Chapter 001

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 1

The Aging Population

Chapter 1

The Aging Population


IntroductionIntroduction

• Myths of aging

• Misinformation as an injustice

• Role of the gerontological nurse:

– Know the facts

– Educate the public


Views of Older Adults Through HistoryViews of Older Adults Through History

• Current older population:

– Positivism, intelligence, concern

• Historically:

– Age of Confucius, Taoism, Ancient Chinese, Early Egyptians, Greeks, Aristotle, Ancient Romans, Dark Ages, Middle Ages, and Medieval Times


Improvements for Older Adults Improvements for Older Adults

• 1914: Dr. I. L. Nascher—“Father of Geriatrics”— first geriatric textbook

• 1935: Federal Old Age Insurance Law under the Social Security Act

• 1965: formation of the Administration on Aging, Older Americans Act, Medicare, and Medicaid

• Continued growing concern for older adults


QuestionQuestion

• Is the following statement true or false?

The first significant step in improving the lives of older adults during the 20th century was the publication of the first geriatric textbook in 1914.


AnswerAnswer

False.

The first significant step in improving the lives of older adults was the passage of the Federal Old Age Insurance Law under the Social Security Act in 1935.


Subsets of the Older Adult PopulationSubsets of the Older Adult Population

• Young-old

• Old-old

• Middle-old

• Centenarians

• Diversity rather than homogeneity


Population Growth and Increasing Life Expectancy

Population Growth and Increasing Life Expectancy

• Persons 65+ currently represent more than 12% of the U.S. population

• By the year 2020 older adults will grow to 17% of the population

• Increasing life expectancy:

– 1930: 59.7 years

– 1965: 70.2 years

– Present: 77.8 years


Factors Influencing Increased Life Expectancy

Factors Influencing Increased Life Expectancy

• Advancements in disease control and health technology

• Lower infant and child mortality rates

• Improved sanitation

• Better living conditions


Life Expectancy: Race and GenderLife Expectancy: Race and Gender

• Gap between white people and black people

– Societal issues

– Concern for nurses

• Gap is narrowing between males and females


Marital Status and Living ArrangementsMarital Status and Living Arrangements

• Older women are more likely than men to be married

• Most older adults live with a spouse or other family member

• More women than men live alone

• Potential for living alone increased with age

• Most older adults have family contact


Geographic DistributionGeographic Distribution

• States with the greatest number of older adults: California, Florida, New York, Texas, and Pennsylvania

• States with dramatic increases in the past decade: Nevada, Alaska, Hawaii, and Arizona

• States with the lowest percentage of total population over age 65: Alaska, Utah, and Georgia


Income of Older AdultsIncome of Older Adults

• 10% of older adults live below the poverty level

• Older adults dependent on Social Security for more than half of their income

• Median net worth is twice the national average related to home ownership

• “Asset rich and cash poor”

• Women and minority groups are poorer than white men


QuestionQuestion

“Asset rich and cash poor” relates to which of the following statements related to older adults?

a.Net worth of older adults is half the national average of middle-age adults

b.Homes are paid for but there is not enough money available for monthly expenses

c. The majority of older adults live below the poverty level

d.Financial problems in the older adult population are due to level of debt


AnswerAnswer b. Homes are paid for but there is not enough

money available for monthly expenses

Median net worth of older households is nearly twice the national average because of the high prevalence of home ownership, but many older adults are “asset rich and cash poor”; they live in a house that has appreciated in value over the years, but they barely have sufficient monthly income to meet basic expenses.


Employment and the Older Adult PopulationEmployment and the Older Adult Population

• Declining percentage of workers in the labor force

• Men leaving the workforce at an earlier age

• Increase in the number of middle-aged women who are employed

• Increased desire to work at the age of retirement


EducationEducation

• Increasing levels of education in the older adult population

• Advanced degrees and higher income

• Impact on health care:

– Older adults will be more informed consumers


Health Status of Older Adults: Acute Conditions

Health Status of Older Adults: Acute Conditions

• Fewer acute illnesses

• Lower death rates

• Longer period of recovery

• More complications


Health Status of Older Adults: Chronic Conditions

Health Status of Older Adults: Chronic Conditions

• Major problem that increases with age

• Most have at least one chronic disease; many have several

• Result in limitations in ADLs and IADLs

• Leading cause of disability and death


QuestionQuestion

• Is the following statement true or false?

Chronic disorders most prevalent in the older adult population are ones that can have a significant impact on independence and the quality of life.


AnswerAnswer

True.

Chronic illness is a major problem for the older population and results in limitations in ADLs, IADLs, and quality of life.


Implications of an Aging PopulationImplications of an Aging Population

• Impact on health and social service agencies

• Need for gerontological nurses

• Future needs

• Payment of services

• Impact and characteristics of the “baby boomers”


WHAT MAKES A BABY –BOOMER??WHAT MAKES A BABY –BOOMER??

• NEXT WAVES OF INCOMING SENIORS

• HIGHLY DIVERSE

• EXAMPLES - BILL GATES, BILL CLINTON, CHER, BONO


CHARACTERISTICS OR BABY BOOMERSCHARACTERISTICS OR BABY BOOMERS

• FEWER BIOLOGICAL CHILDREN TO ASSIST

• BETTER EDUCARED THAT PREVIOUS GENERATIONS

• HIGHER HOUSEHOLD INCOMES (MOST A 2+ INCOMES)

• LESS FORMAL DRESS CODES

• COMPUTER SAVVY

• < LEISURE /FREETIME EQUALS GREATER #’S EXPEREINCING STRESS

• MORE LIKELY TO EXERCISE (these group invented the fitness movement)


Provision and Payment of ServicesProvision and Payment of Services

• Higher rates of hospitalization, surgery, and physician visits

– Paid by federal dollars most often

• Less than 5% of older adults live in a nursing home, assisted living, or other institutions

• Long-term care payment

• Role of the gerontological nurse

Chapter 001

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