Week 1 - Concepts, Principles, History and Theories in the Care of Older Adults

Older Adults in the Time of Confucius

Age was directly correlated with the degree of respect a person was entitled to.

Early Egyptians’ View of Aging

Early Egyptians dreaded growing old and experimented with potions and schemes to maintain youth.

Plato’s View of Older Adults

Plato promoted older adults as society’s best leaders.

Aristotle’s View of Older Adults

Aristotle denied older people any role in governmental matters.

Older Adults in the Roman Empire

In nations conquered by the Roman Empire, the sick and aged were customarily the first to be killed.

Bible’s View of Older Adults

The Bible expresses concern for the well-being of the family and encourages respect for elders.

Medieval View of Aging

Medieval times gave rise to strong feelings regarding the superiority of youth.

1) Recognize age-related changes in abilities;

2) Understand age-related differences in life situations;

3) Acknowledge temporal dynamics in individual differences;

4) Advocate for work systems that optimally integrate age-related changes, differences, and dynamics.

Four Ways to Adopt a Lifespan Perspective on Aging at Work

Florence Nightingale and Doreen Norton

Nursing Pioneers in Gerontological Nursing: provided early insights into the “care of the aged”.

Florence Nightingale

She was considered the first geriatric nurse.

Doreen Norton

She focused her career on care of the aged and wrote about the unique and specific needs of older adults.

1902 Gerontological Nursing Landmark

American Journal of Nursing published the first geriatric article by an MD.

1950 Gerontological Nursing Landmark

The first geriatric nursing textbook, “Geriatric Nursing” by Newton, was published; Eleanor Pingrey completed the first master’s thesis in geriatric nursing; geriatric nursing became a specialization.

1952 Gerontological Nursing Landmark

The first geriatric nursing study was published in Nursing Research.

1961 Gerontological Nursing Landmark

ANA recommended a specialty group for geriatric nurses.

1962 Gerontological Nursing Landmark

ANA held the first National Nursing Meeting on Geriatric Nursing Practice.

1966 Gerontological Nursing Landmark

ANA formed a geriatric nursing division and the first Gerontological Clinical Nurse Specialist master’s program began at Duke University.

1968 Gerontological Nursing Landmark

The first RN, Laurie Gunter, presented at the International Congress of Gerontology.

1969 Gerontological Nursing Landmark

Standards for geriatric nursing practice were developed.

1970 Gerontological Nursing Landmark

ANA created the Standards of Practice for Geriatric Nursing.

1973 Gerontological Nursing Landmark

ANA offered the first generalist certification in gerontological nursing.

1975 Gerontological Nursing Landmark

The first nursing journal for the care of older adults, Journal of Gerontological Nursing, was published; the first nursing conference was held at the International Congress of Gerontology.

1976 Gerontological Nursing Landmark

ANA Geriatric Nursing Division changed its name to Gerontological Nursing Division.

1981 Gerontological Nursing Landmark

ANA Division of Gerontological Nursing published a statement on scope of practice.

1982 Gerontological Nursing Landmark

The Robert Wood Johnson Teaching Home Nursing Program was developed.

1983 Gerontological Nursing Landmark

The first university chair in gerontological nursing in the United States was established at Case Western Reserve.

1987 Gerontological Nursing Landmark

ANA revised Standards and Scope of Gerontological Nursing Practice.

1988 Gerontological Nursing Landmark

The first PhD program in gerontological nursing was established.

1989 Gerontological Nursing Landmark

ANA certification was established for Clinical Specialist in Gerontological Nursing.

1998 Gerontological Nursing Landmark

ANA certification became available for geriatric advanced practice nurses as geriatric nurse practitioners or gerontological clinical nurse specialists.

Gerontology

The broad term used to define the study of aging and/or the aged.

Gero

Means old age.

Ology

Means study of.

Young Old

Older adults ages 65–74.

Middle Old

Older adults ages 75–84.

Old Old

Older adults ages 85 and up.

Gerontophobia

Fear of aging; inability to accept aging adults in society.

Age Discrimination

Emotional prejudice among older adults.

Ageism

Dislike of aging and older adults.

Geriatrics

A generic term relating to the aged; specifically refers to medical care for the aged.

Gerontological Nursing

The aspect of gerontology that falls within the discipline and scope of nursing practice.

Graying of America

A phenomenon involving an increasing older population faced by all nations, not only the United States.

Demographic Tidal Wave / A Pig in a Python

A bulge in the population moving slowly through time, referring particularly to the Baby Boomer generation born from 1946–1964.

Baby Boomers

The generation born between 1946 and 1964.

Older Adults in the United States

About 1 out of 8 Americans are age 65 and older according to the source.

1997 World Aging Population

Approximately 10% of the world’s population was age 60 and above.

Expected U.S. Older Population by 2025

The number of people age 65 and older was expected to increase from 12% of the population in 2000 to 19%.

13% of the U.S. population was over age 60.

U.S. Older Population in 2005

18.3 million.

U.S. Population Ages 65–74 in 2005

12.9 million.

U.S. Population Ages 75–84 in 2005

4.7%.

U.S. Population Ages 85+ in 2005

20 million, or 6.8% of the total population.

Projected U.S. Older Population in 2010

33 million, or 9.2% of the total population.

Projected U.S. Older Population in 2030

Almost 50 million, or 11.6% of the total population.

Projected U.S. Older Population in 2050

Global Aging Population by Mid-21st Century

Older people are expected to outnumber young people for the first time in history.

Aging Population in Developing Countries

The greatest increases in aging populations are expected in developing countries.

Aging Population in Asia

Asian countries have less time to prepare because aging is occurring more rapidly than economic growth.

Healthcare Challenge in Asian Countries

Adequate healthcare services for the elderly may be beyond the reach of many Asian countries because of limited institutions and financial systems.

Improved sanitation, advances in medical care, and implementation of preventive health services.

Reasons for Increase in Older Population

Major Health Transition in the 1900s

Deaths were mainly due to infectious diseases and acute illnesses.

Older adults increasingly face chronic disease and healthcare funding issues.

Current Health Challenge of Older Adults

Has approximately 3 chronic diseases and uses 5 types of medications.

Average 75-Year-Old

95% of healthcare expenditures are for chronic diseases according to the source.

Healthcare Expenditures for Older Americans

Occurred from 1946–1964 and involved approximately 3.5 children per household.

Baby Boom After WWII

The older population was expected to increase significantly between 2010 and 2030 as baby boomers reached age 65.

Baby Boomer Aging Impact

Baby Boomers’ Education

They are better educated than preceding generations.

Baby Boomers’ Household Income

Their household incomes tend to be higher than other groups, partly due to two incomes.

Baby Boomer Women in the Labor Force

Three out of four baby boomer women are in the labor force.

Baby Boomers and Dress

They favor a more casual dress code than previous generations of older adults.

Baby Boomers and Technology

They are enamored with high-tech products and are likely to own and use a home computer.

Baby Boomers and Leisure

Their leisure time is scarcer than other adults, and they are more likely to report feeling stressed at the end of the day.

Baby Boomers and Fitness

As inventors of the fitness movement, they exercise more frequently than other adults.

Baby Boomers as Healthcare Consumers

They are informed healthcare consumers and desire a highly active role in their care.

Baby Boomers and Long-Term Care

They are unlikely to be satisfied with traditional nursing homes and may demand facilities with internet access, gyms, pools, juice bars, and alternative therapies.

Baby Boomers and Family Caregiving

Blended families may need special assistance because of caregiving demands involving several sets of stepparents and step-grandparents.

U.S. Life Expectancy

75.7 years old according to the source.

Life Span

115 years according to the source.

Longest Reported Female Life Expectancy

French women lived for 122 years in 1994 according to the source.

Factors Affecting Life Expectancy

Improved sanitation, advances in medical care, and implementation of preventive health services.

Centenarians

People who reach 100 years of age; the source describes them as predominant in lower educated, more impoverished, widowed, and more disabled populations.

Characteristics of Centenarians

They weigh less, take fewer medications, and have fewer chronic diseases.

Feminization of Later Life

Women comprise a larger proportion of the older population because they have a longer life expectancy.

Women in the Older Population

Women comprise 55% of the older population.

U.S. Female Life Expectancy

81 years according to the source.

U.S. Male Life Expectancy

75.2 years according to the source.

Reason for Sex Difference in Life Expectancy

Male exposure to risk factors may account for differences in life expectancy.

Effect of Increased Female Risk-Factor Exposure

Increases in female exposure to risk factors may reduce the difference in life expectancy.

Older Adults and Health

Majority of older adults enjoy good health.

Chronic Disability Among Adults 65+

20% of adults age 65 and above report a chronic disability.

Older Adults with Chronic Conditions

80% have at least one chronic condition.

Decline in Heart Disease and Stroke

Heart disease and stroke, two of the three leading causes of death, declined by one third.

Deaths in Older Adults

The majority of deaths in the United States occur in people age 65 and older.

Major Causes of Death in Older Adults

50% of deaths are caused by heart disease and cancer according to the source.

Reason for Decline in Overall Deaths

Improvements in prevention, early detection, and treatment of diseases.

Top Causes of Death

Heart disease and cancer are two top causes of death regardless of age, race, gender, or ethnicity.

Functional Independence of Adults 75+

Majority remain functionally independent.

Trend in Activity Limitations

The proportion of older Americans with limitations in activities is declining.

Modifiable Risk Factors for Physical Decline

Smoking, poor nutrition, physical inactivity, and failure to use preventive and screening services.

Ageing Population in the Philippines

The number of older people in the Philippines is increasing rapidly and is growing faster than the total population.

Philippine Senior Citizen Age

An individual who is 60 years old or older is legally considered a senior citizen.