Chapter 2: The Aging Population

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.

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 & ^.

Real and Projected Numbers of People 65+ in the US

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

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

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.

Sources of Income for Persons 65+

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

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

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.

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.

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.

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)

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

Mortality and Morbidity

Mortality and Morbidity (cont’d)

• 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% – Alzheimer’s disease 3.7% – Diabeties, influenza/pneumonia, nepthritis, accidents, septicemia Less than 3.2% each

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

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 one’s 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

Centenarians

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

Secrets of Aging

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

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

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

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.

Question

The cohort that is expected to be the largest consumers of healthcare in the next three decades is known as the: a)Baby boomers b)Sandwich Generation c)Generation X d)War Generation

Question The leading cause of death in the elderly is:

a)Infectious disease b)Cardiovascular disease c)Cancer d)Complication from falls