Understanding Ageing

Introduction

In humans, ageing includes changes in social, physical and psychological aspects. The rise in the ageing population creates demands for larger and better trained professionals and workforce in health and social care those are able to offer long-term care with less error and considering the needs of the aged people. In this essay, the theories of ageing are to be evaluated population trends regarding older people, as well as their healthcare predictions, are to be interpreted. The impact of government policies and regulations which influence the healthcare of older people is to be discussed. The common conditions experienced by people due to ageing are to be discussed and supported through discussion of proper theories. In the end, the factors which inhibit as well as assist the multi-agency profession to care for older people are to be critically appraised.

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LO1: Critically evaluating ageing theories and interpreting older population trends

Ageing in humans is simply regarded as the process of being older where one loses theory capability or become functionally diminished to effectively perform everyday activities and care for them (Hearon Jr and Dinenno, 2016). The Disengagement theory of ageing informs that ageing is inevitable and mutual withdrawal of a person from the society and personal relationships as a result of decreased interaction between the person and others in the social system (Asiamah, 2017). This informs that with ageing a person’s abilities are going to deteriorate compared to the way they used to perform during younger age. The theory postulated that since men have central instrumental role in the family in America and women have socioeconomic role, thus the disengagement as a result of ageing in men and women would be different (Zaidi and Howse, 2017). This is because men being centrally responsible for running the family would show partial disengagement with ageing as total disengagement would lead them unable to perform their duties and manage the family. However, women playing the socioeconomic role may show entire disengagement as they develop withdrawal from social relationships over time with ageing (Cosco et al. 2017). The strength of disengagement theory of ageing is that it explains the reason behind older people quitting and trying to relax in their older years. However, the critics of the theory are that it does not focus on the variation and diversity process related to ageing where broader determinants such as class, culture and gender are involved in influencing the way ageing impacts people (Zaidi and Howse, 2017).

The Activity theory of ageing informs that successful ageing happens when the older people remain active as well as maintain proper social interaction (Marsillas et al. 2017). This informs that ageing process among older people can be delayed if they enhance their quality of living and remain active in society. Thus, the theory opposes the postulates made by the Disengagement theory by informing that active management of relationship would delay psychological ageing among older people. The Activity theory informs that there is an existing positive relationship between activity and satisfaction of life among the elderly (Fernández-Mayoralas et al. 2015). This is because remaining active leads the older people to share their emotions with others to cope with frustrations and negative feelings as well as avoid isolation and access support in performing in everyday activities offering them the satisfaction of life by remaining active. The critics regarding Activity theory of ageing is that it does not look into the inequalities of health and economies which hinder the ability of older individuals to remain effectively engaged in performing their activities (Almalki et al. 2016). Moreover, it is found that many older people avoid engaging in new challenges to lead their life and the activity theory is unable to explain the reason behind such action or the way the older people can be made to remain active and engaged (Zaidi and Howse, 2017). On considering the theories regarding ageing, in the UK it is seen that there is an increased trend of ageing population.

The reports published in 2018 regarding population in the UK indicate that there are nearly 12 million people living in the country who are aged 65 and above. Among them, nearly 5.4 million are aged above 75 years, 1.6 million aged above 85 years, 500,000 people aged above 90 years and 14,430 people who are centurians (ageuk, 2019). The reports mention that in the past 15 years there is an increased of 85% of people who are 100 years and above living in the UK (ageuk, 2019). The trends mentioned in the reports predict that by 2030 1 in 5 people which is 21.8% would be 65 years and above and among them 6.8% would be 75 years and above age along with 3.2% of them would be 85 years and above the age (ons.gov.uk, 2018). It is predicted that by 2041 the people in the UK having 85 years and above age would be doubled and the figures are going to be trebled by 2066 indicating 7% of the entire population in the UK by 2066 would be 85 years and above (ageuk, 2019). This informs that a considerable part of the population in the UK is ageing and it would impact in many ways towards the future health and social care provision for the people within the country.

The study by Fortuna et al. (2017) informs that the likelihood of people facing disability and multiple chronic health conditions increases with ageing. This is because ageing leads individuals face wear and tear of cells which lowers their physical ability to cope with health issues making them prone to get sick. Therefore, the rise of the older population in the UK would impact them in future to focus more on developing care provision that is especially able to manage as well as treat disability and multiple health conditions of the elderly rather than focussing on primary healthcare. As mentioned by MacLeod et al. (2017), the rise of the ageing population impacts future care provisions by making healthcare workers invest more time and energy in caring for the elderly. This is because elderly individuals are usually unable to support their own care and required effective support in long time to assist them to lead a healthy life till death. As argued by Malwade et al. (2018), ageing population impacts the future care provisions to ensure presence of better and innovative healthcare staffs and technologies that are able to provide elderly-friendly care. This is because elderly people are often found to have complicated healthcare needs and demands that are difficult to be fulfilled by the less educated and primary healthcare workers. The ageing population would impact the UK to arrange future care provisions in a cost-effective way. This is because elderly people do not have proper financial ability to avail costly services as they are no more employed or earn money to support their living (Picco et al. 2016).

LO2: Critically evaluating the effect of the modernisation agenda (i.e. government policy) on health care of the elderly

In the UK, various healthcare policies and regulations are developed nationally as well as socially for the elderly to support their well-being and healthy living. One of the regulations is the Care Act 2014 which had mentioned clear guidelines to be followed by the local authorities where it is mentioned that the authorities are liable to prevent harm or abuse towards the adults as well as have duty to promote proper care for the elderly so that their needs are fulfilled. The section 42 of Act mentions that local authorities are to develop the leading role to coordinating safeguarding inquiries and are required to involve other authorities to work closely to ensure proper safeguarding of the vulnerable adults (legislation.gov.uk, 2014). This aspect of the Act is effective to influence in protecting the elderly from harm and abuse in society. As asserted by Buckinx et al. (2015), elderly people being lower in strength and considered as burden of care are often abused and harm in the society. This is done to make overcome caring for elderly people by the family and friends. Therefore, providing safeguarding to the elderly through the Care Act 2014 would avoid harm towards them, in turn, allowing them to lead a safe life.

The Care Act 2014 mentioned that elderly people are to be encouraged in taking their own decision regarding care and this is to be done through informed consent (legislation.gov.uk, 2014). It influences care for the elderly to be provided according to their wish, in turn, values their opinion and perspectives. This, in turn, would avoid forceful care towards the elderly and offer them ability to have preferred care to ensure them satisfaction. The Care Act 2014 informs that effective actions are to be taken before occurrence of any harm as well as care support are to the provided at the earliest to people who are in greatest need (legislation.gov.uk, 2014). In this respect, the Act guides that no health professional are to assume that information regarding the safety and well-being of an adult is to be passed by others. It is the duty of the health professional to share information regarding an elderly who is likely to be harmed or abused so that proper professionals can intervene to protect the elderly (legislation.gov.uk, 2014). This influences immediate and effective care to be provided to elderly for protecting them from facing adverse health and social condition. Thus, the Act is effective to provide empowered and protective healthcare to the elderly.

The section 2 of the Health and Social Care Act 2015 states that information regarding health of an elderly is to be shared by the care provider only to the relevant person who is working or caring for the individual (legislation.gov.uk, 2015). This is because it would avoid personal information of the elderly to be inappropriately shared in the public which may lead to harm and abuse towards them. Therefore, this Act is effective to positively influence care provided to the elderly as it informs the way health data of patients are to be shared protectively to ensure safeguarding to the older people. The Keogh Review was the report that was published in 2013 based on the review of 14 hospital trusts in England who offered care to the elderly and others to inform the wrong care actions taken and the areas of actions to be considered in improving quality of care (NHS.uk, 2013). The Keogh review informed that listening to the views and feedback of the patients and staffs are essential to provide proper care and the management of the hospitals are to understand the way they are to engage patients and staffs in improving care services (NHS.uk, 2013). This is an effective step to be taken influence care of the elderly as listening to the views of the elderly patients regarding their care would lead the management of the hospitals to understand which needs of them are fulfilled. It would guide hospital management in taking further actions for improvising the care quality to ensure satisfactory care and well-being of the elderly patients.

The Berwick Report published by the NHS mentions that constant vigilance, learning and monitoring is to be established in care environment to ensure patients are safe from any unavoidable harm or abuse (England.nhs.uk, 2013). This aspect of the report is going to influence positive care for the elderly. It is evident as constant vigilance along with monitoring the care support and the care staffs offering care to the elderly would lead the manager of the organisation to determine whether or not the staffs are following proper protocols to offer safe and effective care to the elderly (Johansson-Pajala et al. 2016). Thus, changes in care can be made as well as withdrawal of staffs to offer care can be done for the care providers who are not following proper care providing protocols for the elderly making the patients suffer from improper care. The Berwick Report mentions that a culture of openness along with honest and support are to be built within care environment to ensure safety and proper care of the patients (England.nhs.uk, 2013). This aspect of the report influences positive elderly care as the older people due to open culture can communicate their needs and demands of care to the staffs. Moreover, healthcare providers can interact with the elderly to understand what changes in care are to be made to offer them better care satisfaction and improved well-being.

LO3: Critically evaluating the physical, psychological and social aspects related to ageing

The elderly people face various health complications with progressing age which can be explained through different biological and psychological theories. One of the common health complications seen among the elderly is rheumatoid arthritis. This is evident as nearly 400,000 people in the UK are affected by the disease and most of them are above the age of 40-60 years and the disease is seen mostly among men who are older than 60 years (nras.org.uk, 2019). The Rheumatoid Arthritis is a nature of the long-term autoimmune condition in which the immune system of the body attacks the cells and tissues in the joints leading to inflammation as well as thickening of the joints (Zhang et al. 2016). This health complication can be explained through the support of the immunological theory of ageing. The immunological theory of ageing informs that immune system of the body has been programmed to decline after a certain time which creates increased vulnerability of the humans to get affected by health issues (Nagaratnam, 2019). Therefore, the declining immune system of the body with age performs inappropriately which leads the joints of the elderly people to get affected in turn making them develop rheumatoid arthritis.

The type-2 diabetes is referred to the health issues that are characterised by the build-up of sugar in the blood due to insulin resistance of the cells of the body or relative lack of production of insulin (Bode et al. 2015). It is another common health issue to be faced by the elderly because with age the body becomes resistant to use insulin and the islets of Langerhans which are involved in controlling insulin products are also damaged (Bode et al. 2015). The cause of the disease can be explained through the Wear and Tear Theory of ageing. The Wear and Tear Theory of ageing informs that tissues and cells are vital part of the body and with age, the body due to wear and tear of repeated use of cells loses and kills many cells. These wear and tear of cells and tissues many organs to be non-functional or function inappropriately (Chmielewski, 2017). Thus, it informs that due to wear and tear of cells of the body as well as islets of Langerhans with age they lose their ability to function properly in maintaining production of insulin which leads the elderly individuals to be at risk of developing diabetes.

The individuals with ageing develop various psychological health conditions out of which the most common is Alzheimer's disease. The Alzheimer's disease is the nature of irreversible and progressive disorder of the brain among the elderly which slowly destroys their ability to think and memorise. This result the elderly individuals eventually to be unable to perform simple everyday tasks making them dependent for care on the family and care providers (Da Mesquita et al. 2018). According to Love and Miners (2016), Alzheimer develops as a result of abnormal accumulation of protein in as well as around the brain cells. The proteins involved in the process are amyloid protein which leads to formation of plaques in the brain cells and tau protein which tangles the brain cells. The exact mechanism is not known that leads the proteins to be accumulated but it is informed that the process initiates from a long time (Wyss-Coray, 2016). It is also mentioned that brain cells are adversely affected in the process and chemical messengers are unable to send proper signals to the brain (Baker-Nigh et al. 2015).

The developed of Alzheimer among the elderly can be explained through age-related neuronal morphological theory. This theory informs that in normal ageing neurofibrillary tangles present in the brain are comparatively low in relation to the number of tangles found in the brain of elderly with Alzheimer's disease. Moreover, the theory informs that in people with normal ageing no plaques in the brain are found but the elderly people who are affected by Alzheimer’s are found to have amyloid plaques present in the brain (Gant et al. 2018). Therefore, the theory supports the fact that the presence of increased neurofibrillary tangles and plaques as a result of abnormal ageing leads individuals to develop Alzheimer’s disease.

In respect to social aspects, the older people who try to age normally and in a healthy way are found to retain proper social interactions. This is because effective social interaction leads them to maintain proper psychological balance by reducing development of unnecessary depression, anxiety and stress, in turn, helping to them control their thinking process (Steptoe et al. 2015). The fact can be supported through the continuity theory of normal ageing which informs that elderly would try to maintain similar behaviour, activities and relationship with others as they did earlier during the young age by adopting new strategies based on their past experiences to live their life. This is done to continue their life in a normal way until death by maintaining a state of equilibrium with the society and personal needs of the individual (Stones and Gullifer, 2016). Thus, the theory informs that older people who shows effective social engagement and continues to perform their activities effectively are able to show normal social engagement with ageing.

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The symbolic interaction theory regarding ageing informs that ageing is mainly socially constructed and it is determined by different symbols which are related to ageing through social interactions among people (Evans et al. 2018). This indicates that social aspects of ageing are determined by the symbols developed by interaction between people in different cultures in society. For instance, in Eastern societies, it is seen that people with older age are shown value due to their wisdom and knowledge in society. Thus, elderly individuals in societies retain their behaviour of being old to access respect from society (Koleva, 2016). However, in Western society, older people are regarded as incapable to take their care and are avoided to be respected as they become burden on the family (Koleva, 2016). Thus, elderly individuals in western societies try to retain their younger image and behaviour in society even being old to earn respect from others.

LO4: Critically appraising factors which inhibits and helps multi-agency care delivery to the elderly people

The Multi-agency working is referred to the working process in which different healthcare professionals from various agencies work together to collaboratively offer certain supports to the service users (Noga et al. 2016). The commitment of the service providers and professionals assists in effective multi-agency care delivery to the elderly (Solomon, 2019). This is because proper commitment leads the healthcare professionals to invest time in improving care quality delivered to the elderly as well as assist to work collaboratively to instil shared values for driving the care to reach highest professional standards. As argued by Bermúdez-González et al. (2016), lack of commitment among the professionals in multi-agency working makes them show lack of zeal and effort to provide effective care. This hinders the care for the elderly as their specific needs and demands are not properly determined and fulfilled through the care effort provided by the multi-agency professionals. As mentioned by Krayer et al. (2018), effective commitment of worker in multi-agency working brings in coherence to existing care initiatives. This helps to unite the professionals from multiple agencies to work towards a common care goal for providing improved quality care to the elderly service users. As asserted by Stevens and Cook (2015), proper understanding of the roles and responsibilities by the professionals and staffs in multi-agency working assist to provide effective care to the elderly. This is because identification of the roles leads the health professionals from different agencies to understand the duties they have to perform in providing effective care to the elderly. Thus, it would avoid confusion between the professionals of different agencies regarding which part and duties each have to play in delivering successful care to the elderly (Stanley et al. 2018).

The presence of common aims and objectives of care acts as major factor in assisting multi-agency care delivery to the elderly. This is because the common goals make the professionals from multiple agencies work in a unified way so that each of them reaches the same care goal which is determined by analysing the needs and demands of the health condition of the elderly (Jarvis et al. 2016). As commented by Staniforth et al. (2019), the presence of proper leadership is a key factor for assisting multi-agency care delivery to the elderly. This is because effective leadership helps to set clear vision and goals for all professionals involved in care which directs them to realise specific roles and responsibilities to be performed by them in accomplishing successful care delivery to the elderly. As mentioned by Sullivan et al. (2015), effective leadership assist in multi-agency care delivery for the elderly by resolving conflicts and problems in delivering care. This is because the leaders communicate with the professionals and staffs of each agency to understand the issues they are facing in collaborating to perform their duties in delivering care to the elderly service user. The leaders based on the information provide them with resolutions to be followed and direction to change working to resolve the conflict, in turn, instilling effective care delivery to be provided to the elderly by the multi-agency professionals.

In multi-agency working, the lack of adequate resources and funding act as an inhibiting factor for delivering care services to elderly (Trotman and Tucker, 2018). This is because the materials, facilities, personals and finances required by the health professionals of different agencies to work collaboratively in providing care to the elderly is not available. As criticised by Noblett (2019), the lack of effective communication is an inhibiting factor in care delivery to the elderly through multi-agency working. This is because communication in multi-agency working leads the professionals of different agencies to know which roles and responsibilities are being performed by which professional from which agency. In addition, communication helps the multi-agency professionals to share the progress of their care for the elderly and decide collaboratively which steps are to be taken next by which professional to ensure smooth flow of care for the service user. As asserted by Khadjesari et al. (2018), effective communication in multi-agency working ensuring proper care delivery to the elderly as it resolves confusion between professionals. This is because through interaction the professionals are able to know what already has been performed and what further is to be executed to ensure proper care services to the elderly.

In multi-agency working, the lack of good working relationship acts as an inhibiting factor to deliver successful care to the elderly (Trotman and Tucker, 2018). This is because the lack of good working relationship between multi-agency workers in healthcare makes them unable to work collaboratively through proper teamwork. It is evident as hindered working relationship makes the workers rarely to be on good speaking terms to share their work progress and ideas to work together in accomplishing the common care goal for the elderly (Bower, 2016). Moreover, the lack of good working relationship inhibits multi-agency care delivery for elderly as the morale of the professionals are not positively supported. This is because hindered relationship between them makes professional unable to be friendly with other staffs in different agencies making them lose trust over the ability of the other workers. It leads at times to create duplication of services or gaps in care making the elderly to be unable to have required care as per their needs and demands (Khadjesari et al. 2018).

The presence of negotiation and compromising skills among multi-agency professionals is a key factor which would assist in delivering effective multi-agency care to the elderly. This is because without negotiation the multi-agency professionals cannot develop better relationships among one another to work as a team and they would fail to reach proper solutions in delivering quality care due to conflicting ideologies of the professionals at work (Trotman and Tucker, 2018). The involvement of trained professional is required for assisting the multi-agency care delivery to the elderly. This is because the trained professionals have proper skills and knowledge regarding the way to work collaboratively to meet the complex needs and demands of the elderly based in their health and social condition (Trotman and Tucker, 2018). The lack of trained professional inhibit the multi-agency care delivery to the elderly as care services could not be properly planed along with collaborative work activities could not be established to offer support to the elderly as a result of improper knowledge and skills of the professionals to work together in the field (Trotman and Tucker, 2018).

Conclusion

The above discussion mentions that according to disengagement theory with age elderly people withdraw from society and show less involvement in executing activities. However, the activity theory mentions that individuals who retain their ongoing social activities and maintain a positive sense of self are seen to enter health ageing where they adopt strategies to continue roles that are played at younger age to be also played at older age. In the UK, there is rise of elderly population and this is going to impact the healthcare field to include better trained professionals who can work long hours, improved supportive resources for the elderly, lower cost of care and others. The Care Act 2014, Health and Social Care 2015, Berwick Report and Keogh Review are few of the current local and national policies to be abided to ensure safe and protective care to the elderly. The elderly people are seen to face major health issues such as Alzheimer’s disease, diabetes and others which is able to be explained through different ageing theories. The symbolic interaction theory and continuity theory are ageing theories which explain that ageing is influenced by social interactions and learning. The factors such as communication, negotiation, trained professional, leadership and others are responsible for inhibiting and assisting multi-agency care for the elderly.

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