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OUR LATER YEARS
                        CHAPTER




Aspects of aging that affect our…
          Health
          S o c i a l E m ot i o n a l We l l b e i n g
          Re p r o d u c t i v e H e a l t h a n d S e x u a l i t y


“Our we as old as we look or as old
as we feel”
QUESTIONS FOR THOUGHT???

1. How can we make the adaption needed to
maximize good health and maintain Independence
and Quality of Life?

2. How much medical intervention are we
comfortable with in our later years? (60 -80 yrs.)
            Breast Exams
            Vaginal Exams
            Preventative Health


3. How does sex and sexual pleasures fit into our
lives in our later years?
THE NEW OLD AGE

Aging has become feminized
              Women live longer
              Fitness becomes a problem as we
age
                                                  65 and older
12% live in poverty
              Our bodies in context
              Most cultures value and honor older
people
*In the United States they idealize the young and discriminate
against older adults.
ADVERTISEMENTS

Advertisements play on and exaggerate a women’s fear and
anxieties about the natural changes in their body as they age
               Pharmaceutical – Hormone
replacement & cologin
               Plastic Surgery – Botox & Laser
Treatment
               Cosmetics – Oil of Olay & Clinique
“ Self acceptance as we age can be hard won but…invaluable”     pg
                              550
RELATIONSHIPS

Maintaining Connections
            Set new goals as relationships change
            Evaluate or assess our love and
relationships
            Change in gestational hierarchy in
family
No matter how we define relationships, social connections have
positive effect on ones health
Dealing with Loss
           During our older years we experience
the death of                more friends and
loved ones
GOING AT IT ALONE

65 and older – 42% of women are widowed



65 and older – 14% of men are widowed




65 and older – 45% of women live alone




65 and older – 19% of men live alone
AGING AND HEALTH

We all age dif ferently


some women have developed disabilities from
an early age



More women develop disabilities in midlife or
older
PREVENTIVE MEASURES: TAKING CARE OF
              OURSELVES

The key word is prevention



Prevention is doing what we can to take care of ourselves so as
to avoid or ease the chronic conditions associated with later life




Healthy habits include no nicotine and excessive alcohol and as
much exercise and nutritious eating as possible.
PREVENTIVE MEASURES: TAKING CARE OF
         OURSELVES CONTINUED

There are many factors beyond our control
             such as…
                           Occupational Health Hazard
                           High Blood Pressure
                           Diabetes
                           Ethnicity
   “Strive to make changes that are within out
                     power”
BASIC PREVENTATIVE MEASURES

Start and or continue to exercise

Engage your mind

Get to bed – you need sleep just like young adults

Schedule checkups which can now be paid for by the 2010
health care reform act
COMMON CHRONIC DISEASES

Hearth Disease
Osteoporosis
Diabetes
Arthritis
Forms of Cancer
Urinary incontinence… everyone’s favorite topic
You can visit www.cdc.gov/chronicdisease for more
information about chronic diseases
GUIDELINES FOR SEXUAL AND
           REPRODUCTIVE HEALTH CARE
By the age of 60 a women has undergone regular screenings for
                Cervical Cancer
                        or
                Breast Cancer
Longevity is a recent phenomenon in women
                so…
There is not a lot of data on screening for women over 85. It is
important to maintain
                Vaginal Health
                Mamograms – every year for women age 50 -74
                Pap screenings – 65 and older should discuss with
their                             health care provider
                Bone screenings should be done at 65 and every 2
years           following
SEXUALIT Y

The Sex Continuum
              Our society views older women as “drugged up”
              and sexless.

Sexuality unlike, fertility, can continue throughout your life

Many women enjoy sex more in the middle and later stages of
their lives due to appreciating their body and sexuality more
fully

Adjustments, disruptions or feeling less sexual can also result
from chronic or acute illness or surgery
PHYSICAL CHANGES THAT AFFECT SEXUALIT Y

  2 01 0 H a r v a r d M e d i c a l S c h o o l S p e c i a l H e a l t h Re p o r t S ex u a l i t y i n M i d l i fe a n d
  B eyo n d

  Po s s i b l e A g e Re l a te d S ex u a l C h a n g e s f o r Wo m e n :

                                 P hy s i c a l C h a n g e s :          Low estrogen
                                                                  Decreased blood flow to
  genitals
                                                            Thinning of vaginal lining
                                                            Muscle tone
                                 Desire –               Decreased libido, fewer sexual
  thoughts
                                 Arousal – Reduced vaginal lubricants, less
  blood and                                     congestion
                                 Orgasm – Delayed or absent
                                 Resolution – body returns rapidly to a non -
                                       aroused state

      “Only 22% of women discuss sex with a physician af ter 50”
PRACTICAL APPROACH TO AGE RELATED
         SEXUAL CHANGES

      Declining Health
      Body Changes
      Chronic Illness
      Medication
       Health Benefits to Sexual Activity
      Expand Energy
      Burns Calories – Brain release endorphins
      Reduced Stress
      Sleep Better
      Delay or minimize incontinence by working pelvis
      Delay Pain – Orgasm can reduce pain
LOSS OF DESIRE

Women experience a shift in levels of desire throughout their
lives

Reasons for less sexual desire include:

              Overwork and anxiety
              Loss of newness
              Abuse
              Gradual changes/accommodations
              Not being attracted
PLEASURING OTHERS AND YOURSELF

Viagra and other erectile dysfunction medications exist for men

                       Navigating Health Care
In the twenty -first century medical care there is a great
shortage of doctors, nurses, psychologists, psychiatrists,
dentists and other health care professionals trained in caring
for older adults
THE INSTITUTE OF MEDICINE

Predictions in the near future…


2007 = 1 geriatrician for every 2,546 older adults
2030 = 1 geriatrician for every 4,254 older adults

2007 = 1 geriatric psychiatrist for every 11,372 older
adults
2030 = 1 geriatric psychiatrist for every 20,195 older
adults
WRONG DIAGNOSIS, WRONG TREATMENT

Providers without adequate training may treat older women
inaccurately

             They may not fully treat chronic illness
             Misdiagnosis or fail to manage reversible
             conditions
             Over proscribe medications
             People over the age of 65 take 34% of
             medications
             Prescriptions are based on a yearly basis
             in the US
             They are only 13% of the US population
PLANNING AHEAD

Be proactive … Plan Ahead

             Look into retirement
                            Health Care
                            Long-term Care
                            Housing
                            Activities
                            Your Community Can Help
PLANNING AHEAD CONTINUED

Retirement and Social Security
Planning ahead is critical in dealing with gaps in your earning
during employment years
             Raising children
             Taking care of older parents

Housing
As you get older you may…
              Move to a smaller home
              Get a roommate
              Moving to a retirement home
              Receive elder services in your own house
MORE PLANNING AHEAD

Household help and Long Term Care

Long term care services are very expensive

Community Living Assistance Services and Support Act (Class
Act) 2010 Health Reform Law


              Voluntary Long-Term Care insurance
                     program for senior and disabled people to
pay no               medical services and support
              Contribute for 5 years – A benefit on
                     average of $50 a day
HEALTH AND LEGAL DECISION

Power of Attorney – A trusting person has the authority to act on
your behalf in financial and legal matters if unable to take
action yourself

Health Care Proxy Document – A person you trust authority to
make medical testing and treatment decisions

Medical Advance Directive or Living Will – Describes the medical
treatment one wishes to receive or refuse… and under what
conditions
END OF LIFE CARE

Sometimes medical science, not the concern of a women’s life
quality, shapes the advice we receive about death and dying

              Talk to a health care provider about your wishes

              You need to manage your own healthcare

Compassionate end-of-life care that addresses you emotional,
spiritual and practical needs is essential, regardless of the type
of treatment or care chosen
CAREGIVER

66% of caregivers are women
41% work full time
13% work part time
The economic value of caregivers unpaid contributions
is estimated at $375 billion
Care givers have high rates of
            Depression
            Chronic Diseases
            Infections
            Exhaustion
This is compared to non-caregivers of the same age
RESPITE AND RESOURCES

Family Caregiver Alliance ( caregive.org)
               Information services and advocacy for caregivers
National Alliance for Caregivers ( caregiving.org)
               Non-profit coalition of national organizations
                              focused as family caregivers
Roselynn Carter Institute of Caregiving ( roselynncarter.org)
               Established local and state partnerships that
build                 quality long-term and home based services
Share the Care (sharethecare.org)
               creative models in which neighborhoods help
families
ACCEPTING CARE WHEN WE NEED IT

Women need to accept help without feeling deminished

Helpers need to provide choices when possible

Living Full: Building Community, Continuing Advocacy

“From the bottom of my heart: Life gets greater and more
surprising after 40, 50, 60 and yes 70.”
-Gloria Steinem-

One must have a sense of purpose and enthusiasm for life
ACCEPTING CARE WHEN WE NEED IT
             CONTINUED
You need fulfillment during later years

Why do you need fulfillment…
             Less time left
             Clarified priorities
             More knowledge of what matters

Dr. Gene Cohen, geriatric psychiatrist was convinced older
people have untapped wells of creativity and skills

“Chocolate for the aging brain”
INTERGENERATIONAL LIVING

Older women’s wisdom and skills are much needed by younger
generations



We must work toward building a society that celebrates and
supports the elderly
WORKING TOGETHER TO CREATE CHANGE

Older women need to build on the strength they have in numbers
by creating and supporting programs that meet older women’s
needs

Such as…
               Long-Term Care
               Health Care
               Work-Family Balance
               Retirement security
Everyone will age

Women need to continue to tell their stories of being mothers,
sisters, daughters, caregivers, workers and push their local, state
and national governments to provide services for their older years!

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Teachback womens health

  • 1. OUR LATER YEARS CHAPTER Aspects of aging that affect our… Health S o c i a l E m ot i o n a l We l l b e i n g Re p r o d u c t i v e H e a l t h a n d S e x u a l i t y “Our we as old as we look or as old as we feel”
  • 2. QUESTIONS FOR THOUGHT??? 1. How can we make the adaption needed to maximize good health and maintain Independence and Quality of Life? 2. How much medical intervention are we comfortable with in our later years? (60 -80 yrs.) Breast Exams Vaginal Exams Preventative Health 3. How does sex and sexual pleasures fit into our lives in our later years?
  • 3. THE NEW OLD AGE Aging has become feminized Women live longer Fitness becomes a problem as we age 65 and older 12% live in poverty Our bodies in context Most cultures value and honor older people *In the United States they idealize the young and discriminate against older adults.
  • 4. ADVERTISEMENTS Advertisements play on and exaggerate a women’s fear and anxieties about the natural changes in their body as they age Pharmaceutical – Hormone replacement & cologin Plastic Surgery – Botox & Laser Treatment Cosmetics – Oil of Olay & Clinique “ Self acceptance as we age can be hard won but…invaluable” pg 550
  • 5. RELATIONSHIPS Maintaining Connections Set new goals as relationships change Evaluate or assess our love and relationships Change in gestational hierarchy in family No matter how we define relationships, social connections have positive effect on ones health Dealing with Loss During our older years we experience the death of more friends and loved ones
  • 6. GOING AT IT ALONE 65 and older – 42% of women are widowed 65 and older – 14% of men are widowed 65 and older – 45% of women live alone 65 and older – 19% of men live alone
  • 7. AGING AND HEALTH We all age dif ferently some women have developed disabilities from an early age More women develop disabilities in midlife or older
  • 8. PREVENTIVE MEASURES: TAKING CARE OF OURSELVES The key word is prevention Prevention is doing what we can to take care of ourselves so as to avoid or ease the chronic conditions associated with later life Healthy habits include no nicotine and excessive alcohol and as much exercise and nutritious eating as possible.
  • 9. PREVENTIVE MEASURES: TAKING CARE OF OURSELVES CONTINUED There are many factors beyond our control such as… Occupational Health Hazard High Blood Pressure Diabetes Ethnicity “Strive to make changes that are within out power”
  • 10. BASIC PREVENTATIVE MEASURES Start and or continue to exercise Engage your mind Get to bed – you need sleep just like young adults Schedule checkups which can now be paid for by the 2010 health care reform act
  • 11. COMMON CHRONIC DISEASES Hearth Disease Osteoporosis Diabetes Arthritis Forms of Cancer Urinary incontinence… everyone’s favorite topic You can visit www.cdc.gov/chronicdisease for more information about chronic diseases
  • 12. GUIDELINES FOR SEXUAL AND REPRODUCTIVE HEALTH CARE By the age of 60 a women has undergone regular screenings for Cervical Cancer or Breast Cancer Longevity is a recent phenomenon in women so… There is not a lot of data on screening for women over 85. It is important to maintain Vaginal Health Mamograms – every year for women age 50 -74 Pap screenings – 65 and older should discuss with their health care provider Bone screenings should be done at 65 and every 2 years following
  • 13. SEXUALIT Y The Sex Continuum Our society views older women as “drugged up” and sexless. Sexuality unlike, fertility, can continue throughout your life Many women enjoy sex more in the middle and later stages of their lives due to appreciating their body and sexuality more fully Adjustments, disruptions or feeling less sexual can also result from chronic or acute illness or surgery
  • 14. PHYSICAL CHANGES THAT AFFECT SEXUALIT Y 2 01 0 H a r v a r d M e d i c a l S c h o o l S p e c i a l H e a l t h Re p o r t S ex u a l i t y i n M i d l i fe a n d B eyo n d Po s s i b l e A g e Re l a te d S ex u a l C h a n g e s f o r Wo m e n : P hy s i c a l C h a n g e s : Low estrogen Decreased blood flow to genitals Thinning of vaginal lining Muscle tone Desire – Decreased libido, fewer sexual thoughts Arousal – Reduced vaginal lubricants, less blood and congestion Orgasm – Delayed or absent Resolution – body returns rapidly to a non - aroused state “Only 22% of women discuss sex with a physician af ter 50”
  • 15. PRACTICAL APPROACH TO AGE RELATED SEXUAL CHANGES Declining Health Body Changes Chronic Illness Medication Health Benefits to Sexual Activity Expand Energy Burns Calories – Brain release endorphins Reduced Stress Sleep Better Delay or minimize incontinence by working pelvis Delay Pain – Orgasm can reduce pain
  • 16. LOSS OF DESIRE Women experience a shift in levels of desire throughout their lives Reasons for less sexual desire include: Overwork and anxiety Loss of newness Abuse Gradual changes/accommodations Not being attracted
  • 17. PLEASURING OTHERS AND YOURSELF Viagra and other erectile dysfunction medications exist for men Navigating Health Care In the twenty -first century medical care there is a great shortage of doctors, nurses, psychologists, psychiatrists, dentists and other health care professionals trained in caring for older adults
  • 18. THE INSTITUTE OF MEDICINE Predictions in the near future… 2007 = 1 geriatrician for every 2,546 older adults 2030 = 1 geriatrician for every 4,254 older adults 2007 = 1 geriatric psychiatrist for every 11,372 older adults 2030 = 1 geriatric psychiatrist for every 20,195 older adults
  • 19. WRONG DIAGNOSIS, WRONG TREATMENT Providers without adequate training may treat older women inaccurately They may not fully treat chronic illness Misdiagnosis or fail to manage reversible conditions Over proscribe medications People over the age of 65 take 34% of medications Prescriptions are based on a yearly basis in the US They are only 13% of the US population
  • 20. PLANNING AHEAD Be proactive … Plan Ahead Look into retirement Health Care Long-term Care Housing Activities Your Community Can Help
  • 21. PLANNING AHEAD CONTINUED Retirement and Social Security Planning ahead is critical in dealing with gaps in your earning during employment years Raising children Taking care of older parents Housing As you get older you may… Move to a smaller home Get a roommate Moving to a retirement home Receive elder services in your own house
  • 22. MORE PLANNING AHEAD Household help and Long Term Care Long term care services are very expensive Community Living Assistance Services and Support Act (Class Act) 2010 Health Reform Law Voluntary Long-Term Care insurance program for senior and disabled people to pay no medical services and support Contribute for 5 years – A benefit on average of $50 a day
  • 23. HEALTH AND LEGAL DECISION Power of Attorney – A trusting person has the authority to act on your behalf in financial and legal matters if unable to take action yourself Health Care Proxy Document – A person you trust authority to make medical testing and treatment decisions Medical Advance Directive or Living Will – Describes the medical treatment one wishes to receive or refuse… and under what conditions
  • 24. END OF LIFE CARE Sometimes medical science, not the concern of a women’s life quality, shapes the advice we receive about death and dying Talk to a health care provider about your wishes You need to manage your own healthcare Compassionate end-of-life care that addresses you emotional, spiritual and practical needs is essential, regardless of the type of treatment or care chosen
  • 25. CAREGIVER 66% of caregivers are women 41% work full time 13% work part time The economic value of caregivers unpaid contributions is estimated at $375 billion Care givers have high rates of Depression Chronic Diseases Infections Exhaustion This is compared to non-caregivers of the same age
  • 26. RESPITE AND RESOURCES Family Caregiver Alliance ( caregive.org) Information services and advocacy for caregivers National Alliance for Caregivers ( caregiving.org) Non-profit coalition of national organizations focused as family caregivers Roselynn Carter Institute of Caregiving ( roselynncarter.org) Established local and state partnerships that build quality long-term and home based services Share the Care (sharethecare.org) creative models in which neighborhoods help families
  • 27. ACCEPTING CARE WHEN WE NEED IT Women need to accept help without feeling deminished Helpers need to provide choices when possible Living Full: Building Community, Continuing Advocacy “From the bottom of my heart: Life gets greater and more surprising after 40, 50, 60 and yes 70.” -Gloria Steinem- One must have a sense of purpose and enthusiasm for life
  • 28. ACCEPTING CARE WHEN WE NEED IT CONTINUED You need fulfillment during later years Why do you need fulfillment… Less time left Clarified priorities More knowledge of what matters Dr. Gene Cohen, geriatric psychiatrist was convinced older people have untapped wells of creativity and skills “Chocolate for the aging brain”
  • 29. INTERGENERATIONAL LIVING Older women’s wisdom and skills are much needed by younger generations We must work toward building a society that celebrates and supports the elderly
  • 30. WORKING TOGETHER TO CREATE CHANGE Older women need to build on the strength they have in numbers by creating and supporting programs that meet older women’s needs Such as… Long-Term Care Health Care Work-Family Balance Retirement security Everyone will age Women need to continue to tell their stories of being mothers, sisters, daughters, caregivers, workers and push their local, state and national governments to provide services for their older years!