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COBH4030Chp9.pptxChapter 9
Older Adults
Chapter Objectives (1 of 2)
After studying this chapter, you will be able to:
Identify the characteristics of an aging population.
Define the following groups—old, young old, middle old, and old old.
Refute several commonly held myths about the older adult population.
Describe the factors that affect the size and age of a population.
Define fertility and mortality rates and explain how they affect life expectancy.
Explain the difference between dependency and labor-force ratios.
Describe older adults with regard to marital status, living arrangements, racial and ethnic background, education, economic status, and geographic location.
Chapter Objectives (2 of 2)
Describe the effects of chronic conditions and physical impairments on older adults.
Explain how health behaviors can improve the quality of later life.
Briefly outline elder abuse and neglect in the United States.
Identify the six instrumental needs of older adults.
Explain the role of caregivers with older adults in the United States.
Describe different housing options available to older adults.
Briefly summarize the Older Americans Act of 1965.
List the commonly provided services for older adults in most communities.
Explain the difference between respite care and adult day care.
Introduction
Number of older adults and their proportion in the total population increased significantly in the 20th and early 21st century
Represent 13.1% of population
1 in every 8 Americans
Young old – 65-74
Middle old – 75-84
Old old – 85+
Aging Myths
Ageism – prejudice and discrimination against older adults
Common myths not accurate representation of older adults
Reality
Majority of older adults today are active and well
Many still working
Many strongly engaged in community, volunteer, and advocacy programs
Demography of Aging (1 of 3)
Size and growth of the older adult population
Number and proportion of older adults grew significantly
Older adult population projected to continue growing; baby boom generation
85+ fastest-growing segment of older population
Growth in median age
Data from: U.S. Census Bureau, Population Division, Interim State Population Projections. www.census.gov/population/projections/files/natproj/pyramids/mp_p2.pdf
Demography of Aging (2 of 3)
Projected resident population of the United States: July 1, 2000
Data from: U.S. Census Bureau, Population Division, Interim State Population Projections. www.census.gov/population/projections/files/natproj/pyramids/mp_p4.pdf
Projected resident population of the United States: July 1, 2050
Demography of Aging (3 of 3)
Factors Affecting Population Size and Age
Fertility rates
Baby boomers: 1946-1964
Mortality rates
Life expectancy has continued to increase; significant increase in 20th century
Dependency and Labor Force Ratios (1 of 2)
Dependency ratio – economically unproductive to economically productive
Traditionally defined by age
Can be used for social policy decision making
Labor force ratio – number of people actually working and those who are not, independent of their ages
Ratio of workers to dependents will be lower in the future than today
Data from: U.S. Census Bureau. (2010). "The Next Four Decades, The Older Population in the United States: 2010 to 2050, Current Population Reports" Current Population Reports (#P25-1138). Available at http://www.census.gov/newsroom/releases/archives/aging_population/cb10-72.html. Accessed November 30, 2010
Dependency and Labor Force Ratios (2 of 2)
Dependency ratios for the United States:
2010 to 2050.
Other Demographic Variables
Affect community health programs for older Americans
Marital status
Living arrangements
Racial and ethnic composition
Geographic distribution
Economic status
Education
Housing
Marital Status
Almost ¾ of older men are married; just over half of older women are married
Older women are three times more likely to be widowed
Number of divorced older adults continues to rise
New concerns: lack of retirement benefits, insurance, lower net worth assets
Living Arrangements
Closely linked to income, health status, and availability of caregivers
Over ½ non-institutionalized older adults live with someone else
Women more likely to live alone
Only 3.4% of older adults live in nursing homes
¾ of nursing home residents are women
More than half of nursing home residents are 85+
Racial and Ethnic Composition
U.S. older population growing more diverse
2013 older adults:
78.8% white, 8.6% African American, 7.5% of Hispanic origin, 3.9% Asian
Coming decades:
Percentage of white older adults will decline and older Americans of Hispanic origin will become largest minority group in the U.S.
Geographic Distribution
More than 60% live in 13 states: CA, FL, TX, NY, PA, OH, IL, MI, NC, NJ, GA, VA, AZ
CA greatest number; FL greatest proportion
Reasons some states “age”
Inward migration (FL), young people leave (farm belt states)
~81% of older adults age 65+ live in metropolitan areas
Economic Status
1970 – 25% of older adults lived in poverty
2013 – 9.5% lived in poverty
Major sources of income
Social Security (reported by 86% of older adults)
Income from assets (reported by 51%)
Private pensions (reported by 27%)
Gov’t employee pensions (reported by 14%)
Earnings (reported by 28%)
Education
Percentage of older adults who completed high school rose from 28% in 1970 to 84% in 2014
25% of older adults had a bachelor’s degree or higher in 2014
Differences by race and ethnicity
Baby boomers most educated cohort in U.S. history
Housing
Most live in adequate, affordable housing
81% own, 19% rent
Older adults’ homes tend to be older, of lower value, and in greater need of repairs than the homes of younger counterparts
For most older adults, housing represents an asset
Health Profile of Older Adults
Health status of older adults has improved over the years (living longer and functional health)
Chronically disabled has been decreasing
Health status usually not as good as younger counterparts
Morbidity (1 of 2)
Top causes of death for older adults (responsible for almost 2/3 of deaths)
Heart disease
Cancer
CLRD
Stroke
Alzheimer’s disease
Morbidity (2 of 2)
Activity limitations increase with age
Chronic conditions
Substantial burden on health and economic status of individuals, families, and nation
Impairments
Very prevalent in older adults
May be sensory, physical, memory
Health Behaviors and Lifestyle Choices
Generally have more favorable health behaviors than younger counterparts
Less likely to consume large amounts of alcohol, smoke cigarettes, or be overweight
Areas for improvement
Physical activity, immunizations
Physical Activity
Older adults are least physically active of any age group
Loss of physical fitness due to aging, chronic conditions
Physical activity recommendations for older adults are the same as other adults
But only about 11% of older adults meet physical activity guidelines
Nutrition
Dietary concerns for older adults include:
Reduced sodium intake
Reduced caloric needs
Increased vegetable consumption
Increased water consumption
Obesity
Number of obese older adults has increased
In 2010, 38% of those 65+ were obese
Only 26% of older adults are in healthy weight range
Cigarette Smoking
Just over 9% of older adults are cigarette smokers
Number has decreased significantly over past few decades
Special concern: older adults who are former smokers
Vaccinations
Immune systems tend to weaken with age
Recommended immunizations for older adults
In 2014-2015 flu season, 66.7% of older adults received flu vaccination
Only about 60% have ever received pneumococcal vaccination
Vaccination rates among older adults have improved over time
But racial disparities exist
Mistreatment of Older Adults
Reports have increased greatly in recent years
All states have set up reporting systems
Special problem for older adults
Dementia and cognitive impairment
Past experience with domestic violence
Frailty
Social isolation
Instrumental Needs of Older Adults
Six instrumental needs that determine lifestyle for people of all ages; aging process can alter needs in unpredictable ways
Income
Housing
Personal care
Health care
Transportation
Community facilities and services
Income
Change in types of expenses in elder years
Achieving older adult status often reduces income needs
Income has improved significantly in recent years
Social Security is major source of income
Unmarried women and minorities have highest rates of poverty
Housing
Major needs: appropriateness, accessibility, adequacy, affordability
Changing residence can have negative effects
Variety of housing options available
Independent living
Assisted living
Continuing Care Retirement Communities
Nursing Homes/Skilled Nursing Facilities
Affordable housing
Personal Care
Four levels of tasks that may need assistance:
Instrumental tasks, expressive tasks, cognitive tasks, tasks of daily living
Activities of daily living (ADLs): measure functional limitations
Instrumental activities of daily living (IADLs): measure more complex tasks
Caregivers
Caregivers for older adults face number of problems
Increased financial burden, lack of privacy, demands on time and energy
Need for personal care and paying for long-term care services for older adults is projected to increase in coming years
National Family Caregiver Support Program
Support for working caregivers is a growing concern
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Health Care
Older adults heaviest users of healthcare services
Use of healthcare services increases with age
Most money spent on health care is in last years of life
Medicare primary source of payment for healthcare services of older adults
Will see major changes in future years
Transportation
Transportation allows older adults to remain independent
Greatest influence on transportation needs:
Income and health status
Many public transportation challenges
Solutions for transportation needs of older adults
Community Facilities and Services (1 of 2)
Older Americans Act of 1965 (OAA) to increase services and protect rights of older adults
National nutrition programs for older adults
State Departments on Aging and Area Agencies on Aging
Other programs
Services can vary greatly across the country
Community Facilities and Services (2 of 2)
Meal service
Homemaker service
Chore and home maintenance
Visitor service
Adult day care
Respite care
Home health care
Senior centers
Other services
Discussion Questions
What can happen to increase the likelihood of older adults utilizing community facilities and services?
How will the changing demographics of older adults affect healthcare services?
