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The Aging Population NCM 114 MA. CONCEPCION MAICO-BACUS, EdD, MAN, RN Geriatrics Is the medical specialty that deals with the physiology of aging and with the diagnosis and treatment of diseases affecting older adults. Geriatrics, by d...

The Aging Population NCM 114 MA. CONCEPCION MAICO-BACUS, EdD, MAN, RN Geriatrics Is the medical specialty that deals with the physiology of aging and with the diagnosis and treatment of diseases affecting older adults. Geriatrics, by definition, focuses on abnormal conditions and the medical treatment of these conditions. Gerontology The term gerontology comes from the Greek words “gero,” meaning related to old age, and “ology,” meaning the study of. Thus, gerontology is the study of all aspects of the aging process, including the clinical, psychologic, economic, and sociologic problems of older adults and the consequences of these problems for older adults and society. Gerontology affects nursing, health care, and all areas of our society— including housing, education, business, and politics. Ageism Is the disliking of aging and older adults based on the belief that aging makes people unattractive, unintelligent, and unproductive. It is an emotional prejudice or discrimination against people based solely on age. Ageism allows the young to separate themselves physically and emotionally from the old and to view older adults as somehow having less human value GERONTOLOGICAL NURSING Involves nurses advocating for the health of older persons at all levels of prevention. The scope of the practice includes all older adults from the time of ”old age” until death. Views of Older Adults Through History United States – offered the sacrifice, strength, and spirit that made this country great. They were the proud GIs in world wars, the brave immigrants who ventured into an unknown land, the bold entrepreneurs who took risks that created wealth and opportunities for employment, and the unselfish parents who struggled to give their children a better life. In the time of Confucius, there was a direct correlation between a person’s age and the degree of respect to which he or she was entitled. Taoism viewed old age as the epitome of life. The ancient Chinese believed that attaining old age was a wonderful accomplishment that deserved great honor. The early Egyptians dreaded growing old and experimented with a variety of potions and schemes to maintain their youth. Plato promoted older adults as society’s best leaders. Aristotle denied older people any role in governmental matters. Ancient Romans had limited respect for their elders. In the nations that Rome conquered, the sick and aged were customarily the first to be killed. Woven throughout the Bible is God’s concern for the well-being of the family and desire for people to respect elders. The medieval times gave rise to strong feelings regarding the superiority of youth; these feelings were expressed in uprisings of sons against fathers. Older people were among the first to be affected by famine and poverty and the last to benefit from better times. In the early 17th century, England developed Poor Laws that provided care for the destitute and enabled older persons without family resources to have some modest safety net. Dr. I. L. Nascher, known as the father of geriatrics, wrote the first geriatric textbook in 1914. THE OLDER AGE GROUP The Young Old The Old Old Ages 65 – 74 Ages 85 and up The Middle Old Note: Ages 75 – 84 How and at what rate a person ages depends upon a host of factors. Vast differences exist between biological and chronological aging, and between the physical, emotional, and social aspects of aging. AGING IS A DEVELOPMENT PROCESS A Erik Erikson Generativity vs Stagnation Integrity vs Despair B Gene Cohen Developmental Intelligence Quotient The 4 Stages of Maturity C The 5 Stages of Aging Independence, Interdependence, Dependency, Crisis Management, End of Life Erikson’s Stages of Psychosocial Development Gene Cohen’s Developmental Intelligence Quotient What is it? Specifically… The degree to which a person Reflects the maturing synergy of has manifested his or her cognition, emotional unique neurological, emotional, intelligence, judgment, social intellectual, and psychological skills, life experience, and capacities. consciousness. Gene Cohen’s Developmental Intelligence Quotient Phase 1 – Midlife Reevaluation Phase 2 - Liberation Ages mid-30s to mid-60s. Midlife people often Ages late 50s into the 70s. In the busy brain, new become less impulsive, more thoughtful about neurons are growing in the hippocampi. their work, more open to life’s complexities, Towards innovation and the willingness to take more aware of their intuitive feelings. risks. To many, retirement means time to do the things they always wanted to do. Phase 3 – Summing Up Phase 4 – Final Phase, Encore Ages late 60s through 80s. Time of review, Ages late 70s until the end of life. Learning always resolutions, and the desire to give back. A review possible, and the depth of experience gives an added dimension of wisdom to the quality of one’s thinking. The of one’s life with recognition of its meaning. oldest-old can cope well and have high levels of satisfaction and psychological resilience. The 5 Stages of Aging INDEPENDENCE INTERDEPENDENCE Stage 1 Stage 2 DEPENDENT CRISIS MANAGEMENT END OF LIFE Stage 3 Stage 4 Stage 5 INDEPENDENCE INTERDEPENDENCE The vast majority still live in their own Likely to find daily tasks more difficult. homes. Can still look after their Decline of both physical and needs (transportation, finances, mental ability. Will start forgetting health care). May experience a things. A caregiver may be minor decline in mental/physical necessary to assist with one or ability, but does not impact their more daily activities. Older adult life. may resist asking for help. DEPENDENCY CRISIS MANAGEMENT Age-related changes are becoming AND END OF LIFE more noticeable. An older adult is likely to be experiencing difficulty Typically monitored round the clock. with a number of ADLs. Difficulty Access to formal health care with physical and mental activity. facilities. Assisted living facility, nursing home or hospice. GLOBAL AGING AN INCREASE IN THE OLDER ADULT POPULATION Ageing and health (who.int) All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift. In 2050, 80% of older people will be living in low- and middle-income countries. The pace of population ageing is much faster than in the past. In 2020, the number of people aged 60 years and older outnumbered children younger than 5 years. Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%. By 2030, 1 in 6 people in the world will be aged 60 years or over. At this time the share of the population aged 60 years and over will increase from 1 billion in 2020 to 1.4 billion. By 2050, the world’s population of people aged 60 years and older will double (2.1 billion). The number of persons aged 80 years or older is expected to triple between 2020 and 2050 to reach 426 million. FACTORS Life Fertility of the Demographic Expectancy Population Tidal Wave Improved sanitation, Fertility rates of some countries Will explode between 2010 advances in medical care, has been steadily falling for the and 2030 when the baby implementation of past 200 years. Acceptance of boomer generation reaches preventive health services. birth control and changing values 65. of different generations. FACTORS Living Effects of Education Arrangements Ethnicity Tend to have more money, Linked not only to income, but African Americans – higher higher standards of living, also to health status. rates of DM, HPN, and CKD. and above-average health. Asians & Pacific Islanders – life expectancy at birth is higher THE OTHER DEMOGRAPHIC The Aging Disabled Elderly Inmates Advances in health care “Elderly” in the world of jails cells have increased the lifespan begin at age 50 or even earlier. of persons with disability. The Impact of the Baby Boomers Baby boomers will be entering their senior years between 2008 and 2030. Boomer Characteristics Most have children, but this generation’s low birth rate means that they will have fewer biologic children available to assist them in old age. They are better educated than preceding generations. Their household incomes tend to be higher than other groups, partly due to two incomes (three out of four baby boomer women are in the labor force). They favor a more casual dress code than previous generations of older adults. They are enamored with “high-tech” products and are likely to own and use a home computer. Their leisure time is scarcer than other adults, and they are more likely to report feeling stressed at the end of the day. As inventors of the fitness movement, they exercise more frequently than other adults Boomers as Retirees They will be informed consumers of health care and will desire a highly active role in their care. Their ability to access information may enable them to have as much knowledge as their health care providers on some health issues. They will not be satisfied with the conditions of today’s nursing homes and will demand that their long-term care facilities be equipped with computer stations, gymnasiums, juice bars, pools, and alternative therapies. Plans for services and architectural designs must take these factors into consideration. The WHO Response The United Nations (UN) General Assembly declared 2021–2030 the UN Decade of Healthy Ageing and asked WHO to lead the implementation. The UN Decade of Healthy Ageing is a global collaboration bringing together governments, civil society, international agencies, professionals, academia, the media and the private sector for 10 years of concerted, catalytic and collaborative action to foster longer and healthier lives. The UN Decade of Healthy Ageing (2021–2030) seeks to reduce health inequities and improve the lives of older people, their families and communities through collective action in four areas: changing how we think, feel and act towards age and ageism; developing communities in ways that foster the abilities of older people; delivering person-centred integrated care and primary health services responsive to older people; and providing older people who need it with access to quality long- term care. END OF TOPIC DISCUSSION

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