ATTITUDES ABOUT AGING

1. ATTITUDES ABOUT AGING

2. 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. • Discuss the concept of successful, creative aging.

3. Objectives • 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.

4. Sub-categories Young Old = 65-74 Old Old = 75-84 Oldest Old = 85+

5. 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.

6. Demographic Trends • We are living longer • Male 77 years • Female 83 years • Older adults are predominantly women (3-to-2) • Personal relationships are changing.

7. Cultural diversity is increasing

8. Demographic Trends • We are becoming more educated • You may never retire or will retire more than once • Chronicity is probable • Caregiver burden is increasing

9. 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

10. 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

11. 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

12. 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 “fuddy-duddy”

13. 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.”

14. 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

15. 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.

16. Human Potential Phases • Midlife Re-evaluation Phase • Liberation Phase • Summing Up Phase • Encore Phase

17. 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?

18. 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

19. 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

20. 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

21. 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

22. Sexuality: changes Hormones • Lack of testosterone in men (male menopause) • Lack of estrogen, progesterone and androgen in women

23. 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

24. 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

25. 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?

26. Summary • Graying of America • Ageism • Myths • Successful, creative aging • Spirituality and assessment • Sexuality: myths, issues, and normal changes

27. Questions?