Aged care

Elderly care, or simply eldercare, is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospice care, and In-Home care. Because of the wide variety of elderly care found globally, as well as differentiating cultural perspectives on elderly citizens, the subject cannot be limited to any one practice. For example, many countries in Asia use government-established elderly care quite infrequently, preferring the traditional methods of being cared for by younger generations of family members.
Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity. It is an important distinction, in that the design of housing, services, activities, employee training and such should be truly customer-centered. It is also noteworthy that a large amount of global elderly care falls under the unpaid market sector.


A distinction is generally made between medical and non-medical care, care provided by people who are not medical professionals. The latter is much less likely to be covered by insurance or public funds. In the US, 67 percent of the one million or so residents in assisted living facilities pay for care out of their own funds.The rest get help from family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home. Assisted living facilities usually do not meet Medicare's requirements. However, Medicare does pay for some skilled care if the elderly person meets the requirements for the Medicare home health benefit. 
Thirty-two U.S. states pay for care in assisted living facilities through their Medicaid waiver programs. Similarly, in the United Kingdom the National Health Service provides medical care for the elderly, as for all, free at the point of use, but social care is only paid for by the state in Scotland, England, Wales and Northern Ireland are yet to introduce any legislation on the matter, so currently social care is only funded by public authorities when a person has exhausted their private resources, for example, by selling their home.
However, elderly care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities rather than the resident may be providing the cost of care. Where residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern. The Adult Protective Services Agency — a component of the human service agency in most states — is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers.


Improving mobility in the elderly


Impaired mobility is a major health concern for older adults, affecting fifty percent of people over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs, and to rise from a chair, they become completely disabled. The problem cannot be ignored because people over 65 constitute the fastest growing segment of the U.S. population.
Therapy designed to improve mobility in elderly patients is usually built around diagnosing and treating specific impairments, such as reduced strength or poor balance. It is appropriate to compare older adults seeking to improve their mobility to athletes seeking to improve their split times. People in both groups perform best when they measure their progress and work toward specific goals related to strength, aerobic capacity, and other physical qualities. Someone attempting to improve an older adult’s mobility must decide what impairments to focus on, and in many cases, there is little scientific evidence to justify any of the options. Today, many caregivers choose to focus on leg strength and balance. New research suggests that limb velocity and core strength may also be important factors in mobility.
The family is one of the most important providers for the elderly. In fact, the majority of caregivers for the elderly are often members of their own family, most often a daughter or a granddaughter. Family and friends can provide a home (i.e. have elderly relatives live with them), help with money and meet social needs by visiting, taking them out on trips, etc.
One of the major causes of elderly falls is hyponatremia, an electrolyte disturbance when the level of sodium in a person's serum drops below 135 mEq/L. Hyponatremia is the most common electrolyte disorder encountered in the elderly patient population. Studies have shown that older patients are more prone to hyponatremia as a result of multiple factors including physiologic changes associated with aging such as decreases in glomerular filtration rate, a tendency for defective sodium conservation, and increased vasopressin activity. Mild hyponatremia ups the risk of fracture in elderly patients because hyponatremia has been shown to cause subtle neurologic impairment that affects gait and attention, similar to that of moderate alcohol intake.
Elderly tourists in countries affected by malaria are almost ten times more likely to die of the disease than younger persons.  This study based in the U.K. found that 4.6 percent of those infected with the disease died from it.


Legal issues about incapacity
Legal incapacity is an invasive and sometimes, difficult legal procedure. It requires that a person file a petition with the local courts, stating the elderly person lacks the capacity to carry out activities that include making medical decisions, voting, making gifts, seeking public benefits, marrying, managing property and financial affairs, chosing where to live and who they socialize with. Most states' laws require that a minimum of two doctors or other health professionals, provide reports as evidence of such incompetence and the person must be represented by an attorney. Only then can the individual's legal rights be removed and legal supervision by a guardian or conservator be initiated. The legal guardian or conservator is the person to whom the court delegates the responsibility of acting on the incapacitated person's behalf and must report regularly his or her activities to the court.

A less restrictive alternative to legal incapacity is the use of "Advance Directives"; powers of attorney, trusts, living wills and health care directives. The person who has these documents in place, should have prepared them with their attorney when that person had capacity. So, if the time comes when that person lacks capacity to carry out those tasks laid out in the documents, the person they named (their agent) can step in to make decisions on their behalf. The agent has a duty to act as that person would have and in their best interest.