pressure, degenerative joint disease affecting her back, and grade 1+ cataracts. She has difficulty getting to medical appointments in the larger community 40 minutes away. She reports stumbling in and around her home and has started limiting some community activities. She enjoys watching television, visiting with neighbors, and going to church services when feeling strong enough to do so.
Provocative Questions
What are the social determinants of health factors that influence Ms. Brown’s health and wellbeing?
How would an occupational therapist address International Classification of Functioning, Disability, and Health (ICF) aspects of body functions and structure, activity, and participation?
How could Ms. Brown’s environmental factors and personal factors influence the therapist’s intervention plan?
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This chapter provides an overview of many influences on individuals’ experiences of later life. The first section explores definitions of aging and relevant demographic data followed by historical perspectives on aging. Factors that influence aging are discussed, including social determinants of health (SDOH); health literacy; and personal, environmental, and socioeconomic factors. The interrelationships among these elements and the experience of aging are examined, as are concepts of positive and successful aging. Social and occupational justice are explored, followed by an examination of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) as a framework for practice.
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