Chronic illness and Older Adults
Older Adults
- Aging population
- Surviving acute illness
- Living with chronic illness
- Becoming more educated and resourceful
- More ethnically diverse
Demographics of Aging
- Those reaching age 65 can expect additional years of life
- 17.8 for men
- 20.4 for women
- Young-old adults are 65-74 years
- Old-old adults are 85 and older
- Frail old have conditions that may interfere with independent ADLs
Attitude toward aging
- Aging is normal
- Older adults have diverse characteristics
- Care should not be based on age alone
- Myths and stereotypes can lead to poor care
- Ageism leads to discrimination and disparate care
Special Older Adult population
- Homeless Older Adults
- Numbers are increasing
- Mortality rates are higher than for those with housing
- Have a higher risk for more health problems
- Require an inter-professional approach
- Frail Older Adults
- Clinical manifestations of frailty
- Unintentional weight loss
- Self-reported exhaustion
- Weakness
- Slow walking speed
- Low level physical activity
- Clinical manifestations of frailty
Social support and older adults
- Family caregivers
- Semiformal levels of support
- Formal systems of support
- Elder mistreatment/abuse
- From 2%-10% of community-dwelling older adults in the United States are abused, neglected, or exploited by trusted others
- Mortality risk is 3 times higher
- Mandatory reporting exists in most states
- Self-Neglect
- Unable to meet basic needs
- Refuse help
- Have multiple, untreated medical or psychiatric conditions
- Live alone, often in squalor
- Experience higher rates of mortality
Social services for older adults
- Administration on Aging (AoA)
- Part of the Department of Health and Human Services
- Federal agency responsible for many older adult programs
- Area Agency on Aging
- State and local agencies funded from the AoA
Medicare and Medicaid
- Medicare
- Medicare is federally funded insurance for people >65
- Also covers those < 65 with disabilities or end-stage kidney disease
- Coverage is limited
- Out-of-pocket expenditures continue to rise
- Medicare is federally funded insurance for people >65
- Medicaid
- Medicaid is a state-administered, needs-based program to assist eligible low-income people with medical expenses
Care alternatives for older adults
- Adult day care and adult day health care
- Centers provide social, recreational, and health-related services to individuals in a safe, community-based environment
- Home health care
- Can be a cost-effective care alternative for older adults who are homebound, have health needs that are intermittent or acute, and have supportive caregiver involvement.
- Long-term care facilities
- Rapid patient deterioration or function
- Caregiver stress and burnout
- Alteration in or loss of family support system
- Transition may be difficult for patients and families
- Relocation stress syndrome
- Program for All-Inclusive Care for the Elderly (PACE)
Legal and Ethical issues
- Many complex situations may arise for older adults
- Decisions may be difficult
- You can help
- Stay informed about concerns
- Be knowledgeable about resources
- Advocate for patients and resolution
