GERO 501 Final Exam Study Guide

What is the primary government program that pays for health care for older Americans?
Medicare
What percent of older adults are in nursing homes at any given time?
Only 5% of the population over age 65 live in nursing homes.
What factors influence social class position in old age?
Social class is affected by occupation, income property, and education.
What is the percentage of retirement income for older women as compared to men?
In 2009, 21% of single older women and 16% of single older men fell below the poverty line. Among people over age 65, more than twice as many men as women receive private pensions. (p. 317)
Compare the income (greater or lesser) for older people as compared to younger people or as compared to other adults in the United States.
Median cash income is highest for middle-aged families and lowest for the very young and for those ages 85 and over. (p. 315)
What elements are included in the “three-legged stool” of retirement income?
1) Social Security; 2) private pensions; and 3) Individual savings and other assets that yield income
What is the largest source of income for people over age 65 in the United States?
Social Security is the biggest source of income for people over age 65 in the US representing approximately 39% of their income. (p. 317)
What is the maximum human life span?
120 years
What are the processes that occur according to the cellular theory?
The cellular theory of aging argues that aging ultimately results from this progressive weakening of capacity for cell division, perhaps through exhaustion of the genetic material. That cellular limit, in turn, may be related to the maximum life span of species. One of the major milestones in the contemporary biology of aging was the discovery that cells in laboratory culture have a fixed life span. In 1961, Leonard Hayflick and associates found that normal human cells in tissue culture go through a finite number of cell divisions and then stop. This maximum number of divisions is known as the Hayflick limit. One of the most intriguing points in favor of the cellular approach to aging is the discovery that tiny tips at the ends of chromosomes — structures known as telomeres — become shorter each time a cell dividses. Telomeres, it seems, comprise a biological clock marking the unique age of a cell as it divides. (p. 62-63)
What are the reasons for the improvement in functioning of current cohorts of older persons?
Healthy life expectancy (another expression of “active life expectancy”) is increased via reductions in mortality and morbidity, but disease prevalence is increasing, fo functional independence must maintained in the face of advancing age and comorbidity. (p.83)
What theories of aging apply to patterns of caregiving?
productive aging: the alternative of work versus retirement. People over age 65 are already productive in many different ways. This includes family caregiving. 42% of adults over age 55, in national survey, were helping children or grandchidren, and 29% were assisting people who were sick or had disabilities. (p. 429)

Exchange theory of aging: interaction in social groups is based on reciprocal balance. Parents care for children and spouses care for one another because they are motivated by both moral obligation and the knowledge that they can count on reciprocal help in times of difficulty. (p. 203)

What is the priority of persons whom older older people depend upon when they develop long term needs?
spouse (spousal responsibility), adult children (filial responsibility) (p. 207)
Who is the primary payer of long-term nursing home care?
Medicaid
What is the average annual cost of nursing home care in the U.S.?
In 2012, the average cost of a year in a private room in a nursing home was $90,520. (p. 209)
According to Blaser, what are the reasons that those who support paying family caregivers do so?
Advocates may argue that a policy of paying the family caregiver supports and strengthens basic family values.
What is the definition of “assisted suicide?”
Assisted suicide is when a doctor or family member activelyprovides the means or carries out the instructions required for an individual to end his or her life. (p 269)
What is the fraction of older adult deaths in the United States?
More than two thirds of all deaths in the United States occur among people over age 65. (p. 269)
Among the patients studied by Pearlman and Starks, what are the reasons physician-assisted death was pursued?
Interest usually arose out of an interactive process involving multiple factors in three broad categories: illness-related experiences (symptoms, functional losses, effects of pain medication, and the like), threats to the person’s sense of self (as revealed by his or her desire for control over the circumstances of dying and long-standing beliefs in favor of hastened death), and fears about the future. (p. 283)
Illness-related experiences: feeling weak, tired, and uncomfortable; loss of function; pain or unacceptable side effects of pain medication
Threats of sense of self: loss of sense of self, desire for control; long-standing beliefs in favor of hastened death
Fefars about the future: fears about future quality of life and dying; negative past experiences with dying; fear of being a burden on others (p. 286)
What are the specific public concerns about assisted dying?
Most people sharply condemn involuntary euthanasia-that is,killing someone without his or her consent because one believes that person would be better off dead. But there is much more controversy about voluntary euthanasia. Moreover, some critics wonder whether there really is a valid ethical distinction between active and passive euthanasia. Others ask whether there is any difference between direct killing and assisting someone who takes his or her own life. (p. 270)
It may not be easy to say whether an older person’s refection of lifesaving treatment, for instance, represents an informed choice to be respected or instead is a sign that the patient needs help for a depressive disorder. (p. 272)
What state was the first to pass a law permitting physician-assisted dying?
Oregon
What criteria describes an example of a cohort?
A group of people born within a bounded period of years, such as the baby boom generation (born 1946-1964). A group of people who experienced specific historical events
More than half of older people in the United States depend on Social Security for what percentage of their income?
The majority of older adults rely on Social Security for at least half of their income. (p. 375)
According to Peterson, what are the reasons for population aging?
Takes aim at the politics of aging in the US. He compares population aging to a giant iceberg that threatens to sink the ship of state if we don’t change course. The political power of the old, he believes, has caused us to spend tooo much onolder people and not enough on children. He believes that need, not chronological age, should be the basis for how government helps people. In Peterson’s view,universal , age-based entitlements are a big problem. (p. 349)
Poverty in America is three times as likely to afflict the very young as the very old. The US is the global leader in the life expectancy of 85-year olds but has fallen near the bottom of the industrial world’s rankings in rates of infant mortality, marital breakup, child poverty, child suicide, hours of school-assigned homework, and functional illiteracy. Meanwhile, per capita federal spending on the elderly towers eleven to one over federal spending on children. (p. 354)
According to Peterson, by the 2030s, what percent of the adult population of the nation’s industrialized countries will have approached the eligibility age for publicly financed retirement?
By 2040, one out of every four or five Americans will be over 65, and the vast majority will be supported to some degree by govt. entitlements. (p. 353)
Describe the generational interdependence framework.
Advocates for the generational interdependence interpretive package argue that Social Security and Medicare policy makers need to take into consideration the interdependence of generations when making and changing policy. they refect the idea that each generation can or should be expected to provide for itself. When there are demographic, economic, or other factors that make it difficult to provide for the retirement of a particular generation, the burden should be shared by both generations, those who are retired and those still in the labor force. It is unreasonable to expect either generation to bear the entire burden in such situations. What different generations have to offer one another as opposed to what one is or will be consuming at the expense of the other. At the level of individual families this includes transfers of income, child care support, psychological support, and advice. Many of the elderly care for grandchildren and disabled family members. Elderly are making major artistic, intellectual, and leadership contributions to society more generally. (p. 368)
Give examples of new and emerging “silver industries.”
Financial services: banking, brokerage, investment, insurance. Health care: vitamins, supplements. Travel and hospitality: cruise industry. Retirement housing: active adult communities. (p. 478)
In what ways is marketing to older consumers most successful?
Older people can take offense at ads that stereotype them. Use models a bit younger than older adults. Address individual differences. Aging will also increase demand for specific goods and services that are directly relevant to older consumers. (p. 4790480)
What are the concerns for consumers who fall into the “older-old” age category?
Most likely to have concerns about financial security and failing health. they are prime consumers for options like continuing-care retirement communities or assisted living. (p. 478)
What kind of age branding does the Dove campaign called “Pro-Age” focus on in their line of personal care products?
Age-affirmative brands: promise us a positive benefit linked to age. do not ignore or deny age but instead focus on elements we can celebrate and affirm.
What kind of age branding is the marketing for the drug Viagra based on?
Age-adaptive brands: brands that are more functional in nature and help seniors to reognize age-related issues and proactively adjust to the effects of aging. (p. 486)
What does business analyst David Wolfe call consumers over 45 years?
Consumers over age 45 already compose what business analyst David Wolfe calls “the new customer majority.” (p. 477)
What do older people tend to think of themselves (as younger, same or older than their chronological age)?
younger
How does the concept that anti-aging products is based on age affect ageism within society?
perpetuates it
What scope of influence (national/global) does the increase in the older consumer population have upon trends?
The 50-plus segment of the US opulation controls three quarters of the total net worth and financial assest of the country, or more thatn $7 trillion. This segment of the market is also responsible for more than 50% of discretionary income. (p. 477)
According to Weintraub, what is the true anti-aging regime?
Exercise is probably the only anti-aging regimen that actually works. (p. 491)
What is the amount of people over age 65 who need assistance with ADL?
The majority of people over age 65 are healthy enough to engage in most activities of daily living (ADLs) such as bathing, dressing and preparing meals. A majority of older adults living in noninstitutional settings report experiencing no significant limitations in performing these regular, daily activities. (p. 136)
What are characteristics of normal aging?
The underlying irreversible process that is characteristic of each species. Aging can be defined as a time-dependent series of cumulative, progressive, intrinsic, and harmful changes that begin to manifest themselves at a reproductive maturity and eventually end indeath. Primary aging would describe those changes that occur over time independent of any specific disease or trauma to the body, whereas secondary aging would describe disabilities resulting from forces such as disease. (p. 136)
What is the duration of time someone will typically remain in a nursing home after admission?
Around 2/3 of nursing home stays will last fewer than three months. (p. 156)
Do people tend to age similarly or differently?
Differently
Who comprises the largest growing minority group among the aged?
African Americans constitute the largest minority group among the aged, comprising 8.4% of all Americans over age 65. BBy 2050, Hispanics will be the largest minority, and Hispanics and Asians/Pacific Islanders will have the highest rates of growth numerically. (p. 305)
Hayflick likens aging to….
How do surveys on health in later life measure health status in multiple ways and what are the challenges in determining the needs for care in the older population?
To measure subjective well-being, Life Satisfaction Index, considers items such as zest and apathy, self-blame, attainment of life goals, an dmood. Chronological age by itself is only weakly correlated with subjective well-being; in other words, old age in and of itself is not necessarily a cause of poor morale or unhappiness. Physical health, however, especially self-rted health, is a strong predictor of subjective well-being. Health problems, are more common in later life, but subjective rating of one’s own health reflects individual coping style and not simply objective physiological function. In fact, self-report measures ofetn are more positive than objective health status measures for the same individual. Relationships, quality not just the mere existence. (p. 244)
The vast majority of care for aged relatives is provided by….
Unpaid caregivers (87%)
What is the status in which the majority of older people live?
A majority of older people live with others: around half with their spouses, another 14% with other relatives, and smaller numbers in other living situations. Even those alone are usually within a close distance of relatives or only a phone call away. Fewer than 1 out of 20 are socially isolated, and usuallly they are so because they have lived that way most of their lives. (p. 205) More than 2/3 of older noninstitutionalized people live in a family seetting. (p. 202)
How accurate is the stereotype that older people are abandoned by their children?
Largely inaccurate. Nearly half of older adults reported that they lived or expected to live in proximity to their children, two thirds within 30 minutes of a child. (p. 204)
Has poverty been eliminated among the older adult population?
Today, child poverty is substantially higher, and older people as a group are less likely to be poor than other adult groups. Near-poor older adults do face serious problems, however, and subgroups, including minorities, have high rates of old-age poverty. Social Security, above all, has been dramatically effective in reducing, though not eliminating, poverty among the old. When Medicare is taken into account, the proportion of older people who are “poor” drops to only 6%. If we were to ignore all govt. cast transfer programs, such as Social Security, then 44% of Americans over age 65 would fall below the poverty line. Also, 87% of people 65 and older receive Social Security, and that 53% of married couples and 74% of unmarried older adults get half or more of their income from Social Security. Then if we look at the group of older adults who could be called “near-poor” – those with an income up to 1.5 times the poverty line – then more than one out of four older people are facing economic hardship. Another group just above the poverty line, vulnerable if for example rent increase. Poverty among young people has been going up, whereas poverty among the old has been declining. (p. 338)
What factors indicate whether or not the average condition of older Americans has improved markedly in recent past?
What indicates whether or not individuals have a right to accept or reject medical treatment?
Patient Self-Determination Act (PSDA) of 1991, requires hospitals, nursing homes, and other health care facilities to advise all patients at the point of admission about their right to accept or refuse medical treatment. Advance Directive (2 kinds) : gives specific directions or designates someone else in case an individual is unable to express a wish about medical treatment. 1st) Living Will: a written statement expressing an individual’s wish for what should be done in a life-threatening situation. It permits physicians to stop undesired medical treatment even if stopping treatment might result in death. If a clear living will has been drafted beforehand, everyone can know that the patient would want life-sustaining treatment withdrawn. 2nd) Durable power of Attorney for Health Care: permits an incapacitated person to designate, in advance, another person who is trusted to make health care decisions for the patient.
How do courts view the withdrawing life-sustaining interventions?
Courts have relied on two kinds of standards to determine when it is proper to withhold or withdraw life-sustaining treatment from patients deemed legally incompetent: the standard of substituted judgment (What would this patient have wanted under these conditions?) and the best interest standard (What is the balance of benefits and burdens that a “reasonable person” might want under these conditions?)
What is the emotional status of most older adults the majority of the time?
The majority of older people do not feel sad or unhappy most of the time. Contrary to stereotype, a third of respondents said old age was the happiest period of their lives. The psychological problem is that multiple losses and the expectation of further losses can be damaging to self-esteem and can weaken healthy psychological defense mechanisms. Depressed older adults do not differ from nondepressed elders in the number and types of medical interventions they want when their overall outlook is poor. (p. 271-272)
Older people, by and large, are not unhapppy. In fact, most older people enjoy good mental health and a positive attitude. 86% of those over age 60 reported feeling “very confident” or “somewhat confident” about maintaining a high quality of life as they grow older. (p. 1165)