The Aging Wave: Are We Ready?
Age is tradition, heritage, immutability, stability, longevity, persistence, even stubbornness-a sense of permanence and survival, perpetuity and fragility combined. We are a combination of our forbears, our life experiences, and our future dreams. - Barbara J. Brown, Nursing Administration Quarterly 1990
When I wrote that, I did not think of myself as aging. I was thinking of my mother, who was 81, suffering from Alzheimer disease, and died in 1991. Now, I am among those considered "aging," having just celebrated my 76th birthday. While this issue of Nursing Administration Quarterly is focused on nursing practice, education, research, and administrative aspects of readiness for the overwhelming, increasing numbers of aging population, it is significant to reflect on the journey in life to achieve aging status. Yes, it is a status if you are able to intellectually and even physically contribute to society and those around you. If not, you may become a less than treasured member of society and limited resources for healthcare may affect your quality of life-a major concern in the healthcare debates and town hall meetings being held to consider healthcare reform legislation.
"The Aging Wave: Are We Ready?" could not be more timely, and our esteemed colleague and Issue Editor Marilyn Rantz, PhD, RN, NHA, FAAN, Professor, Sinclair School of Nursing, University of Missouri-Columbia, Missouri, envisioned the need for this issue of Nursing Administration Quarterly. She has dedicated her career as a distinguished researcher and educator on behalf of the aging. In 2001, she was awarded the American Journal Book of the Year as the coauthor of How to Find the Best Eldercare: A 20-Minute Guide to Assisted Living, In-home Care, Nursing Homes, and Senior Housing in Your Community.
In 2003, she was honored by the Missouri Association of Homes for the Aging's Distinguished Service Award. She has conducted more than 15 funded research projects relating to aging, including: Aging in Place: A New Model for Long Term Care; Quality Improvement for Nursing Homes in Missouri; and Multilevel Intervention to Improve Nursing Home Outcomes. Her many published works have been instrumental in providing knowledge for nursing practice that enhances care for the aging in multiple settings.
What is all the furor about the aging population and healthcare? In 2011, the oldest of the baby boomers will turn 65, marking a turning point in consumers of healthcare in America. As millions of baby boomers leave the workforce, there will be a mass retirement move and additional drain on Medicare resources. Will there be enough nurses? Of course not because there are not enough generation X nurses to fill the gap. Will the younger nurses have the wisdom and experience to value and wish to care for this aging population?
The development of gerontological nursing practice began in the 1920s as a uniquely distinguishable body of knowledge. Aging is progressive, irreversible, and a natural process that begins at conception. Older adults can age with high mental and physical function, sometimes greater than those junior to them. With the increasing percentage of older Americans who have increasing life expectancy, healthcare requirements will include multiple, interacting acute and chronic conditions. Comprehensive healthcare reform must include a Medicare follow-up care benefit to help people safely return to their homes following hospitalization and prevent readmission to the hospital, the most costly of care and most injurious to aging persons who are more susceptible to hospital-acquired infections.
The proposed Medicare Transitional Care Act, if passed, would create a new Medicare benefit to coordinate care from hospital to home or another care setting. Living comfortably at home is essential to healthy aging, and most seniors prefer to do that but may not have sufficient support systems to maintain a quality of life at home. More than 1 million Americans are living in nursing homes and would prefer to be at their own home, where they would be more comfortable and save the healthcare system money in the long run. As a member of the "private generation" (1926-1945), I will be among the largest pool of octogenarians, nonagenarians, and centenarians ever. Is it possible to learn how (and how not) to age with dignity and continue to be useful? How many companies are targeting older workers for layoff because of age? Fortunately, I am still writing and love communicating professional and life experiences so that others may learn. Many younger colleagues have asked me what I do to be a part of the "silver tsunami," to preserve my health and maintain a level of fitness, and look forward to longevity. Tips for better health are well documented and since you asked, the following are mine:
* An exercise and physical activity schedule that suits my lifestyle and needs. This includes daily water aerobics and swimming laps. Golfing at least once a week, when weather and climate permit, skiing 10 to 20 days a season in Colorado, as well as hiking and walking.
* Drink plenty of water and eat healthy foods, including fiber. Take my daily vitamins, 1 aspirin, and no prescription medications, except when absolutely necessary. I am fortunate to be able to maintain physical stamina and do not need other medications.
* Monitor your health and have annual physical examinations, including influenza shots as indicated. Good dental care and daily flossing. I have some problems here but try to keep on top of scheduled cleaning and dental visits.
* Manage stress and get enough sleep. Easier said than done; however, since my desk work is on my time schedule, it is much easier to work in a much more relaxed way than my more than 20 years as a nursing administrator. I have strong social and family networks and have adopted stress reduction strategies, such as listening to music and attending concerts.
* Drink alcohol in moderation. A daily glass of wine is fine and is healthy. Enjoy dinner, whether dining alone or with family or friends.
* Live safely, wear seat belts, and avoid ladders and more difficult housekeeping and yard maintenance chores. I am fortunate to have a son visit and do some of these for me.
* Laugh at your self and with others as much as possible and on a daily basis. Did you know that laughter can make your real age as much as 8 years younger?
* Be a lifelong learner-not difficult as so much new information comes about daily. I read USA Today and a daily newspaper, as well as have a subscription of The Week,a wonderful recap of everything worldwide. Of course, I continue with nursing journal readings and daily press releases for nursing and healthcare. I also belong to a monthly book club where we discuss novels as well as other books-nonnursing. I have done this for years wherever I have lived.
* Involve yourself in your community. I have volunteered as a ski instructor at the National Sports Center for the Disabled for 9 years while living in Colorado full-time and participate whenever possible. I serve as an adjunct professor at the University of Arizona and volunteer something each year, whether it is about leadership, writing for professional publications, or whatever seems appropriate. I also am a member of the Saddlebrooke Symphony Guild, which supports the Tucson Symphony Orchestra, and other community activities.
I do a lot to preserve my health and fitness, and sometimes I am alarmed when people smoke or are very overweight-yes I could lose a few pounds, too. But we are in control of our own destiny and aging is a wonderful time to experience so much that you did not have time for because you were busy raising children (I have 4 sons, 2 daughters, now 14 grandchildren, 2 great grandsons) and having an almost overwhelming career as a nurse executive. Having lived and worked in Saudi Arabia during the later part of my nurse executive years (1987-1991), my love for travel never stops.
A very dear friend, aged 85, has joined me on several international trips. Most recently, she joined me with a group of seniors from where I live in Arizona on a South American cruise around Cape Horn, and certainly, I did swim in icy cold water, on the ship, and earned my "Penguin Cape Horn Swim" certificate. Adventures are always waiting for me, such as climbing Machu Picchu a few years ago and Kilimanjaro while I was working in Saudi Arabia. The quality of life in aging is the essence of living-each day fully and to the fullest with a sincere love of self and those around you. Be ready for me as I represent the "aging wave."
Barbara J. Brown, EdD, RN, CNAA, FNAP, FAAN
Editor-in-Chief Nursing Administration Quarterly