1. Health and Wellness in an Aging Society
Chapter 1
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Health and Wellness in an Aging Society

2. Health Perspectives
In medicine, absence of physical and psychiatric illness
Measured in terms of accepted “norms”
Function independently versus debility
Population health status considerations are based on life expectancy, morbidity, and mortality
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3. Considerations Does defining health based on illness reflect:
quality of life?
functional limitations?
contributions to community/society?
movement toward self-actualization?
Health is more than the absence of disease
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4. Healthy People 2020: Older Adults
New areas focus on quality of life and wellness of the older adult
Social well-being is recognized as an important aspect of mental health
A wellness model based on a holistic paradigm is changing the perceptions of health and health care
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5. Gerontological Nurses
Can shape the world of persons where they can thrive and grow old, not merely survive
Wellness-based models whether acute or chronic:
Maximize strengths
Minimize limitations
Facilitate adaptation
Encourage growth
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6. Health Perspectives The Years Ahead
While countries vary, persons over the age of 60 worldwide will double in 2050
The majority will be women
Most of the elders worldwide will be poor and in need of support
How can global conditions be changed to maximize and enrich the lives of elders across the world?
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7. Growth in the Number of Persons atleast 60 across the Globe
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8. Distribution of World Population Aged 60 and Over by Development Region: 1950-2050
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9. Health Perspectives Aging
 The term geriatrics was coined to recognize that medical care of persons in later life differed from other groups in the population
 The first medical textbook about the “old” was published in 1914 with the focus that it must be reversed, eradicated, or delayed
 Gerontology considers the nexus of time and human development
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10. Health Perspectives (Cont.)
How Old Is Old?
Each culture is different and a variety of terms are used to refer to the aging person: elder, senior citizen, granny, older adult, etc.
From a functional perspective, it’s when the person is no longer able to perform usual activities
Biological aging: outward expression of individual genetic makeup
Chronological aging: varies around the world, but generally around years
As the average life expectancy rises this may change
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11. Life Expectancy at Birth, by Race and Sex: United States, 2010
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12. Health Perspectives Super-Centenarians
Those that are still alive at 110 years of age
There are worldwide, with 60 of those in the United States
Survived outbreaks and pandemic diseases
It is theorized that the reason these individuals have survived to this point is “rare and unpredictable”
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13. Health Perspectives (Cont.)
Centenarians
Those between the ages of 100 and 109 years
Many people who would be of that age today died in WWII, were part of the Great Depression, and lived during the smallpox epidemic and other childhood diseases
This age group is rising rapidly
New research is identifying that genetic markers for disease are not activated until later in life for this group
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14. Number of Those Persons Over 100 per 10,000 Persons in the Population
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15. Health Perspectives
Those In-Between
Those between the centenarians and the baby boomers, born between 1915 and 1945
Includes Holocaust survivors
Came of age during the civil rights movement, assassination of President Kennedy, the “Cold War,” and part of the Depression
See Table 1-1 for communicable diseases during this time
This group is growing at an exponential rate, with the greatest increase in Hispanics
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16. Health Perspectives (Cont.)
The “Baby Boomers”
 Youngest of the older generation, born between 1946 and 1964
 The greatest number were born in 1946, when WWII ended
 Great variation in life experiences among this group
 Better access to medication and treatment
 Immunizations became a standard of care from 1960 on, when the eldest boomer was 13 years old
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17. Ten Leading Causes of Noncommunicable Death Worldwide
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18. Wellness-Based Model
Encompasses the idea that health is composed of multiple dimensions
Wellness is expressed in the following dimensions of human experience within the context of culture:
Functional
Environmental
Intellectual
Psychological
Spiritual
Social
Biological
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19. The Flower Model
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20. Wellness-Based Model for Healthy Aging
Health is viewed on a continuum
Healthy aging must be viewed from the prenatal period to death
Epigenetics is leading to a new understanding of the impact of environment factors
Health promoting strategies are important in achieving and maintaining the highest level of wellness on a continuum
Preventative services are highly underutilized
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21. Disease Prevention and Health Promotion for Older Adults
The National Prevention Council’s six priorities:
Tobacco-free living
Preventing drug abuse and excessive alcohol use
Healthy eating
Injury and violence-free living
Reproductive and sexual health
Mental and emotional well-being
Need to empower people, create healthy and safe community environments, provide clinical and community preventative services, eliminate health disparities
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23. Prevention
Primary
Strategies that can and are used to prevent illness before it occurs
Secondary
Early detection of the disease or health problem that has already developed
Tertiary
Addresses the needs of persons who have their day-to-day wellness challenged, by slowing disease or limiting complications
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24. Promoting Healthy Aging: Implications for Gerontological Nursing
Utilize a wellness model that includes biological, social, functional, environmental, psychological, and spiritual considerations across the continuum of wellness and care settings
Objectives and interventions will vary for healthy older adults and those who are frail
By listening closely nurses can hear what is most important to promote personal wellness
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25. Question 1 60 and older. 65 and older. 75 and older. 85 and older.
The greatest increase in aging by group percentage is occurring among those:
60 and older.
65 and older.
75 and older.
85 and older.
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ANS: D

26. Question 2 Minimize limitations Facilitate adaptation
Gerontological nurses can shape the world of persons where they can thrive and grow old, not merely survive by utilizing which of the following wellness-based strategies?
Minimize limitations
Facilitate adaptation
Maximize strengths
All of the above
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ANS: D