MCOM 105: Reader MEDIA & DISABILITY ISSUES Prof



MCOM 105: Reader MEDIA & DISABILITY ISSUES Prof. Bob Rucker

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Disabilities/Limitations

All noninstitutionalized persons:

[pic]Number of persons with limitation(s) in usual activities due to chronic conditions: 34.2 million

[pic]Percent of persons with limitation(s) in usual activities due to chronic conditions: 12%

Noninstitutionalized adults

[pic]Number of adults with hearing trouble: 35.1 million

[pic]Percent of adults with hearing trouble: 16%

[pic]Number of adults with vision trouble: 19.1 million

[pic]Percent of adults with vision trouble: 8.9%

[pic]Number of adults unable (or very difficult) to walk a quarter mile: 15.0 million

[pic]Percent of adults unable (or very difficult) to walk a quarter mile: 7.0%

[pic]Number of adults with any physical functioning difficulty: 31.7 million

[pic]Percent of adults with any physical functioning difficulty:  15%

Noninstitutionalized older adults

[pic]Percent of adults 65 years and over who need help with personal care from

other persons: 6.3

Noninstitutionalized children

[pic]Number of children age 3-17 years of age ever told had a learning disability:

4.9 million

[pic]Percent of children age 3-17 years of age ever told had a learning disability:

8.0 %

DEMOGRAPHICS - People with Downs Syndrome: (Mentally Challenged)

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• Down Syndrome, the most commonly identified cause of mental retardation, occurs in about 1 in 800 births. Despite many years of research to identify risk factors associated with Down syndrome, only one factor, advanced maternal age, has been well established.

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• Previous studies of risk factors for Down syndrome have pooled all cases regardless of parental origin or timing of the chromosome error. With new DNA technology and chromosome 21-specific genetic markers, determining the parental origin of the chromosome error and the timing of that error during meiosis is possible. [Meiosis is the special process of cell division that creates egg and sperm cells so that each has half the number of chromosomes normally found in other cells in the body.]

•

• Younger mothers ( less than 35 years) who smoke and have meiotic II error are at an increased risk of having children with Down syndrome. The combined use of cigarettes and oral contraceptives increased the risk even further.



Date: October 5, 2005

Content source: National Center on Birth Defects and Developmental Disabilities

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|Birth Defects: Frequently Asked Questions (FAQs) |

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Q:  What is a birth defect?

A birth defect is a problem that happens while the baby is developing in the mother’s body. Most birth defects happen during the first 3 months of pregnancy.

A birth defect may affect how the body looks, works, or both. It can be found before birth, at birth, or anytime after birth. Most defects are found within the first year of life. Some birth defects (such as cleft lip or clubfoot) are easy to see, but others (such as heart defects or hearing loss) are found using special tests (such as x-rays, CAT scans, or hearing tests). Birth defects can vary from mild to severe.

Some birth defects can cause the baby to die. Babies with birth defects may need surgery or other medical treatments, but, if they receive the help they need, these babies often lead full lives. 

Q. What causes birth defects? 

We do not know what causes most birth defects.  Sometimes they just happen and are not caused by anything that the parents did or didn't do.  Many parents feel guilty if they have a child with a birth defect even if they did everything they could to have a healthy child.  If you have a child with a birth defect, it might be helpful to talk with other parents who have had a child with the same condition. Sometimes the causes of birth defects are figured out after the baby is born.  Whenever possible, it is important to know what you can do for a better chance of having a healthy child in the future.  Some actions might increase the chances of having a baby with a birth defect. 

ALCOHOL: Prenatal exposure to alcohol can cause a range of disorders, known as fetal alcohol spectrum disorders (FASDs). One of the most severe effects of drinking during pregnancy is fetal alcohol syndrome (FAS). FAS is one of the leading known preventable causes of mental retardation and birth defects. If a woman drinks alcohol during her pregnancy, her baby can be born with FAS, a lifelong condition that causes physical and mental disabilities. FAS is characterized by abnormal facial features, growth deficiencies, and central nervous system (CNS) problems. People with FAS might have problems with learning, memory, attention span, communication, vision, hearing, or a combination of these. These problems often lead to difficulties in school and problems getting along with others. FAS is a permanent condition. It affects every aspect of an individual’s life and the lives of his or her family. All FASDs are 100% preventable—if a woman does not drink alcohol while she is pregnant.

SMOKING: A woman who smokes while she is pregnant has a greater chance of having a premature (early) birth, a small baby, or a stillborn baby.  If the mother smokes while pregnant, there is also an increased risk of the baby dying during the first year of life.  Some types of birth defects have been linked to the mother’s smoking.  Birth defects that may be increased when the mother smokes include:  cleft lip, cleft palate, clubfoot, limb defects, some types of heart defects, gastroschisis (an opening in the muscles of the abdomen that allows the intestines to appear outside the body), and imperforate anus (there is no opening from the intestines to the outside of the body to allow stool or gas to be passed).  Talk with your health care provider about ways to help you quit smoking if you are pregnant or can get pregnant.  

DRUGS: Women who use illegal drugs, or “street drugs,” can have babies who are small, premature, or have other health problems, such as birth defects.  Women who use cocaine while pregnant are more likely to have babies with birth defects of the limbs, gut, kidneys, urinary system, and heart.  Other drugs, such as marijuana and ecstasy, may also cause birth defects in babies. Women should not use street drugs while they are pregnant.  It is also important that women not use street drugs after they give birth because drugs can be passed through breast milk and can affect a baby’s growth and development.  Talk with your health care provider about ways to help you quit using street drugs before you get pregnant.

VACCINES: The MMR is a vaccine for measles, mumps, and rubella.  If a woman gets one of these viruses while pregnant, it may cause her to have a miscarriage or to have a baby with birth defects.  The MMR, like some other vaccines, is made with viruses that are alive but very weak.  Because these viruses are alive, there is a very slight chance that they may cause harm to the baby.  For this reason, a woman who may be pregnant should not get an MMR or other vaccine unless she is at high risk of getting a serious illness without it.  She should talk about the risks and benefits of getting the vaccine with her doctor.  A woman who has just gotten the vaccine and then learns she is pregnant should also talk with her doctor.  Vaccines such as those for tetanus and hepatitis are made from dead viruses or parts of dead viruses and do not cause infection in the mother and should not harm the fetus.  

Birth defects happen before a baby is born.  Inherited or genetic factors; things in the environment, such as smoking or drinking alcohol or not getting enough folic acid; and a woman’s illness during pregnancy can cause birth defects.  Most birth defects happen in the first 3 months of pregnancy, when the organs of the baby are forming.  This is the most important stage of development.  However, some birth defects happen later in pregnancy.   During the last six months of pregnancy, the tissues and organs continue to grow and develop.

Some birth defects can be found before birth.  If you want to know more about your risk of having a baby with a birth defect, contact a genetic counselor.

 

How Journalists use People with Disabilities

[pic] Center Study Looks At Coverage



"Print journalists are much more likely to use people with disabilities as examples in their news stories than as sources."

This is one of the major findings in the study "News Coverage of Disability Issues," a study done to determine how agenda-setting U.S. news media cover disability issues. As part of the NIDRR funded project to get mass media coverage of disability research, the Center examined news coverage of disability issues in major news outlets during a two-month period in the fall of 1998.

"Almost 70 percent of the stories concerning disability "had no identifiable source with a disability in it," reports study author Beth Haller. While this could simply mean that journalists are "not identifying the disability status of sources," said the report, this is unlikely since reporters tend to identify the "status" of sources. What's more likely, writes Haller, is that journalists are not using people with disabilities as sources; in any case, the sources are not identified as being with any disability organization.

The finding suggests that people with disabilities, "while not ignored, are not in control of disability-related coverage," said the report. In the list of sources used in stories in agenda-setting media, "national disability organizations were largely missing." "The message that may be getting to the public" is that "people with disabilities can't speak for themselves."

People with disabilities were more likely to be used as news sources on local stories than national stories.

The most surprising finding from the quantitative part of the study is the conspicuous link between disability issues and education and children in the print stories. Several common sense reasons contribute to this. First, the study collected stories from October and November, when all U.S. schools are in session. Secondly, mandatory public education is a prominent feature of American society and has been for decades, and each U.S. newspaper, no matter how large or small, traditionally covers education and schools as part of their geographic community. Thirdly, inclusive education for children with disabilities has been a major focus for local disability activists and parents of children with disabilities since the Individuals with Disabilities Education Act (IDEA) became law.

The fact that the print media are finally covering education issues related to disability is of major importance. One question answered by this study is how they are covering it. And many times they are writing stories that have no person with a disability as a source.

Print journalists are much more likely to use people with disabilities as examples in their news stories rather than as sources. In addition, people with disabilities were much more likely to be sources in feature stories, rather than news stories, which means they may not have been used as sources on more hard-hitting issues. This has implications for the message that may be getting across to the general public: That people with disabilities can't speak for themselves. This is obviously untrue, but that is the impression that might be left in the minds of readers.

Also of concern is the finding that so few women with disabilities are involved in news stories about disability issues. This is especially problematic given the fact that there are slightly more females than males in the United States in general, and that women continue to be prominent in education-related jobs. Yet, women and girls with disabilities are largely ignored.

However, people with disabilities and local disability organizations did have a "voice" in disability-related stories. People with disabilities or their families were most often sources in the stories, which is a very good sign. Local disability organizations were also often sources in 10% the stories. The disability groups that were largely missing from the coverage were national disability organizations, which is a somewhat unexpected finding because the newspapers and news magazines used in the print study are the largest in the United States and many consider themselves to be "national" newspapers. The journalistic practice of localizing stories may have accounted for this lack of national disability sources.

But because numerous studies have shown that the news media heavily relies on government sources and "expert" sources, their lack of contact with the major disability experts in America is cause for concern. Experts affiliated with NIDRR, the Society for Disability Studies, or the World Institute on Disability could have commented on many of the topics covered by the news stories, but journalists don't seem to know they exist.

From the Recommendations:

-- In terms of news stories, disability-related organizations need to stick to the slogan on the disability rights poster: "Nothing about us, without us." This study shows that journalists do know to use people with disabilities in stories about disability issues because they are used as sources in about 30% of the articles. But the disability "side" of the story should be in every story that includes those issues.

--. With the obvious media and public interest in education issues, disability and education spokespeople need to actively work together to get correct information about these issues into the news. As found previously in the study of ADA coverage, other groups can work against laws preventing discrimination against people with disabilities and their side of the story may be given equal credence. For example, people who are against inclusive education -- even schools and parents -- may actively seek to turn the news discourse into one about inclusive education being "bad." Disability organizations must be pro-active in controlling the news agenda on this and other topics about disability issues.

-- Disability topics are part of the multicultural discourse that needs to be entering the journalistic marketplace of ideas. Disability organizations should be aggressive and not wait for journalists to decide it's time to do a story. They should actively pitch serious story ideas.

For example, before a major Supreme Court decision is even handed down, disability organizations should show journalists the implications of the case in their local community. Normally, journalists will do this story anyway, but the disability focus will be stronger if disability sources intervene as early as possible.

-- In suggesting print stories, disability organizations need to plug into current print media norms of featurizing stories and localizing stories. Because of today's information overload among news audiences, the public's relationship to different media has been changing. People tend to watch TV for spot news, and those who want to know more about the issues in-depth read newspapers and news magazines. People who make an effort to keep up with the news are the opinion leaders, so disability organizations need to get correct information about the issues before them by getting into the major print news media.

-- In terms of television, disability organizations should focus on getting more stories onto the evening news because it is the number one news source in the United States. They should also work on creating non-stigmatizing sound bites that can get into disability-related stories because there is not the opportunity to go into the issue in-depth.

The longer the TV story, the more need for the program to be entertaining and provocative to hold viewers' attention. Therefore, the longer format has more potential to perpetuate stigma. TV news magazines, which are a more recent media phenomenon that fit somewhere between TV spot news and print news magazines, have an "infotainment" focus that has the potential to do double damage if not managed properly. They look to Supercrips as sources and as subjects of stories because they fit with the "infotainment" format. These news magazine segments can give lengthy, in-depth, possibly incorrect, disability information in a visually compelling and potentially stigmatizing format. In contrast, a TV news story has less chance to stigmatize or give incorrect information because it usually lasts only 30 seconds to 2 minutes.

Disability organizations need to get the names of their expert sources into the hands of TV news producers and prominent print journalists. Most journalists and producers don't even know the names of national disability groups or national disability experts. In contrast, they do know national business experts or national education experts. Disability experts must be equally as prominent. However, disability expert sources should be trained so as to avoid being turned into a Supercrip on camera. It is crucial that the issues, not a person, be the subject of the stories.

Links below online at :

News coverage of disability issues: report

Oscar nominees stir protest from disability rights advocates

Prize-winning news coverage confuses disability with tragedy

Guidelines on reporting and language

Center's Study on News Coverage

7/17/2001 E-letter: 'Homebound rule' coverage the work of disability columnists in nation's newspapers

7/10/2001 E-letter: Inspiring 'overcomer' stories are newsroom cliches

6/5/2001 E-letter: Casey Martin victory coverage is mixed

12/19/2000 E-letter: Looking back at year's media coverage of disability issues

12/12/2000 E-letter: News coverage causes both problem and solution

11/28/2000 E-letter: De-institutionalization: do reporters know it's a trend?

11/21/2000 E-letter: Getting it right -- and not getting it at all

1/23/2001 E-letter: Wendland case coverage 'one-sided,' charges attorney

Books Available online: [pic][pic] [pic]

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BEYOND THE AP STYLEBOOK

Language and Usage Guide for Reporters and Editors

copyright 1992 The Advocado Press, Inc.

INTRODUCTION

The 1987 edition of the Associated Press Stylebook for the first time contained an entry under "handicapped." The appearance of the category was the result of work by disability organizations -- primarily the Research and Training Center on Independent Living at the University of Kansas -- to change the way in which reporters and editors wrote about disability.

The Stylebook was a start. Since then, many disability organizations have produced sets of guidelines for avoiding demeaning and sensationalized words and phrases when writing about people with disabilities. The fact that so many groups see this as an area for concern should alert journalists to the fact that the way they use words does matter. Two simple rules should be kept in mind when writing stories about people who have disabilities:

1. Avoid cliches and cliched constructions.

2. Use "value-neutral" terms and constructions. Don't interject your admiration -- or pity -- into your story.

A GROUP -- AND ITS TERMINOLOGY -- IN EVOLUTION

People with disabilities do not agree on the best terms to use in describing themselves. In this they are similar to other minorities who did not settle on what they were to be called until their movement gained some prominence in the press. People who we once called "colored" or "Negro" we next called "black" and are now often referring to as "African-American." Until recently, the term of choice was "black." "Black" itself became accepted terminology only during the "black power" days of the Civil Rights movement. Prior to that, the "correct" term had been "Negro." "Colored" was also used. Years ago, of course, "nigger" was also used.

Today the word "nigger" is taboo. Yet, we know that some African-Americans will use the term "nigger" among themselves. We know, however, that the press is not to use it. And we adhere to that rule. We also know that some African-Americans, particularly elderly African-Americans, refer to themselves as "colored" or "negro." Yet we do not then use either of these terms in writing about them. The term still used by the news media often is "black" -- although "African-American" is replacing it.

The disability community is still in the process of deciding how to refer to its members. Many new terms are being tried out. Some disabled people are beginning to refer to themselves as "physically challenged" or "handicapable" or "inconvenienced"; others continue to refer to themselves as "victims" or "crippled." However, none of these terms is acceptable usage for news media.

"DISABLED" AND "DISABILITY" TERMS OF CHOICE

Most people involved in disability issues today see "disabled" or "disability" as terms of choice. Many want journalists to write "person with a disability" rather than "disabled person." A number of groups issue pamphlets explaining that the "person should come first." The terms "handicap" and "handicapped" have been used in much legislation concerning disabled people. During the 1960s and early 1970s, it was the word of choice. It fell into disrepute, however, when leaders of the disability rights movement insisted it was a term coined by special education professionals and not a term the movement chose. Today, most disability groups are changing the "handicap" in their titles to "disability."

INSIDE TERMS:

Within the disability rights movement, individuals may refer to themselves as "crips," "gimps," "deafies," "paras," and "quads." These are "in" terms within the movement. While an interview subject may use them, they are still considered slang and are not ordinarily to be used by the press.

GROUP TERMS:

While many prefer that journalists use "people (or persons) with disabilities," they accept "disabled people" as a substitute. The phrase "the disabled" is not good usage. Since "disabled" is an adjective, it's important to avoid ridiculous -- and improper -- constructions such as "disabled group" or "disabled rights" or "disabled transportation." Instead, build phrases using the word "disability."

• "the disability movement"

• "the disability rights movement"

• "disability activists"

• "disability advocates"

• "disability community"

When you're writing a housing story, you refer to the people affected as "residents." When writing an election wrap-up, you use the term "voters." Use these kinds of group nouns when referring to disabled people, too, to vary the "people with disabilities" phrase. Possible terms could include:

• voters with disabilities

• disabled shoppers

• disabled travelers

• residents who have disabilities

• disabled opponents (or proponents)

Avoid terms beginning with "the" followed by an adjective, such as:

• "the disabled"

• "the blind"

• "the handicapped"

• "the retarded"

Instead, use:

• blind protesters

• deaf students

• people with head injuries

• people with disabilities

Avoid making nouns out of conditions. Don't write that someone was "a retard" or "a handicap" -- even if your interview subject uses the term in this fashion.

INAPPROPRIATE ADJECTIVES AND RIDICULOUS CONSTRUCTIONS

Frequently, one will see a term such as "handicapped parking" or "handicapped seating." The construction is incorrect. ("Disabled organization" is wrong, too.) Think through the concept to figure out a cleaner, more accurate way to express it. Some options include:

• accessible seating

• parking for disabled people

• disability organization

DISABILITY IS NOT A FATE WORSE THAN DEATH. DON'T WRITE AS THOUGH IT WERE.

The single greatest harm done disabled people in writing about them is to give them the added emotional baggage of sensationalized words and phrases describing their disabling condition. It's done so much -- and so unconsciously -- that it creeps into the ordinary language used to refer to disability conditions. Some editors will insist, for example, that disabled people are "afflicted with" AIDS or are "victims" of multiple sclerosis. Gradually, however, more individuals with disabilities are insisting the language used to describe them be emotionally neutral.

Emotionally loaded language is to be avoided. Avoid using "suffers from," "afflicted with," "bound," "confined," "sentenced to," "prisoner," "victim," or any other term or colorful phrase that conjures up tragedy.

The goal is to write about people with disabilities in a nonjudgmental fashion. Simple terms like "had polio" should replace "suffers from" or "afflicted with." "In" or "uses a wheelchair" does nicely as a replacement for "prisoner of" or "confined to." Most of the time, no term at all is needed other than, perhaps a reference, if relevant to the story, that the person "uses a wheelchair" or "is deaf."

SENTIMENTAL OR CUTE TERMS

Many trendy terms crop up that should be avoided. "Physically challenged," "inconvenienced," "differently abled" and "handi-capable" are among the more recent terms. They act as euphemisms and are best avoided. Stick to "disability" or" disabled." This also is true of terms such as "temporarily able-bodied." Stick to "nondisabled."

Many reporters and editors believe that if people have a disability, they must be heroic, courageous, inspiring, or special. These terms have become knee-jerk descriptors. Most disabled people resent having such language applied to them. Avoid referring to a person with a disability as "courageous," "heroic," "inspiring," "special," or "brave."

"OVERCOMING" "IN SPITE OF"

Many journalists -- and copy editors -- feel no story about a disabled person should be without the terms "overcame her disability" or "in spite of his handicap." Beyond being trite and overworked, these terms inaccurately reflect the problems disabled people face.

Disabled people do not succeed "in spite of" their disabilities as much as they succeed "in spite of" an inaccessible and discriminatory society. They do not "overcome" their handicaps so much as "overcome" prejudice.

Using the term "overcome" inaccurately suggests that the task at hand is for a disabled person to somehow solve discrimination by himself or herself. This is much the same as suggesting a woman act like a man or a black person overcome race and try to act more white. The concepts themselves are flawed; they should be avoided.

A "SPECIAL" NOTE

The term "special" as in "special education" has been, is, and will be used to refer to efforts made to meet group and individual educational needs. However, the term "special" has come to be used as a euphemism for segregated programs or physical facilities that are almost always inferior to what is available to nondisabled individuals. "Special" has definite negative connotations within the disability rights movement.

If you are using the term "special" to mean "separate," use "separate" instead. Instead of writing, "special buses for the disabled," write, "separate buses for disabled people." For "special handicap bathroom," write, "separate bathroom."

If you are using the term "special" to mean "disabled," use "disabled" or "disability" instead.

In general, avoid the term, except when you must refer to it as part of a title, such as Special Olympics or Department of Special Education.

IS YOUR PERSPECTIVE SHOWING?

If you get tired of using "person with a disability" and find it hard to come up with new ways to say "disabled person," ask yourself: Is any description needed at all? Sometimes journalists unnecessarily refer to disability when it is not relevant to the story. Apply the same rules you'd use covering an African-American: If there's no impelling need to discuss the disability of the person in the story, leave it out.

DON'Ts AND DOs

• Don't use "victim of," "victim," "afflicted with," "suffers from," "stricken with." Do write, "has" (or "had") if relevant to story; otherwise, don't use at all.

• Don't use "confined to a wheelchair." Do write, "in a (uses a) wheelchair."

• Don't use "wheelchair-bound," "prisoner of," "abnormal," "defective," "invalid." Use nothing; no term is needed.

• Don't use "special" bus, "special" bathroom. Do write, "separate bus," "segregated bathroom."

• Don't use "physically (or mentally) challenged." Do write, "person with a disability" or "disabled person."

• Don't use "inconvenienced." Do write, "person with a disability" or "disabled person."

• Don't use "handi-capable." Do write, "person with a disability" or "disabled person."

• Don't use "deaf-mute." Do write, "deaf"; "hearing impaired."

• Don't use "in spite of disability." Avoid the concept altogether.

• Don't use "overcame her handicap." Avoid the concept altogether.

• Don't use "handicapped parking." Do write, "accessible parking."

• Don't use "disabled seating." Do write, "seating for viewers in wheelchairs."

[pic] Ragged Edge magazine is successor to the award-winning periodical, The Disability Rag. On our website you'll find the best in today's writing about society's "ragged edge" issues: medical rationing, genetic discrimination, assisted suicide, long-term care, attendant services. We cover the disability experience in America -- what it means to be a crip living at the start of the 21st century.

[pic]The ELDERLY In America [pic]

At the last turn of the century, people over 65 made up about four percent of the population– around 3.1 million out of 75 million. The median age of the population then was just under 23 years. Today there are more than 30 million Americans over the age of 65, representing 12.1 percent of the population. Thus, while the general population has about tripled in size, the group over 65 has increased nearly tenfold. ( )

It is the fastest-growing segment of the American population.

Data Highlights

[pic]70 percent of home health care patients were ages 65 and older.

[pic]Medicare was the primary payment source for most home care patients (52 percent), followed by Medicaid (20 percent) and private sources (17 percent).

[pic]Heart disease (11 percent), diabetes (8 percent), cerebral vascular disease (7 percent), COPD (5 percent), malignant neoplasms (5 percent), congestive heart failure (4 percent), osteoarthritis and allied disorders (4 percent), fractures (4 percent), and hypertension (3 percent) are among the most prevalent admission diagnoses for home health care patients.

[pic]Most patients received medical/skilled nursing services (75 percent), followed by personal care (44 percent) and therapeutic (37 percent) services.

[pic]Over half of home care patients received help from the agency with at least one activity of daily living (ADL) (51 percent); of those patients receiving help with ADLs, 83 percent received help with bathing or showering.

[pic]Average length of service since admission was 312 days; patients with an admission diagnosis of pneumonia had the shortest length of service (111 days), whereas patients with essential hypertension had the length of service (515 days).

Approximately 1,355,300 patients were receiving home health care services from 7,200 agencies at the time of the 2000 NHHCS. Between 1990 and 1996, home health care was the fastest growing segment of the health care industry with expenditures for these services more than doubling, increasing from $13 to $30 billion.

During the mid 1990’s concerns about inappropriate and fraudulent use and the rapidly growing aging population spurred the Centers for Medicare and Medicaid Services (CMS), the major funding source for home health care, to implement major cost-containment strategies to curtail escalating Medicare costs.

More info - Trends on Health and Aging:

[pic] Elder Care Terminology

Primary caregiver–is an individual or organization that is responsible for providing personal care assistance, companionship, and/or supervision to the patient.

Home health care–is provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health or for maximizing the level of independence while minimizing the effects of disability and illness, including terminal illness.

Hospice care–is a program of palliative and supportive care services providing physical, psychological, social, and spiritual care for dying persons, their families, and other loved ones. Hospice services are available in both the home and inpatient settings. Home hospice care is provided on part-time, intermittent, regularly scheduled, and around-the-clock basis. Bereavement services and other types of counseling are available to the family and other loved ones.

Some 86 percent of hospice patients died in hospice care in 2000; the rest were discharged for other reasons such as transferred to other health facilities, recovered or stabilized, or left when private insurance coverage ended.

[pic]There were 621,000 discharges from hospice care in 2000.  Most patients were elderly, white, and lived in a private or semiprivate residence while receiving hospice services.  Most lived with a relative who was the primary caregiver.

[pic]Cancer remains the most common primary diagnosis for those discharged from hospice, but the proportion decreased from 75 percent in 1992 to 58 percent in 2000.  Other primary diagnoses for recipients of hospice care are heart disease, dementia, cerebrovascular disease and chronic obstructive pulmonary disease.  

[pic]Hospice patients usually receive a high level of care.  Three-fourths of patients were seen by three or more providers during the 30 days before discharge and 85 percent received three or more services.

[pic]Seven out of 10 patients receive help with one or more activity of daily living (such as bathing, dressing or eating).  About 70 percent were incontinent, four out of five had mobility limitations, and half used oxygen.

Medicare–is the medical assistance provided in Title XVIII of the Social Security Act. Medicare is a health insurance program administered by the Centers for Medicare and Medicaid Services for persons 65 years and over and for disabled persons who are eligible for benefits.

Medicaid–is the medical assistance provided in Title XIX of the Social Security Act. Medicaid is a Federal/State administered program for the medically indigent.

Primary expected source of payment–is the one payment source expected to pay the greatest amount of the patient's charges.

[pic]Private insurance, own income, or family support–includes private health insurance (health maintenance organization, independent practice association, preferred provider organization), family income, Social Security (including Supplemental Security Income), retirement funds, or welfare. It does not include Veterans Administration (VA) contracts, pensions, or other VA compensation.

[pic]Medicare–is money received under the Medicare program for home health care and may be obtained through fee-for-service Medicare or Medicare health maintenance organization (HMO). Medicare is a health insurance program for people 65 years of age and over, some disabled people under 65 years of age, and people with end-stage renal disease (permanent kidney failure treated with dialysis or a transplant).

[pic]Medicaid–is money received under the Medicaid Program for home health care and may be obtained through fee-for-service Medicaid or Medicaid HMO. Medicaid provides medical assistance for certain individuals and families with low incomes and resources. Medicaid eligibility is limited to individuals who fall into specific categories. Although the Federal government establishes general guidelines for the program, Medicaid requirements are established by each State. Whether a person is eligible for Medicaid will depend on the State of residence.

[pic]All other sources–includes religious organizations, foundations, Veterans Administration contracts, pensions, or other VA compensation, and other military medicine. This category also includes no charges for care, payment sources not yet determined, and unknown sources.

Activities of daily living–refers to six activities (bathing, dressing, transferring, using the toilet room, eating, and walking) that reflect the patient's capacity for self-care. The patient's need for assistance with these activities is measured by the receipt of help from agency staff at the time of the survey (for current patients) or the last time service was provided prior to discharge (for discharges). Help that a patient may receive from persons that are not staff of the agency (for example, family members, friends, or individuals employed directly by the patient and not by the agency) is not included.

Instrumental activities of daily living–refers to six daily tasks (light housework, preparing meals, taking medications, shopping for groceries or clothes, using the telephone, and managing money) that enables the patient to live independently in the community. The patient's need for assistance with these activities is measured by the receipt of help from agency staff at the time of the survey (for current patients) or the last time service was provided prior to discharge (for discharges). Help that a patient may receive from persons who are not staff of the agency (for example, family members, friends, or individuals employed directly by the patient and not by the agency) is not included.

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Studies Analyze Elderly Use of Television

Research conducted over the last 20 years offers a number of theories about the relationship between older people and TV.

• Television viewing does go up after age 50. Physical limitations related to advancing age help to explain why, according to several studies. Older people experiencing problems with seeing or hearing (which afflict at least 20 percent of people over 65) find television easier to deal with, since it provides both verbal and visual information together. Thus they may turn to it when sensory loss begins to discourage use of radio and/or print.

• Several researchers have suggested that television replaces lost social contacts for older viewers, helping them maintain an ongoing sense of participation in society and combat feelings of alienation and loneliness. A 1974 study (M. Graney) developed a theory of activity "substitution" or "compensation," which sees heavier media use as a means of compensating for financial, social and physical losses people experience as they age. According to the behavior exchanges they postulate, decreases in the ability to read and lower attendance at religious services and organizations both lead to increased TV viewing.

• Many researchers suggest increased television viewing by older people as a sign of disengagement from the world; others see it as an attempt to remain in touch. And the process is not a neutral one. The negative stereotypes of aging seen on some television programs may actually hasten withdrawal by promoting lower self-esteem, according to a study by F. Korzenny and K. Neuendorf (1980). Characterizations that depict seniors as "assets" or "hindrances" to society tend to promote self concepts that match the portrayals, research showed.

How does Hollywood Handle Ageism?



"Between 1969 and 1980 only one percent of network shows featured characters 65 and older. Their omission apparently reflects the sentiment of a market-based, productivity-obsessed culture. Since the elderly are seen as past their prime as productive employees and consumers, they are no longer important enough to dramatic social life to merit major dramatic roles or be used as positive role models in advertisements."

— Lawrence A. Powell and John B. Williamson

[pic] Hollywood & The Elderly

A conversation with two industry veterans: Dorothea and Dan Petrie

Editor's Note: Is there ageism in Hollywood? According to a recent report by the Writers Guild of America on employment trends in the mid-1980s, the preference for youthful writers, directors and producers may be increasing even as movies and television feature more older people as primary characters.

In the following interview, Media&Values talks with Dorothea and Daniel Petrie, a Hollywood couple who are both well-known for their production savvy and topflight direction and production credits. Dorothea Petrie produced, among other projects, Foxfire, Love Is Never Silent and Picking Up the Pieces. Daniel Petrie's most recent directorial credits are Cocoon II: The Return, Rocket Gibraltar and Square Dance. In this discussion they ponder the issue of ageism and the influence of maturity on the movies and television we see.

Dorothea: You do sometimes hear, "We'd prefer someone younger for this project," but usually it's more subtle than that. In my opinion, it often seems that younger writers, directors and producers are more comfortable working with people their own age. Sometimes younger people doubt that their seniors are up on what's happening. Often, however, they're uncomfortable about exercising authority over someone older. It's easier to work with your same age peers.

Daniel: When started out years ago, I remember that too many people were telling me, "Listen, kid, I've been in the business for 25 years, and therefore I know." Just because we've been working longer doesn't mean we're necessarily wiser or more intuitive.

Dorothea: But it does mean that we've faced a number of situations that younger people may not have had the opportunity to work through. On the other hand, I'm aware that I'm not always perceived as current as perhaps a younger producer would be. But different ages, working together, can strike a remarkable balance. I'd like to feel that's why younger executives, directors and crews enjoy working with me. I add a value to a project that can't be bought.

Daniel: Yes, the experience of all stages of life are valuable, not just of youth. The projects I've worked on are about people, not about people of a certain age. But I do feel that the trend is away from ageism and toward a recognition that older people have a unique voice.

Dorothea: That's not to deny that identifying a creative person as older can be restricting. I never answer the question: "How old are you?" — not because I want to deny my years, but because I do not believe numbers reflect age. But numbers do reflect a perception, and that perception may be limiting. I don't believe in limitations at any age.

Daniel: I had that feeling about directing Cocoon II: The Return. At first I wasn't too interested because it was a sequel. Then I read the script and was excited by the relationships and its mystic quality. The first Cocoon posited the idea that it was desirable to escape age and death. The second film questions that and deals much more directly with the value of living in the real world with its trials and tribulations. I would say it's about that and not about aging or death.

Dorothea: Those ideas about human values are also what I look for in a property. Anything that deals with the human condition is of interest. We all grow old, but it's the issues of maturity and not the physical process of aging that relates to our development as human beings.

Daniel: There has been a change in attitude, though. For example, when the first Cocoon came out Twentieth Century Fox issued an edict: "No pictures of old people." Advance publicity focused on the grandson and the other younger characters. They were flabbergasted when they discovered how interested everybody was in 'those old people.' And now many upcoming projects feature older people; it's become a trend.

Dorothea: Of course, I hope that trend will continue. The attitude regarding age isn't new. I remember 25 years ago hearing, "Good heavens, if you want to lose your audience, do a story about old people." But with Cocoon and Foxfire we've seen what an audience a story about older people can generate.

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Attacking Ageism in Advertising



At AARP, Senior Stereotypes Give Way to Active Advertising

By Robert Wood

An advertisement for a calcium dietary supplement, recently seen in numerous national magazines, depicts a woman's silhouette frame by frame as she moves rightward across a page. She is apparently aging before our eyes, growing progressively older and more stooped as she succumbs to osteoporosis. By the last frame she needs the support of a cane.

Another ad, obviously directed to the over-50 age group, pictures a stereotypical white-haired old lady leaning out of a car window and holding a glass of dark liquid. The headline reads: 'Prune Power To Go." Accompanying copy describes the virtues of a prune product in dealing with a failing digestive system.

Both ads reflect the lack of respect and fear of aging – in short, the ageism – typical of the media's treatment of older people. For years, until The Golden Girls and Murder, She Wrote began to buck the trend, advertising and entertainment media alike reflected the prevailing stereotype of seniors as bumbling, crotchety or senile. With perpetual frowns on their faces, the older people in shows and commercials lived only to criticize younger people and nurse their aches and pains.

These advertisements have something else in common. Neither would be accepted for the advertising schedule of Modern Maturity. Although only formulated in 1982, our extremely strict advertising policy is rooted in Modern Maturity's history as a major communication arm of the American Association of Retired Persons (AARP).

Staying Active

Founded in 1958 by Dr. Ethel Percy Andrus, a retired teacher and high school principal who also formed the National Retired Teachers Association and AARP, the magazine's positive, enlightened tone toward aging reflects her emphasis on urging older Americans to be active in society, to be committed to the future and to lead lives of independence, dignity and purpose. As the most prominent magazine for seniors, and now the largest circulation magazine in the United States, Modern Maturity has long recognized that its readers, all 19.4 million of them, comprise a vital and productive segment of our population.

"Instead of a message that says, 'I feel terrible, give me product X,' we welcome ads that say, 'I feel great with product X.'"

– Modern Maturity advertising standards

Older people are not a homogeneous group. They are as economically, socially and politically diverse as any other segment of our population, comprising sick and well, rich and poor, dynamic and depressed, all stripes of society, and they deserve to be portrayed that way, not shown as stuck in the mud, or in a wheelchair, or rocking and whittling, when in fact some may be rocking and rolling. Today, when we go over the river and through the woods to Grandmother's house, Grandma may not be awaiting us sweetly with a big plate of cookies fresh from the oven. She may be working on the computer, or taking a psychology class, or holding down the late shift at the cannery.

As a general interest publication, Modern Maturity is written for, not about, this diverse and energetic elderly population. Issues crammed full of lavishly illustrated articles on current affairs, travel, art, health, fitness, literature and personal finance reflect the variety and breadth of this age group's interests. This positive outlook is mirrored in our advertising.

In keeping with our long-term editorial philosophy are the strictest advertising guidelines of any publication we've heard of. In fact, the magazine's advertising department turns down 35 to 40 percent of the ads submitted for publication, mostly because we consider them downers, or ageist, or because the ad message tends to pigeonhole older people in some way.

For example, ads for wheelchairs, back braces, tub lifts, page magnifiers and many other products whose makers aim "to remedy the aches and pains of aging" are forbidden. The reasoning? Aging is not necessarily about aches and pains. Aging is about living.

The guidelines also focus on ad layouts and art; we try to persuade advertisers to make ads aimed at the older population as attractive and appealing as those directed at any other age group. Luckily for us, many advertisers are seeing the point and working with us. Unfortunately, many of the image creators in the media and at the ad agencies haven't caught on yet. They still imagine older people as old coots and crones, deaf to today's reality and lost in mumblings of the good old days of Calvin Coolidge – or immersed in their physical complaints. Most ad people haven't picked upon the dramatic demographic revolution that's taking place in our country. Truly, we are witnessing a change as profound as the one that shook America 25 years ago, when baby boomers started flexing their economic muscle.

At the last turn of the century, people over 65 made up about four percent of the population– around 3.1 million out of 75 million. The median age of the population then was just under 23 years. Today there are more than 30 million Americans over the age of 65, representing 12.1 percent of the population. Thus, while the general population has about tripled in size, the group over 65 has increased nearly tenfold. It is the fastest-growing segment of the American population.

"People age 50 and over represent a huge, many-faceted public, which to many advertisers represents a new target market spanning (depending on how you view it) three or four generations of men and women, every ethnic group and income level and all walks of life."

– Modern Maturity advertising standards

Modern Maturity is upbeat about older people, and as part of AARP is trying hard to educate everyone about the realities and opportunities of aging. To help educate advertisers, the magazine has created and distributed guidelines for How To Advertise to Maturity (see below). Its goal is to help develop positive advertising communications to people age 50 and over. We dedicated it to "understanding the millions of mature Americans who are active, involved and eager for new experiences."

In contrast to the advertisements described at the beginning of this article, one ad that we recently accepted with great delight pictured a sleek white convertible Mustang. It looks like almost any other automobile advertisement until the reader hits the tag line: "Just when the kids had you all figured out." Now that's a refreshing line. Another ad that could have been mundane, but wasn't, sports the headline "Cure baldness." The visual pictures two vanilla ice cream cones– one naked, the other with a sprinkling of wheat germ. It's a funny and inspiring way to suggest that readers eat more wheat germ to promote good health.

As the population ages, many members of the media may find, as we have, that respect for the humanity of the aging makes good business sense. But much more importantly, they will also find that they can enrich the stories their commercials and programs tell by recognizing the humanity and diversity of older characters. For whether or not it is true that "growing older is growing better," it is clear that people don't lose individuality as they grow older. Instead, they become ever more themselves, and that is one of the beauties of age.

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[pic] How to Advertise to Maturity

• Don't make a long story short: older people like to have plenty of product information on which to make a decision.

• Take 15 years, at least, off your target age group: people tend to report that they feel younger than their chronological age.

• Don't put them all on a diet: most older people eat the same foods as anyone else, and many have cooked nutritious food for years.

• Keep a sense of humor: more time to relax means more time to smile.

• Don't take the romance out of life: there may be more time for it.

• Plan for their future: life is continuing, not rushing toward its close.

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Find out more online. Links listed below are available at:

|Coming of Age: |Issue #45 |

|Media and the Mature Audience |Winter 1989 |

|[pic] |[pi|Exploring the Theme |

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| | |•    |

| | |STARTING POINT: It's not the same old story. |

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| | |Lifeline or Leisure? |

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| | |Video Visits Help Families Say 'I Love You' |

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| | |•    |

| | |Studies Analyze Elderly Use of Television |

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| | |•    |

| | |Producer's Lament: Bottom Line Still Tops |

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| | |•    |

| | |How does Hollywood Handle Ageism? |

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| | |Going for the Gold: The Golden Girls are a Hit! |

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| | |•    |

| | |Attacking Ageism in Advertising |

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| | |•    |

| | |TVs Dark Vision Can Be Frightening to Elders |

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| | |Reflection / Action |

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| | |How to Watch Television with Your Grandchildren |

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| | |CHILDREN: Media Help Fill Grandparent Gap |

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| | |PASTORING: Senior Productions Raise Self-Esteem |

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| | |ADVOCACY: TV Still Sidesteps Real Life Struggles |

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| | |FAMILY: Oral Histories Harvest Family Heritage |

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| | |•    |

| | |WOMEN: Evaluating the Portrayal of Older Women Characters |

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