EldersChapter 9
Introduction• Number of elders and the proportion to the  total population increased significantly in the  20th century• R...
Definitions•   Aged•   Aging•   Gerontology•   Geriatrics•   Geriatrician• Terms – seniors, older adults, mature adults,  ...
Aging Myths• Ageism – prejudice and discrimination against  the aged• Common myths not accurate representation of  elders ...
Demography of Aging• Size and growth of the elder population  • Population pyramids describe aging of    populations  • Am...
Symbolic Age Pyramid
Population Pyramids, U.S.
Factors Affecting Population Size and Age• Fertility rates   • Baby boomers – 1946-1964• Mortality rates   • Life expectan...
Dependency and Labor Force Ratios• Dependency ratio – economically  unproductive to economically productive  • Traditional...
Dependency Ratio, U.S., 2010-2050
Other Demographic Variables• Affect community health programs for older  Americans  •   Marital status  •   Living arrange...
Marital Status• ¾ of elder men are married; just over half of  elder women are married• Elder women 3x’s more likely to be...
Living Arrangements• Closely linked to income, health status, and  availability of caregivers• 2/3 of noninstitutionalized...
Racial and Ethnic Composition• U.S. older population growing more diverse• 2010 elders:  • 80% white, 9% black, 7% of Hisp...
Geographic Distribution• 2/5 live in southern states• More than half live in 10 states: CA, FL, IL,  MI, NJ, NY, NC, OH, P...
Economic Status• 1970 – 25% of elders lived in poverty• 2006 – less than 9% lived in poverty• Income  •   37% of elder inc...
Housing• Most live in adequate, affordable housing• 80% own, 20% rent• Elder homes are more likely to be older, more  like...
Health Profile• Health status of elders has improved over the  years (living longer and functional health)• Chronically di...
Mortality• Top causes of death for elders (responsible for  2/3 of deaths)  •   Heart disease  •   Cancer  •   Stroke  •  ...
Morbidity• Activity limitations increase with age• Chronic conditions  • Substantial burden on health and economic    stat...
Health Behaviors and Lifestyle Choices• Generally have more favorable health  behaviors than younger counterparts  • Less ...
Elder Abuse and Neglect• Reports have increased greatly in recent years• All states have set up reporting systems• Special...
Instrumental Needs of Elders• Six instrumental needs that determine lifestyle  for people of all ages; aging process can a...
Income• Change in types of expenses in elder years• Social Security is major source of income for  ~2/3 of recipients; 90%...
Housing• Major needs: appropriateness, accessibility,  adequacy, affordability     • Needs are intertwined• Changing place...
Personal Care• Four levels of tasks that may need assistance:  • Instrumental tasks, expressive tasks, cognitive    tasks,...
Health Care• Elders heaviest users of health care services  • Use of health care services increases with age     • Most mo...
Transportation• Transportation allows elders to remain  independent• On average, elders live 10 year after they stop  driv...
Community Facilities and Services• Older Americans Act of 1965 (OAA) to  increase services and protect rights of elders  •...
Community Facilities and Services•   Meal service•   Homemaker service•   Chore and home maintenance•   Visitor service•  ...
Discussion Questions• What can happen to increase the likelihood of  elders utilizing community facilities and  services?•...
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Ch09 outline

  1. 1. EldersChapter 9
  2. 2. Introduction• Number of elders and the proportion to the total population increased significantly in the 20th century• Represent 12.8% of population • 1 in every 8 Americans age 65+• Young old – 65-74• Middle old – 75-84• Old old – 85+
  3. 3. Definitions• Aged• Aging• Gerontology• Geriatrics• Geriatrician• Terms – seniors, older adults, mature adults, elderly, aged, etc.
  4. 4. Aging Myths• Ageism – prejudice and discrimination against the aged• Common myths not accurate representation of elders • Majority of elders today are active and well • Many still working • Many strongly engaged in community, volunteer, and advocacy programs
  5. 5. Demography of Aging• Size and growth of the elder population • Population pyramids describe aging of populations • America’s pyramid shape has drastically shifted • Other countries have had shifts as well • 85+ fastest growing segment of older population • Growth in median age
  6. 6. Symbolic Age Pyramid
  7. 7. Population Pyramids, U.S.
  8. 8. 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• Migration • Movement of people from one country to another can affect population size
  9. 9. Dependency and Labor Force Ratios• 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 dependants will be lower in the future than today
  10. 10. Dependency Ratio, U.S., 2010-2050
  11. 11. Other Demographic Variables• Affect community health programs for older Americans • Marital status • Living arrangements • Racial and ethnic composition • Geographic distribution • Economic status • Housing
  12. 12. Marital Status• ¾ of elder men are married; just over half of elder women are married• Elder women 3x’s more likely to be widowed • Men have shorter life expectancies • Men tend to marry women younger than selves • Men more likely to remarry after loss of spouse• Number of divorced elders continues to rise • New concerns: lack of retirement benefits, insurance, lower net worth assets
  13. 13. Living Arrangements• Closely linked to income, health status, and availability of caregivers• 2/3 of noninstitutionalized elders live with someone else • Women more likely to live alone• Only 5% of elders live in nursing homes • ¾ of nursing home residents are women • More than half of nursing home residents are 85+
  14. 14. Racial and Ethnic Composition• U.S. older population growing more diverse• 2010 elders: • 80% white, 9% black, 7% of Hispanic origin, 3% Asian• 2050 projection of elders: • White 58%, Hispanic origin 15%, black 11%, Asian 8%
  15. 15. Geographic Distribution• 2/5 live in southern states• More than half live in 10 states: CA, FL, IL, MI, NJ, NY, NC, OH, PA, TX• California greatest number; Florida greatest proportion• Reasons some states “age” • Inward migration (FL), young people leave (farm belt states)
  16. 16. Economic Status• 1970 – 25% of elders lived in poverty• 2006 – less than 9% lived in poverty• Income • 37% of elder income from Social Security • 15% asset income • 18% pension income • 28% earnings
  17. 17. Housing• Most live in adequate, affordable housing• 80% own, 20% rent• Elder homes are more likely to be older, more likely to have lower value, in great need for repairs, less likely to have central heat/air• 30% of elders pay more for housing than they can afford
  18. 18. Health Profile• Health status of elders has improved over the years (living longer and functional health)• Chronically disabled has been decreasing• Health status usually not as good as younger counterparts
  19. 19. Mortality• Top causes of death for elders (responsible for 2/3 of deaths) • Heart disease • Cancer • Stroke • CLRD • Alzheimer’s Disease
  20. 20. Morbidity• Activity limitations increase with age• Chronic conditions • Substantial burden on health and economic status of individuals, families, and nation • 1/3 report limitation of activity due to chronic conditions• Impairments • Very prevalent in older adults • May be sensory, physical, memory
  21. 21. 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
  22. 22. Elder Abuse and Neglect• Reports have increased greatly in recent years• All states have set up reporting systems• Special problem for elders • May be frail • Unable to defend themselves • Vulnerable to telemarketing and mail scams • Most common victims of theft of benefit checks
  23. 23. Instrumental Needs of Elders• 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
  24. 24. Income• Change in types of expenses in elder years• Social Security is major source of income for ~2/3 of recipients; 90% of income for 1/3• Nonmarried women and minorities have highest rates of poverty
  25. 25. Housing• Major needs: appropriateness, accessibility, adequacy, affordability • Needs are intertwined• Changing place of residence can have negative effect on elder and family members• Group housing • Nursing homes, Eden Alternative facilities, Green Houses, retirement communities, CCRCs, assisted-living
  26. 26. 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) to measure functional limitations• Instrumental activities of daily living (IADLs) to measure more complex tasks• Caregiver issues• Caregiver services
  27. 27. Health Care• Elders heaviest users of health care services • Use of health care services increases with age • Most money spent on health care is in last years of life• Medicare primary source of payment for health care services of elders • Will see major changes in future years
  28. 28. Transportation• Transportation allows elders to remain independent• On average, elders live 10 year after they stop driving• Greatest influence on transportation needs: • income and health status• Many public transportation challenges• Solutions for transportation needs of elders
  29. 29. Community Facilities and Services• Older Americans Act of 1965 (OAA) to increase services and protect rights of elders • National nutrition programs for elders • State and Area Agencies on Aging • Other programs• Services can vary greatly across the country
  30. 30. Community Facilities and Services• Meal service• Homemaker service• Chore and home maintenance• Visitor service• Adult day care• Respite care• Home health care• Senior centers
  31. 31. Discussion Questions• What can happen to increase the likelihood of elders utilizing community facilities and services?• How will the changing demographics of elders affect health care services?

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