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VN 057 Intro to Gerontology. Categorizing the Population 55-64older 60-74 young-old 65-74 elderly...
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Transcript of VN 057 Intro to Gerontology. Categorizing the Population 55-64older 60-74 young-old 65-74 elderly...
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VN 057 Intro to Gerontology
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Categorizing the Population
55-64 older 60-74 young-old
65-74 elderly75-84 aged
75-84 middle-old85+ extremely aged
85+ old-old
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Attitudes About Aging
Role of the family/societyAgeism-myth vs fact
SocialFamilyJobsHealth care
Gerontophobia: Fear of aging Can be extreme
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Demographics
Life expectancies-HistoricallyBiblical times 20 years old1776 35 [though 65+ not uncommon]1900 47 [4% of pop. >65]2000 77.4 [13% of pop>65; 4%>85]Effects of improved sanitation, immunization, healthcare
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Demographics
What does greater numbers of older and elderly people mean?
l 1st time in history: Number of >65 is greater than number of children <5 years old.
Social securityMedicareWhat do you think?
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DemographicsGender and ethnic disparityGender Women outlive men by an average of 7 yearsEthnicity White women:81 black women: 76.9 White men: 76 black men: 70Hispanic & Asian variable, often depends on how long they’ve been in US
l ?what do you think???l Disease risk
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Baby Boomers
The largest single cohort in history1946-1964Started retiring in 2011One third of US population todayBy 2029, all will be retiredCauses the older population to be twice the size as it is today
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Baby Boomers
The good, the bad and the ugly... Influence on all areas of society through their life span How?
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Boomers
Informed consumersMore technologically advanced
Retirees in 2008 43% use internet
Retirees in 2009 77% use internet
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US Geography
Most elderly live in CA, TX, IL, MI, OH, PA, NY, NJ, FL
Least in Mid-west, north and mountain states
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Education
Average educational level Changed dramatically over last 30 years
1970 28% of people >65 graduated from high school
2008 78% had HS diploma 21% had Bachelor degree or higher
27% of men 16% of women
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Income After Retirement
2007 median incomes [½ make more, ½ less] Households: $43,159 Men: $24,142 Women: $13,877
Income disparity when working Housewife's [or lower earning spouse] dilemma
P husband's death, wife gets ½ whatever husband received in social security
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Income Sources
WorkSocial Security
Future of social security Based on income
savings/investmentsPensions
2007 about 1/3 receive at least some pension Ave Public: $16,629 Ave Private: $7,200
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Landmark Legislation
1965: medicare & medicaid1967: age discrimination act1972: SSI & social security indexed to inflation. 1972: Older adult nutrition act1990: ADA2006: Medicare drug act2012: Affordable care act
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Politics/Lobbies
AARP Major political force
NCSC:National Council of Senior CitizensNASC:National Alliance of Senior CitizensOWL: Older Women's LeagueGRAY PANTHERS
Public awareness & demonstrations
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Wealth
Discuss in small groups Frugal vs. Poor Home ownership: Positive and negative Income vs savings Discretionary vs non-discretionary spending
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Housing
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Independent Housing
Fully independent Intermittent caregiversFT or live in caregiversFamily
Own house or apartment Rented house or apartment Gvt subsidized
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Housing-Mostly Independent
Group housing Can be independent or assisted
Senior Housing Can be independent or assisted
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Modified, Non-Institutional
Community based residentialGroup housing
Can be independent or assisted
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Other housing
Institutional Assisted living Skilled nursing
Combination Life Lease Life care
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Medicare
Elderly and/or permanent disabilityComes with social security
Pays 80% UCR fees Part A
Inpatient hospital DRG's
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More Medicare
B, C and D premiums are optional and taken out of SS checkPart B
80% UCR Outpatient and MD officePart C
HMO Capitulation and co-pay
Part D Drug benefit-varies wildly by plan
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Medicare
Part b outpatient and MD-80% ucr feesPart c-HMO Capitulation usually with feesPart d-drug benefits
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??????
How many of you have ever been uninsured?Without a 2ndary insurance you will owe 20% after medicareHow much does an office visit cost?ER visit for chest pain?
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Supplemental Insurance
Private medicare supplement insuranceMedicaid
Medi-cal in CA Asset and income based If you own a house and receive benefits after
the age of 55-the state takes your house when you die
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Impact on Family
Societal changes Demographic changes
Smaller families Sandwich generation re-location
Cultural differences Expectations re responsibility for care Changes with acculturation
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Impact on Family
Spending time with childrenwisdomCaregiver stressors
Physical Emotional financial
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Abuse and Neglect
Self NeglectFamily or caregivers
Physical abuse [includes sexual] Emotional abuse Financial abuse Neglect Abandonment
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From the Victim....
Responses to abuse from the victim?
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Support
Support groupsRespite careReferrals
Alzheimer's [etc] association[s] Council on aging Senior's resource yellow pages Social workers Adult day health centers/senior centers
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Theories on aging
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Biological
Programmed Biological clock
Gene theory Harmful genes activate over time
Error theory Progressive decline in accuracy of cell division
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Biological
Free Radical Byproducts of metabolism create damaging free radicals
Wear and tearImmunological
Decreased immune function causes diseaseNeuro-endocrine
Hormonal changes trigger aging- like puberty signals sexual maturity
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Psychosocial
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Psychosocial
Disengagement Systematically separated from society Depression and withdrawal Used to justify agism
“mutually beneficial” [sic]
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Psychosocial
Activity theory Mental and physical activity needed to thrive
Life course Personality and personal adjustment through life
EricksonMidlife crisisNursing implications