At the end of the nineteenth century, there were two million Americans over the age of sixty-five according to James F. Fries, author of Aging Well for Successful Seniors. Today there are about forty-five million senior citizens, approximately one-sixth of the American population. Future trends show that by the year 2015 there will be seventy-five million "senior boomers."
The majority of people over the age of sixty-five live healthy, independent lifestyles. They are a vital social group and have been achieving good health by making informed choices to eat right, get enough exercise, deal with stress in positive ways, and get enough sleep for their individual needs; only 5 percent of those aged sixty-five to eighty-five require being placed in a nursing home.
The majority of senior citizens are living life to the fullest, free from the burdens of work and raising a family. These are the men and women who fought for freedom during World War II and Korea. They are patriotic and civic-minded neighborhood volunteers, vital workers for McDonald's and greeters at Walmart stores. Many are grandparents who have willingly accepted the challenge of rearing their grandchildren. Others are living healthy, alternate lifestyles. Senior citizens are the majority of Americans on the move, living and traveling in recreational vehicles. Famous seniors include Supreme Court Justice Sandra O'Connor, actor Sidney Poitier, and former astronaut and statesman, John Glenn.
Old Elderly
For social and economic purposes that include the delivery of health care services, housing, food, and other commodities, social scientists have labeled people aged eighty-five and over as "the frail elderly," "the old-old," and "the old elderly." They are viewed this way because of their longevity. However, longevity does not necessarily mean fragility. According to Aging Well for Successful Seniors, people in their eighties today are as healthy as those who were sixty to sixty-five years old twenty-five years ago.
Included among this group are 100,000 Americans who are 100 years old. The majority of them is in good health and has no memory problems, according to Thomas Perls, M.D., a geriatrician (a doctor who specializes in the care of the elderly).
Jeanne Clavert of France was an example of a healthy person who lived to be 122 years old. In fact, she is listed in the Guiness World Records. During the last years of life, Ms. Clavert was blind, hard-of-hearing, and wheelchair bound. French reports about Jeanne state that she was mentally alert and enjoyed a good laugh until the last days of her life.
Some elders aged eighty-five and over are in poor health and are in need of nursing assistant services because of disabilities that prevent them from living independently. Some frail elderly people have mental function problems that interfere with the ability to think, remember, and reason. As a result, they might forget to shop, eat or drink, or take their daily medications.
Fictional Scenario
Gloria H. is an eighty-eight-year-old widow of Spanish-American heritage. She lives alone and cannot remember when she last ate. Mrs. H. enters her kitchen and opens a can of Campbell's chicken and rice soup. She puts the soup in an aluminum pot and turns the gas burner on high. She hears the telephone ring and leaves the kitchen to answer it. "Carmen," she says to the caller, "Why don't you call me anymore?" There is a sound like a sigh as the caller responds. "Mama, I call you every day at this time." Mrs. H. has already forgotten the heating soup.
The majority of burns and falls happen at home, according the National Safety Council. Accidents that happen to elderly people at home are caused by physical disabilities that limit their mobility. Ambulation (walking) problems are caused by diseases such as arthritis or as a result of poor vision and/or hearing. Mental problems include dementias that cause faulty memory and poor judgment. Brain function problems are a result of chronic health problems that affect blood vessel function. Healthy arteries and veins are needed to transport blood and oxygen to all body parts.
Dementias
Dementia is not a result of living to old age, but its incidence is rare in people under the age of sixty. Dementia affects 5 percent, or two million Americans, who are over the age of sixty-five, according to the American Alzheimer's Association. Vascular (blood vessel) diseases cause some types of dementias. These dementias can go into remission (absence of symptoms) for unspecified time periods. More than 60 percent of diagnosed cases of dementias can be prevented through medical intervention and lifestyle changes.
Alzheimer's disease is the worst and most devastating form of dementia. It causes mental dysfunction and impairs the brain's ability to think, learn, recall, and reason. Alzheimer's disease shrinks the size of the brain by destroying groups of nerve cells. Until recent years, its cause has been unknown. Genetic links have been implicated, and medical breakthroughs are expected to control the drastic effects of Alzheimer's disease. People with Alzheimer's require custodial care that involves daily supervision and assistance with activities of daily living. Families often require respite services when caring for a loved one who has Alzheimer's disease.
C.N.A. course content includes subjects about caring for frail elderly people who have physical, mental, or emotional problems. Geriatric nursing is a specialty that often requires additional on-the-job training after completion of a C.N.A. course.
Patients with Infectious Diseases
The term infectious refers to impairment of physical processes due to pathogens (harmful germs) in the body. The term disease refers to the absence of health and well-being. Diseases cause pain and discomfort: some of them cause residual health problems, others result in death.
Pathogens are microscopic in size (can be seen only under a microscope) and enter the body by various routes. Some enter the respiratory tract hidden in saliva from coughs and sneezes. These types of viruses cause colds and flu. Others enter through the skin from dirty hands and unclean cuts; they cause bacterial infections that can cause serious illness and, in some cases, result in death. Some pathogens enter the digestive system through contaminated food and water. They cause food poisoning and typhoid fever, which are health problems that sometimes result in death.
Pathogens can enter any body orifice (opening). One deadly pathogen is the HIV virus that causes AIDS (acquired immune deficiency syndrome), a sexually transmitted infectious disease that enters the bloodstream and attacks the body's white blood cells. These cells fight the entry of pathogens into the body. When white blood cells are killed by the HIV virus, the body loses its immunity and is defenseless against disease. AIDS wears out the body's systems and interferes with its functions. People who have AIDS live with flulike symptoms that cause them to experience pain, discomfort, and lack of energy, symptoms that can interfere with their ability to work or to live independent lives. Medical researchers are working to defeat AIDS.
Standard precaution guidelines were developed by the Georgia-based Disease Control Centers to protect health care workers from getting AIDS (a blood-borne disease transmitted through the skin by infected blood and body fluids) and other blood-borne diseases like hepatitis B, a disease that causes liver inflammation and interferes with liver functions. The majority of people infected with hepatitis B are drug abusers who used dirty needles and people who chose not to practice safe sex (wearing condoms). Health care workers who provide direct care services are advised to be vaccinated against hepatitis B. Vaccination involves a series of three injections.
Nursing assistants work in a variety of health care settings caring for people who have infectious diseases. They are expected to use standard precautions during the performance of their daily work tasks.
Death and Dying
People die, and nursing assistants care for them during the dying process. A team of two nursing assistants prepare (bathe and groom) a patient's body after death for family viewing. After a family leaves a patient's room, the team might shroud the deceased for easier transport by funeral directors to funeral homes.
