Transcript ATTITUDES ABOUT AGING

ATTITUDES ABOUT
AGING
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Objectives
1. Describe the Graying of America concept
and the demographic trends of older
adults in the United States.
2. Discuss the concept of ageism and its
relevance to nursing.
3. Delineate myths about aging and
understand why they are false.
4. Discuss the concept of successful,
creative aging.
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Objectives
5. Describe spirituality as an integral
component of high quality health care for
older adults.
6. Include spiritual assessment and care in
the comprehensive care plan for older
adults.
7. Identify the myths and issues
surrounding older adults’ sexuality.
8. Describe the normal changes and
problems with sexuality of older adults.
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Sub-categories
Young Old = 65-74
Old Old
= 75-84
Oldest Old = 85+
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The nation is graying…..
In 2002, 65+ was 35.6 million (12.3% of US
population)
90% of nursing home patients
80% of home care patients
60% of hospitalized patients
In 2030, 65+ will be 71.5 million ( 20% of the US
population)
62.5% of new nursing graduates describe patients
ages 65 to 85 as the majority of the patient
population in their care, and 19.3% of new nursing
graduates worked with patients age 85 and older.
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Demographic Trends
 We are living longer
Male 77 years
Female 83 years
Older adults are predominantly
women (3-to-2)
Personal relationships are
changing.
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Cultural diversity is increasing
18%
17.24%
16.40%
16%
African-Americans
14%
Asians/Pacific
Islander
American Indian or
Native Alaskan
Hispanic-American
12%
10%
8%
6%
4%
Of Total Population
2%
0%
2000
2002
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Demographic Trends
We are becoming more educated
You may never retire or will retire
more than once
Chronicity is probable
Caregiver burden is increasing
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Where do they live?
 California
>3.7 million (10.4%)
Florida
2.9 million (8.2%)
New York
2.5 million (7.0%)
Texas
2.2 million (6.2%)
Pennsylvania
1.9 million (5.3%)
Ohio
>1 million (3.1%)
Illinois
>1 million (3.1%)
Michigan
>1 million (3.1%)
New Jersey
>1 million (3.1%)
Source: Profile of Older Americans, 2003 edition, Administration on Aging, US
Department of Health and Human Services
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Demographic Trends
• Increasing number of older adults
hospitalized with average LOS 5.8 days
•1.56 million in nursing homes;1.78 million in
senior housing
• 6.2 MD contacts/yr; Increasing out-of-pocket
health care expenses = $3,586/year
•Social Security, income from assets,
pensions, and earnings make up major
sources of seniors’ income
•30% report sedentary lives
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Demographic Trends
• 50% of those 70 and older have osteoarthritis,
50% have hypertension, and 20% have heart
disease
•Net worth of older people has improved
($108,885), yet with marked racial/ethnic and
educational disparities
•$13,000 – older black households
•$181,000 – older white households
•26.1% of older adults (young old) and 45.1% of
75+ are limited by a chronic condition; 73.6% of
those aged 80+ report at least one disability
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Ageism : the prejudice,
stereotyping, and scapegoating of
people based solely on age.
• Fear of death
• Emphasis on youth culture
• Decline of productivity and
economic potential
• Research only examines negative
stereotypes of old age
• Nursing’s view of care of the
elderly – follows culture
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Myths about aging….
•“To be old is to be sick.”
•“You can’t teach an old dog new tricks.”
•“The secret to successful aging is to
choose your parents wisely.”
•“Older people don’t pull their own weight.”
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New Attitudes: Successful,
creative aging
Aging as growing (adaptation)
Aging as life-long learning
Aging as self expression
Aging as a wisdom
Aging as a spiritual journey
Aging as a developmental process
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Creative Expression
• A basic human attribute, sees life as a
journey, a process or an outlook, not a
product
• Types of creative expression: dance,
music, poetry, theater, art.
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Human Potential Phases
• Midlife Re-evaluation Phase
• Liberation Phase
• Summing Up Phase
• Encore Phase
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Creativity Assessment
– What makes you feel most alive?
– What projects give you pleasure?
– What skills do you desire to pass on?
– What are your sources of imagination?
– What creative issues are troubling you?
– What ways do you express yourself
creatively?
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Spirituality
• Spirituality vs. religion
– Purpose and meaning in life vs. organized
groups
• Research
– Connection between faith and health
– 82% believe prayer assists healing
– 75% use religious beliefs as a means of
coping
– 63% want doctors to ask about spirituality
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Spiritual Assessment
– Instruments
• Stoddard’s spiritual assessment instrument
– Spiritual Interventions
• Acknowledge role of religion and spirituality
• Inquire about religious or spiritual beliefs and
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practices
Refer to clergy
Provide spiritual counseling
Pray for or with the patient
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Myths about sexuality
• “Sexual desires diminish with age”
• Issues/facts:
• Little available information / attention to older
adults’ sexuality
• sexual patterns persist throughout their lives
• Societal view restricts the sexuality of older
adults
• Staff discomfort about sexual expression
among older adults – regarded as behavioral
problem
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Myths about sexuality
• “Sexual intercourse is mainly a younger
person’s activity for the purpose of
procreation”
• Issues/facts
• Older adults need to touch and be
touched
• Older adults may have difficulty accepting
and understanding sexuality
• Health care professionals do not facilitate
expression of sexuality
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Sexuality: changes
Hormones
• Lack of testosterone in men (male
menopause)
• Lack of estrogen, progesterone and
androgen in women
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Sexuality: changes
Physiological Changes
• Male: increased time for erection and
ejaculation, lower semen volume, longer
period between ejaculations; fatigue, loss of
muscle mass, depression, and decline in
libido
• Female: follicular depletion in ovaries, fewer
and shortened orgasmic contraction, labium
atrophy, shortened orgasmic phase,
dyspareunia; breast tissue replaced with fatty
tissue
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Sexuality
Sexual Problems
• Medical Conditions: cardiac
problems, diabetes, neurological
disorders, arthritis
• Medications and treatments may
interfere with sexual response
• 50% of older males have erectile
impotence
• Clients > 60 with AIDS has increased
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Assessing Sexuality
• Can you tell me how you express your sexuality?
• What concerns or questions do you have about
fulfilling your continuing sexual needs?
• In what ways has your sexual relationship with
your partner changed as you have aged?
• What interventions or information can I provide
to help you to fulfill your sexuality?
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Summary
• Graying of America
• Ageism
• Myths
• Successful, creative aging
• Spirituality and assessment
• Sexuality: myths, issues, and normal
changes
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Questions?
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