HLTH340: Ageing in Australia - Social Determinants and Policies

This report analyzes the challenges of ageing in Australia, focusing on the social determinants of health and national legal and policy frameworks. It presents a case study involving a 68-year-old woman named Barbara, her elderly parents, and a friend, illustrating how factors such as housing, income, dependency, and transportation influence the health outcomes of the elderly population. The report also discusses various theories of ageing, including the disengagement theory and activity theory, and how these theories shape attitudes and values. Furthermore, the report examines the impact of chronic diseases and the importance of long-term aged care facilities. The study highlights the need for specific policies to manage and prevent chronic diseases within the context of an aging population, drawing attention to the importance of social support and economic stability for the well-being of older adults.

Running head: AGEING IN AUSTRALIA
Ageing in Australia
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Introduction:
In the recent era, demand for aged care has increased exponentially due to the prevalence
of aged population as a result of a population of aging in Australia. In Australia, the aged
population over 85 years has increased to 40000 and it will be 1.8 million in 2051 (Theou, Tan,
Bell, Emery, Robson, Morley ... & Visvanathan, 2016Theou et al., 2016). Underlying these
trends are changes in life expectancy at retirement age of 65. In 2017, more than half of older
people were aged to 65 to 74 years and one-third of them were 75 to 84 years ( 30 %
approximately) and only 13 % of them were aged 85 years (Kendig, Gong, Cannon & Browning,
2017Kendig et al. 2017). Therefore, the aged care facilities are crucial for reducing the morbidity
and mortality rate among elderly population of Australia. According to Arabiat, Whitehead and
Al Jabery Arabiat et al. (2018), it was observed that the importance of long term aged care for
the older population has become increasingly important due to the prevalence of a disease such
as cardiovascular disease, diabetes, obesity, mobility issues, and psychological disorders. The
diversity of these diseases not only affected the health of the aged population but also increased
health care expenditure exponentially (Scott, Hilmer, Reeve, Potter, Le Couteur, Rigby ... &
Jansen, 2015Scott et al., 2015). Therefore specific policies and practice framework need to
analyse be analysed in order to manage and prevent these chronic diseases. According to Lucas,
Annear, Harris, Eyles and Rotheram Lucas et al. (2018), national legal and policy frameworks
were relevant to the aging population in order to provide them comprehensive long term care.
The case study represents the different perspective of aging involving a 68 years old female,
Barbara, her parents who are 93 and 91 respectively and her friend Jim. This paper will illustrate
social determinates determinants of health that impacted the aged population of Australia in the
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context of Barbara, demonstration of national legal and policy frameworks for the disease and
policies for prevention of and management in theof the chronic disease.
Social determinants of health and influence of it in the older population:
As observed in this cases study, Barbara martini is a 68 years old woman who is a
working woman and never got married on childrenor had children. In the case study, different
perspective were shown with respect to their aging process,
As discussed by Atkins and Tonts (2016), the social determents determinants of the
health care encompass the economic and social conditions of the population, which influence
individuals and groups differ in the health statusbrings about a difference in their health status.
According to the World Health Organization suggested that these factors are health-promoting
factors found as an integral part of individuals which enhances the risk of developing chronic
disease or vulnerability to injury. These social determinants are often shaped by public policies
and therefore proper policies are required to reduce the global burden of disease. According to
Hillman, Athari, Frost and BraithwaiteHillman et al. (2018), the social determents determinants
of health are stress, early life experience, social exclusion, work environment, unemployment,
social support, addiction, accommodations, food habits, and transportation. The social
determinantsdeterminists interfere with the quality of the life, and functionality of the older
pollution.population. In addition, there are several psychological factors that largely contribute
to, or often deter the social, emotional, and mental wellbeing of older adults (Braveman &
Gottlieb, 2014). In other words, the aforementioned factors have resulted in a worsening of the
physical symptoms of Barbara, thus deteriorating the patient health outcomes.
Effect of housing on older population:
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A study by Hoff and Park (2016), suggested that the current inadequate housing impacted
the functionality of the older population. A majority of the people want to age in a
placeaccomplish a healthy aging, in a setting that is perceived comfortable and secure, such as
their homes; the house should have age-friendly elements, zero-step entranceno steps to the
entrance of their houses, and single floor living with wide halls, wheelchairs that facilitate access
with wheelchairs. Puts, Hsu, Szumacher, Sattar, Toubasi, Rosario ... and MussPuts et al. (2017),
suggested that only 3.5% of the house offers these three elements to the individuals, therefore,
the majority of elderly individuals are suffering from the mobility issues, hip fractionsfractures,
and sudden falls. In the case study, Barbara’s parents are living independently in town but due to
frail healthlive in town, and are not dependent on their daughter. Their ill health does not permit
them to live with Barbara. In addition, the fact that Barbara’s parents and her friends do not have
steady economic resources also created a major impact on their health. Exclusion and/or social
isolation is another major factor that results in an exposure of a person to chronic stress
experiences, and subsequent negative outcomes. Hence, it can be suggested that living away
from her parents contributed to her health complications.Therefore, living away from Barbara
affected their aging process.
Effect of income on older population:
A steady income and associated economic status support welling wellbeing of the
individuals as the study suggested that the majority of the older people are above 65 years of age,
and due to their retirement, they have lower economic status and for few individuals, the family
lives away from them as observed in this case. Another study by Harling, Payne, Davies,
Gomez-Olive, Kahn, Manderson ... and Witham Harling et al (2019) shows that , a considerate
number of individuals are suffering from depression and social isolation due to unemployment.
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Barbara was a working lady who finds business as a way of satisfaction through income. On the
other hand, parents of BarbaraBarbara’s parents, as well as her close friend Jim, were
unemployed and therefore, it impacted their lifewhich in turn created a significant impact on
their lives by reducing their access to services and conditions that are able to promote healthy
lifestyle. Lack of employment and adequate financial opportunities limited their access to
healthy housing and food, in addition to provisions for high quality medical services (Fazel,
Geddes & Kushel, 2014). It also subjected them to social exclusion, and inferior public services.
Effect of dependency on the aged people:
The state of the dependency affected the majority of the individuals. It was observed
from the accumulated evidence that the a significant number of older people are suffering from
depression and other health issues because of dependency on self-care and lack of belongingness.
They have to depend on other family members as observed in cases of parents of Barbarain the
case study. Barbara parents demand more time from Barbara due to a health condition which
Barbara failed to offer which further may result in social isolation (Hoff & Park, 2016). With an
increase in age, elderly parents generally lose their capabilities, and have to depend on their
children for assisting them with activities of daily living, medication management, and a healthy
aging (Pacolet, Bouten & Versieck, 2018). While there are home-care aids that assist older
people with their regular activities, they require companionship and care from their kids, which if
inadequate, results in the onset of sorrow and depression among the parents. Hence, isolation
from Barbara was largely responsible for the deterioration in her parent’s health status.
The effect of transportation on older people:
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Due to mobility issues and week weak health, the walking and travelling by transport
affects the wellbeing of the older population. Aging is a painful process which affected thealters
the human anatomy and therefore transportation to access health care and other service required
the assistance of others as observed in this case. Aging is also responsible for bringing about
alterations in the cells, tissues, and organs where the organs gradually being to lose their
functionality, with an increase in age. This exerts a major impact on the appearance and health
status of the elderly (Levasseur, Généreux, Bruneau, Vanasse, Chabot, Beaulac & Bédard, 2015).
Older adults have unique transportation needs that are accessible, affordable and
convenient. Furthermore, although there is no specific age at which the elderly are not
considered safe drivers, their disability and chronic illness often creates an impact on their
driving skills. Furthermore, lack of transportation facilities also results in social exclusion that
lowers the access to emergency medical services such as, hospital visits, appointment with
clinicians, and continual care (Takemoto, Carlson, Moran, Godbole, Crist & Kerr, 2015).
Therefore, it can be stated that lack of adequate transportation facilities often lessens the
independence of the elderly, thereby creating a major influence on the health status, as was
evident in this case study.
Theory of aging and how it shapes attitude and values of individual’s person:
Most of the people are bound to experience aging and the age-related deterioration is
affecting and growing number of people. Although the process is unavoidable, different people
experienced it in a different way. Accumulate An accumulation of evidences showed highlighted
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different theories that are useful in evaluating the effect of the aging on the attitude and values of
older people (Rosset, 2017). Disengagement theory suggested that everybody is expected to die
one day and as older individuals experience meant and physical declines, they tend to withdraw
themselves from the social effect situations (Reed, 2017). Moreover, the theory suggested
postulated that social withdrawal is gender-based that means it is experienced differently by men
and women. Men tend to focus on work and women focus on the marriage. In this context,
Barbara is fit and living a satisfied life due to the role she adopted as a working lady, and has it
shaped her attitude. The aging process can be explained by activity theory which stated that
activity level, and social involvement isn the key to happiness. The more active an elder older
person more happy he or she will be. In this context, due to social involvement and interactions,
it shaped her attitude towards life (Maatouk, Mueller, Schmook, Angerer, Herbst, Cranz ... &
GündelMaatouk et al., 2016). On the other hand, due to lack of activity and social involvement,
her parents have different the attitude towards life. This theory is also applicable for Jim for
activity, although he had many hobbies, due to retirement and lack of activity affected his
attitude towards life. The TheA age stratification theory and exchanged theory explained how
aging shaped the values and beliefs of individuals (Deane & Fain, 2016). Age stratification
theory is stratified by race and gender and it showed that age serves as the basis of social control
and therefore, different age groups have has varying access to the social resources such as
political and economic. For example, in this case of Barbara, it is inconsideratethe theory is in
consideration for a woman who is fit, unmarried and is involveds in business. On the other hand,
her parents were retired and therefore unable to access the social resources equally well. It
shaped their values and attitude towards life. The exchanged theory suggested that with the age,
elder older people experience dependence and become less active to exchange resources as
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observed in this case study (Ji, Ling & McCarthy, 2015). Barbara is 65 and involved in the
business and is able to exchange resources. On the other hand, her parents who are 91 and 93 are
not able to exchange resources and had to depend on Barbara. These theories suggested that age
and genders are effective in shaping the values of the individuals that further reflects their
attitude towards life.
National and legal policies related to the aging:
Population agingHealthy aging is one of humanity’s greatest triumphs and it has also
become one of the greatest challenges of in the 21st century and global aging increased the
economic and social demands on all of the countries. Therefore, the Australian human rights
commission hasis legislated different policies for protecting the rights of older persons in order
to provide for patient-centred care and active aging (Australian Human Rights Commission,
Humanrights.gov.au., 2019). These aging policies and framework help in evaluating fist is an
international legal framework and under this framework, the principles of older persons are
integrated and second is the domestic legal frame. The legislations do not make discrimination of
any type based on age and work towards ensuring that all older people are provided with
necessary standard of living, in addition to proper access to clothing, housing and food. In
addition, the aged people are also entitled to safe work and living conditions and are protected
against all types of degrading and inhuman treatment. These frameworks provided three relevant
policies which are accurate for Barbara, her parents and her best friend.
First policy: National palliative care strategy
For improving the health and nutrition wellbeing of the older people of the Australia
older people, The National palliative care strategy was enforeced with the aim of improving the
health, nutrition, and wellbeing of the older people of the Australia. National palliative care
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strategy was endorsed in 2000 by commitment ofthe common wealth, territory and state
government (Department of Health, 2018). According to the World Health Organization, in the
aging process, the biological changes are observed in the body during aging process that
affectsed the wellbeing of the individuals (Ji, Ling & McCarthy, 2015). In the current context of
Barbara, although she is fit and involved in business, due to the her advancing age she maymight
develop the different chronic diseases such as, back pain, heart disease, visual impairment,
obstructive pulmonary disease, and diabetes. Some of the most common reasons that contribute
to such chronic diseases are sedentary lifestyle, poor nutrition, alcohol consumption, and tobacco
usage. In other words, chronic disease co-occur in aged people and creates an impact on the
health related quality of life. Moreover, her parents demand her time which she has failed to
give. Consequently, it may give rise to mental health issues such as depression because of her
work pressure and being unable to spend time with family. These are the physical and
psychological changes that may impact Barbara’s situations (Smith & Parker, 2015).
On the other hand, her parents lived away, independently and required the time from her
due to physical weakness. At the Due to older age, lack of physical activity, they may develop
chronic heart disease and kidney disease, mental health issues and additionally, Alzheimer’s
disease (Reinharz, 2018). The similar kind of health condition can be observed for the Jim due
to lack of active life. Although Jim has several hobbies, he enjoyed He was living a sedentary
lifestyle, which may affect his physical health and mental health (Alligood, 2017). Therefore,
National palliative care strategy is in practice for improving the health and nutrition for the older
people. For health and nutritional improvements, National palliative care strategy allows the
nurses to promote active aging and aim to provide improved services. Three components of the
patient-centric care conceptual frameworks would be aligned with the national palliative care
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strategy where a first component (structure) would give formal and informal support through
primary service, palliative services, and rehabilitation services to parents of BarbaraBarbara’s
parents to cope up with the health conditions including neurological disease (Department of
Health, 2018). In order to promote active aging, support of nursesnursing care should be given to
the family members of the Barbara and Jim. Assistance from nursing professionals in performing
daily activates, leading a healthy lifestyle, and showing adherence to healthy diet patterns will
largely benefit them who will assist them to perform daily activities, consuming healthy foods
(Bauman, Merom, Bull, Buchner & Fiatarone Singh Bauman et al., 2016). National palliative
care strategy assist to providealso emphasises on delivering long term care including the mental
health services in order to overcome the loneliness they are experiencingthat are typically
experienced by aged people due to because of separation from dear ones. Such mental care
services are effective in managing depression and grief that are a direct manifestation of social
exclusionwhich is effective for their end of life. This strategy help to identify the barriers of
safe delivery of palliative care services and therefore it is effective for care process. The care
strategy also focuses on implementation of a person-centred approach, whereby older people
who are affected by a range of life-limiting diseases, and their family members are generally
included in while planning for their care program, in addition to identification and address of all
barriers to healthcare choice and access. In addition, good symptom management is another key
consideration of the strategy that must be taken into account in this case scenario as well.
Second policy: Residential aged care end of life care pathway
It is usually observed that due to the aging process, older people tend to be physically
weak because of weak muscles. In this current context, Barbara’s parents and Jim were suffering
from these issues due to the health frail health conditions and Jim were experiencing due to
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retirementdue to their advancing age, socioeconomic condition, housing facility and
transportation facility. Therefore, in order to improve the housing and living conditions, the
residential care is in the current practiceefforts must be taken for developing provisions for
residential care services (Alligood, 2017). Residential aged care end of life care pathway was
developed by collaboration of government and non-government professionals and incorporate
best clinical management, accommodation, personal care and complex services for the aged
people (Queensland Health, 2013). In the current context, creating provision for a single floor
house residential centre near the house of BarbaraBarbara’s house with proper lighting for their
survivalfacilities, a ground for physical activities, and frequent access to the food and water,
clothing and health care services (Australian Human Rights CommissionHumanrights.gov.au.,
2019). The strength of the policy is that this pathway assist nurses to guide patient perform self-
care, assist them to live life independently by engaging them in income gathering activities,
spiritual activities, healthy eating, and management of dementia (König & Schilling, 2016). It
will shape their attitude towards life and they will feel more empowered and able to participate in
social activities. The care pathway will make it necessary for nurses to ensure that the religious,
cultural and spiritual needs of the clients are met and proper communication is fostered with
Barbara, in relation to the health status of her parents and Jim. Special provisions for comfort
care must also be created, to ensure satisfaction among the clients.
Third policy: National primary health care strategic framework
Inadequate family and community support not only increases the burden of disease but
also increase morbidity and mortality rates. According to Wlodarczyk, Chylińska, Lazarewicz,
Rzadkiewicz, Jaworski, Adamus ... & Espnes Wlodarczyk et al. (2017), strengthening of the
family and community is proved to improve the wellbeing of individuals and help in getting the
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lifeenhances their quality of life. The National Primary Health Care Strategic Framework is the
first national statement, endorsed by stand council on health for creating robust primary health
care system and strengthening family and community support (Standing Council on Health,
2013). In the current context, National Primary Health Care Strategic Framework provides
primary health care services to the Australian community in collaboration with community,
population groups and family members. The unique feature of the policy is that community-
based care approach is the integrated part of the policy. The policy has been formulated and
enforced by the Standing Council on Health and aims to improve healthcare provisions for all
Australians, with a special emphasis on those citizens who are demonstrate inequitable health
outcomes. The policy also intends to prevent illness among the citizens, while keeping them
healthy and enhancing the management of chronic conditions.
Through a community-based approach Barbara can engage in different social activities with her
family members and Jim, establishing a therapeutic communication with them in order to release
their feeling of loneliness and share her experience with them (Aird & Buys, 2015). It will
strengthen the relationship between Barbara and her parents and they will feel more secure about
the relationship (Smith & Parker, 2015). Additionally, other community caregivers can be
recruited to give support to them through neighbour helpingthe help of neighbours and, peer
monitoring. The community-based care approach also includes providing the education to the
Barbara to balance her work and time with the family (Bauman et al., 2016). The education
should be given to them for managing the mental health issues and how to overcome it quickly.
The Eeducation should be given to Jim in order to enhance his healthy aging process through
different activities such as formal work, informal work, and unpaid activities at home to enhance
his health (Aird & Buys, 2015). It will reduce the feeling of unemployment and boost self-
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