Chapter 2: The Aging Population

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Chapter 2 The Aging Population
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Learning Objectives

• Review statistics related to aging in the United
  States.
• Describe social and economic issues related to
  aging in the United States.
• Discuss aging across different cultures.
• Recognize differences between aging in the 21st
  century and aging in the past.
• Critically evaluate successful aging.

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Statistics of Aging in the United States

• The older population (65) numbered 40.4 million
  in 2010. They represented 12.9 of U.S.
  population.
• The older population in 2030 will be 72.1
  million, twice than 2000. Old people will
  outnumber young people for the first time in
  history.- the graying of America
• Approximately 20,000 nursing homes in the U.S.
• with 1.5 2 million nursing home beds.
  
• Approximately 5 of the population age 65 .

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Real and Projected Numbers of People 65 in the US
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Health Reasons of increasing older adults

• Increasing life expectancy of seniors
• improved sanitation through the 20th century
• advances in medical care
• preventive health services implemented
• medical advances treat formerly fatal illnesses
• Older adults dealing with more chronic disease
• average 75 year old has 3 chronic diseases and
  takes 5 medications

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Gender

• As of 2010, 23 million older women vs. 17.5
  million older men
• In 2010,
• 72 of older men were married
• 42 of older women were married
• Women age 75-84 37 married
• Women age 85 15 married

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Education

• Education affects older adults socioeconomic
  status more educated have better income,
  standard of living, and health.
• High school graduation rates among older adults
  in the U.S. have increased. Rates vary among
  ethnic groups.

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Sources of Income for Persons 65
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Living Arrangements

• Living arrangements of older adults are linked to
  income, health status and the availability of
  caregivers.
• 55.1 of non-institutionalized older adults lived
  with their spouse in 2010
• The likelihood of living alone increases with
  age 47 for women age 75
• 485,000 grandparents age 65 have primary
  responsibility for their grandchildren.
• Fig. 2-3, page 34

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Minorities

• Ethnic minority elders will be 42 of the older
  population in the next 40 years.
• Health problems associated with aging affect
  different ethnicities at different rates.
• Access to health care varies for different
  ethnicities.
• Other minorities include older foreign-born
  people living in the U.S., veterans, the aging
  disabled population, elderly inmates

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African Americans

• The largest cultural minority.
• Poverty rate for older African Americans was 24
  in 2004, compared to 10 for the total elderly
  population.
• Often do not use routine preventive services at
  recommended rates and are less likely to have a
  regular provider of health care.

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Hispanics

• The over 65 year old Hispanic population is the
  fastest growing segment of the total U.S.
  population.
• Diverse population from Mexico, Cuba, Puerto
  Rico, the Dominican Republic, and other Central
  and South America.
• 72 of Hispanics age 60 or over live in
  California, Florida, New York, and Texas.
• Generally receive assistance in the home rather
  than to stay LTCF.

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Asians and Pacific Islanders

• Composed of 40 different ethnic groups with
  various economic, educational, and health
  profiles.
• life expectancy 79.3 years for males and 84.9
  years for females, as compared to 73.6 and 80.1
  for white males and females, respectively.

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American Indians/Alaskan Natives

• 500 tribes and native villages in which 150
  languages are used.
• Heart disease is the leading cause of death due
  to a rise in risk factors (Obesity, diabetes,
  smoking, hypertension, high cholesterol, and
  sedentary lifestyle)

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Other Minorities

• The older foreign-born population Nurses should
  explore whether patients are first generation in
  their new country, second, third, etc.
• U.S. Veterans
• Developmentally disabled
• Elderly prison inmates

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Mortality and Morbidity
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Mortality and Morbidity (contd)

• Most older adults in the U.S. are, by and large,
  active and healthy.
• Leading causes of elderly death (2004)
• Heart disease 30.4
• Cancer 22
• Stroke 7.4
• Chronic lower respiratory disease 6
• Alzheimers disease 3.7
• Diabeties, influenza/pneumonia, nepthritis,
  accidents, septicemia - Less than 3.2 each

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History of Aging in the U.S.

• Pre-1900
• old age started at age 60
• elders were generally respected for their wisdom
  and experience
• old age was usually a privilege of the rich poor
  people did not live to old age
• 1900s
• President Theo. Roosevelt established old age as
  a disability 25 of the elderly was receiving
  military pensions, which accounted for 43 of
  federal expenditure
• President Franklin Roosevelt signed the Social
  Security act in 1935
• Medicare and Medicaid established in 1965

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Aging Today

• 55 of persons 85 in the US are impaired and
  require long-term care
• The majority of older adults are healthy, active,
  and continue to be engaged in society after
  retirement
• Aging in Place
• Is defined as the ability to live in ones own
  home and community safely, independently, and
  comfortably, regardless of age, income, or
  ability level.
• Elders need better education on available
  services, financial preparation for retirement,
  and proactive measures to successfully age in
  place

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Centenarians

• The fastest-growing segment of the population
• Lower income
• Lower educational level
• Widowed (84)
• More disabled people

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Secrets of Aging

• Protective factors
• No smoking, no drinking and driving
• Regular exercise
• Moderate weight
• Education
• Low blood pressure
• Stable marriage
• Mature defenses

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Secrets What elders Say (Cont.)

• Everything in moderation
• Strong relationships
• Ability to deal with stress
• Fewer chronic diseases
• Little to no alcohol intake
• Always having something to look forward to

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Successful Aging

• Successfully adapting to changes in the aging
  process.
• Acceptance of death, life satisfaction, and
  feelings of well-being.
• An avoidance of disease and disability.
• Achievement of a sense of autonomy, dignity, and
  absence of suffering

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Summary

• Aging of baby boomers will greatly impact U.S.
  society.
• Health disparities will continue among minority
  elderly groups.
• Successful aging is possible with wise lifestyle
  choices and avoidance of risk factors.

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Question

• The cohort that is expected to be the largest
  consumers of healthcare in the next three decades
  is known as the
• Baby boomers
• Sandwich Generation
• Generation X
• War Generation

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Question

• The leading cause of death in the elderly is
• Infectious disease
• Cardiovascular disease
• Cancer
• Complication from falls