Chapter 1

Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 1

The Aging Population
Introduction
Myths of aging
Misinformation as an injustice
Role of the gerontological nurse:
Know the facts
Educate the public
Views of Older Adults Through History
Current older population:
Positivism, intelligence, concern
Historically:
Age of Confucius, Taoism, Ancient Chinese,
Early Egyptians, Greeks, Aristotle, Ancient
Romans, Dark Ages, Middle Ages, and
Medieval Times
Improvements for Older Adults
1914: Dr. I. L. NascherFather of Geriatrics
first geriatric textbook
1935: Federal Old Age Insurance Law under the
Social Security Act
1965: formation of the Administration on Aging,
Older Americans Act, Medicare, and Medicaid
Continued growing concern for older adults
Question
Is the following statement true or false?

The first significant step in improving the lives
of older adults during the 20th century was
the publication of the first geriatric textbook in
1914.

Answer
False.

The first significant step in improving
the lives of older adults was the
passage of the Federal Old Age
Insurance Law under the Social
Security Act in 1935.
Subsets of the Older Adult Population
Young-old
Old-old
Middle-old
Centenarians
Diversity rather than homogeneity

Population Growth and
Increasing Life Expectancy
Persons 65+ currently represent more than 12%
of the U.S. population
By the year 2020 older adults will grow to 17%
of the population
Increasing life expectancy:
1930: 59.7 years
1965: 70.2 years
Present: 77.8 years
Factors Influencing Increased
Life Expectancy
Advancements in disease control and health
technology
Lower infant and child mortality rates
Improved sanitation
Better living conditions
Life Expectancy: Race and Gender
Gap between white people and black people
Societal issues
Concern for nurses
Gap is narrowing between males and females
Marital Status and Living Arrangements
Older women are more likely than men to be
married
Most older adults live with a spouse or other
family member
More women than men live alone
Potential for living alone increased with age
Most older adults have family contact
Geographic Distribution
States with the greatest number of older adults:
California, Florida, New York, Texas, and
Pennsylvania
States with dramatic increases in the past
decade: Nevada, Alaska, Hawaii, and Arizona
States with the lowest percentage of total
population over age 65: Alaska, Utah, and
Georgia
Income of Older Adults
10% of older adults live below the poverty level
Older adults dependent on Social Security for
more than half of their income
Median net worth is twice the national average
related to home ownership
Asset rich and cash poor
Women and minority groups are poorer than
white men
Question
Asset rich and cash poor relates to which of the
following statements related to older adults?
a.Net worth of older adults is half the national
average of middle-age adults
b.Homes are paid for but there is not enough
money available for monthly expenses
c. The majority of older adults live below the
poverty level
d.Financial problems in the older adult population
are due to level of debt
Answer
b. Homes are paid for but there is not
enough money available for monthly
expenses
Median net worth of older households is
nearly twice the national average because
of the high prevalence of home
ownership, but many older adults are
asset rich and cash poor; they live in a
house that has appreciated in value over
the years, but they barely have sufficient
monthly income to meet basic expenses.
Employment and the Older Adult Population
Declining percentage of workers in the labor
force
Men leaving the workforce at an earlier age
Increase in the number of middle-aged women
who are employed
Increased desire to work at the age of
retirement
Education
Increasing levels of education in the older adult
population
Advanced degrees and higher income
Impact on health care:
Older adults will be more informed
consumers
Health Status of Older Adults:
Acute Conditions
Fewer acute illnesses
Lower death rates
Longer period of recovery
More complications
Health Status of Older Adults:
Chronic Conditions
Major problem that increases with age
Most have at least one chronic disease; many
have several
Result in limitations in ADLs and IADLs
Leading cause of disability and death
Question
Is the following statement true or false?

Chronic disorders most prevalent in the older
adult population are ones that can have a
significant impact on independence and the
quality of life.
Answer
True.
Chronic illness is a major problem for the
older population and results in limitations
in ADLs, IADLs, and quality of life.
Implications of an Aging Population
Impact on health and social service agencies
Need for gerontological nurses
Future needs
Payment of services
Impact and characteristics of the baby
boomers
Provision and Payment of Services
Higher rates of hospitalization, surgery, and
physician visits
Paid by federal dollars most often
Less than 5% of older adults live in a nursing
home, assisted living, or other institutions
Long-term care payment
Role of the gerontological nurse

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Copyright 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

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