NCM 114: NUR 1217 CARE OF OLDER ADULT
Module 1: Introduction to Gerontology and Demographics of Aging
LEARNING OBJECTIVES: After reading this module, you should be able to:
1. Explain the different ways in which older adults have been viewed throughout history.
2. Describe characteristics of today’s older population in regard to:
Life expectancy
Marital status
Living arrangements
Income and employment
Health status
3. Discuss projected changes in future generations of older people and the implications
for health care.
I. History and Evolution
Burnside (1988) review of historical materials related to Gerontologic Nursing.
In the years between 1900 and 1940, she found 23 writings with a focus on
older adults that covered such topics as rural nursing, almshouses, and private
duty nursing, as well as early case studies and clinical issues addressing home
care for fractured femurs, dementia, and delirium.
II. Definition of Terms
a. Geriatrics: Geriatrics is the branch of medicine that focuses on the
diagnosis, treatment, and prevention of diseases and conditions affecting
older adults. It addresses the complex medical issues that arise with aging,
aiming to improve the quality of life for elderly individuals.
- From the Greek "geron" meaning "old man" + "iatreia" meaning
"the treatment of disease.".
b. Gerontology: Gerontology is the multidisciplinary scientific study of the
aging process and the challenges and issues that elderly individuals face.
It encompasses biological, psychological, social, and economic aspects of
aging, providing a comprehensive understanding of the aging experience
- The word was coined by Ilya Ilyich Mechnikov in 1903.
c. Senescence: Senescence refers to the gradual deterioration of functional
characteristics in living organisms as they age. It involves the accumulation
of cellular and molecular damage over time, leading to decreased
physiological function and increased vulnerability to diseases
- The word "senescence" is derived from the Latin
word senex, meaning "old age."
- It's defined as the period of gradual decline that follows the
development phase in an organism's life.
d. Senility: Senility is a term historically used to describe the physical and
mental decline associated with old age. It encompasses a range of age-
related changes, including cognitive decline, frailty, and diminished physical
capabilities. However, the term is now considered outdated and is less
commonly used in contemporary gerontological literature.
- From the French senilite, from the Latin senectus meaning old age,
old men, gray hair.
- The physical decline associated with old age.
- The mental decline once associated with old age.
e. Old Age: refers to ages nearing or surpassing the life expectancy of human
beings, and is thus the end of the human life cycle.
- Old age comprises "the later part of life; the period of life after youth
and middle age . . ., usually with reference to deterioration".
- The United Nations has agreed that 65+ years may be usually
denoted as old age and this is the first attempt at an international
definition of old age.
- However, for its study of old age in Africa, the World Health
Organization (WHO) set 55 as the beginning of old age.
- WHO recognized that the developing world often defines old age,
not by years, but by new roles, loss of previous roles, or inability to
make active contributions to society.
CHARACTERISTICS OF THE OLDER ADULT POPULATION
- Older adults are generally defined as individuals aged 65 years
and older. At one time, all persons over 65 years of age were
grouped together under the category of “old.” Now it is recognized
that much diversity exists among different age groups in late life,
and older individuals can be further categorized as follows:
- Youngest-old: 65 to 74 years
- Middle-old: 75 to 84 years
- Oldest-old: 85+
f. Aging: Aging is the process of growing older, beginning at birth and
continuing throughout life. It encompasses the physical, psychological, and
social changes that occur over time. Eliopoulos discusses various theories
of aging, including biological theories (stochastic and nonstochastic),
sociological theories (such as activity and continuity theories), and
psychological theories, all of which aim to explain the complex process of
aging.
g. Geriatric Nursing: Geriatric nursing, often used interchangeably with
gerontological nursing, is a specialty within nursing that focuses on the care
of older adults. It involves assessing the health and functional status of
older adults, planning and implementing healthcare services to meet their
unique needs, and evaluating the effectiveness of such care.
h. Gerontological nursing is a specialized field of nursing that addresses the
unique physiological, social, psychological, developmental, economic,
cultural, spiritual, and advocacy needs of older adults. The nursing practice
focuses on the process of aging and the protection, promotion, restoration,
and optimization of health and generalized functions; prevention of illness
and injury; facilitation of healing; alleviation of suffering through the
diagnosis and treatment of human responses; and advocacy in the care of
older adults, caregivers, families, groups, communities, and populations.
III. Demographics of Aging
1. Life Expectancy
Brunei: As of 2025, the life expectancy at birth in Brunei is 75.5 years, with females
at 77.7 years and males at 73.5 years.
Global: Globally, life expectancy varies significantly. For instance, in 2021,
countries like Monaco and Japan had life expectancies of 36.0% and 29.8%
respectively for the population aged 65 and above .
2. Marital Status
Brunei: A study indicates that elderly men in Brunei are more likely to be married
and live with their spouses compared to women. Additionally, men tend to have a
higher number of children, which may influence caregiving dynamics
Global: In many countries, older women are more likely to be widowed due to
higher life expectancy and longer life spans. This demographic shift impacts living
arrangements and caregiving needs.
3. Living Arrangements
Brunei: Many elderly individuals live with their children, with a significant portion
residing in multi-generational households. However, some elderly persons face
abandonment in hospitals due to the lack of suitable caregivers at home
Global: In developed countries, there's a trend towards institutional living, such as
nursing homes, due to smaller family sizes and increased life expectancy.
Conversely, in developing nations, elderly individuals often live with extended
families.
4. Income and Employment
Brunei: The labor force participation rate for individuals aged 65 and over is
approximately 9.6%, with men at 12.1% and women at 7.3% . Income levels vary,
with a significant portion of the elderly population earning below B$1,000 monthly
Global: In many parts of the world, especially in Asia and the Pacific, a substantial
percentage of older individuals work in the informal sector without access to
pensions or social protections.
5. Health Status
Brunei: The prevalence of chronic diseases among the elderly is rising. For
instance, dementia cases are projected to increase from 1,574 in 2022 to 7,317
by 2050 . Furthermore, studies indicate that elderly men report better health
perceptions and higher life satisfaction compared to women.
Global: Globally, older adults often face challenges such as chronic diseases,
mental health issues like depression, and limited access to healthcare services.
The World Health Organization reports that 60% of older people in Asia and the
Pacific do not receive regular health checks.
🔮 Projected Changes and Healthcare Implications
Projected Changes
Brunei: The elderly population in Brunei is expected to double by 2040, with the
proportion of individuals aged 65 and above increasing from 6.6% in 2023 to 9.7%
in 2030 .
Global: The global population aged 65 and older is projected to more than double
by 2050, with Asia experiencing significant growth due to improved healthcare and
declining fertility rates .
Healthcare Implications
Increased Demand for Healthcare Services: A growing elderly population will
lead to higher demand for healthcare services, including long-term care,
rehabilitation, and palliative care.
Workforce Challenges: There will be a need for more healthcare professionals
trained in geriatrics to meet the demands of an aging population.
Policy Development: Governments will need to implement policies that address
the financial security of the elderly, including pension systems and healthcare
coverage.
Community Support Systems: Strengthening community-based support
systems, such as caregiver training and social services, will be essential to assist
elderly individuals in living independently.
References:
1. Gerontological Nursing by Charlotte Eliopoulus (10th Ed.)
2. https://pmc.ncbi.nlm.nih.gov/
3. https://www.population-trends-asiapacific.org
4. https://www.worldometers.info/demographics/brunei-darussalam-
demographics
