Chapter 13: Older Adulthood and Aging

Individuals reaching 65 years of age have an average life expectancy of an additional:
- Females: additional 20.6 years
- Males: additional 18.1 years
A child born in 2017 can expect to live 78.6 years, compared to a child born in 1900 who could expect to live only 47.3 years.
Due to the increase in life expectancy, the demographic definitions of “old” are transitioning and are currently not standardized:
- Young-old adult: Age 50 to 79 years
- Oldest adult: Age 80 to 100+ years

Gerontology: The study of all dimensions of the aging process.
Gerontologic nursing: Specializes in the care of older adults.
Geriatrics: The study of medical, social problems, and care related to older adults.
Older adult: A term applied to individuals older than 50 years; this could be viewed as respectful or derogatory.
Senescence: The process of becoming old or characteristics of old age.
Young-old: Individuals aged 50 to 79 years.
Oldest adult: Individuals aged 80 years and older.
Ageism: The act of labeling and discriminating against older adults.

Challenge: Integrity (or ego integrity) versus despair
Necessary Accomplishments:
- Balance choices
- Achieve stability
- Retire
- Evaluate life
- Accept life choices
Virtues: Renunciation; wisdom; dignity.

Definitions are influenced by individual ability to function in society and maintain self-esteem.
Development is not necessarily correlated with calendar age.
Many older individuals are working past the age of 65 years, indicating a transition in age-based theories.

Generativity versus stagnation:
- Generativity: Adults choose to pass on their knowledge and skills to younger generations.
- Stagnation: Adults focus on personal pursuits without regard for the welfare of future generations.

Integrity versus despair:
- Integrity: Acceptance of one's self and one's life, life has meaning and worth, comfortable with past resolutions.
- Despair: Feelings of regret and failure regarding past decisions.

Statement: According to Erikson, a psychosocial challenge for this developmental stage is intimacy versus isolation.

False: Erikson states that the psychosocial challenge for this developmental stage is integrity (or ego integrity) versus despair. Older adults reflect on their life's events and decisions. They achieve ego integrity when they sense that their lives have been meaningful and worthwhile. Failure to meet the challenges of aging may result in overwhelming regret and feelings of failure.

More educated and aware of healthcare responsibilities.
Majority of individuals aged 64 to 74 years are married and living with their spouse.
Many who live alone can perform Instrumental Activities of Daily Living (IADLs) and Activities of Daily Living (ADLs).
Eventually, these individuals will require support and assistance.
Senescence influences thoughts on retirement.
Physical changes are often intertwined with financial resources and lifestyle choices.

Age Range: 50 to 79 years
Age classification is based on biological effects of aging and functional capacity.
Functional age can differ from chronological age, biological age, or psychosocial age.
The World Health Organization (WHO) highlights that age classification varies by country.

Loss in:
- Strength
- Flexibility
- Endurance
Decrease in organ function
Changes in visual and auditory acuity
Decreased reaction time
Issues like unsteady gait, decreased sense of balance, stiff joints, and loss of bone density
Decrease in tactile sensations, smell, and taste
Trouble sleeping more soundly and the necessity of more frequent naps
Increased emotional and physical losses

Decreased recovery capacity from injury or illness.
Improved quality of life due to enhanced healthcare access, medications, lifestyle education, and preventive health screenings.

General changes in physiological, psychological, and sociological functions and roles.
Adaptation requirements to physiologic, psychological, and sociological changes.
Reduction in income and adaptation to loss.
Development of coping mechanisms.
Increased time for meditation and life contemplation.

Stats: 80% of young-old adults have at least one chronic condition, and over half have multiple chronic conditions.
Treatment and care are major concerns, requiring both professional healthcare provider attention and potential family/caregiver support.
Many chronic conditions are linked to avoidable diseases or disorders (e.g., tobacco use, poor diet).
Common chronic conditions include osteoarthritis and hypertension.

Many medications exist that can successfully treat chronic conditions.
Polypharmacy: A significant concern due to multiple medications being prescribed.
Client education is key for treatment compliance and understanding medication side effects.

Advances allow earlier disease detection and treatment.
Some medications positively influence the prevention of other diseases.
Healthcare Costs: Longer lives with chronic conditions necessitate financial resources for care. Daily medication costs can deplete retirement income significantly.

A prevalent misconception is that mental illness is a normal part of aging.
Fears and anxieties may develop from health concerns.
Depression and dementia are not considered normal parts of aging; changes can be traced back to earlier brain traumas.
Older adults are likely to work past age 65, highlighting the need for age-friendly workplace considerations.

Statement: Severe depression is a normal consequence of typical aging.

False: Severe depression is not a typical consequence of aging and can often lead to additional negative psychosocial issues. Nurses must inform healthcare providers of any observed depression symptoms. Various depression types can typically be treated with medication and/or therapy.