Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 1
The Aging Population
Chapter 1
The Aging Population
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
IntroductionIntroduction
• Myths of aging
• Misinformation as an injustice
• Role of the gerontological nurse:
– Know the facts
– Educate the public
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
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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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Subsets of the Older Adult PopulationSubsets of the Older Adult Population
• Young-old
• Old-old
• Middle-old
• Centenarians
• Diversity rather than homogeneity
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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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
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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
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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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
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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
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
True.
Chronic illness is a major problem for the older population and results in limitations in ADLs, IADLs, and quality of life.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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”
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WHAT MAKES A BABY –BOOMER??WHAT MAKES A BABY –BOOMER??
• NEXT WAVES OF INCOMING SENIORS
• HIGHLY DIVERSE
• EXAMPLES - BILL GATES, BILL CLINTON, CHER, BONO
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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)
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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
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