What are the requirements for a Generalist Certification?
*Entry Level
*Diploma, ADN, or BSN
*2 years nursing experience
What are the requirements for an Advanced Practice Certification?
*Clinical specialist in gerontological nursing
*Gerontological nurse practitioner
What are the roles of the gerontological nurse?
*Direct-care provider
*teacher
*leader/administrator
*advocate
*Evidence based clinician
*Focuses on unique needs of older adults and their families
What is the age range of the subdivision of young-old adult?
(65 - 74)
What is the age range of the subdivision of middle-old adult?
(74 - 85)
What is the age range of the subdivision of Old-old adult?
(85+)
Which subdivision of older adulthood has experienced the biggest growth in numbers recently?
Old-old population
Which is the fastest growing segment?
Centenarians (over a hundred years) This on Exam #1
What is the second fastest growing segment?
Over 85
Describe the subdivision of Frail Elderly?
*Wt. Loss
*Decreased physical activity
*Fatigue and weakness
*Impaired mobility
*Accumulation of health conditions and deficits
*Poor Health outcomes
*Increased risk of hospitalized
*Limited lifespan
Describe the "baby boomers"?
*Born between 1946 and 1964
*Began turning 65 in 2011
*Terms to describe this trend:
- Demographic tidal wave
- Pig in a Python
- Graying of America
- Silver tsunami
What are predictions of the baby boomers?
* "Healthiest, longest lived, best educated, and most affluent in history
What percent do women comprise of the older population in all nations?
55%
Has the life expectancy in the U.S. increased or decreased?
Increased
What is the life expectancy by gender?
*Women: 85.5 years
*Men: 82.9 years
What percentage of men are married in 2015?
75%
What percentage of women are married in 2015?
45%
What percent did widows account for in older women in 2015?
34%
What percent were represented by divorced and separated (including married/spouse absent) older persons in 2015?
15%
Between 1970 and 2015, what percentage of older person had completed high school from 28% to ______?
84%
What percentage of older persons had a bachelor's degree or higher in 2015?
27%
In 2015, what percent of whites completed high school?
89%
In 2015, what percent of African-Americans completed high school?
75%
In 2015, what percent of Asians completed high school?
74%
In 2015, what percent of American Indian, Alaska Natives completed high school?
64%
In 2015, what percent of Hispanics completed high school?
54%
Described the statistics of living arrangement in women and men? (Institutionalized)
*Over half (56%) of older institutionalized persons lived with their spouse in 2015
*70% of older men
*45% of older women
*The proportion living with their spouse decreased with age, especially for women
Described the statistics of living arrangement in women and men? (Non-institutionalized)
*about 29% of all non-institutionalized older person in 2015 lived alone
*36% older women
*20% of older men
*The proportion living alone increased with advanced age
Describe the African American ethnicity group?
*Most frequent chronic conditions: HTN, arthritis, heart disease, diabetes, sinusitis, and cancer
*Lower than recommended rate of preventive services
*Top causes of death: heart disease, cancer, stroke, diabetes, and unintentional accidents
Describe the Hispanics ethnicity group?
*High poverty rate
*Chronic disease: cardiovascular disease, diabetes, cancer, and cerebrovascular disease
*Less likely to obtain preventive services
*Language barrier
*Top causes of death: heart disease, cancer, unintentional injuries, stroke, diabetes
*
Describe the Asian and Pacific Islanders ethnicity group?
*Composed of 40 different ethnic groups
*Inconsistent use of community-based professional resources
*Use of familial and informal ethnic resources common
*Top causes of death: heart disease, cancer, stroke, unintentional injuries, diabetes
Describe the American Indians and Alaskan Natives ethnicity group?
*Represents 500 nations, tribes, bands, and native villages - 150 languages
*Twice level of poverty
*Common chronic disease: diabetes, HTN, vision loss, back pain, obesity, substance abuse, mental health problems
*Causes of death: heart disease, cancer, u
What are groups of minorities?
*Older Foreign-Born population in the U.S.
*U.S. Veterans
*Aging disabled population
*Elderly inmates
What are health care disparities?
*Racial and ethnic disparities
*Gender disparities
*Causes are complex
- caregiver bias
- poverty level
- Language
- Literacy
- Others
What are challenges of aging?
*Chronic Illness
- 3 chronic illness common
- Top chronic diseases: heart disease, stroke, cancer and diabetes
- Women report - HTN & arthritis
- Men report - heart disease and cancer
Affording healthcare services
- Medication for chronic illness - averag
What are Attitudes towards older adults?
*Crucial to recognize attitudes toward aging and older adults
- individual
- Society
- Culture
When and who coined the term "ageism"?
The term "ageism" coined in 1968 by Robert Butler
What is ageism?
The prejudices and stereotypes that are applied to older people sheerly on the basis of their age
What are manifestations of ageism?
*Negative stereotypes including:
- Social isolation
- Psychological rigidity
- Asexual behavior
- Lack of creativity
- Physical and mental decline
- Economic and familial burden
The majority of old people are senile.
False. About 10% of older people have some form of dementia or severe mental illness. Another 10% have some mild or moderate cognitive impairment. The majority of people over 65 have neither.
The majority of old people feel miserable most of the time.
False. A national survey showed about half of those surveyed stated that they were either as happy or happier than they had been at younger ages. One quarter of those surveyed said that this was the unhappiest time of their lives.
Physical strength tends to decline with age
True. Physical strength tends to decrease from about the third decade onward.
At least one tenth of the aged are living in long stay institutions (such as nursing home, mental hospitals, homes for the aged).
False. This is one of the most persistent misconceptions about older people. Only about 5% of older people are in long term care facilities at any one time. However, the chances of being in an institution do increase with age, and as many as 40% of older
Aged drivers have fewer accidents per driver than those under age 65.
True. Older drivers have about the same accident rate as middle aged drivers, but a lower accident rate than drivers under 30. However, older drivers tend to drive fewer miles per year.
Older workers usually cannot work as effectively as younger workers.
False. There are some declines in perception and reaction speed among the older population in general, but studies of employed older people under actual working condition generally show they perform as well as or better than younger people on most measure
Over three fourths of the aged are healthy enough to do their normal activities without help.
True. More than 85% of the aged are able to take care of their own activities of daily living. About 5% of those 65 and over are institutionalized, and another 5 to 8 percent need help with those activities.
Old people usually take longer to learn something new.
True. Older people do tend to take longer to learn something both when compared to younger people, and also compared to their own performances when younger. Factors involved appear to be illness, lack of practice or motivation, and learning style. When th
Depression is more frequent among the elderly than among younger people.
False. Major depression is less common among older people than younger age groups. Unfortunately however, older people have a higher suicide rate than younger individuals. There are probably many reasons for this, among them would be the likelihood of unt
In general, old people tend to be pretty much alike.
False. There is as much variation among older people as there are of people at any age. In fact, a case could be made that after a lifetime of experiences, older people are actually more diverse as a group than younger persons.
Older workers have fewer accidents than younger workers.
True. Older workers do have fewer accidents than younger ones, probably at least in part due to avoidance of dangerous situations and hazardous jobs.
The majority of medical practitioners tend to give low priority to the aged.
True. This has been a long term problem, resulting in fewer physicians who specialize in geriatrics - although the need for geriatric specialists is only going to increase over time.
The majority of old people are working or would like to have some kind of work to do (including housework and volunteer work).
True. According to a rather old study (1981) over three quarters of older people either work or would like to work, when all work is counted - actual employment, house work, and volunteer work.
Old people tend to become more religious as they age.
False. Several studies appear to show that although the current generation of older people may be more religious than younger generations, it is because they were more religious throughout their lives, not because they became more religious as they aged.
What attitudes about the older adult and aging have you seen?
Give examples
Personal Answer
What effect can these have on older adults in general?
Personal Answer
What effect on health care?
Personal Answer
What would you consider successful aging?
Personal Answer
Study of diverse group of older adults found that all or most racial/ethnic groups identified:
Longevity, leisure, spirituality, social involvement, continuous learning, and good physical and cognitive health as essential
Other findings of studies include having a sense of purpose in life
Studies in Brazil and Britain found:
leisure activities, psychosocial support, functional capacity, health and perceived well-being, and family and social relations and engagement important components
Nursing study in Brazil
Found viewpoint that old age was a time for experiencing new possibilities and felt that being healthy was essential for maintaining their autonomy
Applied to people who have overcome disabilities and disease
Examples:
Grandma Moses - painted with arthritis
Monet - painted with cataracts
Renoir - painted with clenched fist from arthritis
Pablo Casals - Played cello each day in his 90s
Maurice Ravel - composed Bolero after affected with dementia
In 2025, it is projected to be how many individuals over the age 65 and over?
800 million individuals
What are reasons for increase in elderly population?
*Longer life expectancy
*Advances in medical care
*Advances in disease prevention, screening services, & health maintenance
*Aging of "baby boomer" generation
Changes in the Integument
*Skin
*Most obvious change to others
*Thinning, dryness, roughness, wrinkles, and lightening are to be expected
*These changes may affect the absorption of some topical medications
Changes in Epidermis
*Slower epithelial renewal
*Regeneration slows
-Significant for slowed wound healing
*Melanocytes decreases in some areas
-Lightening of overall skin tone
-Decrease in protection from ultraviolet rays
*Melanocytes increased in some
-Pigment spots enlarge
Changes in Dermis
*Loses about 20% of thickness
*Dermal blood vessels reduced
*Collagen synthesis decreases
*Elastin fibers thicken and fragment
*Decreased vascular supply to hair bulbs, eccrine, apocrine, and sebaceous glands
*Nerve density decreases
Changes in the Hypodermis
*Subcutaneous fat reduced
-Affects thermal regulation
*Subcutaneous fat "shifts" locations
-Decreased fat around orbit of the eye
-Amount of adipose tissues increases in the abdomen and in women in the thighs
Changes in Musculoskeletal System
*Vertebral disks become thin
*Slight curvature of cervical vertebra
*Stooped, slightly bent forward posture is common
*Shoulder width decreases
*Chest & Pelvis width increases
*Abdominal length decreases