Issues in older person nursing.

Abstract

That older people are the fastest growing portion of the world population is knowledge that Governments and population health planners and policy makers around the world have been grappling with for the past decade. The most recent Australian Bureau of Statistics (ABS) data shows that 25% of the Australian population is over 55 years of age (ABS 2006). Thirteen per cent of the population are already aged 65 years or older and by 2050 this will increase to over 25% of the population totalling 6.6 million people (ABS 2005). According to the Australian Institute of Health and Welfare (AIHW 2006), most Australians consider their health to be good; however, results from the 2004-05 ABS National Health Service (NHS) indicate that 87% had at least one long-term health condition. Notably, the prevalence of these diseases increases with age (ABS 2006).Estimates also show that there will be a substantial change in the structure of our population resulting in a more equal distribution across aged cohorts and between genders (Commonwealth Department of Health and Ageing [CDHA] 2002: 4). Furthermore, the number of people over 80 years will double in the next 20 years and triple over the next 30 years to over 9% of the population (2.3 million people). Indeed, the fastest growing cohort is the over85s who are expected to grow by 50% between 2011 and 2020 (Nay 2004: 59). In 2003, a survey of Disability, Ageing and Carers showed that over 560,000 older Australians had a profound or severe limitation which represents 22% of that population. Among this group, arthritis was the most common health condition, affecting 50% of older people with limitations. Hearing disorders (43%), hypertension (38%), heart dis ease (30%) and stroke (23%) were also common among this group. For each of these conditions, its prevalence in the population combined with its likelihood of being associated with a profound limitation leads to a considerable burden on the community. For example, 10% of people aged 65 years or over reported a stroke and half of these reported a profound activity limitation, meaning that 126,200 older people had both a stroke and a profound or severe limitation (AIHW 2006). In addition, the impact of ageing is magnified in small country towns where the proportion of older people is increasing with the overall decline in their populations and they have significantly worse health status than their metropolitan counterparts (Lavender & Keleher 2004).In other words, for the first time in the history of mankind, there is ageing on a scale never seen before and it is demanding our attention. The exponential growth in the number of older people raises a range of social, economic, political and scientific questions about how best to manage the changing demographics and meet the needs of older people.A fundamental problem in our knowledge about older people is that the maintenance of health and functioning in this population is largely unexplored both clinically and epidemiologically. Whilst chronic disease and disability are declining, chronic diseases change with advancing age. Conditions such as osteoarthritis, one of the most common health problems in older people, lead to functional impairment and increased mortality risks through the effect of co-existing conditions such as gastrointestinal bleeding that may result from treatment for the primary condition, or make its treatment more problematic. The higher incidence of chronic disease, falls, and other health problems associated with ageing, mean that elderly people are also at a greater risk of pain. They are likely to have multiple pains varying in type, location, temporality and intensity because of ageing pathology and the presence of multiple coexisting conditions (Higgins, Madjar & Walton 2004). …