I decided to write a community assessment paper regarding the elderly population with a lower socioeconomic status. Elders desire a life with good health, dignity, economic independence and finally a peaceful death. They long for care, love and affection. Understanding their needs and concerns will ensure their good health. It is important to research beneficial services for older people because they are a vulnerable age group. According to World Health Organization, “Senior citizens are considered a vulnerable population, even if an individual elderly person is physically able to care for herself and is in full possession of her mental capacity” (para. 1). If seniors belong to a lower socioeconomic group it becomes even harder for them to provide for themselves.
When I decided on what population I should choose for this assignment, I thought about my parents who are getting close to this age group and how important it is to provide care and help for them. They are immigrants who moved to the United States from Ukraine at an advanced age, and I see that such people need support. Older people are not as healthy as younger people, so it is harder to work and support themselves. Older people might feel vulnerable due to: untimely or degrading death, lack of physical care and health care, an oversupply of care and interference, poverty, exclusion from participation in society, homelessness, loss of autonomy and independence and other factors. Additionally, older immigrants are facing some extra obstacles such as the language barrier; they can not find a job due to lack of proficiency in English. They do not have much retirement because they did not work here in the United States, even though they worked hard in the country they moved from. Therefore, I will talk about some health benefits out there for seniors, and how these benefits can ease their life in advanced age.
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One of the most important benefits is having easy access to health providers and medical institutions. In order to have this access, people need health insurance, because in the United States medical benefits are really expensive. Since the elderly population is not working they cannot have insurance through their employment, and if they are low-income they are unable to purchase it. Fortunately, Medicare can cover most health-related services. Washington State Department of Social and Health Services (DSHS) is one of the largest governmental organizations that helps the low-income population. The local facility is on 800 NE 136th Ave #110, Vancouver, WA 98684. It is a new building, close to Mill Plain, a convenient location because you can find bus station, food places, post offices and many other things close by. However, there are some elderly people who have disabilities and need assistance in transportation, so it would be great to have free bus travel for disabled passengers right from home to the office. I spoke to one of the representatives at DSHS and she explained what Medicare is and how it works. Medicare is a federal health insurance program that provides benefits to seniors (65 years and older) and those with disabilities and certain illnesses. According to DSHS, Medicare has several parts. “Parts A and B are called Original Medicare. They are run by the federal government. Medicare Part C is called Medicare Advantage. You buy Medicare Advantage plans from private health insurance companies that contract with the government. They work with Original Medicare coverage. Part D covers prescription drugs. Many Medicare Advantage plans combine Parts A, B, and D in one plan. And each Medicare plan only covers one person” (para. 2). In order to apply for the insurance, you can schedule an appointment with the agent, and who will help in processing the application or you can apply directly through the website: https://www.washingtonconnection.org/eapplication/home.go?action=Introduction.
Unfortunately, some plans do not cover all the services, such as dental or vision. Populations with lower incomes can not afford premium plans that have more coverage. Moreover, I found out that even if you have Plan C, due to your low income, more and more providers do not take State insurance at all. Less dental and vision providers (private practices) want to make contracts with State insurance due to lower profit. At times they accept only children up to 21 years old. When I used to work at a dental clinic we used to take DSHS insurance, but as soon as we got more patients and our contract expired my boss did not sign a new agreement and stopped taking that insurance. Also, it did not cover some major services such as crowns, bridges and root canals which may elderly patients need. So even if you have insurance you can not use it. Many barriers arise, patient can not have access to the provider that he wants or sometimes can’t find any provider. Thus, I went ahead and searched for the optimal variant for elderly people and what would the possible solution.
I found the insurance agent who I visited, his name is Ramzan Magomedov. He is a very knowledgeable and helpful agent who speaks English and Russian. It is very helpful for Russian-speaking immigrants who have a language barrier to speak with a person directly without a translator. His company is called Secure Tomorrow Insurance, LLC CQ located at 1000 N.E. 122nd Ave., Suite 116, Portland, OR 97230, you also can visit his website: securetomorrowinsurance.com. The office location is a very convenient place, you can find food stores, restaurants, shop stores, bus stations and other stuff in that area. However, there are some elderly people who have disabilities and need assistance in transportation, so it would be great to have free bus travel for disabled passengers right from home to the office. He told me about the United Healthcare Group Senior Supplement plan which can help to pay for services that are not covered by Medicare. He also told me that this plan is more profitable for the providers, so more of them have a contract with this insurance. According to UnitedHealthcare, “UnitedHealthcare’s Senior Supplement plans are group major medical insurance coverage for Medicare-eligible retirees. They help pay for the costs recognized but not covered by Original Medicare Parts A and B. The insurance plans are regulated by state insurance agencies rather than by the Centers for Medicare and Medicaid Services” (para. 1). After my employer stopped taking Medicare, more patients started to come to the appointments with United HealthCare insurance and my provider got more money out of that insurance versus Medicare. UnitedHealthcare also covers more medical procedures. For example, it covers some crowns, bridges and root canals. Also, you can have a dual plan: Medicare and UnitedHealthcare. If the patient still has a provider who takes Medicare, he still can use both insurances to cover services that one of the insurance does not pay for. Ramzan Magamedov can help elderly people to find out what plan is the best to choose and help with the processing of the application, plus his consultations are free.
Another option to get medical help for no cost it is a Sea Mar. Sea Mar Community Health Centers is a thriving, not-for-profit community-based organization committed to providing quality, comprehensive health, educational, human, housing and cultural services to diverse communities in Washington state. Sea Mar (2018) stated “we take great pride in providing quality, affordable, culturally sensitive health care to low-income and underserved communities in Washington. We are proud of the high-caliber medical providers working on our team. We support access to health care for all and firmly believe that the patient is our first professional responsibility whether man, woman or child; ill or well; seeking care, healing, or knowledge” (para 1). For immigrants who do not speak English, they can request an interpreter for the appointment. Sea Mar is very helpful for all age groups including older people who have low income. There are lots of local offices that you can find on the website: https://www.seamar.org/. One of the local Sea Mar Health Centers is located at 6100 NE Fourth Plain Blvd, Vancouver, WA 98661. It is a convenient area because there is a bus station nearby as well as some food stores/coffee shops. However, the disadvantage is the long waiting period on a phone. As a solution, you can try to call a different Sea Mar office in your city and see if their waiting time is shorter.
As a bonus, I would like to talk about English classes for immigrants. Since many immigrants do not speak English most of the time they can not find a job that will give them enough income. They also can not make doctor appointments for themselves or don’t even go to the doctor due to a lack of proficiency in English. Sometimes, they have to ask their kids or relatives to help them with interpretation, but many parents do not want to bother anyone and fail to schedule an appointment. According to Ku (2016) “factors, like language barriers, also impair immigrants' access to and the quality of medical care they receive. The net result is that immigrants are much less likely to use primary and preventive medical services, hospital services, emergency medical services, and dental care than are citizens, even after controlling for the effects of race/ethnicity, income, insurance status, and health status” (para. 6). Many other conflicts arise, like disclosure of personal health-related information to interpreters, such family members or strangers. Therefore, it is critical to start learning English as soon as it is possible.
Good Will offers free English classes in Portland, Vancouver, Salem, and other communities in Oregon and Washington. In order to register you just need to go to the website; https://goodwilljobconnection.org/esl/free-classes/ and hit ESL free registration. For your convenience, you can pick what location you want to go to, depending on where you live. Elderly people can just go to the local Good Will and sign up for the classes if they can not use a computer. Plus, Goodwill also offers free Citizenship test preparation classes, and everyone is welcome. It helps immigrants to pass the citizen test and get more benefits from other sources and maybe even to find a better job. However, some elderly people especially immigrants, can’t drive or do not have car. So, they could face transportation issues. The solution to that could be offering a free bus pass, especially for low-income people.
Another school that offers ESL (English as a Second Language) classes are at Clark College, which welcomes immigrants and refugees. The advantage of Clark College that it does not require students who are taking ESL classes to provide Social Security Numbers, proof of citizenship, or to identify their national origin. It is helpful for immigrants who did not receive citizenship yet or does not have paperwork. ESL classes cost $25.00 in tuition per quarter. However, tuition assistance is available, and you don’t need to pay if you are a low-income student. The classes are held in T-Building (TBG), and for any information just go to Transitional Studies Reception Room 20. They can help with the application process and answer any questions. Most of the workers are bilingual who can help with the application process in case you do not understand something. Also, older people or anybody who needs accommodation due to a disability in order to fully participate in this event can contact Clark College's Disability Support Services Office at (360) 992-2314 or visit Main Campus PUB 013, two weeks prior to the event. The Clark College area has a bus station that is convenient and anyone who has low income can receive help with the free bus transportation. However, there are some elderly people who have disabilities and need assistance, so it would be great to have free bus travel for disabled passengers right from home to school. Another benefit of Clark College is that you can climb up on the “career stairs” by building your knowledge and maybe even enroll in higher division classes to work toward some profession. Eventually, low-income immigrants can get a better job that will raise their income and improve the financial situation of their life.
In a nurse role, it is very important to do research and know all this information because it helps them advance nurses’ field, stay updated and offer better patient care. Nurses can also help uninsured patients and families locate nearby sources of free or low-cost medical care, such as free clinics and hospitals that offer charity care. Nursing is not just about dispensing medication or administering treatments. Nurses also are responsible for teaching patients about the resources out there. One of the nursing roles is to observe and help her patients. When nurses notice low socioeconomic conditions of their patients she must provide recommendations. Plus, it is really nice to have personal experience and visit actual resources in order to provide reliable, accurate information and build a trustworthy relationship with patients. By relaying information, nurses help patients take control of their healthcare. All the information and sources about insurance for elderly people and free English classes I described above greatly help low socioeconomic patients. Thanks to this information many immigrants learned English and got a good job positions. Some people received medical care and stayed alive because they had access to the sources that someone had told them about. For example, when my dad came to the United States he needed open heart surgery which cost about $320,000. Of course, our family did not have such money, but the nurse told us about Medicare. After applying for it my dad got full coverage and his life was saved. In this example, we can see how the nurse's role is very important in educating and providing more than just care.
References:
- Leighton Ku. (2006). Why do immigrants lack adequate access to health care and health insurance. MPI. Retrieved from https://www.migrationpolicy.org/article/why-immigrants-lack-adequate-access-health-care-and-health-insurance
- Sea Mar Community Health Centers. (2018). Welcome to sea mar community health centers. Retrieved form https://www.seamar.org/
- UnitedHealthcare. (2019). Understanding health insurance. Retrieved from https://www.uhc.com/individual-and-family
- World Health Organization. (2019). Environmental health in emergencies. Retrieved from https://www.who.int/environmental_health_emergencies/vulnerable_groups/en/
- Washington State Department of Social and Health Services. Medicare. Retrieved from https://www.dshs.wa.gov/altsa/home-and-community-services/medicare
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