Your patients bring diverse backgrounds, customs, abilities, and experiences to their health care. Some differences are apparent, while others are not. Factors that contribute to diversity include:

• Geographic and cultural background
• Race and ethnicity
• Age
• Gender identity, gender expression, and sexual orientation
• Preferred language(s)
• Religious and family traditions
• Education and socioeconomic background
• Neurodiversity
• Cognitive, sensory, and physical abilities

Recognizing and appreciating diversity is an essential part of patient-centered care. It can lead to improved patient safety, more open communication, increased health equity, and better patient outcomes. By respecting each patient’s values and preferences, you’ll be more likely to engage them as collaborative partners in their care.

How is diversity related to health?

A patient’s culture and background will affect whether and where they seek health care, their understanding of medical information, and how they make health care decisions. Recognizing the different health issues your older patients are likely to face, as well as the factors that contribute to these differences, will help you provide the most effective care.

Many complex and interacting factors, lifelong and current, underlie disparities in health risk and disease burden. These factors include:

• Unequal access to health care services
• Availability of social support
• Neighborhood and workplace environments
• Food availability and accessibility
• Wealth and income gaps
• Racism, sexism, and other forms of discrimination

Age-related health disparities affect the health of older adults. For example:

• NIA-funded researchers have found a higher prevalence of Alzheimer’s disease among African Americans and Hispanics than among other racial and ethnic groups in the United States.
• Prostate cancer has higher incidence and mortality rates, as well as an earlier average age of onset, in non-Hispanic Black men compared with men of other backgrounds.

Scientists have also observed sex and gender differences in health and longevity. For example, women live longer than men, on average. They are also more likely to develop osteoporosis or depressive symptoms and to report functional limitations as they age. Men, on the other hand, are more likely to develop heart disease, cancer, or diabetes.

Other studies have found that lower socioeconomic status is associated with poorer health and reduced lifespan in the United States. Economic circumstances can determine whether an individual can afford quality health care and proper nutrition from early life into old age. Financial resources and health insurance often determine whether an older adult enters an assisted living facility or nursing home or stays at home to be cared for by family members.

Health care workforce diversity is important

Providers representing a variety of backgrounds and cultures can help meet the health needs of an increasingly diverse population. Some patients feel more comfortable with health care providers who share or understand their language, race, ethnicity, or other cultural characteristics. Research suggests that a diverse health care workforce may also improve patient satisfaction, patient-clinician communication, and access to care.

Communicating with a diverse patient population

Your conversational style can be a subtle but powerful way to connect with your patients. Being thoughtful about how you communicate with each individual can promote understanding, trust, and satisfaction in the patient-provider relationship.

Practical tips for effective communication include:

• Ask patients which name and other descriptive terms they prefer and use those consistently. This small effort can go a long way toward making patients feel welcome, safe, and accepted.
• Use person-first language. This language avoids defining someone by their condition or disability (e.g., people with diabetes instead of diabetics).
• Try to match your communication style to that of your patient. Conventions such as the speed and volume of speech vary across cultures. To some people, interrupting an individual who is speaking is acceptable and even expected, while it is considered rude and off-putting to others. 
• Use plain language. Avoid using medical terminology or abbreviations that your patients might not understand. Remember that certain idioms and figures of speech in English may be unfamiliar or confusing to people who have a different primary language.
• Be aware of nonverbal communication (such as hand gestures) that may have a different meaning to patients from different backgrounds. People also differ in the amount of eye contact, smiling, touching, and physical distance that are comfortable.

Tailoring how you talk with patients can help them better understand the information you are providing. Communicating in a way that makes your patients feel comfortable may help them open up about their health concerns and be more receptive to your guidance.

Providing language assistance in health care settings

Overcoming language barriers is critical for effective patient-provider communication. It allows for mutual understanding, informed decision-making, and better quality of care.

In any type of health care setting, you are likely to encounter patients with a primary language other than English. Here are several ways to support these patients:

• Identify the main languages spoken by your patient population and, whenever possible, match patients with qualified bilingual staff or have other trained medical interpretation services available.
• Start appointments by asking all new patients which language they prefer to speak and read, and whether they would like an interpreter. An “I Speak” card (PDF, 4.6M) can help patients identify their preferred language. Note preferences in their medical records.
• Provide important written materials in your patients’ preferred languages. For example, have office signage, intake and consent forms, prescription labels, and patient instructions available in multiple languages when possible. NIA provides health information for older adults in both English and Spanish as well as links to resources in other languages.
• Maintain a list of referrals to local clinicians and community service providers who speak your patients’ preferred languages, when available.

It can be logistically challenging to provide language assistance services. As a result, some clinicians rely on interpretation by patients’ family members or on bilingual staff members who are untrained in medical interpretation. However, experts strongly discourage this practice. An informal interpreter may be unable to convey medical terminology accurately, may inadvertently misinterpret information, or may be reluctant to share difficult news. Informal interpretation can also interfere with patient privacy.

Using qualified medical interpreters can improve communication, understanding, clinical outcomes, and patient satisfaction with care. Trained interpreters will help ensure that everything said during a medical appointment is relayed accurately and objectively. This checklist (PDF, 207K) provides tips for working with an interpreter.

Providing language assistance isn’t just good medical practice: In some cases, it’s also required by law. Federal policies require health care providers who receive government funds, such as Medicare and Medicaid payments, to make interpretive services and written translations of critical documents available at no cost to people with limited English proficiency. Visit LEP.gov for details about these requirements.

Some states have professional associations and foundations that may provide funding for medical interpreters. Additionally, Medicaid offers reimbursement for some medical interpretation services.

If you are looking for a qualified medical interpreter, the National Board of Certification for Medical Interpreters and the Certification Commission for Healthcare Interpreters have online registries of certified interpreters. The Registry of Interpreters for the Deaf provides a searchable list of certified interpreters in American Sign Language. Many state government websites also provide directories of interpreters and translators to help you locate services in your area.

Tips for culturally sensitive care

How can you work with your patients in a way that respects their diversity? To start, avoid making assumptions about a person’s beliefs, attitudes, or behaviors based on their culture or background. Instead, engage with patients to find out about their individual values and preferences.

Additional ideas for providing culturally sensitive care include:

• Reflect on your own background, beliefs, and values, and consider how they inform your practice. For example, think about your own feelings about aging and how they might influence your interactions with your older patients.
• Get to know the community that you serve. What are the most common racial and ethnic groups? Which languages do they speak? What health, social, and environmental issues do they face? Adapt programs and health care practices so they are appropriate to the groups you serve most often.
• Recognize that a healthy diet plan may differ among cultural traditions. Patients will have difficulty following dietary advice if it doesn’t take their food preferences and cooking methods into account. The Nutrition.gov Culture and Food page provides nutrition guidance, food options, and recipes from around the world.
• Understand that some patients may value having other family members involved in their health care decisions. Clarify how the patient sees the role of family and any specific information they want shared with relatives.
• For patients nearing the end of life, ask about their health care goals. There may be cultural or religious differences in attitudes toward end-of-life decision-making, such as creating advance directives; disclosing a terminal diagnosis to the sick person or family members; and pursuing life-prolonging treatments, such as a feeding tube.

Different beliefs about aging

People from different cultures and traditions have varied attitudes about aging. For example, in some cultures, older adults are customarily respected for their wisdom and experience. Other cultures tend to be more youth-centered, valuing the qualities of youth over those of old age.

When societies prefer youth over old age, it can lead to ageism. This often underrecognized form of discrimination comprises stereotypes and prejudices directed toward people on the basis of their age. Ageism has serious implications for the health of older people: Studies have associated age-based discrimination with poorer physical and mental health, reduced quality of life, and even earlier death.

Because ageism is so pervasive, it’s easy for well-intentioned health care providers to make assumptions about their older patients and inadvertently reinforce harmful stereotypes. For example, patients and their providers may dismiss otherwise treatable health problems as an inevitable part of aging. As a result, older patients may suffer preventable discomfort and disability.

For tips on avoiding ageism when talking with your patients, see the World Health Organization’s Quick Guide to Avoid Ageism in Communication.

Clinical research needs diversity

It is important for clinical trials and studies to include a diverse range of participants so the results will have broader applicability. Researchers need older adults from many different backgrounds to participate in research so they can learn more about how new drugs, tests, and other interventions will work in diverse populations.

Clinical research also needs scientists from diverse backgrounds, particularly from groups that have been historically underrepresented. Diversity in scientific teams can lead to more creative and innovative thinking, which can help biomedical research represent and benefit people from all backgrounds.

To learn more, please visit https://www.nia.nih.gov/health/health-care-professionals-information/providing-care-diverse-older-adult-population.

There are many things you can do to help boost your health as you age, including making healthy food choices and not smoking. But did you know that participating in social and other activities you enjoy can also help support healthy aging?

As you grow older, you may find yourself spending more time at home alone. Being lonely or socially isolated is not good for your overall health. For example, it can increase feelings of depression or anxiety, which can have a negative impact on many other aspects of your health. If you find yourself spending a lot of time alone, try participating in activities you find meaningful — those that create a sense of purpose in your daily life. These can include hobbies, volunteer activities, or time with family and friends.

Benefits of an Active Lifestyle

Engaging in social and productive activities you enjoy, such as taking an art class, joining a hiking club, or becoming a volunteer in your community, may help to maintain your well-being and independence as you age. An active lifestyle is more than just getting your daily steps in. It includes doing activities that are meaningful to you and benefit your mind, spirit, and body.

Research has shown that older adults with an active lifestyle:

• Are less likely to develop certain diseases. Participating in hobbies and other social activities may lower risk for developing some health problems, including dementia, heart disease, stroke, and some types of cancer.
• Have a longer lifespan. Studies looking at people’s outlooks and how long they live show that happiness, life satisfaction, and a sense of purpose are all linked to living longer. Doing things that you enjoy may help cultivate those positive feelings.
• Are happier and less depressed. Studies suggest that older adults who participate in activities they find meaningful, such as volunteering in their communities or being physically active, say they feel happier and healthier.
• Are better prepared to cope. When people feel happier and healthier, they are more likely to be resilient, which is our ability to bounce back and recover from difficult situations. Positive emotions, optimism, physical and mental health, and a sense of purpose are all associated with resilience.
• May be able to improve their thinking abilities. Research suggests that participating in certain activities, such as those that are mentally stimulating or involve physical activity, may have a positive effect on memory — and the more variety the better. Other studies are providing new information about ways that creative activities, such as music or dance, can help older adults with memory problems or dementia.

Find the Right Balance

Everyone has different limits to the amount of time they can spend on social or other activities. What is perfect for one person may be too much for another. You might start by adding one or two activities to your routine and see how you feel. You can always add more. Remember: Participating in activities you enjoy should be fun, not stressful.

Activities to Consider

Read and share this infographic and spread the word about ways that may help foster healthy aging.

There are plenty of places to look for opportunities to engage in activities you enjoy, depending on your interests and ability. Following are ideas that might work for you. Some of these include activities that can be enjoyed even from a distance using phones, computers, and other devices. Others can be done alone. So even if you’re in a rural area or have other restrictions, you can still find ways to engage in activities you like.

Connect with Family and Friends

• Play cards or other games with friends in person or online.
• Travel with a group of older adults, such as a retiree group.
• Video chat or call your friends and family members.
• Try different restaurants with your loved ones.
• Listen and share favorite music with your family.
• Join a group interested in a hobby, such as knitting, hiking, birdwatching, painting, or wood carving.
• Reconnect with old friends through your high school or college alumni association.

Learn Something New

• Take a cooking, art, dance, language, or computer class. Get in touch with your local community college or library. Many offer free or discounted courses for older adults. You may even be able to find classes online.
• Form or join a book or film club
• Try yoga, tai chi, or another new physical activity
• Learn (or relearn) how to play a musical instrument
• Visit local museums. Many offer free group tours and educational programs.

Become More Active in Your Community

• Visit a community or senior center and take part in its events and activities
• Serve meals or organize clothing donations for people in need
• Run errands for people with limited mobility or access to transportation
• Join a committee or help out with an activity at your place of worship
• Volunteer at a school, library, museum, hospital, or animal shelter
• Help with gardening at a community garden or park
• Organize a park clean-up through your local recreation center or community association
• Sing in a community choral group, or play in a local band or orchestra
• Take part in a local theater troupe
• Get a local part-time job or explore opportunities online
• Teach a favorite pastime or skill, such as embroidery, photography, building models, chess, baking, woodworking, calligraphy, or quilting, to a new generation

Go Out and Get Moving

• Garden (indoors or out) or do yard work
• Take an exercise class or do exercises at home
• Go dancing
• Join a sports club for older adults, like a bowling club or bocce league
• Walk or bicycle with a friend or neighbor
• Take a swimming class
• Play with your grandchildren. Teach them a game or dance you remember from childhood
• Take a stroll around the neighborhood or on nature trails

Adopt Healthy Stress-Relieving Habits

• Read a good book, magazine, or newspaper
• Practice gratitude and mindfulness
• Do tai-chi or yoga
• Cook your favorite healthy meal
• Enjoy the little things, such as a cup of coffee or sunrise

To learn more, please visit https://www.nia.nih.gov/health/healthy-aging/participating-activities-you-enjoy-you-age.

Many Americans die in facilities such as hospitals or nursing homes receiving care that is not consistent with their wishes. It’s important for older adults to plan ahead and let their caregivers, doctors, or family members know your end-of-life preferences in advance. For example, if an older person wants to die at home, receiving end-of-life care for pain and other symptoms, and makes this known to health care providers and family, it is less likely he or she will die in a hospital receiving unwanted treatments.

If the person is no longer able to make health care decisions for themselves, a caregiver or family member may have to make those decisions. Caregivers have several factors to consider when choosing end-of-life care, including the older person’s desire to pursue life-extending treatments, how long he or she has left to live, and the preferred setting for care.

What is Palliative Care?

Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients in palliative care may receive medical care for their symptoms, or palliative care, along with treatment intended to cure their serious illness. Palliative care is meant to enhance a person’s current care by focusing on quality of life for them and their family.

Who Can Benefit from Palliative Care?

Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson’s disease, and many others. Palliative care can be helpful at any stage of illness and is best provided soon after a person is diagnosed.

In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment. The organized services available through palliative care may be helpful to any older person having a lot of general discomfort and disability very late in life.

Who Makes up the Palliative Care Team?

A palliative care team is made up of multiple different professionals that work with the patient, family, and the patient’s other doctors to provide medical, social, emotional, and practical support. The team is comprised of palliative care specialist doctors and nurses, and includes others such as social workers, nutritionists, and chaplains. A person’s team may vary based on their needs and level of care. To begin palliative care, a person’s health care provider may refer him or her to a palliative care specialist. If he or she doesn’t suggest it, the person can ask a health care provider for a referral.

Where is Palliative Care Provided?

Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home. Medicare, Medicaid, and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover.

Visit the National Hospice and Palliative Care Organization website to find palliative care near you.

In palliative care, a person does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care if the doctor believes the person is likely to die within six months (see What does the hospice six-month requirement mean?). Or, the palliative care team could continue to help with increasing emphasis on comfort care.

What is Hospice Care?

Increasingly, people are choosing hospice care at the end of life. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.

At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease’s progress.

Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person’s illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.

It’s important for a patient to discuss hospice care options with their doctor. Sometimes, people don’t begin hospice care soon enough to take full advantage of the help it offers. Perhaps they wait too long to begin hospice and they are too close to death. Or, some people are not eligible for hospice care soon enough to receive its full benefit. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones.

Where is Hospice Care Provided and Who Provides it?

Hospice is an approach to care, so it is not tied to a specific place. It can be offered in two types of settings — at home or in a facility such as a nursing home, hospital, or even in a separate hospice center.

Read more about where end-of-life care can be provided.

Hospice care brings together a team of people with special skills — among them nurses, doctors, social workers, spiritual advisors, and trained volunteers. Everyone works together with the person who is dying, the caregiver, and/or the family to provide the medical, emotional, and spiritual support needed.

A member of the hospice team visits regularly, and someone is usually always available by phone — 24 hours a day, seven days a week. Hospice may be covered by Medicare and other insurance companies. Check to see if insurance will cover the person’s particular situation.

It is important to remember that stopping treatment aimed at curing an illness does not mean discontinuing all treatment. A good example is an older person with cancer. If the doctor determines that the cancer is not responding to chemotherapy and the patient chooses to enter into hospice care, then the chemotherapy will stop. Other medical care may continue as long as it is helpful. For example, if the person has high blood pressure, he or she will still get medicine for that.

Although hospice provides a lot of support, the day-to-day care of a person dying at home is provided by family and friends. The hospice team coaches family members on how to care for the dying person and even provides respite care when caregivers need a break. Respite care can be for as short as a few hours or for as long as several weeks.

To learn more, please visit https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care.

The brain controls many aspects of thinking — remembering, planning and organizing, making decisions, and much more. These cognitive abilities affect how well we do everyday tasks and whether we can live independently.

Some changes in thinking are common as people get older. For example, older adults may:

• Be slower to find words and recall names
• Have problems with multitasking
• Experience mild decreases in the ability to pay attention

Aging may also bring positive cognitive changes. For example, many studies have shown that older adults have larger vocabularies and greater knowledge of the depth of meaning of words than younger adults. Older adults may also have learned from their many years of accumulated knowledge and experiences. Whether and how older adults apply this knowledge, and how the brain changes as a result, is an area that researchers are actively exploring.

Despite the changes in cognition that may come with age, older adults can still do many of the things they have enjoyed their whole lives. Research shows that older adults can still:

• Learn new skills
• Form new memories
• Improve vocabulary and language skills

How the brain changes as people age

As a person gets older, changes occur in all parts of the body, including the brain.

• Certain parts of the brain shrink, including those important to learning and other complex mental activities.
• In certain brain regions, communication between neurons may be less effective.
• Blood flow in the brain may decrease.
• Inflammation, which occurs when the body responds to an injury or disease, may increase.

These changes in the brain can affect mental function, even in healthy older people. For example, some older adults may find that they don’t do as well as younger individuals on complex memory or learning tests. However, if given enough time to learn a new task, they usually perform just as well. Needing that extra time is normal as people age. There is growing evidence that the brain maintains the ability to change and adapt so that people can manage new challenges and tasks as they age.

Talk with your doctor if you’re concerned about changes in your thinking and memory. They can help you determine whether those changes are normal or whether it could be something else.

The brain-body connection

There is growing scientific evidence of the brain-body connection. Not only can changes in our brain affect our thinking, but also changes in our physical health may affect our brains.

For example, an NIA-funded study of almost 3,000 older adults showed that healthy lifestyle factors — physical activity, not smoking, not drinking heavily, following the Mediterranean-style diet, and engaging in mentally stimulating activities — can have important benefits. People who engaged in four or five of these behaviors had a 60% lower risk of developing Alzheimer’s compared to those who only followed one or none. People who followed two or three of the activities had a 37% lower risk.

In another study, older adults with higher levels of physical activity showed slower rates of cognitive decline than peers who were less active. Another example of how physical health can affect brain health has to do with the heart. Observational studies have found that high blood pressure in middle age, along with other cerebrovascular risk factors, such as diabetes and smoking, increase the risk of developing dementia.

Results from observational studies such as these can’t prove cause and effect, but they point to how a combination of modifiable behaviors may affect the brain as people age and identify promising avenues to be tested further.

To learn more, please visit https://www.nia.nih.gov/health/brain-health/how-aging-brain-affects-thinking

In recent years, the United States has experienced a number of significant natural disasters. Several of these events happened with little or no warning. One key lesson that we have learned from these unfortunate circumstances is to “be prepared,” a message that is especially important for older Americans and people with disabilities. September is officially designated National Preparedness Month, but preparedness is something we should be thinking about all year long.

Unfortunately, natural disasters can disproportionately impact older people and those with disabilities. These populations are frequently less able to withstand periods of time without food, water, medication, and rest—and they may have mobility or communications limitations that impact their ability to respond. Half of the people who died during and after Hurricane Katrina were over the age of 75. People with disabilities who rely on service providers for meals, personal care, and medical assistance often go without critical support systems during a crisis. As we saw during Hurricane Sandy, the loss of electricity to power medical devices, such as ventilators, or assistive technology, can be life-threatening.

That is why it is critical that older adults and people with disabilities plan for emergencies before they happen. Here are three important steps to consider in preparing for a natural disaster:

• Involve your community. When putting together a plan, individuals with disabilities and older adults should talk with their neighbors, family members, caregivers, and community members about emergency preparedness. Planning should be informed by individuals’ needs and preferences and should focus on creating a support team that can assist with evacuation, finding appropriate shelter, and meeting basic needs during a crisis. Planning should also take into account those situations when local services and supports are not available, and an individual needs to relocate out of the community. Consider including out-of-town relatives or friends in disaster preparedness plans.
• Pack an emergency medical kit. People with disabilities and older people with chronic health conditions should pack an emergency kit. It should contain food, water, medication, copies of medical records, instructions for medical devices, and, if necessary, things like extra wheelchair batteries and oxygen tanks.
• Make a plan for pets and service animals. Millions of people have pets and service animals that they love dearly. Owners should create evacuation and emergency response plans that include the needs of their animals. This includes packing an emergency kit for animals with food, water, and medication Pet owners should learn which shelters in their communities accept non-service animals and enlist the support of friends and neighbors to help with pet care if local shelters are not an option.

Every state is unique in terms of the local risks and types of natural disasters that can take place. But no matter where you are, it is important to take time to ensure that older Americans and people with disabilities engage in emergency planning so they are prepared to weather the storms that come.

For more information and links to resources about emergency preparedness for older adults and people with disabilities, please visit ACL’s emergency preparedness webpage.

Boyd Nursing and Rehabilitation is excited to highlight our outstanding Social Work team! Introducing Whitley Griffith!

Name: Whitley Griffith 

Years of Experience: I started here in December 2019  

What has ‘empowered’ you to become a social worker?: I enjoy being able to make a difference in the lives of others. Not only can it be a demanding job, it’s also a challenging and meaningful one.  Helping others has always been something that has been important to me. 

As we celebrate Social Work Month, what message or advice would you like to share with the community about the importance of social work in long-term care?: A social worker in a long-term care facility works with residents and their families to identify the residents’ psychosocial, mental, and emotional needs. The social worker then aids in providing or obtaining the services to meet those needs.  The social worker is a voice for the resident and helps them with any questions or concerns they may have.

A combination of individual, relational, community, and societal factors contribute to the risk of becoming a perpetrator of elder abuse. They are contributing factors and may or may not be direct causes. Understanding these factors can help identify various opportunities for prevention.

Watch Moving Forward to learn more about how increasing what protects people from violence and reducing what puts people at risk for it benefits everyone.

Risk Factors for Perpetration

Individual Risk Factors

• Current diagnosis of mental illness
• Current or past abuse of drugs or alcohol
• Current physical health problem
• Past experience of disruptive behavior
• Past experience of traumatic events
• High levels of stress
• Poor or inadequate preparation or training for caregiving responsibilities
• Inadequate coping skills
• Exposure to or witnessing abuse as a child
• Social isolation

Relationship Risk Factors

• High financial and emotional dependence upon a vulnerable elder
• Past family conflict
• Inability to establish or maintain positive prosocial relationships
• Lack of social support

Societal Risk Factors

There are specific characteristics of institutional settings such as nursing homes and residential facilities, that can increase the risk for perpetration including:

• Staffing problems and lack of qualified staff
• Staff burnout and stressful working conditions

Protective Factors for Elder Abuse

Protective factors reduce risk for perpetrating or experiencing abuse and neglect. Protective factors have not been studied as extensively as risk factors. However, identifying and understanding protective factors are equally as important as researching risk factors.

Protective Factors for Victimization

Individual Protective Factors

• Emotional intelligence

Relationship Protective Factors

• Having social support

Community Protective Factors

• Sense of community, meaning, residents feel connected to each other and are involved in the community

To learn more, please visit https://www.cdc.gov/violenceprevention/elderabuse/riskprotectivefactors.html

Aging is a process experienced by all workers throughout their life. Although there is no consensus on the age at which workers are considered “older workers,” the aging workforce phenomenon is real. For many older adults, work is increasingly an important avenue to economic security, enhanced social interaction, and improved quality of life. According to the U.S. Bureau of Labor Statistics, in 2021 nearly one in four American workers was age 55 or older. Moreover, labor force participation rates for workers aged 55 and older are projected to increase through 2030, while participation rates for those in younger and middle-aged groups are projected to remain relatively level or decline. These demographic shifts have made the issue of supporting and protecting the health and safety of workers, especially those of advanced age, much more pressing. Vital to any workplace is the safety, health, and well-being of all workers, from their first day on the job to their last.

National Center for Productive Aging and Work

The National Center for Productive Aging and Work (NCPAW) advances lifelong well-being for workers of all ages and supports productive aging across the working life. The Center works on important issues such as how organizations are addressing the needs of an aging workforce and identifying interventions and strategies to support both workers of all age groups and organizations that employ them. The Center is hosted by the NIOSH Office for Total Worker Health^®

Benefits of an Aging Workforce and Age-Friendly Work Practices

Employers increasingly see the value that older workers bring to the job. Older workers have greater institutional knowledge and usually more applicable experience. They report lower levels of stress on the job, and in general, they get along better with their coworkers. Finally, they tend to be more cautious on the job and more likely to follow safety rules and regulations.

A well-designed, employee-centered approach that focuses on multiple aspects of the workplace, including the nature of work, benefits all workers regardless of age. Many workplace accommodations are easy to make and are inexpensive. Modern orthotics, appropriate flooring and seating, optimal lighting, and new information technology hardware and software can smooth the way to continued work for older individuals. A new emphasis on job sharing, flexible work schedules, and working from home can support added years in the job market for many.

Simple Strategies for an Age-Friendly Workplace

These solutions can have large benefits if implemented properly with worker input and support throughout all levels of management. Moreover, these strategies can benefit workers regardless of age.

• Prioritize workplace flexibility. Workers prefer jobs that provide more flexibility over those that offer more vacation days. To the extent possible, give workers a say in their schedule, work conditions, work organization, work location, and work tasks.
• Match tasks to abilities. Use self-paced work, self-directed rest breaks, and less repetitive tasks.
• Avoid prolonged, sedentary work. Prolonged, sedentary work is bad for workers at every age. Consider sit/stand workstations and walking workstations for workers who traditionally sit all day. Design work to include a variety of tasks and skills. Provide onsite physical activity opportunities or connections to low-cost community options.
• Manage hazards. Including noise, slip/trip hazards, and physical hazards – conditions that may result in harm to workers of all ages, but can be more challenging to an aging workforce.
• Provide and design ergonomic-friendly work environments. Examples include adjustable workstations, minimize vibration and noise from tools, floor surfaces that reduce the impact on joints, adjustable seating, good lighting, and screens and surfaces with less glare.
• Utilize teams and teamwork strategies for identifying and solving problems. Workers closest to the problem are often best equipped to find the fix.
• Provide health promotion and lifestyle interventions including encouraging physical activity and healthy meal options, tobacco cessation assistance, screenings for health risk factors, strategies for reducing health risks, health coaching, and onsite medical care. Accommodate medical self-care in the workplace and time away for health visits.
• Invest in training and building worker skills and competencies at all age levels. Help older employees learn and adapt to new technologies, often a concern for employers and older workers. Provide workers the opportunities to practice and apply new skills as they are learning.
• Proactively manage reasonable accommodations and the return-to-work process after illness or injury absences.
• Provide age inclusive workforce management skills training for supervisors. Include a focus on the varying needs of workers at different life stages, and effective ways to manage a multi-generational workplace.

To learn more, please visit https://www.cdc.gov/niosh/topics/productiveaging/.

What is Alzheimer’s Disease?

Alzheimer’s disease is the most common type of dementia. Alzheimer’s disease involves parts of the brain that control thought, memory, and language. It begins with mild memory loss and can lead to losing the ability to carry on a conversation and respond to the environment. If not treated, it can affect a person’s ability to go about their normal routines.

• Alzheimer’s disease and related dementias can seriously affect a person’s ability to carry out daily activities. This memory loss is not a normal part of aging.

Scientists don’t know what causes Alzheimer’s. However, like other chronic conditions, it is probably a result of several things.

How many people have Alzheimer’s disease?

Nearly 6.7 million people in the United States have Alzheimer’s disease.¹  By 2060, that number is expected to grow to 13.9 million.² You may have a friend or loved one who has been diagnosed with Alzheimer’s disease or another type of dementia.

• Most people living with Alzheimer’s disease are 65 or older. People younger than 65 can have Alzheimer’s disease, but it’s uncommon.

Is there a cure for Alzheimer’s Disease?

There is no cure for Alzheimer’s disease at this time, but there are things you can do to help lower your risk.

1. Controlling high blood pressure
2. Maintaining a healthy weight
3. Quitting smoking
4. Being physically active
5. Eating healthy meals
6. Getting enough sleep
7. Avoiding alcohol or drinking alcohol in moderation
8. Managing diabetes

You don’t have to make these changes all at once. For example, getting an extra 30 minutes of sleep at night, getting an annual physical exam, or simply taking a walk every day may make a big difference in brain health.³

If you notice that your memory is changing or getting worse, you should talk to a medical professional.

To learn more, please visit https://www.cdc.gov/aging/publications/features/what-is-alzheimers-disease/index.html.

Adults with disabilities report experiencing frequent mental distress almost 5 times as often as adults without disabilities.  Call your doctor if your mental health gets in the way of your daily activities for at least 14 days in a month.

December 3^rd is International Day of Persons with Disabilities. In the United States, up to 1 in 4 adults have a disability. Many people will experience a disability at some point during their lives. Disabilities limit how a child or adult functions. These limitations may include difficulty walking or climbing stairs; hearing; seeing; or concentrating, remembering, or making decisions.

Although “people with disabilities” sometimes refers to a single population, this is a diverse group of people with a wide range of needs. Two people with the same type of disability can be affected in very different ways. Some disabilities may be hidden or not easy to see.

Many Adults with Disabilities Report Frequent Mental Distress

A CDC study found that adults with disabilities report experiencing more mental distress than those without disabilities.¹ In 2018, an estimated 17.4 million (32.9%) adults with disabilities experienced frequent mental distress, defined as 14 or more reported mentally unhealthy days in the past 30 days. Frequent mental distress is associated with poor health behaviors, increased use of health services, mental disorders, chronic disease, and limitations in daily life.¹

During the COVID-19 pandemic, isolation, disconnect, disrupted routines, and diminished health services greatly impacted the lives and mental well-being of people with disabilities.²

Call your healthcare provider if stress gets in the way of your daily activities for several days in a row. Free and confidential resources can also help you or a loved one connect with a skilled, trained counselor in your area.

It’s Okay Not to Feel Okay

Everyone reacts differently to stressful situations. How you respond to stressful situations, such as the COVID-19 pandemic, can depend on your background, your support systems (e.g., family or friends), your financial situation, your health and emotional background, the community you live in, and many other factors.

People with disabilities or developmental delays may respond strongly to the stress of a crisis, particularly if they are also at higher risk for serious illness from COVID-19 and other respiratory viruses (for example, older people and people of any age with certain underlying medical conditions).

How Are You Feeling?

We are often asked this question, and many of us say we’re “fine.” But this has been a difficult time lately, and emotions can be complex. You may be feeling sad, worried, or stressed.

It helps to stay positive and remind yourself of your strengths. Visit How Right Now for inspiration and resources to find what helps.

Healthy Ways to Cope with Stress

• Know what to do if you are sick and are concerned about COVID-19. Contact a health provider before you start any self-treatment for COVID-19.
• Know where and how to get mental health treatment and other support services and resources, including counseling or therapy (in person or through telehealth services).
• Take care of your emotional health. Taking care of your emotional health will help you think clearly and react to urgent needs to protect yourself and your family.
• Take breaks from watching, reading, or listening to news stories, including those on social media. Hearing about the pandemic repeatedly can be upsetting.
• Take care of your body.
  • Take deep breaths, stretch, or meditate
  • Try to eat healthy, well-balanced meals
  • Exercise regularly
  • Get plenty of sleep
  • Avoid excessive alcohol and drug use
• Make time to unwind. Try to do some other activities you enjoy.
• Connect with others. Talk with people you trust about your concerns and how you are feeling.  During times of increased social distancing, people can still maintain social connections and care for their mental health. Phone calls or video chats can help you and your loved ones feel socially connected, less lonely, or isolated.
• Connect with your community- or faith-based organizations. While social distancing measures are in place, consider connecting online, through social media, or by phone or mail.
• Improving the Mental Health of People with Disabilities
• CDC provides funding for two National Centers on Disability that focus on improving the quality of life for people living with disabilities.
• Special Olympics’ Inclusive Health programming focuses on improving the physical and social-emotional well-being of people with intellectual disabilities by increasing inclusion in health care, wellness, and health systems for Special Olympics athletes and others with intellectual disabilities.
• “I learned relaxation techniques and now always try these when I find myself overwhelmed. I would recommend these strategies to others, too. A strong mind is an important part to a happy body,” shares Kayte Barton, a Special Olympics athlete from Minnesota.  Barton was a part of the Special Olympics committee to help develop emotional health programming for Special Olympics athletes across the world in its flagship Special Olympics Healthy Athletes® program.
• Special Olympics’ Strong Mindfulness program offers free, 1-hour mindfulness sessions for people with intellectual disabilities and their families. Participants learn deep breathing techniques, body awareness and progressive muscle relaxation, mindful movement, and guided meditation. They also receive a Strong Minds Activity Guide designed to help them develop their coping skills in everyday life.
• The National Center on Health, Physical Activity and Disability (NCHPAD) seeks to help people with disabilities and other chronic health conditions achieve health benefits through increased participation in all types of physical and social activities. NCHPAD’s M.E.N.T.O.R program, which stands for Mindfulness, Exercise and Nutrition to Optimize Recovery, takes a holistic approach to restoring, improving, and protecting health. The program divides health into three domains: physical, mental, and emotional.  Through this program, people who have acquired a new disability (e.g., spinal cord injury, stroke, traumatic brain injury), a new diagnosis (e.g., multiple sclerosis, Parkinson’s disease), or have a congenital condition (e.g., cerebral palsy, spina bifida) learn the many ways life can be enhanced through health and wellness activities.

Disability and Mental Health Resources

• Coping with Stress
• Healthy Living
• National Centers on Disability
• CDC Disability and Health Promotion
• CDC National Center on Birth Defects and Developmental Disabilities

As CDC honors International Day of Persons with Disabilities, we ask that you join us in being a part of the global movement to change attitudes toward, and promote the inclusion of, people with disabilities.

To learn more, please visit https://www.cdc.gov/ncbddd/disabilityandhealth/features/mental-health-for-all.html