Spirituality
As individuals age and pass through developmental stages, they often have an opportunity to explore the spiritual side of their nature and to re-examine spiritual needs. Although spirituality and religion are often thought of as connected, they are not necessarily the same thing. Spirituality can be defined as personal feelings that pertain to an individual’s relationship with a divine, nonmaterial, life force or higher power. Religion, on the other hand, refers to a man-made and organized system of beliefs about higher powers. Religion is often expressed by going to church, temple, or other organized and systematic forms of worship, spiritual practices, and codes of conduct
The principles and beliefs of religion and spirituality become important sources of personal solace. This finding may be due to the need for older people to understand death as it approaches. It may also be a part of achieving integrity. Those who have experienced a full life may be able to examine questions of a spiritual nature with more depth and objectivity than can younger individuals.
Key Concept Some people do not adhere to a specific religion but fulfill their spiritual needs by having some quiet, private time to pray or to reflect. Ask clients if you can assist them in some way to meet such needs and then respect their wishes.
Mortality
Death of spouses and peers causes older adults to reflect on their own death or mortality. Religious or spiritual beliefs may strongly influence their attitudes. People prepare for death in different ways. They may systematically talk about the past and be especially interested in sharing family history and experiences with their offspring. Some wish to take a life inventory. They may draw up a family tree, create a scrapbook, organize photograph albums, or create an audio- or videotape to share memories with grandchildren (Fig. 13-2). They may plan for their funeral, choosing music and scripture to be used. Funeral planning should not be considered morbid but a part of a person’s ability to maintain control over the organization of life.
FIGURE 13-2 · Social relationships provide an opportunity to share past experiences.
DEMOGRAPHICS AND POPULATION TRENDS
Demographies is the study of characteristics and changes that cause balance in a population. Demographics related to the aging population is an important consideration for the industrial sector, housing, social agencies, and the healthcare system. Life expectancy continues to increase in the United States and Canada. The fastest growing segment of the population is that of persons 85 years and older. The number of people who are more than 100 years old is increasing and should continue to grow well into the 21st century. A few key facts about the older population are listed in Special Considerations: Lifespan.
Special Considerations : LIFESPAN
The Older Population and Society
• Many older people live on a fixed income, which represents a reduction in resources for them. Income is from savings, investments, and retirement.
• A majority rely on Social Security income, which was originally designed as a supplement to other income.
• Many older people continue to work full time or part time.
• Men earn an average of twice the per capita annual income of women. Many widowed women are living at a much lower income level than they did when their spouse was alive.
• Most older adults own their own homes; many do not move after retirement.
• Most older people live in urban areas. Trends in housing are toward group housing, shared housing, or retirement communities.
• Older minority populations are more likely to face health problems because they are more likely to live below the poverty level.
• Many healthcare professionals have only begun to recognize that women’s healthcare needs differ from those of men of the same age.
• About one third of prescription medications are taken by seniors o Often multiple drugs are taken by one person.
o Adverse drug reactions are more likely to occur in older adults.
• Health problems and disabilities increase with advancing age.
• Children of aging parents are frequently faced with responsibility for their parents. Some of these “children” are over 65 themselves.
Because the number of “old-old” people (85 and older) is increasing so rapidly, research has not yet been able to keep up with their needs. An exciting research prospect is to define this period as a unique stage in life, with its own developmental tasks that build on—but are separate from— those of the age group 65 to 85 years.
Specialists have identified the following important issues related to the expansion of the older population. As a nurse, you need to recognize these concepts as some of the pertinent challenges for society for the 21st century.
• Consumers expect quality, convenient, and cost-effective services for older adults. Groups like the American Association of Retired Persons (AARP) are likely to have significant political influence.
• Financial planning needs to begin in early adulthood to promote self-sufficiency and independence in old age.
• The use of the Internet can benefit the older population via offering various methods of maintaining contact with family and friends. As a consumer source, all individuals need to be aware that the Internet’s information may or may not be entirely accurate so caution must be observed.
• Urban transportation systems must assist older adults in maintaining social contacts and provide easier access to preventive healthcare facilities.
• More flexible working and retirement schedules, opportunities for volunteer work, and recognition of past contributions are necessary to maximize the resources within the older adult population.
• Fitness programs designed for older adults should promote better health in an effort to lower healthcare costs.
• Better nutrition in younger years benefits people as they age. Nutrition should play a greater role in preventive healthcare, restoration of health, and maintenance of optimal health throughout the lifespan.
• Counseling in the areas of health, psychosocial situations, and economic well-being must become standard practice.
• The legal and ethical issues of death and dying will continue to be part of the individual’s and society’s concerns.
• Better training of healthcare professionals in the areas of aging is necessary. Special focus is needed to address the physical changes in older men and women.
KEY POINTS
• The process of aging is a continuation of earlier development. Each person differs in the speed with which he or she ages, in adaptations made to aging, and in coping mechanisms.
• Ageism refers to discrimination against individuals as they grow older.
• Challenges for older people include remaining independent, maintaining self-esteem, finding outlets for energies and interests, developing a happy lifestyle within financial means, continuing positive relationships with others, meeting all basic human needs, and confronting mortality.
• Health, stress, loss, and poverty are significant concerns for older adults.
• Population trends are necessitating more research for adult development past age 85.
• Society must examine healthcare concerns related to the expanding older population.
