Annotated Bibliography Assignment
See the three references below for this assignment. Create an annotated bibliography for each of the three references.
Each annotation must have 150-200 words, making a total of 450-600 words for the entire assignment. Each annotation should have the following elements:
1. APA style reference of the article being annotated
2. A paraphrased summary of the article (See note on paraphrasing below.)
3. An assessment of why it is a scholarly reference
4. A reflection on how it is applicable to your research
Note: Go to the Student Success Center and search key words “Preparing Annotated Bibliographies” for help with this assignment.
Follow these steps for all three references you chose.
Note on Paraphrasing: Paraphrasing the ideas of others is a requirement in academic writing and graduate study. Paraphrasing is using your own words to restate ideas or information from a source material. As you write each annotation use the following paraphrasing guidelines.
There are three main steps to paraphrasing:
1. Identify the original idea(s) in the article
2. Identify general points regarding the idea(s)
3. Summarize the general points of the article in your own words
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit your annotated bibliography to Lopes Write. Please refer to the directions in the Student Success Center.
Please find the following three articles and firm for this assignment below:
1. Films Media Group. (2005). The way we live-golden years: Aging and the elderly. Films On Demand. https://fod.infobase.com/PortalPlaylists.aspx?wID=96349&xtid=71468
2. Diduch, M. (2018). Another Slump: Headwinds facing skilled nursing operators keep impacting occupancy. National Real Estate Investor, 60(5), 18. https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=132451662&site=eds-live&scope=site
3. Annual review of nursing research, volume 37 : Transcultural and social research. (2018). ProQuest Ebook Central http://ebookcentral.proquest.com.lopes.idm.oclc.org
Please see attached grading rubric
Rubic_Print_Format
Course Code Class Code Assignment Title Total Points
UNV-503 UNV-503-O500 Annotated Bibliography Assignment 150.0
Criteria Percentage Unsatisfactory (0.00%) Less than Satisfactory (74.00%) Satisfactory (79.00%) Good (87.00%) Excellent (100.00%) Comments Points Earned
Content 75.0%
Reference 1: A summary (Paraphrase) An assessment of why it is a scholarly reference A reflection on how it is applicable to your research (150-200 words total) 25.0% Annotation does not summarize the article, explain why it is a scholarly reference, or explain how it is applicable to student?s research. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a vague or incorrect manner. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research. Summary and explanation is fairly accurate but lacks some details or quality. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a clear and accurate manner. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a clear, focused, and comprehensive manner.
Reference 2: A summary (Paraphrase) An assessment of why it is a scholarly reference A reflection on how it is applicable to your research (150-200 words total) 25.0% Annotation does not summarize the article, explain why it is a scholarly reference, or explain how it is applicable to student?s research. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a vague or incorrect manner. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research. Summary and explanation is fairly accurate but lacks some details or quality. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a clear and accurate manner. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a clear, focused, and comprehensive manner.
Reference 3: A summary (Paraphrase) An assessment of why it is a scholarly reference A reflection on how it is applicable to your research (150-200 words total) 25.0% Annotation does not summarize the article, explain why it is a scholarly reference, or explain how it is applicable to student?s research. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a vague or incorrect manner. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research. Summary and explanation is fairly accurate but lacks some details or quality. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a clear and accurate manner. Annotation summarizes the article, explains why it is a scholarly reference, and explains how it is applicable to student?s research, in a clear, focused, and comprehensive manner.
Organization and Effectiveness 15.0%
Mechanics of Writing (includes spelling, punctuation, grammar, language use) 15.0% Writing is unclear and not concise. Spelling, punctuation, and/or grammar errors significantly distract from the purpose and organization of the paper. Language use is inappropriate for the academic setting. Clarity and conciseness in writing could be improved. Spelling, punctuation, and/or grammar errors distract from purpose and organization of the paper. Language use could be improved for the academic setting. Writing is generally clear and concise. Some spelling, punctuation, and/or grammar errors may be found. Language use could be improved for the academic setting. Writing is generally clear and concise. Some spelling, punctuation, and/or grammar errors may be found. Language use is appropriate for the academic setting. Writing is consistently clear and concise. Spelling, punctuation, and grammar are free of error. Language use represents high competence in academic writing.
Format 10.0%
APA Formatting and Research Citations 10.0% Does not follow APA formatting. No reference page is included. No citations are used. APA formatting is inconsistently used. Reference page is present. Citations are inconsistently used. APA formatting is used although some errors may be present. Elements may be missing such as introduction, conclusion, or headings. Reference page is included and sources are documented although some errors may be present. APA formatting is present and appropriate. The style is usually correct although some components may be missing such as introduction paragraph, conclusion, etc. Reference page is present and fully inclusive of all cited sources. Writer has a clear understanding of APA formatting and included all necessary components. Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct.
Total Weightage 100%
[MUSIC PLAYING] GOOD EVENING, EVERYBODY.
EVERYBODY’S CARDS CLEARED.
LET’S PLAY BINGO, HERE WE GO, FOR $0.50 A GAME.
G48.
G-4-8.
G49.
VERY RARE THAT HAPPENS, ONE NUMBER AFTER THE OTHER.
O65.
O-6-5.
B2.
B2.
WE HAVE A WINNER, BINGO!
BINGO, WE HAVE A WINNER.
CONGRATULATIONS.
THANK YOU.
THIS IS NOT AN ASSISTED LIVING FACILITY.
THIS IS A NURSING HOME.
AND THERE REALLY IS A DIFFERENCE IN TERMS OF THE HELP THAT PEOPLE NEED HERE.
A VERY HIGH PROPORTION OF OUR PATIENTS NEED ASSISTANCE WITH VERY BASIC ACTIVITIES OF
DAILY LIVING– HELP GETTING ON THE TOILET, HELP BATHING THEMSELVES, SOMETIMES HELP
FEEDING THEMSELVES.
AND SO THE INSTITUTION IS HERE TO HELP PEOPLE WITH THOSE NEEDS.
BUT WHAT MAKES IT DIFFERENT THAN OTHER NURSING HOMES IS WHAT IT IS ABLE TO OFFER ON TOP
OF THAT.
IT’S ABLE TO OFFER A LIVING ENVIRONMENT, SO THAT YOU’RE NOT HERE TO DIE, YOU’RE HERE TO
HAVE AS GOOD A QUALITY OF LIFE DURING THE REMAINING TIME THAT YOU HAVE AS POSSIBLE.
AND SO TO FOSTER THAT, WE HAVE ACTIVITIES.
THERE’S SO MANY PROGRAMS THAT ARE OFFERED HERE.
I JUST WAS OVERWHELMED WITH WHAT IS OFFERED.
I CALL BINGO.
THAT’S ON THE LIGHTER SIDE, OF COURSE, BUT IT’S FUN, AND THAT KEEPS ME BUSY.
I’M ALSO VERY MUCH INVOLVED AND VERY MUCH LIKE ATTENDING THE PSALMS, SONGS, AND STORY
WRITING.
IN THIS GROUP, WE READ A PSALM OUT OF THE BIBLE, AND WE INTERPRET WHAT OUR FEELINGS ARE.
AND FROM THAT POINT, WE WRITE A SONG.
I’M DOING PAINTING HERE, WHICH IS OFFERED TO ME, WHICH I AM LEARNING.
I’VE NEVER HELD A BRUSH IN MY HAND BEFORE.
AND THEY SAID YOU DON’T HAVE TO KNOW.
AND THEY SAY THAT I’M DOING NICELY.
AND I DO ENJOY IT VERY, VERY MUCH.
I’VE ALWAYS DONE A LITTLE ARTWORK, DRAWING LOGOS AND THINGS.
WHEN I CAME HERE, THE ART FACILITY HERE, THE ROOM HERE, IS ABSOLUTELY FANTASTIC.
IT’S JUST WONDERFUL THERAPY.
AND SO I DECIDED I HAD NOTHING ELSE TO DO THE REST OF MY LIFE, BE A GREAT THING FOR ME TO
START TO DO SOME PAINTING, WHICH I HAD NEVER DONE BEFORE.
THIS IS ABSOLUTELY MARVELOUS HERE, BECAUSE THE DEPARTMENT IS SO GREAT.
YOU COULD COME AND GO AS YOU PLEASE.
THIS IS MY LIFE NOW, AND I’M HAVING A LOT OF FUN.
THERE IS A MISCONCEPTION THAT PEOPLE COME TO NURSING HOMES JUST TO DIE.
I’VE BEEN BLESSED TO SEE WHERE RESIDENTS COME HERE AND GROW AND DEVELOP AS
INDIVIDUALS, THAT THERE’S A REAL SENSE OF COMMUNITY.
AT ANY GIVEN TIME AT THE JEWISH HOME, WE HAVE WRITERS, PEOPLE WHO HAVE WRITTEN SONGS,
POETS, ARTISTS.
AND THEY WORK WITH THE OTHER RESIDENTS.
THEY HELP DRAW THOSE RESIDENTS OUT.
THEY HELP THEM DEVELOP HIDDEN TALENTS.
AND SO WHEN PEOPLE COME TO NURSING HOMES, SPECIFICALLY THE JEWISH HOME, THEY CONTINUE
TO GROW AND DEVELOP AS INDIVIDUALS, AND THEY CONTRIBUTE TO THE SENSE OF COMMUNITY
THAT EXISTS HERE AT THE HOME.
I’LL BE 92 IN THREE MONTHS.
AND I’VE BEEN HERE 12 YEARS.
AND IT’S A GREAT, GREAT SENIOR FACILITY, I THINK PROBABLY THE FINEST SENIOR FACILITY IN THE
UNITED STATES– PROBABLY THE WORLD.
AND YOU HAVE TO BE VERY FORTUNATE TO GET HERE.
SO I LOVE MY LIFE HERE.
NARRATOR: NOT ALL NURSING HOMES OFFER THE QUALITY OF CARE OR THE RICH ARRAY OF
PROGRAMS SAN FRANCISCO’S JEWISH HOME PROVIDES ITS 400-PLUS RESIDENTS.
IN LARGE PART, THE BIGGEST CHALLENGE FOR MOST SUCH FACILITIES IS FINANCIAL.
ATTRACTING AND RETAINING QUALITY STAFF MEMBERS AND CREATING AN ENVIRONMENT THAT IS
BOTH STIMULATING AND NURTURING IS EXPENSIVE.
FIRST STEP AT IMPROVING CARE FOR PEOPLE WHO NEED THIS TYPE OF CARE IS TO PROVIDE
ADEQUATE RESOURCES, ENOUGH MONEY FOR FOOD, ENOUGH MONEY FOR NURSING, TO PAY
ADEQUATE SALARIES TO STAFF SO THAT THEY DON’T QUIT AND NEED TO BE REPLACED SO
FREQUENTLY.
ON A SECONDARY LEVEL, I THINK ONE REASON THAT WE PROVIDE BETTER CARE THAN MOST OTHER
FACILITIES IS OUR MEDICAL STAFF.
I USED TO RUN THE TRAINING PROGRAM IN GERIATRIC MEDICINE AT THE UNIVERSITY, AND I HIRED MY
GRADUATES.
SO OUR MEDICAL STAFF ARE TRAINED GERIATRICIANS.
THAT’S REALLY UNUSUAL.
SO THAT THE TENSION THAT INDIVIDUAL PEOPLE GET HERE EARLY IN THE COURSE OF AN ILLNESS IS
WONDERFUL.
NARRATOR: AT THE JEWISH HOME AND ELSEWHERE, MEETING THE NEEDS OF AMERICA’S GROWING
POPULATION OF ELDERLY ADULTS IS A CHALLENGE THAT BECOMES MORE PRESSING EVERY DAY.
THIS IS DUE AT LEAST IN PART TO WHAT SOME HAVE CALLED “THE LONGEVITY REVOLUTION.” WELL,
THE LONGEVITY REVOLUTION REFERS TO THE FACT THAT LIFE EXPECTANCY, THAT IS THE AVERAGE
LENGTH OF LIFE FOR AMERICAN CITIZENS, HAS NEARLY DOUBLED SINCE 1900.
IN 1900, THE AVERAGE LIFE EXPECTANCY WAS RIGHT AT 47 YEARS.
CURRENTLY, LIFE EXPECTANCY IS ABOUT 78 YEARS FOR MALES, AND ABOUT 82 YEARS FOR FEMALES.
THAT’S A TREMENDOUS INCREASE, JUST AN INCREDIBLE INCREASE.
PERSONALLY, I THINK THAT’S THE PROBABLY GREATEST ACCOMPLISHMENT OF THE 20TH CENTURY.
NARRATOR: WHILE THE NUMBER OF ELDERLY AMERICANS HAS RISEN STEADILY OVER THE PAST
CENTURY, THERE’S SOME DISAGREEMENT ABOUT WHETHER THE QUALITY OF THEIR LATER YEARS
HAS KEPT PACE WITH THE QUANTITY.
QUALITY OF LIFE CAN BE A DIFFICULT ISSUE TO ASSESS.
THERE ARE OBJECTIVE INDICATORS OF QUALITY OF LIFE.
ARE PEOPLE HEALTHIER, ARE PEOPLE RICHER, ARE PEOPLE LESS ISOLATED?
ON ALL OF THOSE KINDS OF OBJECTIVE INDICATORS, TODAY’S OLDER POPULATION IS SUBSTANTIALLY
BETTER OFF THAN THAT 30 TO 50 YEARS AGO.
MEDICARE CAME INTO BEING IN THE MIDDLE 1960S, AND WAS A TREMENDOUS BOON TO THE
ECONOMIC STABILITY OF OLDER ADULTS– NOT JUST THEIR HEALTH SERVICES, BUT THEIR ECONOMIC
STABILITY IN TERMS OF NOT BEING BANKRUPTED BY OUT-OF-POCKET HEALTH CARE COSTS.
THE CURRENT OLDER POPULATION ARE THE PARENTS OF THE BABY BOOMERS, SO THEY’RE NOT
ISOLATED.
I THINK OUR HEALTH HAS IMPROVED.
OUR NUTRITION HAS IMPROVED.
AND SO A PERSON WHO IS 75 TODAY MIGHT LOOK LIKE SOMEONE WHO WAS 65 20 YEARS, 30 YEARS
AGO.
AND IN THE MIDWEST WE ASK PEOPLE, WHAT WOULD YOU SAY WAS THE BEGINNING OF OLD AGE?
WHEN DOES SOMEBODY BECOME OLD?
AND ALMOST TO A PERSON THEY SAID 75.
NOW 40, 50 YEARS AGO, I THINK THAT WOULD HAVE BEEN 65 OR MAYBE EARLIER.
THERE ARE PLENTY OF PEOPLE WHO ARE IN THEIR 70S AND YET DON’T CONSIDER THEMSELVES YET
TO BE OLD.
SO IT’S CLEAR THAT OLD AGE IS A TIME THAT BEGINS SOMEWHAT LATER THAN IT USED TO.
AND OF COURSE, PEOPLE ARE LIVING MUCH LONGER THAN THEY USED TO.
ANY GENERALIZATIONS ABOUT OLD AGE TODAY ARE DIFFICULT TO MAKE, BECAUSE THERE ARE
SIMPLY TOO MANY DIFFERENCES AMONG PEOPLE OF THAT AGE GROUP.
MANY PEOPLE ARE ACTIVE IN THEIR JOBS RIGHT INTO THEIR 70S OR EVEN THEIR 80S.
THE FASTEST-GROWING GROUP IN OUR POPULATION ARE THE 85-PLUSERS, WHICH IS A REMARKABLE
THOUGHT IF YOU THINK ABOUT IT.
AND IN FACT, THERE’S A GROUP OF THEM WHO ARE CERTAIN TO LIVE TO 100 BECAUSE THEY STAY
ACTIVE, THEY STAY INVOLVED, AND AGAIN, THEIR HEALTH IS GOOD.
NARRATOR: WHILE THERE ARE MORE ELDERLY PEOPLE IN THE US NOW THAN ANY TIME IN THE PAST,
AND MORE OF THEM ARE LIVING ACTIVE, FULL LIVES, LONG-HELD STEREOTYPES ABOUT SENIORS
REMAINED LARGELY UNCHANGED.
COMMON STEREOTYPES OF THE ELDERLY ARE VERY DIFFICULT TO COMBAT, BECAUSE THERE IS, IN
FACT, AS IS TRUE, I THINK, OF ALL STEREOTYPES, A KERNEL OF TRUTH IN THEM.
ONE OF THE BEST WAYS I KNOW OF MAKING SENSE OF STEREOTYPES, WHERE THEY’RE WRONG AND
WHERE THEY’RE RIGHT, IS THE DISTINCTION BETWEEN WHAT WE CALL THE YOUNG-OLD AND THE
OLD-OLD.
OLD AGE NOW, IF ONE USES THE CONVENTIONAL DEFINING POINT OF AGE 65, IS A VERY LONG PERIOD
OF TIME.
IT’S OFTEN 30 YEARS OR MORE.
AND REALLY, THOSE 30 YEARS ENCOMPASS A LOT OF CHANGE, DEVELOPMENT, GROWTH, DECLINE,
AND SO FORTH.
STEREOTYPES OF THE ELDERLY AS POOR, LONELY, POOR HEALTH, ISOLATED HAVE VERY LITTLE
TRUTH IN GENERAL.
BUT THEY CERTAINLY HAVE VIRTUALLY NO TRUTH FOR THE YOUNG-OLD, THAT IS, PEOPLE WE MIGHT
ARBITRARILY DEFINE AS AGE 65 TO 80.
AND THE STEREOTYPES ARE VERY DAMAGING, BECAUSE THEY KEEP US FROM RECOGNIZING THAT
THESE PEOPLE ARE PRODUCTIVE.
NARRATOR: STEREOTYPES AND MISCONCEPTIONS ABOUT THE ELDERLY ARE MORE PROBLEMATIC IN
THE US THAN IN MANY OTHER SOCIETIES, WHERE OLDER ADULTS ARE NOT ONLY VALUED, BUT
REVERED.
SOME SOCIETIES HAVE LONG PUT AN EMPHASIS AND A PREMIUM ON RESPECT FOR THE ELDERLY.
AND A CLASSIC EXAMPLE WOULD BE CHINA, WITH ITS CONFUCIAN TRADITION OF AUTHORITY AND
HIERARCHY.
IN SOME SOCIETIES A SENIOR IS REVERED AS A STOREHOUSE OF KNOWLEDGE AND WISDOM, AND
ALSO AS A CHILDCARE PROVIDER AND PASSER OF TRADITIONS TO THE GRANDCHILDREN AND GREAT
GRANDCHILDREN.
IN SOME SOCIETIES, THE SENIORS ACTUALLY RUN THE SOCIETIES.
ONE HAS ALWAYS HEARD OF THE ELDERS IN AFRICA WHO COME TOGETHER TO MAKE DECISIONS
ABOUT THE COMMUNITY, AND ARE HIGHLY RESPECTED, AND THEIR OPINIONS ARE SOUGHT AFTER.
IN TRADITIONAL SOCIETIES, AGRARIAN SOCIETIES, PRE-INDUSTRIAL SOCIETIES, THE OLDEST PEOPLE
ARE TYPICALLY THOSE WITH THE GREATEST AMOUNT OF POWER, OFTEN THE GREATEST AMOUNT OF
WEALTH, AND THE GREATEST AMOUNT OF SOCIAL PRESTIGE.
THE TERM THAT THOSE SOCIETIES USE IS “ELDERS.” AN ELDER IS A TERM THAT HAS A POSITIVE
CONNOTATION.
NARRATOR: SOME SOCIOLOGISTS CONTEND THAT CROSS-CULTURAL DIFFERENCES IN THE
TREATMENT OF THE ELDERLY ARE DIRECTLY RELATED TO WHETHER A SOCIETY PLACES MORE VALUE
ON THE INDIVIDUAL OR ON THE COMMON GOOD.
AND THAT BASICALLY BREAKS DOWN TO WESTERN SOCIETIES VERSUS EASTERN SOCIETIES SUCH AS
THE JAPANESE, THE CHINESE, AND SO FORTH.
THE MAJOR UNDERLYING IDEOLOGY OF THOSE CULTURES IS THAT THEY ARE COLLECTIVISTIC
CULTURES, THAT THE COLLECTIVITY IS WHAT IS IMPORTANT, THAT AS AN INDIVIDUAL IN THAT
SOCIETY I WOULD SUPPRESS MY PERSONAL DESIRES AND WISHES FOR THE GREATER GOOD OF THE
COLLECTIVITY.
ADULT CHILDREN HERE OFTEN SAY– THEY REALLY OFTEN GRAPPLE WITH THE QUESTION OF, HOW
MUCH DO I OWE MY PARENTS?
TO WHAT EXTENT SHOULD I REALLY PUT MY LIFE ON HOLD IN ORDER TO CARE FOR THEM?
THOSE QUESTIONS SIMPLY TEND NOT TO COME UP IN THE COLLECTIVISTIC CULTURES.
THAT’S NOT A QUESTION.
YOU DO IT.
AND THAT WILL BE DONE FOR YOU IN TURN.
WELL, IN THOSE FAR EASTERN COUNTRIES, THE OLDEST SON IS REQUIRED TO TAKE CARE OF HIS
PARENTS UNTIL THEY DIE.
THERE’S NO SUCH THING AS A NURSING HOME OR A VERY, VERY FEW NURSING HOMES IN KOREA.
WE AREN’T HONORING OUR ELDERS IN THIS COUNTRY.
NARRATOR: WHILE THERE ARE CULTURAL DIFFERENCES IN THE WAY THE ELDERLY ARE PERCEIVED
AND TREATED FROM ONE SOCIETY TO THE NEXT, THERE ARE CERTAIN CHANGES THAT TAKE PLACE
AS PEOPLE AGE NO MATTER WHERE THE LIVE, CHANGES THAT PRESENT SOME VERY DEFINITE
CHALLENGES.
WITHOUT QUESTION, POOR HEALTH IS THE BIGGEST CHALLENGE ANY PEOPLE FACE AS THEY AGE.
THE COMMON DISEASES IN THE ELDERLY ARE SOME OF WHAT ARE CALLED NEURODEGENERATIVE
DISEASES.
THESE ARE DISEASES THAT AFFECT THE NERVOUS SYSTEM, LIKE ALZHEIMER’S DISEASE, LIKE
STROKES, LIKE PARKINSON’S DISEASE.
SO THESE ARE MORE COMMON IN THE ELDERLY THAN IN YOUNGER PEOPLE.
HEART DISEASE, PARTICULARLY THINGS LIKE CONGESTIVE HEART FAILURE, WHERE THE HEART PUMP
ISN’T WORKING VERY EFFECTIVELY, ALSO BECOMES MORE COMMON.
NARRATOR: ONE SERIOUS AND ALL-TOO-COMMON CONDITION THAT SPECIFICALLY TARGETS THE
ELDERLY IS OSTEOPOROSIS.
OSTEOPOROSIS IS A BONE DISEASE, THE MOST PREVALENT BONE DISEASE IN THE UNITED STATES,
THAT CAN AFFECT ALL THE BONES IN YOUR BODY EXCEPT YOUR SKULL.
AND IT LITERALLY MEANS “POROUS OR THIN BONE.” AND WHAT HAPPENS IS THAT BONE IS A VERY
ACTIVE TISSUE.
WE DON’T THINK OF IT THAT WAY.
WE THINK OF IT AS STRONG.
BUT IN FACT, IT’S BEING REPLACED AND REPLENISHED ALL THE TIME.
EVERY SEVEN YEARS YOUR ENTIRE SKELETON IS REPLACED.
WHEN ONE DEVELOPS OSTEOPOROSIS, THE CELLS THAT TAKE AWAY OLD BONE ARE WORKING
FASTER THAN THE CELLS THAT ARE BUILDING NEW BONE.
AND AS A RESULT, WE HAVE A LOSS OF BONE THAT GOES ON.
THE LOSS OF BONE ITSELF IS NOT THE PROBLEM.
THE FRACTURES THAT OCCUR FROM THAT LOSS OF BONE ARE A PROBLEM.
NARRATOR: AND, IN FACT, IT’S A PROBLEM THAT’S MORE WIDESPREAD THAN IS GENERALLY
UNDERSTOOD BY MOST MEMBERS OF THE PUBLIC, WHO OFTEN ASSUME THAT ONLY CAUCASIAN
WOMEN ARE AT RISK.
JUST ABOUT EVERYBODY IN THE UNITED STATES WHO’S OVER THE AGE OF 21 IS AT SOME RISK OF
OSTEOPOROSIS.
IT IS A MYTH THAT THIS IS AN OLD WHITE WOMEN’S DISEASE.
ONE IN FIVE PEOPLE WITH OSTEOPOROSIS IS MALE, FOR EXAMPLE.
AND AFRICAN AMERICANS, LATINOS, ASIANS ARE ALL AT SUBSTANTIAL RISK OF THIS DISEASE.
SO IT’S SOMETHING WE’RE TRYING TO ENLIGHTEN PEOPLE ABOUT AND HAVE THEM RECOGNIZE THAT
THIS IS A TERRIBLY DEBILITATING DISEASE.
NARRATOR: WHILE PHYSICAL AILMENTS DO PRESENT CHALLENGES TO THE ELDERLY, IN MANY CASES
THERE ARE WAYS TO ELIMINATE OR GREATLY REDUCE THE SEVERITY OF MANY SUCH AILMENTS,
INCLUDING OSTEOPOROSIS.
THE PRESENCE OF CALCIUM AND VITAMIN D IS CRITICAL.
AND EVERYBODY NEEDS TO BE GETTING SOMEWHERE BETWEEN 1,200 AND 1,500 MILLIGRAMS OF
CALCIUM.
MOST OF US DON’T.
THE SECOND THING IS EXERCISE, WEIGHT-BEARING EXERCISE AND STRENGTH TRAINING EXERCISE.
AND I KNOW WHEN I SAY WEIGHT-BEARING TO AUDIENCES, THEY HAVE THIS VISION OF THIS HEAVY
SET OF WEIGHTS THAT PEOPLE HAVE TO LIFT ABOVE THEIR HEADS, BUT IN FACT, WALKING IS THE
VERY BEST WEIGHT-BEARING EXERCISE THAT YOU CAN DO.
AND THEN MEDICATION, WHEN APPROPRIATE.
NARRATOR: ALONG WITH THE PHYSICAL CHANGES THAT COME WITH AGING, THERE ARE SOMETIMES
ACCOMPANYING EMOTIONAL ISSUES THAT ALSO PRESENT PROBLEMS. IN MANY CASES, FOR EXAMPLE,
OLDER ADULTS ARE TROUBLED BY A GRADUAL LOSS OF INDEPENDENCE.
AS WE GROW OLDER WE’RE NO LONGER ABLE TO DRIVE.
SOMETIMES WE’RE NO LONGER ABLE TO BE FUNCTIONAL, GO OUT AND DO OUR SHOPPING AND TAKE
CARE OF OURSELVES.
THAT’S EMBARRASSING.
THAT’S HUMILIATING, IN ADDITION TO BEING A PROBLEM THAT WE HAVE TO SOLVE WITH MONEY,
WHICH IS NOT SOMETHING MANY OLDER PEOPLE HAVE.
I THINK THE MAJOR CHALLENGES AT THE INDIVIDUAL LEVEL FOR OLDER ADULTS ARE, IN FACT,
HEALTH AND ECONOMICS.
THE GREATEST FEAR AND WORRY OF OLDER ADULTS IS THAT THEIR MONEY WILL NOT LAST FOR
THEIR LIFETIME, AND THAT THEY WILL BECOME ECONOMICALLY DEPENDENT, PERHAPS PHYSICALLY
DEPENDENT AS WELL, BUT ECONOMICALLY DEPENDENT.
NARRATOR: ONE OF THE MOST PRESSING CONCERNS OF OLDER ADULTS IS WHETHER OR NOT
THEY’LL BE ABLE TO AFFORD THE CARE AND ASSISTANCE THAT MAY BECOME NECESSARY AS THEY
AGE.
BUT IN MANY CASES, THEIR ANXIETY EXTENDS BEYOND SIMPLY MONEY.
I DON’T KNOW ANYONE WHO WANTS TO SPEND THEIR LAST DAYS IN ONE OF THOSE HOMES.
I THINK IT’S A REAL PANICKY FEAR FOR PEOPLE TO THINK THAT’S WHAT’S WAITING FOR THEM.
ON THE OTHER HAND, THE OLD SYSTEM WAS TO HAVE THE FAMILY DO IT.
BUT GUESS WHO THAT WAS?
IT WASN’T THE FAMILY, IT WAS THE WOMEN DOING IT.
SO IT WAS A WOMAN MAYBE HAVING A BIT OF A JOB, FEEDING HER KIDS, TAKING CARE OF HER
RELATIVES AND HIS RELATIVES.
SO THE OLD SYSTEM WASN’T THAT GREAT, EITHER.
FAMILIES CONTINUE TO PLAY A VERY CRITICAL ROLE IN THE CARE OF DISABLED OLDER PEOPLE.
AT THE SAME TIME, WE HAVE A NUMBER OF PROGRAMS WHICH ALSO ASSIST FAMILIES, FROM
MEDICARE, MEDICAID, VARIOUS SOCIAL SERVICES, SENIOR CENTERS, HOME HEALTH CARE AGENCIES,
AND THE LIKE.
PERHAPS THE DIFFICULTY IS WE HAVE TOO MANY PROGRAMS THAT ASSIST OLDER PEOPLE.
WE HAVE A BALKINIZATION OF SERVICES THAT ARE DIFFICULT TO ACCESS AND DIFFICULT TO
COORDINATE, EACH WITH THEIR OWN ELIGIBILITY AND BENEFIT CRITERIA.
AND SO WE HAVEN’T FIGURED OUT HOW TO HAVE A SEAMLESS SERVICE THAT HELPS LINK FAMILIES
AND COMMUNITIES AND THE BROADER SOCIETY TOGETHER, ALL IN PROVIDING A COORDINATED
SUPPORT OF AN OLDER INDIVIDUAL WHO’S IN NEED OF HELP.
NARRATOR: IN THE CASE OF THE JEWISH HOME AND ITS RESIDENTS, THAT CRITICALLY IMPORTANT
COORDINATED SUPPORT IS PROVIDED, PIECED TOGETHER FROM A VARIETY OF SOURCES.
85% OF THE RESIDENTS HERE DON’T HAVE THE MONEY TO PAY FOR CARE.
SO THEY ARE UNDER OUR STATE’S MEDICAID PROGRAM.
IN CALIFORNIA THEY CALL IT MEDI-CAL.
AND THE AMOUNT OF MONEY THAT MEDI-CAL PAYS IS BETWEEN $10,000 AND $12,000 A YEAR LESS
THAN WHAT IT COSTS.
AND SINCE IT COSTS MORE MONEY TO PROVIDE THE CARE THAN WE GET FROM THE STATE, WE NEED
TO MAKE THAT DIFFERENCE UP IN CHARITABLE DONATIONS.
THE JEWISH HOME OF SAN FRANCISCO IS REALLY UNIQUE, AND IS IN A VERY FORTUNATE POSITION TO
HAVE THE LEVEL OF COMMUNITY SUPPORT, PHILANTHROPIC SUPPORT, THAT ALLOWS IT TO PROVIDE
THE DIVERSITY OF PROGRAMS, IT ALLOWS IT TO PROVIDE A LEVEL OF CARE AND STAFFING THAT IS
UNSURPASSED IN MOST OTHER NURSING HOMES.
IF WE WERE TO ONLY RELY ON THE LEVEL OF GOVERNMENT SUBSIDIZATION OR REIMBURSEMENT, WE
WOULD NOT BE IN A POSITION TO PROVIDE THE KINDS OF PROGRAMS AND SERVICES AND FACILITIES
THAT WE ARE ABLE TO OFFER TO OUR COMMUNITY.
NARRATOR: BUT EVEN WITH ALL THE RESOURCES AVAILABLE HERE, INCLUDING A DEDICATED AND
NURTURING STAFF, RESIDENTS OF THE JEWISH HOME, LIKE AGING ADULTS EVERYWHERE, MUST COPE
WITH A VARIETY OF DIFFICULT ISSUES.
AMONG THE MOST CHALLENGING IS THE REALITY THAT THEIR LIVES ARE COMING TO A CLOSE.
AMERICAN SOCIETY IS NOT A SOCIETY THAT LIKES TO CONFRONT DEATH.
COMPARED TO OTHER CULTURES, FOR EXAMPLE, WE EXHIBIT HIGHER LEVELS OF DEATH ANXIETY, OF
WANTING NOT TO TALK ABOUT IT, EITHER IN GENERAL, IN TERMS OF PUBLIC DIALOGUE, OR
PERSONALLY, IN TERMS OF OUR OWN PERSONAL HOPES, FEARS, WISHES.
THE FACT THAT WE HAVE THIS EXPECTATION THAT PHYSICIANS CAN CURE ANYTHING IS ALSO A
PROBLEM.
SO WE SEE PEOPLE BRINGING IN 95- AND 100-YEAR-OLD PATIENTS WHO’VE BEEN DEMENTED FOR
YEARS, WHO HAVE KIDNEY FAILURE AND WHATEVER ELSE, AND THEY WANT THEM DIALYSED AND
KEPT ALIVE, BECAUSE THAT’S IMPORTANT.
TO ME, QUALITY OF LIFE IS REALLY THE ENTIRE MESSAGE.
AND IF YOU WANT TO SUSTAIN LIFE, YOU SHOULD BE SURE IT’S A QUALITY THAT PEOPLE WILL WANT
TO LIVE WITH.
A LOT OF THE MONEY THAT WE SPEND ON THE ELDERLY, ESPECIALLY WITH FANCY TESTS AND
PROCEDURES THAT OCCUR IN THE LAST YEAR OR TWO OF LIFE, WOULDN’T HAPPEN IF WE SPENT
MORE TIME TALKING TO PEOPLE AND UNDERSTANDING THEIR VALUES AND WHAT THEY WANT.
WE WASTE A LOT OF MONEY DOING THINGS THAT PEOPLE DIDN’T WANT DONE ANYWAY.
NARRATOR: AT SOME POINT, WHETHER LAST-MINUTE MEDICAL INTERVENTION HAS BEEN BROUGHT
TO BEAR OR NOT, THE INEVITABILITY OF DEATH BECOMES UNDENIABLE.
IDEALLY, DECISIONS HAVE ALREADY BEEN MADE ABOUT WHAT TO DO ONCE THIS POINT IS REACHED.
THE REAL ISSUE IS BEING STIMULATED TO TALK ABOUT THIS WITH YOUR PHYSICIAN AND GET SOME
SENSE OF THE THINGS YOU SHOULD BE THINKING ABOUT, THE KINDS OF CHOICES THAT MIGHT
ARISE, AND THEN BEING ABLE TO TALK WITH A SPOUSE OR YOUR CHILDREN AND SO FORTH ABOUT
THAT, SO THAT– IT’LL NEVER BE EASY FOR THEM, BUT THAT IT WOULD BE EASIER IF THEY HAVE
SOME SENSE OF WHAT YOUR WISHES WERE AND THEY HAD TALKED IT THROUGH.
AND I THINK IT IS IMPORTANT WHILE YOU’RE MENTALLY WITH IT AND YOUNGER TO SIT DOWN
ADVANCE DIRECTIVES OF WHAT YOU DO NOT WANT AND WHAT YOU DO WANT DONE WITH YOURSELF
IF YOU SHOULD BE INCAPACITATED.
AND ALSO SET UP A DURABLE POWER OF ATTORNEY WITH PEOPLE, NOT ONLY WHO ARE RELATIVES,
BUT PEOPLE WHO HAVE LIKE MINDS AS YOURSELF.
I’VE SEEN SITUATIONS WHERE THE SENIOR OBVIOUSLY HAD CERTAIN WISHES, AND THE PERSON WHO
HAD DURABLE POWER OF ATTORNEY HAD ETHICAL, RELIGIOUS, AND MORAL DIFFERENCES WITH
WHAT THAT PERSON WANTED.
AND THAT’S A VERY DIFFICULT SITUATION.
SO IN ADDITION TO HAVING FAIRLY DEFINED ADVANCE DIRECTIVES, I THINK HAVING YOUR DURABLE
POWER OF HEALTH CARE IN THE HANDS OF SOMEONE WHO KNOWS EXACTLY WHERE YOU’RE AT, I
THINK IS EXTREMELY IMPORTANT.
PEOPLE AREN’T GOING TO LIVE FOREVER.
AND PEOPLE WANT TO HAVE DIGNITY WHEN THEY DIE.
AND SOMETIMES PUTTING SOMEONE IN INTENSIVE CARE UNIT FOR A PERIOD OF TIME, WITH TUBES IN
THEM, IS NOT WHAT THEY HAD IN MIND.
I THINK THAT IN THE UNITED STATES WE HAVE THE FIRM BELIEF THAT WE SHOULD HAVE ACCESS TO
THE VERY BEST SERVICES WHEN WE SHOULD WANT THEM.
AND I THINK IT’S A RELATIVELY NEW RECOGNITION THAT PERHAPS PEOPLE MIGHT NOT WANT TO
HAVE THE ULTIMATE MEASURE APPLIED TO SAVE THEM IN THEIR LAST DAYS.
NARRATOR: UNFORTUNATELY, HOWEVER, IN SOME CASES, THE DYING PERSON’S WISHES ARE
IGNORED.
IN MANY SITUATIONS, IN HOSPITALS, IF A PHYSICIAN IS DEALING WITH A PATIENT AND THERE IS A
LIVING WILL, AND THE LIVING WILL CLEARLY SPELLS OUT THIS PATIENT WOULD LIKE TREATMENT TO
BE STOPPED AT THIS POINT, BUT THE SURVIVING FAMILY MEMBERS DISAGREE AND URGE THE
PHYSICIAN TO CONTINUE TREATMENT, IN ALMOST EVERY CASE THE PHYSICIAN CONTINUES THE
TREATMENT.
THIS IS CONTRARY COMPLETELY, OF COURSE, TO THE IDEA OF PATIENT AUTONOMY, TO THE IDEA OF
AN ADVANCE DIRECTIVE.
PHYSICIANS WOULD SAY THAT THEY ARE TRYING TO DO THE COMPASSIONATE THING HERE, BY
TENDING TO THE WISHES AND DESIRES OF SURVIVING FAMILY MEMBERS.
IT’S CLEAR THEY’RE PROBABLY ALSO CONCERNED ABOUT LAWSUITS.
THE DYING PATIENT IS NOT GOING TO FILE A LAWSUIT.
THE SURVIVING FAMILY MEMBERS MIGHT.
NARRATOR: EVEN WHEN THERE ARE NO DISPUTES ABOUT HOW A PERSON’S LIFE SHOULD END,
THERE’S NO WAY TO MINIMIZE THE FACT THAT DEATH IS NOT SOMETHING MOST PEOPLE LOOK
FORWARD TO.
BUT THE EXPERIENCE OF GROWING OLDER IS NONETHELESS OFTEN A RICH AND REWARDING TIME OF
LIFE, OR AT LEAST IT CAN BE.
SOMETIMES WHEN PEOPLE LOOK AT OLDER ADULTS, THEY CAN’T GET PAST THE WRINKLES AND THE
GRAY HAIR.
ONE THING THAT’S A VERY, VERY IMPORTANT TO KEEP IN MIND IS THAT IN SPITE OF THEIR PHYSICAL
APPEARANCE, AND IN SPITE OF THEIR CHRONOLOGICAL AGE, OLDER PEOPLE FEEL LIKE THEY’RE
YOUNGER PEOPLE.
THEY’RE US.
MOST OF THE CITIES IN NORTH AMERICA PUT FLUORIDE IN THEIR WATER TO HELP KIDS’ TEETH.
I WOULD LOVE TO BE ABLE TO PUT SOMETHING IN THE WATER THAT WOULD MAKE PEOPLE
RECOGNIZE THAT OUR OLDER ADULTS ARE THE BEST NATURAL RESOURCE WE HAVE. I THINK IF WE
CAN ENABLE MORE OLDER PEOPLE WHO ARE HEALTHY TO STAY IN THEIR JOBS, TO BE ACTIVE AND
PARTICIPATING MEMBERS OF COMMUNITIES, CHURCHES, SCHOOL SYSTEMS, ET CETERA, AND IF WE
CAN TEACH THE KIDS ABOUT HOW WONDERFUL GRANDPARENTS AND GREAT-GRANDPARENTS CAN
BE, WE CAN MAKE A CHANGE HERE.
[MUSIC PLAYING] NARRATOR: “THE WAY WE LIVE” IS A 22-PART SERIES ABOUT SOCIOLOGY.
FOR INFORMATION ON THIS PROGRAM AND ACCOMPANYING MATERIALS, CALL 1-800-576-2988, OR
VISIT US ONLINE.
Annual review of nursing research, volume 37 : Transcultural and social research. (2018)
Annual Review of Nursing Research,
Volume 37 : Transcultural and Social
Research
Series:
Annual Review of Nursing Research, Volume 37, 2019, Transcultural and social research
Authors:
Richard Zoucha, PhD, PMHCNS-BC, CTN-A, FAAN
Publication Information:
New York : Springer Publishing Company. 2019
Resource Type:
eBook.
Description:
One of the most challenging aspects of the current healthcare system, especially for nurses, is
cultural diversity across a variety of societies.Nurses, caregivers, and other practitioners must be
equipped and aware of their patients’cultural background in order to respond appropriately and
sensitively while providing the proper care. Clearly the techniques and beliefs within cultures is
highly diverse, requiring those providing care to possess knowledge that allows them to combine
global and cultural practices into their day-to-day occupation. This consist of not only learning
cultural differences and similarities, but examining nursing throughout other parts of the world,
and the health problems being faced in different geographical settings.This volume is intended to
provide nurses, physicians, specialists, and providers with the information needed to provide
capable care and treatment to individuals of diverse cultures.Each chapter author was selected
for their interest and knowledge of transcultural and social research. The content of this volume
provides a look at classic contributions to the field, up-to-date research, and evaluates the impact
of diverse cultures on issues that may affect nursing and health care, such as:Key
Topics:Leininger’s Culture Care Diversity and UniversalityThe Current State of Transcultural
NursingTranscultural Mental Health NursingCulture and Consent in Clinical CareObesity Among
African Immigrant PopulationsCultural Factors Influencing Suicidal Thoughts and Behaviors
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Brain–Wounds and injuries
Nursing–Research–United States
MEDICAL / Nursing / General
:
9780826162052. 9780826144591.
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SENIORS HOUSING
In Short Supply
Following Hurricane
Florence, which hit the
Carolinas in mid-September,
temporary housing may be
harder to come by. This is
because the storm largely
impacted smaller cities in
North Carolina, where a lot
of rental housing is owned
by smaller landlords, the
Wall Street Journal reports.
A lot of the rental stock in
places like Wilmington and
Fayetteville is comprised of
single-family homes, which
tend to be more susceptible
to damage from storms than
high-rises.
18
Another Slump
Headwinds facing skilled nursing operators keep impacting occupancy.
The occupancy rate for skilled nursing oper
ators in the U.S. hit a new low in the second
quarter, an ongoing pattern stemming from
pressures related to policy changes and shorter
lengths of patient stays, according to a new
report.
The national occupancy rate dropped to
81.7 percent during the months of April to
June, a 79 basis point drop from the quarter
before, according to a quarterly report from
the National Investment Center for Seniors
Housing and Care (NIC). This represents a
137 basis point drop year-over-year. (A shift
in the number of properties participating in
the NIC’s monthly survey led to a revision
of the group’s first-quarter occupancy cal
culation.) Rural markets posted the sharp
est decline of 89 basis points
quarter-over-quarter, accord
ing to the report.
The slide in occupancy
was not unexpected, as the
sector has faced pressure
over the last few years from
policy changes related to
reimbursements and a shift
to a value-based healthcare
system, says Bill Kauffman,
senior principal at the NIC.
Patients in need of more
skilled nursing care are stay
ing for lower lengths of time
because of these policy changes.
However, there has been a drop in the
number of operational beds, even as supply
remains a top concern in seniors housing
in general. In the second quarter, the NIC
tracked 486,787 freestanding campuses in
primary U.S. markets, compared to 488,981
during the same period in 2017. Operators
are converting semi-private rooms to private
rooms and states impose moratoriums on
construction or require certificates of need,
making it hard to add supply, Kauffman says.
This shrinking supply is not offsetting
other headwinds. “The demand decline
has been faster over the last few years,”
Kauffman says.
And increasingly, many patients go to out-
NREI October 2018
patient or rehab facilities—or even straight
home—after procedures. “It’s really the
changing dynamics have basically caused
the patients to potentially bypass properties,”
Kauffman says.
Other longer-term care facilities like assist
ed living homes also have become more capa
ble of taking care of residents that otherwise
might have gone into nursing properties,
says Chris Blanda, a senior vice president at
Lancaster Pollard, a financial services firm.
“It’s just a continuation of headwinds that have
been affecting the nursing home business,” he
says.
Despite the sector’s challenges, a summer
2018 report on seniors housing from CBRE
asked survey respondents where they see the
biggest opportunity for investment in seniors
housing and care, and 17 percent said the
nursing sector, the same as in the second half
of 2017. However, respondents this year were
more interested in opportunities in indepen
dent living, assisted living and active adult
properties.
The cap rates for core class-A nursing-care
assets rose 23 basis points to 11.4 percent on
average in the first half of 2018 from the sec
ond half of 2017, according to CBRE. Rates
for core class-B assets dropped 4 basis points
on average to 12.3 percent; they dropped 10
basis points to 13.6 percent on average for
core class-C assets. Cap rates rose for non-core
assets in all three segments.
— Mary Diduch
www.nreionline.com
A NEW LOW
The national occupancy rate continues to drop for the skilled nursing
sector, sliding 79 basis points in the second quarter.
http://www.nreionline.com
© 2018 Penton Media, Inc. All rights reserved.