Key Points

©2011 Elsevier Ltd, Inc, BV

DOI: 10.1016/B978-1-4377-1160-8.10004-1

Table 4-1 Population by Age and Gender: 2008*

Both Genders

Male

Female

Age

Number

%

Number

%

Number

%

All ages

299,106

100.0

146,855

100.0

152,250

100.0

Under 55 years

229,014

76.6

115,014

78.3

113,999

74.9

55 to 59 years

18,371

6.1

8929

6.1

9442

6.2

60 to 64 years

14,931

5.0

7150

4.9

7781

5.1

65 to 69 years

11,165

3.7

5238

3.6

5928

3.9

70 to 74 years

8423

2.8

3740

2.5

4683

3.1

75 to 79 years

7353

2.5

3200

2.2

4154

2.7

80 to 84 years

5559

1.9

2106

1.4

3453

2.3

85 years and over

4289

1.4

1479

1.0

2810

1.8

Data from U.S. Census Bureau, 2008 statistics. http://www.census *Numbers in thousands; civilian noninstitutionalized population.

.gov/population/www/socdemo/age/older_2008.html.

elderly population, approximately 8% experience severe cognitive impairment, 20% have chronic disabilities and vision problems, and 33% have restrictions in mobility and hearing loss (Freedman et al., 2002). There are also the predictable age-related structural and physiologic changes that occur with aging. External factors such as diet, occupation, social support, and access to health care can significantly influence the extent and speed of the physiologic decline (Arif et al., 2005; Sarma and Peddigrew, 2008; Tourlouki et al., 2009).

America's aging population is also marked by a more racially and ethnically diverse group of individuals. Simultaneously, the health status of racial and ethnic minorities lags far behind that of nonminority populations. The burden of many chronic diseases and conditions, such as hypertension, diabetes, and cancer, varies widely by race and ethnicity. Data from the 2004 National Health Interview Survey (NHIS) indicated that 39% of non-Hispanic white adults aged 65 years or older reported very good or excellent health, compared with 24% of non-Hispanic blacks and 29% of Hispanics.

There is a strong economic incentive for action. The cost of providing health care for an older American is three to five times greater than the cost for someone younger than 65. As a result, by 2030, the nation's health care spending is projected to increase by 25% because of these demographic shifts (CDC, 2006).

A comprehensive geriatric assessment is a systematic approach to the collection of patient data. The approach varies greatly, from single-physician evaluation with referral as needed, to full teams of professionals evaluating all patients. The geriatric assessment can assist in developing an individualized approach to each patient (Table 4-2). It is imperative to recognize the unique "blueprint" of what characterizes each elderly patient, including age, ethnicity, education, religious or spiritual beliefs, traditions, diet, interests/hobbies, daily routines, medical illness and disabilities, language barriers, functional status, marital status, sexual orientation,

Table 4-2 Goals of Geriatric Assessment

1. Focus on preventive medicine rather than acute medicine.

2. Focus on improving or maintaining functional ability and not necessarily on a "cure."

3. Provide a long-term solution for "difficult to manage" patients with multiple physicians, recurrent emergency department visits, and hospital admissions with poor follow-up.

4. Aid in the diagnosis of health-related problems.

5. Develop plans for treatment and follow-up care.

6. Establish plans for coordination of care.

7. Determine the need and site of long-term care as appropriate.

8. Determine optimal use of health care resources.

9. Prevent readmission into the hospital.

family and social support, occupation, life experiences, and socioeconomic position.

The geriatric assessment can be divided into four categories: medical, functional, psychological, and social. Within each of these categories are a number of approaches, including use of office-based instruments that can aid in collection of information and streamline the plan of care.

Curing Eczema Naturally

Curing Eczema Naturally

Do You Suffer From the Itching, Redness and Scaling of Chronic Eczema? If so you are not ALONE! It strikes men and women young and old! It is not just

Get My Free Ebook


Post a comment