1. Chapter 1 The Aging Population

2. Terms to Know
Life expectancy: the length of time that a person can be predicted to live
Life span: the maximum years that a person has the potential to live
Compression of mortality: delaying or compressing the years in which serious illness and decline occur so that an extended life expectancy results in more functional, healthy years
Comorbidity: the presence of multiples chronic conditions simultaneously

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

4. Views of Older Adults Through History
Current older population offered sacrifice, strength, and spirit making the country great
Older adults currently viewed with positivism versus prejudice; knowledge versus myth; concern versus neglect

5. Views of Aging by Societies
Confucius: correlation of age and respected
Chinese: attaining old age was an accomplishment
Egyptians: dreaded growing old
Greeks: struggles between the old and the young
Ancient Romans: limited respect for elders
The Bible: well-being of family; desire to respect elders
Medieval times: rise of superiority of youth
Industrial revolution: persons of advanced age left unprotected

6. Historical Changes for Older Adults
1914: first geriatric textbook written by Dr. I.L. Nascher (known as “Father of Geriatrics”)
1935: significant step: Federal Old Age Insurance Law under the Social Security Act
Provision of some financial security for older adults
1965: formation of the Administration on Aging; enactment of Older Americans Act; introduction of Medicare and Medicaid

7. Question 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.

8. Answer
False
Rationale: 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.

9. Subsets of the Older Adult Population
Young-old: 60 to 74 years
Middle-old: 75 to 84 years
Old-old: 85 to 100 years
Centenarians: over 100 years
Profile, interests, and health care challenges vary with each subset

10. Population Growth and Increasing Life Expectancy
Persons 65+ currently represent more than 13% of the U.S. population
By 2020, older adults will grow to 120% of the population
Life expectancy has increased:
1930: 59.7 years
1965: 70.2 years
Present: 78.2 years
Population over 85 years. Double by year 2036 and triple by 2049
Centenarians increasing

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

12. Life Expectancy: Race and Gender
Gap widening between white people and black people
Nurses should be concerned with health and societal issues
Gap narrowing between males and females

13. Marital Status and Living Arrangements
Half of women over 65 are widowed.
The majority of men are married.
Most older adults live with spouse or other family member.
Twice the number of women than men live alone in later life.
The potential for living alone increases with age of both men and women.

14. Geographic Distribution
Varies with state population and location.

15. Income of Older Adults
Percentage of older adults living below the poverty level has declined.
Most depend on Social Security for more than half of their income.
High prevalence of home ownership by older adults.
“Asset rich and cash poor”
Women and minority groups have less income than white men.

16. Question
“Asset rich and cash poor” relates to which of the following statements regarding older adults?
Net worth of older adults is half the national average of middle-age adults.
Homes are paid for, but there is not enough money available for monthly expenses.
The majority of older adults live below the poverty level.
Financial problems in the older adult population are due to level of debt.

17. Answer
B. Homes are paid for, but there is not enough money available for monthly expenses.
Rationale: 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.

18. Employment and the Older Adult Population
Percentage of older workers in labor force declining
Men leaving workforce at earlier age
Number of middle-age women employed increasing
Baby boomers desire to continue to work at the age of retirement

19. Education Trend toward increased education of older adults.
Advanced degrees are more prevalent than in the past and have higher incomes.
Older adults will be more informed health care consumers.

20. Health Status Chronic illnesses are major problems.
Most older adults have at least one chronic illness.
Chronic conditions limit ADLs and IADLs: major source of disability.
Leading chronic conditions: arthritis, hypertension, hearing issues, heart conditions, visual impairments, orthopedic issues, diabetes, sinusitis, allergies, and varicose veins.

21. Question 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.

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

23. Health Insurance Medicare: health insurance program
Part A: hospital and other services
Part B: medical visit services and other services
Part C: Medicare Advantage Plans
Part D: drug plan
Affordable Care Act

24. Implications of an Aging Population
Approximately one in four older adults will spend some time in a nursing home.
Increasing need for gerontological nurses.
Health and social agencies must anticipate future needs.
Government payment of services in jeopardy in age of budget cuts.
Baby boomers are the next wave of older adults.

25. Baby Boomers Individuals born between 1946 and 1964
January 1, 2011, beginning of baby boomers turning 65
Diverse group
Better educated
Enamored with “high-tech” products
Inventors of “fitness movement”
Informed consumers
Will demand changes in long-term care

26. 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

27. Gerontological Nurses
Need to be advocates in ensuring that cost-containment efforts do not jeopardize the welfare of older adults