Chapter 1 The Aging Population

1. Chapter 1The Aging Population

2. Introduction • Myths of aging • Misinformation as an injustice • Role of the gerontological nurse: • Know the facts • Educate the public

3. 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

4. Subsets of the Older Adult Population • Young-old • Old-old • Middle-old • Centenarians • Diversity rather than homogeneity

5. 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

6. Factors Influencing Increased Life Expectancy • Advancements in disease control and health technology • Lower infant and child mortality rates • Improved sanitation • Better living conditions

7. Life Expectancy: Race and Gender • Gap between white people and black people • Societal issues • Concern for nurses • Gap is narrowing between males and females

8. Marital 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

9. Geographic 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

10. Income 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

11. Employment 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

12. Education • 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

13. Health Status of Older Adults: Acute Conditions • Fewer acute illnesses • Lower death rates • Longer period of recovery • More complications

14. 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

16. Implications 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”

17. Provision 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