This document provides information about a course on care for the older adult. It discusses the course units which include lectures, clinical rotations, prerequisites, and contact dates. It also outlines 4 modules that will be covered in the course: individual vs aging population; economic implications of population aging; the epidemiologic transition and health implications of aging; and the profile of older Filipinos. The modules will define key concepts, describe demographic trends, and discuss the social, economic, and health impacts of an aging population in the Philippines.

1. NCM 114
Care for the Older Adult
Jerry H. Somera, RN,MAN,CWCN

2. Care of the Older Adult
• This course deals with concepts, principles, theories and techniques
in the care of older adults. The learners are expected to perform
holistic nursing care of the older persons in wellness and chronic
illness utilizing the nursing process

3. Course Unit
• Course Credit: Theory: 2 units – 36 hours; RLE Clinical – (Hospital /
Community) 1 unit 51 hours
• LECTURES 2 hours /day for 4 days x 6 weeks
• RLE 8.5 hours x 6 weeks
• Prerequisite: NCM 103

4. • August 15 to September 23, 2022 (6 weeks)- 3B & 3C
• September 26 to November 4, 2022 (6 weeks)- 3A
• Week 1
• Week 2
• Week 3
• Week 4
• Week 5
• Week 6

5. Contact Details:
Email: jerrysomera82@gmail.com
Mobile Number: 09952852253

6. Module 1
Individual vs Aging Population

7. Module Objectives:
1. Define individual age in terms of:
a) Chronological age
b) Physical Age
c) Functional age
2. List the Factors that affect individual aging
3. Define Population aging in contrast with individual aging
4. Describe the Causes of population aging

8. I. INDIVIDUAL AGING = Growing Older
AGING PERSON
PASSAGE OF YEARS
CHANGES IN THE BODY
PHYSICAL FUNCTION

9. • Chronological Age = a person’s age based on the date of birth
• Physical Age = aging of the body

10. • Functional Age = our ability to carry on an independent, self-sufficient
life in which we take care of our own basic personal needs like self-
care.

11. Factors that affect Individual aging
• Heredity, nutrition, habits and vices, lifetime working condition,
lifestyle and attitudes towards life in general.

12. II. POPULATION AGING
• Is a condition that describes the state of a population.
• Phenomenon where the proportion of older people to total
population is increasing steadily so that a significant percentage now
lives up to advances old age.
• Country is considered Aging if the proportion of people aged 60 is
over at least 7%

13. Distribution by age Group and Sex (n=126,860,299 )
Japan | Year 2019
Distribution by age Group and Sex (n=108,116,622)
Philippines | Year 2019

14. Population Projection
Philippines
Japan

15. Stages of Population Growth
• Stage 1 (Pre-transition Stage) = main
distinguishing feature high births and deaths
• Stage 2 = High Births and Low Deaths
• Stage 3 (Transition Stage) = not equal

16. • Stage 4 (post Transition Stage) = very low in population growth
=

17. Total fertility rate
• Average number of children that a woman expects to have if she were
to subjected to the same schedule of fertility as the women
population at that specific period of time.
• Fertility Rate
2.1 and above = Population Growth
Less than 2.1 = population decline

19. Mortality Decline
• Declining deaths

20. Module 2
Economic Implications of Population Aging

21. Life Expectancy
• Number of years that person expects to live if he/she were subjected
to the same risk of dying prevalent in the population at that time.
Life Expectancy by Country:
Africa – 48 (Year 2000)
Japan – 81.5 (Year 2000)
Philippines – 71 (Year 2019)

22. OLD
• Age
• Life course stage
• Culture
• Diminished earning capacity and increasing risk of health problems
• Changing roles of society, such as Grandparents assuming parental
roles in the lives of their gran children

23. Economic implications of Aging population
• strain on social insurance programs and pension systems. (Pay as you
go)
• money coming into social security will lessen due to fewer contributions from
workers and more funds going to an aging retired population.
Economically Proactive
Not Economically Proactive

24. • GSIS and SSS
• increase in health care costs.
• As the population ages, health generally declines with more medical attention
required such as doctor visits, surgery, physical therapy, hospital stays, and
prescription medicine
• PhilHealth
• there will also be shortages of skilled labor trained to care for aged
patients.
• t is projected that the registered nurse workforce in the United States will see
a decline of nearly 20 percent by 2020 which is below projected requirements
• increase in the age dependency ratio which is the ratio of working-age
to old-age individuals.

25. • Developing countries with young populations rely on the traditional
social support system of family and kin networks-mainly children.

26. Sociocultural Implications
• Increasing older population
increase dependency
• Dependency according to
culturally prescribed
• Confucian Ethic- primary source of
support is the oldest son.
• Other Asian countries no gender
preferences.
• Asia and Africa, older people
depend of their families for needs
(economic, social and emotional
support and assistance with ADL)

27. Asian model of elderly care
• Filial piety = virtue and primary duty of respect, obedience, and care
for one's parents and elderly family members.
• Social reciprocity requires that we repay in kind what another has
done for us. It can be understood as the expectation that people will
respond favorably to each other by returning benefits for benefits,
and responding with either indifference or hostility to harms.
• “Utang na loob” =debts of gratitude

28. Western Cultures
• Elderly appear less dependent on family networks
• Due to life ling autonomy and independence, elderly strongly value
their privacy and their independence. (Desire to be respected by
family members)

29. European Societies
• Belief in social contract bet the citizen and the state
• State guarantees care of the elder

30. MODULE 3
THE EPIDEMIOLOGIC TRANSITION:
Health Implications of Population Aging

31. Objectives:
1. Describe epidemiologic transition.
2. Describe implications of emerging chronic diseases.

32. A. EPIDEMIOLOGIC TRANSITION
• Describes the long term trend in mortality across populations.
• It focuses on the complex change in patterns of health and disease
and on the interactions between these patterns and their
demographic, economic and sociological determinants and
consequences in a population.
• Epidemiologic transition claims that long term decline in mortality
levels is liked to changes in the major causes of death in a population.
• Epidemiologic transition paralleled demographic transition and is
believed to go through three stages.

33. Demographic Transition Phase
PRE-TRANSITION
- Major cause of
mortality are
infectious diseases.
- Mortality rates are
generally high at all
ages but are higher
among the youngest
group- infants and
children.
TRANSITION
- population
experiences a mix of
both infectious and
chronic diseases as the
major cause of
mortality.
- the population
structure affected are
characteristically
young. (Death rates
are elevated at all ages
but are higher among
the youngest-infants
and children.)
POST-TRANSITION
- The major cause of
death is chronic
disease.
CIMMUNICABLE DISEASES
CHRONIC DISEASES

34. B. EMERGENCE OF CHRONIC DISEASES
(NONCOMMUNICABLE DISEASES)
1) Implications of High Prevalence of Chronic Diseases in an Aging
Population.
• High Health Care Cost
2) Having to pay for medications or medical consultations to effectively
manage the condition.
• The need to build health services and health infrastructure required.
3) Requires a shift toward preventive services as an integral part of medical
care as an addition to curative services.
4) Increasing average length of time between the onset of illness and death.
• Infectious disease – period between onset and death is not normally prolonged.
• Chronic Disease – duration between onset and death is generally longer.

35. End Module

36. Module 4
PROFILE OF OLDER FILIPINOS

37. Objectives:
Describe the socio-demographic profile of Filipino older persons of
today in terms of:
1. Age and sex distribution.
2. Marital Status
3. Education
4. Regional affiliation
5. Employment
6. Living Arrangement
7. Activities of daily living

38. Derive Socio-economic issues based on the
profile
1. Age and Sex Distribution
a. Percentage Age Distribution if Elderly population Based
on year 2000 Census. There were 4,567,134 people
aged 60 years and over in the
Philippines.
The mean age of the elderly
population was 68.9 years.
54 percent were female.

39. Percentage of Share of Male and Female elderly by
age, Philippines 2000

40. 1. Sex Distribution of Older Filipinos
a. Majority of older people in the Philippines are in the
young elderly, ages, 60-64 and 65-69 years.
• Men have relatively “younger” composition.
• As age advances, the proportion of women relative to
men increases.
• Moreover, the gap between male and female
populations widens with increasing age.

41. 2. Marital Status
• The most predominant
marital status is
married.
• A third of all elderly are
widowed.
• 5 percent never
married.

42. 3. Education
• One in ten elderly has not gone to school.
• Vast majority have gone through elementary schooling only.
• Minority of 10 percent had some college education.

43. 4. Regional Affiliation
• The distribution of the elderly by Region is but a reflection of the
relative distribution of the entire population across Regions.
• The highest concentration of older people is in the more densely
populated regions of Central Luzon, Southern Tagalog, NCR and
Western Visayas.

44. Labor
Participation

45. Income Distribution
Percentage of older person in the
bottom of income tier categorized
by sociodemographic
characteristics, PES 1996

46. 5. Employment
• The percentage of the elderly whose reported incomes fall in the bottom tier of
the income distribution categorized by selected background characteristics;
• Percentage with very low incomes generally increases with advancing age.
• Unmarried women are more likely to have lower incomes than married ones.
• Those with no education are most likely to have low incomes compared with the
better educated.
• Those who had accumulated assets in terms of investments, own business,
savings or pensions are less likely to end up in the bottom tier of the income
distribution.
• Very high percentage of those who have no assets of their own and have to
depend on their children and other relatives end up with the lowest incomes.
• Those who live with married children or alone with spouse only tend to have very
low income compared with those who live with unmarried children or with
others.

48. 6. Living Arrangement
• The most dominant living arrangement is living with a child.
• The older elderly are more likely to live alone or with others and are
less likely to live with any child, compared to the younger elderly.
• Older elderly are less likely to have a living spouse, and to have
children who are still in the family home.
• In terms of gender, more females than males live alone or live with
others.
• This table indicated the importance of having children among the
current cohort of the elderly in the Philippines.

49. 7. Activities of Daily Living
• The table presents self reported difficulties in performing selected
activities of daily living; walking around the house, eating without
assistance, bathing / using the toilet, and dressing.
• The percentages of having difficulty in performing each of the ADL’s
increase with age.
• Walking around and bathing are two of the ADL’s most affected by
increasing age.
• There is no apparent gender differential.

51. END Slides