IntroductionUnderstanding the aging process provides the nurse with an important perspective on the care of the elderly patient. The longest living humans today, live no longer than they did centuries ago. Maximum human life span is approximately 100 years of age. This has not changed. However, the average life expectancy has increased dramatically. The average life expectancy in 1900 was 47 years old. In 1990 the average life expectancy is now 75 years old. In 1900 only about 4% of the population was age 65 years or older. Today about 12-13% of the population is over 65. Within the next 50 years, the over 65 population is expected to double. One of the prime reasons for this increased life expectancy is the dramatic increase of infant survival. The advent of good prenatal care and improved delivery techniques have given people in our country a tremendous advantage at the start of our lives. There are other contributing factors as well. Better sanitation, better nutrition, better standard of living, better medical care and prevention and treatment of diseases have all contributed to our longer life expectancy in this country and around the world. All these factors contribute to a better survival rate for children born in America. Once these children reach adults, they are more likely to get to old age. These major reasons for the lengthening of life EXPECTANCY are:
In addition, society’s attitudes and the attitudes of each of us toward those who have lived long enough to become a part of the aged statistics are also important. These attitudes cannot be so quickly listed and resolved. The medical and nursing professions have not been quick to plan for, or implement health care to meet the unique needs of people in later maturity, the not-so-old, and the very old. One of the objectives of this program is to stimulate you, the nurse, to look at the person and family in later maturity with a more positive yet realistic attitude. This objective includes stimulating your senses of empathy and compassion. Empathy and compassion for elderly clients are fostered by your understanding of the aging process and all the social attitudes and stressors imposed upon the person (Murray 1980). Remember how very important you, the nurse, are to the elderly person with whom you work. Through an appraisal of your involvement with the person living through the lat developmental stage, you will grow in self-knowledge, self-acceptance and fulfillment. These qualities, with indicate a personal depth and integrity, may then become the basis for further compassionate caring and knowledgeable nursing (Murray 1980). Later Maturity refers to the last developmental stage in life. This stage begins after retirement age, usually 65-70 years of age, in this country. Traditionally, this era has been called old age. However, this encompasses such a large time span. Therefore, some persons refer to these ages of 65 to 75 as the YOUNG-OLD Ages. The OLD-OLD Ages are considered the years of 75 and greater. The end stage of later maturity is stereotyped by some authors as being a period of dependency upon others for assistance in meeting basic needs. This stereotype often persists and is what some people refer to as old age. The definitions of the terms “old”, “aging” and “aged” are pertinent to later maturity, but not necessarily in the same in meaning. “Old” is defined (Murray 1980) as having existed for a long time or being advanced in years. “Aged is defined as that point in the life span of a person when changes of aging markedly interfere with functioning. “Aging” is commonly thought of as those changes associated with declining function after the person reaches maturity. The works “OLD” and “AGE” have different meanings to each of us. This meaning depends upon:
To the 4-year old, 20 may seem ancient. To the teenager, 30 may seem old. To the 30-year old, 50 begins to look younger. To the 75-year old, old means anyone over 80. To the average white American, old is associated with retirement from the job. To the Mexican-American, 50 years may be considered old. The word “old” has negative connotations to many people in the United States. However, in some cultures, the old are even revered as very special and knowledgeable. No other developmental era (the elderly) is so rigidly stereotyped. In no way can all older people be alike. Just as all toddlers, all adolescents, or all young adults cannot be considered to be alike. Seniors must be perceived to be individual, each having a wide range of personality characteristics, distinct patterns of coping with life and unique relationships to others (Murray 1980). In order to perceive the senior as a unique person, you must consider your personal definitions, values, attitudes and feelings about old age and aging. What does old age mean to you? What do you value or consider important: Beauty, youth and strength? Or do you consider wisdom thoughtfulness, experience and age as important? What is your mental set or attitude toward elderly people, which in turn affects your behavior, or overt reactions? What is your feeling or subjective response when you are with the elderly person? Do you feel pleasure or impatience, respect or repugnance? Do you fear growing old or do you look forward to later maturity? When you initially care for elderly people, you may feel afraid, disgusted or impatient. These feelings are not at all unusual. It is important that you face these feelings and try to understand your values and attitudes. Certainly, you will not like every old person that you care for. However, you will be a more effective care-giver if you are not sad, angry at or disgusted with him or her only because he or she is old. You could also be more effective if you can appreciate their strengths as well as their limits. Respect the elderly person simply because he or she is a human being like yourself. Accept their limits and perceive him or her as a unique person. He or she will then respond to your acceptance. Understand and respect the elderly person. He or she will then share more of themselves with you. This sharing is gratifying and will enable you to give even more of yourself. A helping relationship will then develop. It can be a relationship in which both of you mature (Murray 1980). Next: Chapter I: The Nursing Process and Geriatric Assessment |