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LONG-TERM CARE FOR OLDER ADULTS IN THE UNITED STATES: SOCIAL JUSTICE, SOCIAL WELFARE, AND SERVICE MODELS

Yıl 2023, Cilt: 23 Sayı: 61, 693 - 729, 25.12.2023
https://doi.org/10.21560/spcd.vi.1150176

Öz

As a result of longer life expectancies and time spent with chronic diseases, physical and mental difficulties experienced during old age has become widespread. Long-term care models that provide personal care services to older adults experiencing these difficulties have reached critical importance. Long term care services, as a subdomain of social welfare seeking to ensure social justice should address these needs through rights-based framework. This study aimed to establish the relationship between social welfare models and long-term care in the context of the United States (USA). For this purpose, it was discussed how American market-centered liberal welfare model shaped the long-term care system in a historical context with reference to long-term care models, financing, and service delivery. This discussion concluded that the American long-term care system has a market-centered income-testing model and does not adhere to a rights-based social justice framework. As a result, there are significant disparities in both availability of long-term care and quality of services offered. The USA must address the structural inequalities in organization, financing, and provision of long-term care services in order to ensure social justice in the provision of care, while at the same time, new care models should be developed to better integrate emerging technology into care models.

Kaynakça

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AMERİKA BİRLEŞİK DEVLETLERİ'NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ

Yıl 2023, Cilt: 23 Sayı: 61, 693 - 729, 25.12.2023
https://doi.org/10.21560/spcd.vi.1150176

Öz

Uzayan yaşam süreleri ve kronik hastalıklarla geçen sürelerin artması neticesinde yaşlılık süresince deneyimlenen fiziksel ve zihinsel engellilik yaygınlaşmıştır. Bu engelleri yaşayan yaşlı bireylere kişisel bakım hizmetleri sunan uzun süreli bakım modelleri kritik bir öneme ulaşmıştır. Sosyal adaleti sağlamayı hedefleyen sosyal politikalar, yaşlılıkta engellilik yaşayan ve bakıma muhtaç bireylerin bu ihtiyaçlarına uzun süreli bakım hizmetleri aracılığı ile hak temelli bir çerçevede yaklaşmalıdır. Bu çalışma Amerika Birleşik Devletleri (ABD) bağlamında sosyal refah modelleri ve uzun süreli bakım modelleri arasındaki ilişkiyi kurmayı hedeflemiştir. Bu amaçla, Amerikan sosyal refah sisteminin piyasa merkezli liberal refah modeline sahip olmasının uzun süreli bakım sistemini nasıl şekillendirdiğini, uzun süreli bakım modelleri, finansmanı ve hizmet sunumuna değinerek tarihsel bir çerçevede tartışmıştır. Bu tartışma, Amerikan uzun süreli bakım sisteminin piyasa merkezli gelir-testi modeline sahip olduğu ve hak temelli ve sosyal adaleti sağlamayı hedefleyen bir yaklaşım takip etmediği sonucuna ulaşmıştır. Bunun neticesinde uzun süreli bakıma erişimde ve erişilen hizmetin kalitesinde büyük eşitsizliklerle karşılaşılmaktadır. ABD, bu bakımın sunulmasında sosyal adaleti sağlamak için uzun süreli bakım hizmetlerinin organizasyonu, finansmanı ve sunumunda yapısal reformlar yaparak bu alanda yaşanan eşitsizliklere müdahale etmeli, aynı zamanda da gelişen teknolojiyi bakım modellerine daha iyi entegre etmek için uzun süreli bakım modellerini geliştirilmeli ve düzenlenmelidir.

Kaynakça

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  • Bohl, A., Schurrer, J., Miller, D., Lim, W., and Irvin, CV. (2014). The changing medical and long-term care expenditures of people who transition from institutional care to home-and community-based services. National Evaluation of the Money Follows the Person (MFP) Demonstration Grant Program, Report from the Field, (15).
  • Borella, M., De Nardi, M., and French, E. (2018). Who receives Medicaid in old age? Rules and reality. Fiscal Studies, 39(1), 65-93.
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  • Konetzka, RT., and Werner, RM. (2009). Disparities in long-term care: building equity into market-based reforms. Medical Care Research and Review, 66(5), 491-521.
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  • Livne, R. (2019). Values at the End of Life : The Logic of Palliative Care. Cambridge, MA: Harvard University Press. Marshall, TH. (1950). Citizenship and social class (Vol. 11, pp. 28-29). New York, NY: Cambridge.
  • Mauldin, RL., Sledge, SL., Kinney, EK., Herrera, S., and Lee, K. (2021). Addressing Systemic Factors Related to Racial and Ethnic Disparities among Older Adults in Long-Term Care Facilities. In Effective Elimination of Structural Racism. IntechOpen.
  • Michaels, D. (2020). History of nursing homes in America. Erişim Tarihi: 27 Temmuz 2022, https://www.americannursinghistory.org/history-nursing-homes-in-america.
  • Musumeci, M., and Claypool, H. (2014). Olmstead's role in community integration for people with disabilities under Medicaid: 15 Years after the Supreme Court's Olmstead decision. Henry J. Kaiser Family Foundation.
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  • Ng, T., Harrington, C., and Kitchener, M. (2010). Medicare and Medicaid in long-term care. Health Affairs, 29(1), 22-28.
  • Özdemir, S. (2005). Sosyal gelişim düzeyleri farklı refah devletlerinin sınıflandırılması üzerine bir inceleme. In Journal of Social Policy Conferences (No. 49). Istanbul University.
  • Özgökçeler, S. (2006). Sosyal Dışlanma Sorunsalı Ve Engellilerin Sosyal Politikası Bağlamında Değerlendirilmesi. Yayımlanmamış Yüksek lisans tezi. Uludağ Üniversitesi.
  • Peetoom, KK., Lexis, MA., Joore, M., Dirksen, CD., and De Witte, LP. (2015). Literature review on monitoring technologies and their outcomes in independently living elderly people. Disability and Rehabilitation: Assistive Technology, 10(4), 271-294.
  • Qualls, SH. (2016). Caregiving families within the long-term services and support system for older adults. American Psychologist, 71(4), 283-293
  • Reaves, EL., and Musumeci, M. (2015). Medicaid and Long-Term Services and Supports: A Primer, Erişim Tarihi: 27 Temmuz 2022. http://kff.org/medicaid/report/medicaid-and-long-term-services-and-supports-a-primer/.
  • Reinhard, SC. (2010). Diversion, transition programs target nursing homes’ status quo. Health Affairs, 29(1), 44-48.
  • Robine, JM. (2021). Ageing populations: We are living longer lives, but are we healthier. United Nations, 2.
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  • Şeker, A., ve Kurt, G. (2018). Bir Sosyal Politika Alanı Olarak Yaşlılık Ve Sosyal Hizmet Uygulamaları. Nüfusbilim Dergisi, 40, 7-30.
  • Shapiro, A., Loh, CP., Mitchell, G. (2011). Medicaid cost-savings of home-and community-based service programs for older persons in Florida. Journal of Applied Gerontology, 30(1), 3–21.
  • Shirk, C. (2006). Rebalancing long-term care: The role of the Medicaid HCBS Waiver Program, Washington, DC: National Health Policy Forum.
  • Shrider, EA., Kollar, M., Chen, F., and Semega, J. (2021). Income and poverty in the United States: 2020. US Census Bureau, Current Population Reports, (P60-273).
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  • Spencer-Wood, SM. (2001). Introduction and historical context to the archaeology of seventeenth and eighteenth century almshouses. International Journal of Historical Archaeology, 5(2), 115-122.
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  • Tauke, B., and Smith, K. (2020). Marginalized by design. Journal of Interior Design, 45(1), 5-12.
  • Thach NT., and Wiener JM. (2018). An overview of long-term services and supports and Medicaid: final report. Erişim Tarihi: 27 Temmuz 2022. https://aspe.hhs.gov/pdf-report/overview-long-term-services-and-supports-and-medicaid-final-report.
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  • Tufan, İ. (2016). Antik Çağ’dan Günümüze Yaşlılık ve Yaşlanma. Geliştirilmiş 2. Basım. Ankara: Nobel Yayıncılık. Turner, BS. (1990). Outline of a Theory of Citizenship. Sociology, 24(2), 189-217.
  • Upadhyay, P. and Weiner, J. (2019). Long Term Care Financing in the United States. Erişim Tarihi: 27 Temmuz 2022. https://ldi.upenn.edu/brief/long-term-carefinancing-united-states.
  • Van Houtven, CH., DePasquale, N., and Coe, NB. (2020). Essential long‐term care workers commonly hold second jobs and double‐or triple‐duty caregiving roles. Journal of the American Geriatrics Society, 68(8), 1657-1660.
  • Vladeck, B. (1980). Unloving Care. New York: Basic Books.
  • Voorhies, P. and Kirsten, C. (2020). Overview of Federally Certified Long-Term Care Facilities, Congressional Research Service.
  • Wang, Y. (2019). Understanding Home and Community-based Services: An Evaluation of Medicaid's Balancing Incentive Program (Yayınlanmamış Doktora Tezi). The Pardee RAND Graduate School.
  • Wiener, JM., Anderson, WL., Khatutsky, G., Kaganova, Y., and O’Keeffe, J. (2013). Medicaid spend down: New estimates and implications for long-term services and supports financing reform. Washington, DC: RTI International.
  • Wiener, JM., and Anderson, WL. (2009). Follow the money: Financing home and community-based services. Pittsburgh, PA: University of Pittsburgh.
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  • World Health Organization (WHO). (2019). WHO methods and data sources for life tables 1990–2019, Erişim Tarihi: 27 Temmuz 2022, https://www.who.int/docs/default-source/gho-documents/global-health-estimates/ghe2019_life-table-methods.pdf?sfvrsn=c433c229_5.
  • Yılmaz, V. (2018). Sosyal politika ve yaşlanma. Yaşlanma ve yaşlılık: Disiplinlerarası bakış açıları içinde. İstanbul Bilgi Üniversitesi Yayınları. s.173-187.
Toplam 100 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sosyal Hizmetler (Diğer)
Bölüm Makaleler
Yazarlar

Hazal Swearinger 0000-0001-8573-641X

Yayımlanma Tarihi 25 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 23 Sayı: 61

Kaynak Göster

APA Swearinger, H. (2023). AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ. Sosyal Politika Çalışmaları Dergisi, 23(61), 693-729. https://doi.org/10.21560/spcd.vi.1150176
AMA Swearinger H. AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ. Sosyal Politika Çalışmaları Dergisi. Aralık 2023;23(61):693-729. doi:10.21560/spcd.vi.1150176
Chicago Swearinger, Hazal. “AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ”. Sosyal Politika Çalışmaları Dergisi 23, sy. 61 (Aralık 2023): 693-729. https://doi.org/10.21560/spcd.vi.1150176.
EndNote Swearinger H (01 Aralık 2023) AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ. Sosyal Politika Çalışmaları Dergisi 23 61 693–729.
IEEE H. Swearinger, “AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ”, Sosyal Politika Çalışmaları Dergisi, c. 23, sy. 61, ss. 693–729, 2023, doi: 10.21560/spcd.vi.1150176.
ISNAD Swearinger, Hazal. “AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ”. Sosyal Politika Çalışmaları Dergisi 23/61 (Aralık 2023), 693-729. https://doi.org/10.21560/spcd.vi.1150176.
JAMA Swearinger H. AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ. Sosyal Politika Çalışmaları Dergisi. 2023;23:693–729.
MLA Swearinger, Hazal. “AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ”. Sosyal Politika Çalışmaları Dergisi, c. 23, sy. 61, 2023, ss. 693-29, doi:10.21560/spcd.vi.1150176.
Vancouver Swearinger H. AMERİKA BİRLEŞİK DEVLETLERİ’NDE YAŞLILIKTA UZUN SÜRELİ BAKIM: SOSYAL ADALET, SOSYAL REFAH VE HİZMET MODELLERİ. Sosyal Politika Çalışmaları Dergisi. 2023;23(61):693-729.