Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 24 Older Adults: Aging in Place

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Status of Older Adults Growth in number and proportion of older adults living in the U.S.; projected to reach almost 20% of population by 2030 Increased demands on public health system, medical and social services, and health care delivery Chronic disease contributes to disability, diminished quality of life, and increased health care costs Globally: –Number of adults over age 65 is expected to reach 1.4 billion by 2050 –Those over age 80 years are growing faster than any other group

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Status of Older Adults (cont.) Nationally: –Increased life expectancy (females > males) –Older adults are healthier than ever before Hearty elderly Young-old (65-75 yrs) Old-old (75-85 yrs) Oldest old ( yrs); approximately 40% Elite-old (centenarians) Frail elderly (over age 85 yrs and need assistance with ADLs)

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Ageism: Common Misconceptions About Older Adults Cannot live independently Chronologic age determines oldness Most have diminished intellectual capacity or senility All are content and serene Cannot be productive Are resistant to change No Social Security on retirement

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Males have a longer life expectancy than females do.

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False –Life expectancy has increased, with females having a longer life expectancy than males.

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Characteristics of Healthy Older Adults Lifetime of healthy habits Strong social support system Positive emotional outlook Affected by personality traits, life experiences, current physical health, and current societal supports

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Needs of Older Adults Primary prevention –Health education; follow-through of sound personal health practices; recommended routine screenings and appropriate immunizations (see Display 24.2) –Nutrition, oral health, exercise, safety needs –Economic security needs –Psychosocial needs: coping with multiple losses, maintaining independence, social interaction, companionship and purpose –Spirituality, advance directives, hospice, palliative care, and preparing for death

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? A healthy older adult has a positive emotional outlook.

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True –A healthy older adult is characterized by a lifetime of healthy habits, a strong social support system, and a positive emotional outlook.

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Needs of Older Adults (cont.) Secondary prevention –Education on preventive measures and positive health behaviors (routine screenings; see Table 24.1) Tertiary prevention –Follow-up and rehabilitation –Health issues: Alzheimer’s disease, arthritis, cancer, depression, diabetes, cardiovascular disease, osteoporosis

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Approaches to Older Adult Care Geriatrics: medical specialty dealing with health and social care of elderly Gerontology: study of all aspect of aging process (economic, social, clinical, and psychological factors) and effects on older adult and society Case management and needs assessment: assessing needs, planning and organizing services, and monitoring response to care throughout length of caregiving process, condition, or illness

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Criteria for Effective Health Services Must be comprehensive –Adequate financial support –Adult day care programs –Access to high-quality health care services –Health education (including preparation for retirement) –In-home services –Recreation and activity programs –Specialized transportation services

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Criteria For Effective Health Services (cont.) Coordination Accessibility Promotion of quality programs

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Services for Healthy Older Adults Goal: Maintaining functional independence Living arrangements and care options –Day care and home care services –Arrangements based on level of care Skilled nursing facilities Long-term care services Intermediate care; assisted living Personal care homes Continuing care retirement communities –Respite care services

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following reflects the goal of service programs for healthy older adults? a.Provision of necessary care b.Comprehensiveness of services c.Maintenance of functional independence d.Ensured access to care

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer c. Maintenance of functional independence The goal of services for healthy older adults focuses on maintaining the adults’ functional independence. Comprehensiveness and accessibility are criteria for effective service delivery. Provision of care reflects the activity of a service.

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins CHN in an Aging America Case management for resources and referrals Development of creative living arrangements and services Encouragement of healthy lifestyle changes to avoid disease and disability Education about immunizations and safety measures, including fall prevention

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Internet Resources Administration on Aging: American Association of Retired Persons: Generations United: Gerontological Society of America: National Institute on Aging: The Geezer Brigade: