Care for Elderly

Old age consists of ages nearing or surpassing the average life span of human beings, and thus the end of the human life cycle. Euphemisms and terms for old people include seniors (American usage), senior citizens (British and American usage), older adults (in the social sciences[1]), the elderly, and elders (in many cultures including the cultures of aboriginal people). Old people often have limited regenerative abilities and are more prone to disease, syndromes, and sickness than younger adults. For the biology of ageing, see senescence.

The medical study of the aging process is gerontology, and the study of diseases that afflict the elderly is geriatrics. Contents [hide] * 1 Definition * 2 Changes associated with aging * 3 Demographic changes * 4 Psychosocial aspects * 5 Life expectancy * 6 Assistance and Care * 7 See also * 8 References * 9 External links| -------------------------------------------------

[edit]Definition

Elders from Turkey, 2010

The boundary between middle age and old age cannot be defined exactly because it does not have the same meaning in all societies. People can be considered old because of certain changes in their activities or social roles.

Get quality help now

writer-Charlotte

Verified writer

Proficient in: Aging Process

4.7 (348)

“ Amazing as always, gave her a week to finish a big assignment and came through way ahead of time. ”

+84 relevant experts are online

Hire writer

Examples: people may be considered old when they become grandparents, or when they begin to do less or different work—retirement. Most countries have accepted the chronological age of 65 years as a definition of 'elderly' or older person. German chancellor Otto von Bismarck created the world's first comprehensive government social safety net in the 1880s, providing for old age pensions. In the United States of America, and the United Kingdom, the age of 65 was traditionally considered the beginning of the senior years because, until recently, United States and British people became eligible to retire at this age with full Social Security benefits.

In 2003, the age at which a US citizen became eligible for full Social Security benefits began to increase gradually, and will continue to do so until it reaches 67 in 2027. Full retirement age for Social Security benefits for people retiring in 2012 is age 66.[2] Originally, the purpose of old age pensions was to prevent elderly persons from being reduced to beggary, which is still common in some underdeveloped countries, but growing life expectancies and elder populations has brought into question the model under which pension systems were designed.

Changes associated with aging
Main article: Aging

A grey-haired old woman from the United Kingdom

There is often a general physical decline, and people become less active. Old age can cause, amongst other things: * Wrinkles and liver spots on the skin due to loss of subcutaneous fat

* Change of hair color to gray or white
* Hair loss
* Reduced circulatory system function and blood flow
* Reduced lung capacity
* Reduced immune system function
* Changes in the vocal cords[citation needed] that produce the typical "old person" voice * Heightened risk for injury from falls that otherwise would not cause injury[3] * Lessened and weakened hearing. Of individuals 75 and older, 48% of men and 37% of women encounter difficulties in hearing. Of the 26.7 million people over age 50 with a hearing impairment, only one in seven uses a hearing aid * Diminished eyesight. It becomes more difficult to read in low lighting and in smaller print. Speed with which an individual reads may also be impaired. * Reduced mental and cognitive ability[4]

* Depressed mood[5]
* Lessening or cessation of sex, sometimes because of physical symptoms such as erectile dysfunction in men, but often simply a decline in libido.[citation needed] * Greater susceptibility to bone and joint diseases such as osteoarthritis and osteoporosis * Memory loss is common due to the decrease in speed of information being encoded, stored, and received. It may take more time to learn new information. Alzheimer's disease, the most common form of dementia, is found in old age. It is a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 80 percent of dementia cases. * Behavioral changes can include wandering, physical aggression, and verbal outbursts due to diseases such as depression, psychosis, or dementia.

Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing. According to Cox, Abramson, Devine, and Hollon (2012), old age is a risk factor for depression caused by prejudice (i.e., “deprejudice”). When someone is prejudiced against the elderly and then becomes old herself, her anti-elderly prejudice turns inward, causing depression. “People with more negative age stereotypes will likely have higher rates of depression as they get older.” [6] It must be stressed that each individual is different, and health issues that affect one elderly person may not affect another.

Demographic changes

Population aged at least 65 years in 2005

In the industrialized countries, life expectancy has increased consistently over the last decades.[7] In the United States the proportion of people aged 65 or older increased from 4% in 1900 to about 12% in 2000.[8] In 1900, only about 3 million of the nation's citizens were 65 or older (out of 76 million total American citizens). By 2000, the number of senior citizens had increased to about 35 million (of 280 million US citizens). Population experts estimate[citation needed] that more than 50 million Americans—about 17 percent of the population—will be 65 or older in 2020. The number of old people is growing around the world chiefly because of the post–World War II baby boom, and increases in the provision and standards of health care. The growing number of people living to their 80s and 90s in the developed world has strained public welfare systems and has also resulted in increased incidence of diseases like cancer and dementia that were rarely seen in premodern times.

When the United States Social Security program was created, persons older than 65 numbered only around 5% of the population and the average life expectancy of a 65 year old in 1936 was approximately 5 years, while in 2011 it could often range from 10–20 years. Other issues that can arise from an increasing population are growing demands for health care and an increase in demand for different types of services.[citation needed] Of the roughly 150,000 people who die each day across the globe, about two thirds—100,000 per day—die of age-related causes.[9] In industrialized nations, the proportion is much higher, reaching 90%.

Psychosocial aspects

An elderly Somali woman.

According to Erik Erikson’s "Eight Stages of Life" theory, the human personality is developed in a series of eight stages that take place from the time ofbirth and continue on throughout an individual’s complete life. He characterises old age as a period of "Integrity vs. Despair", during which a person focuses on reflecting back on his life. Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness and despair. Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death.[10][11][12] Coping is a very important skill needed in the aging process to move forward with life and not be 'stuck' in the past. The way a person adapts and copes, reflects his aging process on a psycho-social level (Griffiths,Y & Thinnes,A).

Newman & Newman proposed a ninth stage of life, Elderhood. Elderhood refers to those individuals who live past the life expectancy of their birth cohorts. There are two different types of people described in this stage of life. The "young old" are those healthy individuals who can function on their own without assistance and can complete their daily tasks independently. The "old old" are those who depend on specific services due to declining health or diseases. This period of life is characterized as a period of "immortality vs. extinction." Immortality is the belief that your life will go on past death, some examples are an afterlife or living on through one's family. Extinction refers to feeling as if life has no purpose, an individual could have lived past all family and friends and feel a great loss. The Disengagement Theory is a mutual withdrawal between elders and society that takes place in anticipation of death. Older people become free from work and family responsibilities allowing them to enjoy the rest of their lives peacefully.

They begin to interact less often and activity levels are decreased. However, not all older adults prefer to be disengaged (Berk, 2007). The process of aging and the ways with which it is dealt are directly related to the society to which the aging person belongs. Therefore, disengagement theory is mostly connected with societies that do not place an emphasis on the value, importance, and respectibility of its elders. Many modern societies for example, value high efficiency and contribution, neither of which the elderly are able to provide as well as their younger counterparts. In many ways, they are seen as burdens to these societies, which triggers mutual disengagement between the elderly and the rest of society. According to the disengagement theory, the elderly who disengage take it upon themselves to do so for the benefit of society. In response to the Disengagement Theory, The Activity Theory of Old Age is a theory of aging which states that the psychological and social needs of the elderly are no differenct from those of the middle-aged and that it is neither normal nor natural for older people to become isolated and withdrawn. This theory is also often called the Implicit Theory Of Aging".

Life expectancy

In most parts of the world, women live, on average, longer than men; even so, the disparities vary between 9 years or more in countries such as Sweden and the United States to no difference or higher life expectancy for men in countries such as Zimbabwe and Uganda.[13] The number of elderly persons worldwide began to surge in the second half of the 20th century. Up to that time (and still true in underdeveloped countries), five or less percent of the population was over 65. Few lived longer than their 70s and people who attained advanced age (i.e. their 80s) were rare enough to be a novelty and were revered as wise sages. Accidents and disease claimed many people before they could attain old age, and because health problems in those over 65 meant a quick death in most cases. If a person lived to an advanced age, it was due to genetic factors and/or a relatively easy lifestyle, since diseases of old age could not be treated before the 20th century.

Assistance and Care

Old man at a nursing home in Norway.

According to the Journal "Demography", there is a rise in the elderly living alone if not with a spouse. Individuals 75 and older have decreased in amount needing help taking care of themselves. Many new assistive devices made especially for the home have contributed greatly to this. Some examples of devices are a shower seat (making it so the person does not get tired in the shower and fall), a bed cane (offering support to those with unsteadiness getting in and out of bed), and an ADL cuff (used with eating utensils for people with paralysis or hand weakness).[citation needed] However around 25% of individuals 85 and older say that they need help with their activities of daily living. There are many options for long term care to those who require it. There is home based care where a family member, volunteer, or trained professional will aid the person in need and help with daily activities. Another option is community services which can provide the person with transportation, meal plans, or activities in senior centers. A third option is assisted living where 24 hour round the clock supervision is given with aid in eating, bathing, dressing, etc. A final option is a nursing home which provides professional nursing care.[citation needed]

Physiological Changes

While some changes in old age are readily apparent to those around us, there are many more that do not show any outward signs. Since our bodies begin their decline around the age of thirty, the percentages quoted below are based on age 30 being 100%. * Heart pumping efficiency decreases 20% by the time we reach 55 * Kidney function decreases 25% by the time we are 55

* Breathing capacity decreases 40% by age 55 and 60% by age 75 Physical Changes

When it comes to physical changes as we age, most are pretty obvious such as graying hair, loss of hair, stooped appearance, aged skin, slower movements, etc. Other changes are not so noticeable but more debilitating. These can include loss of bone density (osteoporosis), hip or knee degeneration, compressed spinal discs, arthritis, reduced eyesight, hearing loss and balance issues-.

Some of the mental changes noticed in old people are as below.

1) Learning :- Older people are more cautious about learning need more time to integrate their responses are less capable of dealing with new material that cannot readily be integrated with earlier experiences and are less accurate than younger people.

2) Reasoning :- There is a general reduction in the speed which the individual reaches a conclusion in both inductive and deductive reasoning. This is partly the result of the tendency to become increasingly cautions with age.

3) Creativity :- Older people tend to lack the capacity of interest in creative thinking. Thus significant creative achievement are less common among older people than among younger ones.

4) Memory :- Old people tend to have poor recent memories but better remote memories. This may be due partly to the fact that they are no always strongly motivated to remember things partly to lack of attentiveness and partly to not hearing clearly and instinctively what others say.

5) Recall :- Recall is affected more by age than recognition. Many older people use cues, especially visual auditory and kinesthetic ones to aid their ability to recall.

6) Reminiscing :- The tendency to reminisce about the past becomes increasingly more marked with advancing age. How much the individual depends mainly on how pleasant or unpleasant the elderly find their living conditions now.

7) Sense of humor :- A common stereotype of the elderly people is humorless tendency. While it is true that their comprehension of the comic tends to decrease with advance age, their appreciation for the comic than they can comprehend increases.

8) Vocabulary :- Deterioration of vocabulary is very slight in old age because elderly people constantly use words most of which were learned in childhood or adolescence. Learning new words in old age is more infrequent than frequent.

9) Mental rigidity :- When mental rigidity sets in during middle age it tends to become more pronounced with advancing age partly because the elderly learn more slowly and with more differently than they did earlier and partly because they believe that old values and ways of doing things are better than new ones.

Today I interviewed an elderly woman who is a resident in the Webster County Nursing Home. As I entered her room, she was sitting up awake and alert. As we talked, I explained to her that as a nursing student, I'm required to complete a paper on any person over the age of sixty-five. I asked her if it would be okay to interview her. She enthusiastically agreed, therefore, I proceeded with the interview. I first took her vital signs. They were as followed:

Temperature (oral): 97.8
Pulse: 92
Respirations: 22
Blood Pressure: 170/60

She stated my name, followed by hers. She said that she was at home but couldn't recall the time or the year. Therefore, she was oriented to person and place but not to time. As she spoke, her speech was clear and understandable. Her hair and scalp was clean and intact. Facial structures and ears were symmetrical. Her hand-grips were strong and equal. Her nail beds were clean with a capillary refill of < 3 seconds. Her skin was warm and dry with no signs of bruises or abrasions on upper extremities. Her breath sounds were equal bilaterally with no coughing present. Her apical heart rate was 96 beats per minute. During the course of the interview, she stated that she was born in Tupelo, Ms on September 6, 1921.

She worked as a meter maid in Clarksdale, Ms for over twenty years. She said that she was married in Roanoke, Virginia but she couldn't recall the year that it occurred. She had two sons but couldn't remember their birthdates. She said that the only surgery she has experienced was a hysterectomy, which was done some years after her second son was born. She has not been hospitalized in years and never used any type of home remedies that she could recall. She stated that for her age, she feels that her health is excellent. The most exciting historical event that she experienced was when her husband came home from the war. Her advice for bringing children up in today's society was "Leave them alone...