Aging: What It Is and What It Is NOT
3 Inservice or Class Hours
Objectives:
At the end of this class, you should be able to:
- Describe the elderly.
- List some false ideas about older people.
- List some true facts about older people.
- Define some basic terms about older people.
- List the normal changes of the aging process.
- Describe some basic terms about older people.
Introduction
There are more aging people in the United States than every before. Many people say it is the “Graying of America”. We have learned a lot about these people and their needs in the last few years. Many old people are young in body and mind. Some are not. All old people are not all the same. They are different. They all have different needs.
This class will teach you about aging and the normal changes of aging. To learn
about the problems of aging people and their care, take our classes“Aging: Common Problems and Care I: Skin, Nails, Muscles, Bones and Respiration”, “Aging: Common Problems and Care II: Heart, Blood, Digestion (GI), Urine Tract, and Nervous System”, and “Aging: Common Problems and Care III: Eyes, Ears, Taste, Smell, Reproductive and Endocrine Systems, Thinking and Emotions, Social and Legal Aspects”.
Are All “Old” People the Same?
All of us know “old” people. It may be a parent. It may be a grandparent. It may be a neighbor or a person from church. It may also be the person that you take care of. Think for a minute about these “old” people. Are they all the same? Or, are they different? Think about how they all are in a physical way. Are they all in poor health? Think about how they are in a mental way. Are they all confused? Think about how they are in a social way. Do they go out or do they all stay alone in their home? Think about how they are in terms of money. Are they all poor? Do all “old” people have the same spiritual needs? Are they different or, are they all the same? Are all “old” people set in their ways? Or, are some different? Think about all of the “old people that you know. Make a list. How are they the same and how are they different? I think that they are different in many ways and the same in only a few ways. Not all “old” people are the same. Not all “old” people have the same needs. Not all “old” people want to be treated the same. We must care for them in different ways. We must also communicate with them in different ways, as based on their own special needs.
What is “Old”?
The meaning of the word “old” is always changing, as more and more people get old and live longer than ever before. Some people use these words for these ages:
60 to 74 Young-old
75 to 84 Middle-old
85 and older Old-old
55 to 64 Older
65 to 74 Elderly
75 to 84 Aged
85 and older Very aged
Even though people of these ages are referred to as old-old, aged, etc., it still does not mean that all people of a certain age are the same. They may have many differences.
Some Basic Terms
Geriatrics – special medical care and treatment for the older adult
Gerontology – the study of the older adult
Gerontophobia – a fear of aging and that lack of acceptance of older adults
Ageism – a dislike of older adults; age discrimination
Tell Me More About Older People
· The number of old people increased by 4.3 million people from 1999 and 2009,.
· More than 1 in 8 people in America are old.
· People who live to 65 will live about another 18 years.
· There are more older women than older men.
· More older men, rather than women, are married.
· About ½ of older women live alone. About one half of older women (49%) age 75+ live alone.
· Nearly 475,000 people over 65 care for their grand children.
· The number of old people will rise to 55 million in 2020 which is a rise of 36% over 2010.
· The number of people 85 and over will increase to 6.6 million in 2020, which is a rise of 15% over 2010.
· The average income for older men is $25,877 and $15,282 for older women. Social Security is the biggest income for these people.
· 80% of older people own their own home. 20% rent their home.
· 17.2 % of those 65 and older still work.
· About 41.6% of older people, NOT living in a health care place, say that their health was very good.
· About 37% of old people have some form of a minor or major problem such as vision, hearing, walking, etc.
How Do You Feel About Aging and Aging People
It is important for you to look at yourself and how you feel about older people before you start learning about this group of people. Do you have negative feelings about them? Are you guilty of ageism?
Many people place a great value on youth, beauty and wealth. People tend to think less of those who are NOT young, beautiful or rich. It is very hard for young people to even know what it is like to be old until they, too, age. They also may fear it. Some 20 and 30 year olds are using special creams to fight off wrinkles. Some young people in their 30s are getting facelifts. Many young people try many things to fight off aging.
Also, many old people use and do many things to look younger. They do not want to look “old”. They want to look younger. Gray hair goes away with hair dye. Wrinkles go away with plastic surgery. Skin looks younger and fresher with make up.
Some people and cultures say that aging is NOT wanted and others say that aging is a good thing. Some people believe that old people have more wisdom and value than young people. Aging is good for these people.
Why Are People Living Longer and Longer?
People are living longer and longer ever since our earliest times. At the time of the birth of Jesus, the average person lived 20 years. To live until 40 was rare. At the time of the birth of the United States in 1776, the average life was 35 and it was rare to see a person that was 60 or more. By the time of our Civil War (1860), the average life span was 40. During the year 2000, life expectancy increased to over 70 years of age and that age is still increasing.
There are several reasons for this increase of life span. Babies are living even when they are very small or ill. Before, they died. Deadly infections and diseases have been wiped out with vaccines and drugs. People do not get smallpox any more because they get the vaccine. Many people in the past died from it. People can fight off infections like strep and the flu with good medical care and drugs. People with long term chronic illness, like diabetes and heart disease, can live long with good care and drugs. All of these things used to kill people at young ages. Now, people prevent these things (smallpox) or they get good treatment and care (diabetes and heart disease).
Why Do People Get Old?
There is no fountain of youth. People, all people, age. Some say that people begin to age as soon as they are born. It is a long process. No one knows for sure why people age, but some have some thoughts about it.
Biological Aging
Some people say that people age because the cells of the body change or “age” over time. The person may have their own “biological clock”. This clock keeps ticking as the cells of the body and the body itself changes. For example, a woman reaches menopause; hair turns gray; and the skin changes. Others people believe that the body just runs out of healthy genes. Harmful genes then take over to produce the signs of aging. Still more believe that DNA damage, radiation and a break down of our immune system lead to aging. Recently, “free radicals” have been found to perhaps lead to aging. Antioxidants (vitamins A, B, C, C, folic acid) lower these “free radicals”.
Psycho-Social Aging
Some believe that people age for a number of things NOT having to do with the human body. These people believe that people age because they:
- separate themselves from the people around them;
- no longer keep their body active (active people tend to be happier with life); and
- separate themselves from the people around them AND they no longer keep their body active;
Myths About Aging
There are many things said about older people that are just not true. Some of these false myths are below:
- All old people are the same.
- Old people cannot learn. You just cannot teach “an old dog new tricks”.
- Old people are forgetful.
- All old people will get confused and senile.
- Old people are sick and frail. Old people become sicker and sicker as they age.
- Old people cannot exercise.
- Old people depend on others.
- Old people will lose their teeth.
- Old people are usually lonely, alone and withdrawn.
- Old people retire at the age of 65.
Now, here is the truth about older people.
All old people are NOT the same. Often the age of the person is not the best way to know about the person, their strengths and weaknesses. Some 90-year-old people exercise daily; some take college courses; some are very active in their area (church, civic groups, politics, etc.). Aging does not affect our personality. It remains about the same. Old people keep these personality differences as they age. Happy old people who liked to talk as a young person continue to be happy and talkative as they age.
Old people can still learn and they are not always “forgetful”. Aging does not mean that the person can not learn. Their long-term memory stays good for most. Some have short-term memory problems but they cope with this and can learn. They may “think things out” more than when they were younger. My own Father took college courses, and passed, when he was in his late 80s. The mental functions of older people should stay the same. Confusion is NOT a normal sign of aging.
Many old people are NOT sick and frail. Some are very healthy and with no disability. For example, Jack LaLanne is still physically active in his mid 90s. Older people can, and should, exercise on a daily basis. Healthy aging involves many things, including a good diet and exercise. Although some older people may need some assistance because they have some disability, many more are NOT dependent on others.
Old people do NOT have to lose their teeth. Good dental care is needed. Socially, NOT all old people are lonely, alone and withdrawn. They remain active.
Most old people are NOT alone. More than ½ of people who are 65 and older live with a spouse or with other family members. Less than one out of five live alone. Also, many old people remain active and involved with family, friends and other friends. Some may enter a senior group home or an assisted living place with lots of activities.
Retire at 65? Not the case at all. Look at these people, their age and what they are doing.
- Bill Cosby who is in his mid 70s is still performing on the stage.
- Paul Newman, who died at 83, continued his racing career until shortly before his death.
- President George H.W. Bush jumped out of an airplane at age 80.
- Jimmy Carter, now 87 years of age, is still active.
- The world's wealthiest man, Warren Buffett, age 81, is still very active.
- George Burns continued to perform well into his 90s.
- Willie Nelson still has an active concert tour at the age of 78.
- Maya Angelou is 83.
- Woody Allen is 76.
- B.B. King still plays at 86.
And, the list can go on and on.
The Special Needs of the Older Person
As you learned, not all people are the same, but some, or many,older people may have some of these health problems.
- A slowing down of the mind and thinking
- A slowing down of the body’s physical function
- A slowing down of the person’s coping
- Less social support
- Losses of loved ones (friends, husband, wife)
- Lower quality of life
Success with aging has these parts:
- Low disease and disability
- High physical and mental function
- High level of active participation in life and social areas
- Satisfaction with life
Normal Changes With Older People
Physical Changes
Skin, Hair and Nails
Some of the normal skin changes are:
· The skin becomes more fragile. Skin tears may happen.
· Rashes are more common. Contact with some soaps and “make up” can lead to rashes.
· The skin may become more pale. The person may be more prone to bad sunburn.
· “Age spots” or “liver spots” may appear.
· Skin tags may appear, mostly on the neck.
· The skin may become more thin. Wrinkles appear.
· Dry skin may occur.
· The hair gets gray and faded.
· Hair thins on the head, under the arms and in the pubic area.
· Nose and ear hair becomes thicker and more visible.
· Facial hair for women may appear.
· Finger nails and toe nails get thick.
· The sweat glands in the skin slow down. The person may not tolerate hot rooms because this “cooling” (sweat) slows down.
· Red, purple or brown spots may begin on the arms and legs.
Take our course “ Aging: Common Problems and Care I ” to learn more about these changes, some common problems of the skin, hair and nails, and patient care.
Muscles and Bones
Some of the normal bone and muscle changes are:
· The bones lose calcium.
· Bones get weaker and thinner.
· The disks of the spine get smaller so some will have a curve in the spine and lose a couple of inches in their height.
· The joints get less flexible and less mobile.
· Muscle tone gets less.
· Muscle mass gets lower.
· As muscle mass gets lower, fat builds up.
Take our course “ Aging: Common Problems and Care I” to learn more about these changes, some common problems of the bones and muscles, and patient care.
Respiratory System
Some of the normal respiratory systems changes are:
· The nose gets more dry.
· The vocal cords lose their elastic so the voice of the person may change.
· Lung capacity may decrease.
· Breath sounds decrease.
· Lower air moving out as the person breathes out.
· An increase in the amount of air held in the lungs as the person breathes.
Take our course “ Aging: Common Problems and Care I” to learn more about these changes, some common problems of the respiratory system, and patient care.
Heart
Some of the normal heart changes are:
· Loss of heart muscle tone.
· Increased size of the heart muscle.
· A larger left side of the heart.
· Less elasticity of the heart and blood vessels.
· Lower output from the heart.
· Greater deposits in the blood vessels.
· Lower pulse.
Take our course “ Aging: Common Problems and Care II” to learn more about these changes, some common disorders of the heart, and patient care.
Blood
Some of the normal blood changes are:
· The blood gets thicker.
· A small drop in the red blood cells and white blood cells.
· The T cells get less effective.
Take our course “ Aging: Common Problems and Care II” to learn more
about these changes, some common problems of the blood, and patient care.
Digestion (GI)
Some of the normal GI changes are:
· The gums pull back from the teeth so the teeth may get loose.
· Increase in the number of cavities.
· Less feelings of thirst.
· Poor gag reflex.
· Less muscle tone at the end of the esophagus to the stomach.
· Less saliva.
· Less stomach digestion.
· Slower movement of the GI tract.
· Smaller liver size.
· Lower stomach mucus production.
Take our course “ Aging: Common Problems and Care II ” to learn more about these changes, some common problems of the GI system, and patient care.
Urine
Some of the normal urinary changes are:
· The kidneys get smaller.
· The kidneys lose some of their function.
· Lower blood flow to the kidneys.
· The concentration of the urine decreases.
· The bladder gets smaller.
· Less holding power of the bladder.
· Loss of bladder muscle tone.
· Loss of bladder elasticity.
· Slower and/or lower feeling of the need to void.
· More urine at night.
· Prostate in men gets larger.
Take our course “ Aging: Common Problems and Care II” to learn more about these changes, some common problems of the urine system, and patient care.
Nervous System
Some of the normal nervous system changes are below.
· The brain gets smaller.
· The brain weighs less.
· Blood flow to the brain gets lower.
· Reflexes get slower.
· A decrease in the number of nerves in the brain and the entire body.
Take our course “ Aging: Common Problems and Care II ” to learn more about these changes, some common problems of the nervous system, and patient care
Eyes
Some of the normal eye changes are:
· Less able to focus.
· The eyelids sag.
· Eyelashes get thin, short and less.
· A gray area around the edges of the cornea.
· People get far sighted. They cannot see things that are close to them.
· Lower eye muscle tone.
· Less tears.
· Decrease in eye muscle elasticity so things may be blurry to the person.
Take our course “ Aging: Common Problems and Care III ” to learn more about these changes, some common problems of the eyes, and patient care.
Hearing
Some of the normal ear changes are:
· Thinner ear membrane.
· Less able to hear higher tones as well as they did in the past.
· Less ear wax in the outer ear.
· The parts of the inner ear shrink.
Take our course “ Aging: Common Problems and Care III” to learn more about these changes, some common problems of the ears, and patient care.
Taste and Smell
Some of the normal taste and smell changes are:
· Less taste buds.
· Less nose scent cells.
Take our course “ Aging: Common Problems and Care III ” to learn more about these changes, some common problems of taste and smell, and patient care.
Endocrine (Glands) System
Some of these normal changes are:
· Less growth hormone (less muscle mass).
· Lower thyroid function.
· Less insulin.
· Less parathyroid function.
Take our course “ Aging: Common Problems and Care III ” to learn more about these changes, some common problems of the glands, and patient care.
Reproductive System
Some of these normal changes for women (vagina) are:
· Lower estrogen and lower moisture.
· Low elasticity.
· Less pubic hair.
· Increase in alkaline fluid in the area.
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Some of these normal changes for men are:
· Lower testosterone.
· Lower circulation to the penis.
Take our course “ Aging: Common Problems and Care III ” to learn more about these changes, some common problems of this system, and patient care.
Thinking and Emotional Changes
As stated before, not all old people have a mental problem or confusion. These things are NOT a normal change. Most are fine in terms of their thinking, learning and communication, but some have a disease or problem that affects these things. Some of these problems are things like Alzheimer’s and some drugs. It is also known that the personality of the person does not change, as the person gets old.
Lastly, most old people are happy with life for the most part. The person copes well if they have done so during their earlier life.
Take our course “ Aging: Common Problems and Care III ” to learn more about these changes, some common problems thinking problems, and patient care.
Social Changes and Needs
There are many social changes and needs for old people. Many of these are related to the fact that loved ones, both friends and spouses, may have died. Others miss working after they retire. Others may have a physical problem that does not let them to be with others as they used to do. For example, some old people lose their sight so they are not able to drive their car; some may have muscle weakness so they can not take long walks as they used to.
Take our course “ Aging: Common Problems and Care III ” to learn more about these changes, some common social problems, and patient care.
Legal Needs
The elderly also have their own legal needs. Some of these special needs are:
· Maintaining rights and dignity
· Advanced directives
· Health care proxy
· Power of attorney
Take our course “ Aging: Common Problems and Care III ” to learn more about these legal needs and patient care.
Summary
The body and its functions change as life moves along. This class has covered some of the NORMAL changes associated with the aging process.
To learn about how these, and abnormal changes of the aging, impact on patient care, take our classes “Aging: Common Problems and Care I: Skin, Nails, Muscles, Bones and Respiration”, “Aging: Common Problems and Care II: Heart, Blood, Digestion (GI), Urine Tract, and Nervous System”, and“Aging: Common Problems and Care III: Eyes, Ears, Taste, Smell, Reproductive and Endocrine Systems, Thinking and Emotions, Social and Legal Aspects”.
References
National Institute on Aging, U.S. National Library of Medicine
National Institutes of Health, and U.S. Department of Health & Human Services. (2011). NIH: Senior Health.http://nihseniorhealth.gov/
US Administration on Aging. (2010). A Profile of Older Americans: 2010.
http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2010/2.aspx
Word, Gloria Hoffmann. (2008). Basic Geriatric Nursing. Mosby, Inc.
Copyright © 2011 Alene Burke