Our Nation’s Elders:
The Facts
Chapter 1
McGraw-Hill/Irwin
© 2013 McGraw-Hill Companies. All Rights Reserved.
Ageism
The
assumption that personal traits of older
individuals and their situations are due to
age, not other factors.
“By ignoring an oppressed minority,
which we are inevitably going to join,
we do not realize that we are slashing
our own tires.”
– Alex Comfort
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Who are Our Nation’s Elders?
Elders
are defined as 65 and over.
In a survey by the National Council on Aging:
Most saw themselves as “young or middle-aged”
90% agreed that, “As I look back on my life I am
fairly well satisfied”
70% agreed that, “As I grow older things seem
better that I thought they would be”
Half agreed that “These are the best years of my
life”
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Who are Our Nation’s Elders?
Demographics
of elders is very
heterogeneous.
Demography
is the study of the size,
geographical distribution and vital statistics of
a particular group.
Information largely gathered via surveys
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Number and Growth of the
Older Population
Older
population is growing rapidly and will
continue to grow.
2004 – 1 in 8 people were 65 and over
2030 – 1 in 5 people may be 65 and over
Why?
Baby Boomers are “coming of age”
More people survive, birth rate is constant
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Life Expectancy
Life
expectancy in the U.S. continues to
increase.
2003 – 77.6 years
2009 – 78.2 years
Many
factors influence life expectancy:
Gender
Ethnicity
Race
Reduced death of infants and children through
control of infectious disease
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Housing and Geographic
Distribution
In 2009, 4 of 5 elders
owned their own homes
3 of 4 elders live in
metropolitan areas
States with the highest
elder population
California (4.1 million)
Florida (3.2 million)
New York (2.6 million)
1-7
Marital Status and Living
Arrangements
Because of life expectancies:
Marriage is beneficial to
elders:
8.9 million women are widows
2.1 million men are widowers
Companionship, help with daily
activities, higher household
income
Elders who divorce is
increasing
2/3 of elders live in a “family
setting”
Only a small proportion of
elders reside in nursing homes
1-8
Education
Older people have completed
fewer years of formal
education than younger adults.
Baby Boomers are the most
educated cohorts in history.
Educational attainment differs
by race and ethnic origin.
Elders are lifelong learners
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Income
Medicare and Social Security make elders less
financially vulnerable.
Elders living in a family setting are less
financially vulnerable.
Disparity of income level with race and
ethnicity.
Elder men have higher income levels than
elder women.
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Health Status and Health Care
Most
elders have at least one chronic
condition which:
Limits activities
Lengthens hospital stays
Results in more physician visits
Results in more medications prescribed
Raises out-of-pocket expenses
1-11
Foreign-Born Population
More likely than natives
to:
live with families
to be poor
to be uneducated
Most have lived in the
country for more than
30 years
1-12
Racial and Ethnic Diversity
In general, minority elders
are more likely to:
Have lower education levels
Live in substandard housing
Have less money
Have worse health
Racial discrimination during
working years leads to less
financial security.
The four largest groups of
minority elders are:
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African American/Black Elders
Women outnumber
men
Most men are married,
most women are
widowed
20% were living in
poverty (2009)
More apt to suffer from
chronic health problems
than white elders
Health Care Concerns:
Low income can
postpone seeking help
Tuskegee experiment
Racism/Alienation
Professionals should:
Treat them with respect
Establish rapport
Put them at ease
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Hispanic American/Latino Elders
Fastest growing
minority in US
Subgroups are highly
diverse
Many do not speak
English
45% live in poverty
Many live with their
families
Health Care Concerns:
Respectful of health care
workers
Less likely to use social
services
Personalismo
Professionals should:
Exchange pleasantries
Address patients by last
name
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Native American Elders
Diversity: 560 tribes
Higher death rates
Shorter life expectancy
Poorest minority
Most live on
reservations or rural
areas
Low education levels
Strong family network
Health Care Concerns:
Lack of access
Difficult to communicate
Different views of disease
and healing
Professionals should:
Understand cultural
values
Give personal space
Not touch without
permission
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Asian and Pacific Islander
American Elders
Diverse subgroups
including Chinese,
Japanese and Filipino
Uniting influence of
Confucianism
Most live in Metropolitan
areas in the West
Many worked as
seasonal workers and will
not have Social Security
benefits
Health Care Concerns:
Similar health status as
white elders.
Higher incidence of suicide
than their white
counterparts
Professionals should:
Respect filial piety and treat
elders with respect
Recognize the subgroups
and not generalize
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Working with Minority Elders:
Obstacles and Opportunities
1 out of 4 elders will be a
minority by 2030
Must have culturally
competent health service
Consider some obstacles:
Economic and educational
Cultural
Geographical
Institutional
Facilitating minority elder
access to needed services
How can you turn these into
opportunities?
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Our Nation’s Elders: The Facts
Chapter 1
