Q: What threats do older adults face, and what increases people's exposure to threats? How can I help?
A: The concept of vulnerability first emerged in the environmental sciences, specifically in the study of natural disasters such as flood, fire, earthquake, drought, or hurricanes. But, in the wake of those disasters, not everyone suffers equally.
Vulnerability in disaster studies was initially defined as the 'potential for disruption or harm', and the type of hazard, severity of damage relative to magnitude, rapid onset, duration or frequency, which put in place strategic, monitoring and forecasting systems.
Vulnerability faced by older adults goes beyond natural disasters, but includes homelessness, food insecurity, unsafe environments (non-potable water, none or inconsistent heat, proper ventilation, mold/mildew, violence), chronic disease, viruses, verbal threats or physical harm. Vulnerable adults age 65 years or older, who are at high risk for death or functional decline, have self-rated health limitations, physical capability and functional restrictions. These factors place individuals on the vulnerable scale.
Under the Older Americans Act, Title VII authorizes the Long-Term Care Ombudsman program as well as elder abuse, neglect, and exploitation prevention programs. For FY2021, these programs are funded nationally at a total of $23.7 million. The majority of Title VII funding ($18.9 million, or 80%, in FY2021) is directed at the Long-Term Care Ombudsman program, which investigates and resolves complaints of residents in nursing facilities, boarding and care facilities, and other adult care homes.
Group housing, large living complexes, crowded facilities, locations with insufficient or fresh food sources, unsanitary conditions, or buildings with inadequately trained staff in high-crime neighborhoods are threats to the older population. A person's risk of suffering harm-their vulnerability-are those distinct, but related risks, being exposed to that threat, the risk of a threat materializing, and lack of defenses against that threat.
What is the susceptibility to threats?
Exposure factors influencing risk can be ambiguous. At times the risk can occur in small increments, or perhaps suddenly because of unexpected financial or personal loss. Vulnerability to poverty could occur after retirement, or childlessness, and unavailability of services. Or, in a wider context, vulnerability may be due to social exclusion, gender or ethnic inequalities, mental capacities, cultural patterns and historical unsatisfactory wellness systems. Past outcomes determine present exposure and coping mechanisms.
What is a person's coping capacity to threats?
A set of assets and relationships that allows people to protect themselves from a 'bad end' or to recover from a crisis includes labor assistance, human capital, productive assets, household relations and social capital. What makes a person vulnerable is their individual capacities in addition to other relationships and assets they bring to that event or crisis.
A person's individual wealth, education, skills, physical and mental health guide coping outcomes. Fully successful coping capacities rely heavily on social networks and resources of support, rather than relying solely on an individual's capacity.
What can we do
Reducing older adult vulnerability requires examination of the size and composition of people's networks, but also the quality of relationships, and understanding changes will occur over time to those personal interactions and community supports. Keeping family, friends and voluntary associations intact, while offering financial support, companionship and advocacy, can reduce older adults' vulnerability to threats, external dangers or harm.
Karen Casanovas, PCC, CPCC, is a restorative coach in Anchorage. If you have a question for Karen, email her at info@karencasanovas.com.
