OUR LATER YEARS CHAPTERAspects of aging that affect our… Health S o c i a l E m ot i o n a l We l l b e i n g Re p r o d u c t i v e H e a l t h a n d S e x u a l i t y“Our we as old as we look or as oldas we feel”
QUESTIONS FOR THOUGHT???1. How can we make the adaption needed tomaximize good health and maintain Independenceand Quality of Life?2. How much medical intervention are wecomfortable with in our later years? (60 -80 yrs.) Breast Exams Vaginal Exams Preventative Health3. How does sex and sexual pleasures fit into ourlives in our later years?
THE NEW OLD AGEAging has become feminized Women live longer Fitness becomes a problem as weage 65 and older12% live in poverty Our bodies in context Most cultures value and honor olderpeople*In the United States they idealize the young and discriminateagainst older adults.
ADVERTISEMENTSAdvertisements play on and exaggerate a women’s fear andanxieties about the natural changes in their body as they age Pharmaceutical – Hormonereplacement & cologin Plastic Surgery – Botox & LaserTreatment Cosmetics – Oil of Olay & Clinique“ Self acceptance as we age can be hard won but…invaluable” pg 550
RELATIONSHIPSMaintaining Connections Set new goals as relationships change Evaluate or assess our love andrelationships Change in gestational hierarchy infamilyNo matter how we define relationships, social connections havepositive effect on ones healthDealing with Loss During our older years we experiencethe death of more friends andloved ones
GOING AT IT ALONE65 and older – 42% of women are widowed65 and older – 14% of men are widowed65 and older – 45% of women live alone65 and older – 19% of men live alone
AGING AND HEALTHWe all age dif ferentlysome women have developed disabilities froman early ageMore women develop disabilities in midlife orolder
PREVENTIVE MEASURES: TAKING CARE OF OURSELVESThe key word is preventionPrevention is doing what we can to take care of ourselves so asto avoid or ease the chronic conditions associated with later lifeHealthy habits include no nicotine and excessive alcohol and asmuch exercise and nutritious eating as possible.
PREVENTIVE MEASURES: TAKING CARE OF OURSELVES CONTINUEDThere are many factors beyond our control such as… Occupational Health Hazard High Blood Pressure Diabetes Ethnicity “Strive to make changes that are within out power”
BASIC PREVENTATIVE MEASURESStart and or continue to exerciseEngage your mindGet to bed – you need sleep just like young adultsSchedule checkups which can now be paid for by the 2010health care reform act
COMMON CHRONIC DISEASESHearth DiseaseOsteoporosisDiabetesArthritisForms of CancerUrinary incontinence… everyone’s favorite topicYou can visit www.cdc.gov/chronicdisease for moreinformation about chronic diseases
GUIDELINES FOR SEXUAL AND REPRODUCTIVE HEALTH CAREBy the age of 60 a women has undergone regular screenings for Cervical Cancer or Breast CancerLongevity is a recent phenomenon in women so…There is not a lot of data on screening for women over 85. It isimportant to maintain Vaginal Health Mamograms – every year for women age 50 -74 Pap screenings – 65 and older should discuss withtheir health care provider Bone screenings should be done at 65 and every 2years following
SEXUALIT YThe Sex Continuum Our society views older women as “drugged up” and sexless.Sexuality unlike, fertility, can continue throughout your lifeMany women enjoy sex more in the middle and later stages oftheir lives due to appreciating their body and sexuality morefullyAdjustments, disruptions or feeling less sexual can also resultfrom chronic or acute illness or surgery
PHYSICAL CHANGES THAT AFFECT SEXUALIT Y 2 01 0 H a r v a r d M e d i c a l S c h o o l S p e c i a l H e a l t h Re p o r t S ex u a l i t y i n M i d l i fe a n d B eyo n d Po s s i b l e A g e Re l a te d S ex u a l C h a n g e s f o r Wo m e n : P hy s i c a l C h a n g e s : Low estrogen Decreased blood flow to genitals Thinning of vaginal lining Muscle tone Desire – Decreased libido, fewer sexual thoughts Arousal – Reduced vaginal lubricants, less blood and congestion Orgasm – Delayed or absent Resolution – body returns rapidly to a non - aroused state “Only 22% of women discuss sex with a physician af ter 50”
PRACTICAL APPROACH TO AGE RELATED SEXUAL CHANGES Declining Health Body Changes Chronic Illness Medication Health Benefits to Sexual Activity Expand Energy Burns Calories – Brain release endorphins Reduced Stress Sleep Better Delay or minimize incontinence by working pelvis Delay Pain – Orgasm can reduce pain
LOSS OF DESIREWomen experience a shift in levels of desire throughout theirlivesReasons for less sexual desire include: Overwork and anxiety Loss of newness Abuse Gradual changes/accommodations Not being attracted
PLEASURING OTHERS AND YOURSELFViagra and other erectile dysfunction medications exist for men Navigating Health CareIn the twenty -first century medical care there is a greatshortage of doctors, nurses, psychologists, psychiatrists,dentists and other health care professionals trained in caringfor older adults
THE INSTITUTE OF MEDICINEPredictions in the near future…2007 = 1 geriatrician for every 2,546 older adults2030 = 1 geriatrician for every 4,254 older adults2007 = 1 geriatric psychiatrist for every 11,372 olderadults2030 = 1 geriatric psychiatrist for every 20,195 olderadults
WRONG DIAGNOSIS, WRONG TREATMENTProviders without adequate training may treat older womeninaccurately They may not fully treat chronic illness Misdiagnosis or fail to manage reversible conditions Over proscribe medications People over the age of 65 take 34% of medications Prescriptions are based on a yearly basis in the US They are only 13% of the US population
PLANNING AHEADBe proactive … Plan Ahead Look into retirement Health Care Long-term Care Housing Activities Your Community Can Help
PLANNING AHEAD CONTINUEDRetirement and Social SecurityPlanning ahead is critical in dealing with gaps in your earningduring employment years Raising children Taking care of older parentsHousingAs you get older you may… Move to a smaller home Get a roommate Moving to a retirement home Receive elder services in your own house
MORE PLANNING AHEADHousehold help and Long Term CareLong term care services are very expensiveCommunity Living Assistance Services and Support Act (ClassAct) 2010 Health Reform Law Voluntary Long-Term Care insurance program for senior and disabled people topay no medical services and support Contribute for 5 years – A benefit on average of $50 a day
HEALTH AND LEGAL DECISIONPower of Attorney – A trusting person has the authority to act onyour behalf in financial and legal matters if unable to takeaction yourselfHealth Care Proxy Document – A person you trust authority tomake medical testing and treatment decisionsMedical Advance Directive or Living Will – Describes the medicaltreatment one wishes to receive or refuse… and under whatconditions
END OF LIFE CARESometimes medical science, not the concern of a women’s lifequality, shapes the advice we receive about death and dying Talk to a health care provider about your wishes You need to manage your own healthcareCompassionate end-of-life care that addresses you emotional,spiritual and practical needs is essential, regardless of the typeof treatment or care chosen
CAREGIVER66% of caregivers are women41% work full time13% work part timeThe economic value of caregivers unpaid contributionsis estimated at $375 billionCare givers have high rates of Depression Chronic Diseases Infections ExhaustionThis is compared to non-caregivers of the same age
RESPITE AND RESOURCESFamily Caregiver Alliance ( caregive.org) Information services and advocacy for caregiversNational Alliance for Caregivers ( caregiving.org) Non-profit coalition of national organizations focused as family caregiversRoselynn Carter Institute of Caregiving ( roselynncarter.org) Established local and state partnerships thatbuild quality long-term and home based servicesShare the Care (sharethecare.org) creative models in which neighborhoods helpfamilies
ACCEPTING CARE WHEN WE NEED ITWomen need to accept help without feeling deminishedHelpers need to provide choices when possibleLiving Full: Building Community, Continuing Advocacy“From the bottom of my heart: Life gets greater and moresurprising after 40, 50, 60 and yes 70.”-Gloria Steinem-One must have a sense of purpose and enthusiasm for life
ACCEPTING CARE WHEN WE NEED IT CONTINUEDYou need fulfillment during later yearsWhy do you need fulfillment… Less time left Clarified priorities More knowledge of what mattersDr. Gene Cohen, geriatric psychiatrist was convinced olderpeople have untapped wells of creativity and skills“Chocolate for the aging brain”
INTERGENERATIONAL LIVINGOlder women’s wisdom and skills are much needed by youngergenerationsWe must work toward building a society that celebrates andsupports the elderly
WORKING TOGETHER TO CREATE CHANGEOlder women need to build on the strength they have in numbersby creating and supporting programs that meet older women’sneedsSuch as… Long-Term Care Health Care Work-Family Balance Retirement securityEveryone will ageWomen need to continue to tell their stories of being mothers,sisters, daughters, caregivers, workers and push their local, stateand national governments to provide services for their older years!