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ATTITUDES ABOUT AGING. Objectives. Describe the Graying of America concept and the demographic trends of older adults in the United States. Discuss the concept of ageism and its relevance to nursing. Delineate myths about aging and understand why they are false.

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  • Describe the Graying of America concept and the demographic trends of older adults in the United States.
  • Discuss the concept of ageism and its relevance to nursing.
  • Delineate myths about aging and understand why they are false.
  • Discuss the concept of successful, creative aging.
  • Describe spirituality as an integral component of high quality health care for older adults.
  • Include spiritual assessment and care in the comprehensive care plan for older adults.
  • Identify the myths and issues surrounding older adults’ sexuality.
  • Describe the normal changes and problems with sexuality of older adults.
sub categories

Young Old = 65-74

Old Old = 75-84

Oldest Old = 85+

the nation is graying
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.
demographic trends
Demographic Trends
  • We are living longer
    • Male 77 years
    • Female 83 years
  • Older adults are predominantly women (3-to-2)
  • Personal relationships are changing.
demographic trends8
Demographic Trends
  • We are becoming more educated
  • You may never retire or will retire more than once
  • Chronicity is probable
  • Caregiver burden is increasing
where do they live
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
demographic trends10
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
demographic trends11
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
ageism the prejudice stereotyping and scapegoating of people based solely on age
Ageism : the prejudice, stereotyping, and scapegoating of people based solely on age.

“OVER the Hill”

  • 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


myths about aging
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.”
new attitudes successful creative aging
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

creative expression
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.
human potential phases
Human Potential Phases
  • Midlife Re-evaluation Phase
  • Liberation Phase
  • Summing Up Phase
  • Encore Phase
creativity assessment
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?
  • 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
spiritual assessment
Spiritual Assessment
  • Instruments
    • Stoddard’s spiritual assessment instrument
  • Spiritual Interventions
    • Acknowledge role of religion and spirituality
    • Inquire about religious or spiritual beliefs and practices
    • Refer to clergy
    • Provide spiritual counseling
    • Pray for or with the patient
myths about sexuality
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
myths about sexuality21
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
sexuality changes
Sexuality: changes


  • Lack of testosterone in men (male menopause)
  • Lack of estrogen, progesterone and androgen in women
sexuality changes23
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

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
assessing sexuality
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?
  • Graying of America
  • Ageism
  • Myths
  • Successful, creative aging
  • Spirituality and assessment
  • Sexuality: myths, issues, and normal changes