Fluent Essays

see attachment 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492 1-800-274-4ANA (4262) www.Nursingworld.org ISBN-13: 878-1-55810-619-2   SAN: 851-3481   10K   07/2015 Scope and Standards of PracticeNursing Nursing Scope and Standards of Practice 3rd Edition The premier resource for professional nursing practice, Nursing: Scope and Standards of Practice, 3rd Edition, is informed by the advances in health care and professional nursing today. This keystone publication contains 17 national standards of practice and performance and their competencies. It describes the scope of nursing practice: the who, what, where, when, why, and how of nursing practice activities. Nursing: Scope and Standards of Practice informs and guides nursing practice and is often used as a reference for: ˩ Quality improvement initiatives. ˩ Certification and credentialing. ˩ Position descriptions and performance appraisals. ˩ Classroom teaching and in-service education programs. ˩ Members’ orientation programs and regulatory decision-making activities for boards of nursing. It also outlines key aspects of nursing’s professional role and practice for any level, setting, population focus, specialty, and more! In sum, Nursing Scope and Standards of Practice is an authoritative, detailed, and practical discussion of the competent level of nursing practice and professional performance. It is a must-have for every registered nurse. N u rsin g : S co p e an d S ta n d a rd s of P ra ctice 3rd E d ition For more information or to order multiple copies, go to www.Nursebooks.org, call 1-800-637-0323 or scan the QR code. 3rd Edition ANA’s Standards of Professional Nursing Practice ANA’s Standards of Professional Nursing Practice The Standards of Practice describe a competent level of nursing care as demonstrated by the critical thinking model known as the nursing process. The nursing process includes the components of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. Accordingly, the nursing process encompasses significant actions taken by registered nurses and forms the foundation of the nurse’s decision-making. The Standards of Professional Performance describe a competent level of behavior in the professional role, including activities related to ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice, professional practice evaluation, resource utilization, and environmental health. All registered nurses are expected to engage in professional role activities, including leadership, appropriate to their education and position. Registered nurses are accountable for their professional actions to themselves, their healthcare consumers, their peers, and ultimately to society. Standards of Practice Standard 1. Assessment The registered nurse collects pertinent data and information relative to the healthcare consumer’s health or the situation. Standard 2. Diagnosis The registered nurse analyzes the assessment data to determine actual or potential diagnoses, problems, and issues. Standard 3. Outcomes Identification The registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Standard 4. Planning The registered nurse develops a plan that prescribes strategies to attain expected, measurable outcomes. Standard 5. Implementation The registered nurse implements the identified plan. Standard 5A. Coordination of Care The registered nurse coordinates care delivery. Standard 5B. Health Teaching and Health Promotion The registered nurse employs strategies to promote health and a safe environment. Standard 6. Evaluation The registered nurse evaluates progress toward attainment of goals and outcomes. Standards of Professional Performance Standard 7. Ethics The registered nurse practices ethically. Standard 8. Culturally Congruent Practice The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles. Standard 9. Communication The registered nurse communicates effectively in all areas of practice. Standard 10. Collaboration The registered nurse collaborates with the healthcare consumer and other key stakeholders in the conduct of nursing practice. Standard 11. Leadership The registered nurse leads within the professional practice setting and the profession. Standard 12. Education The registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Standard 13. Evidence-based Practice and Research The registered nurse integrates evidence and research findings into practice. Standard 14. Quality of Practice The registered nurse contributes to quality nursing practice. Standard 15. Professional Practice Evaluation The registered nurse evaluates one’s own and others’ nursing practice. Standard 16. Resource Utilization The registered nurse utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, and fiscally responsible. Standard 17. Environmental Health The registered nurse practices in an environmentally safe and healthy manner. Source: American Nurses Association. (2015). Nursing: Scope and Standards of Practice (3rd ed.) (pp. 5–6). Silver Spring, MD: ANA. Source: American Nurses Association. (2015). Nursing: Scope and Standards of Practice (3rd ed.) (pp. 4–5). Silver Spring, MD: ANA.©2015 American Nurses Association ©2015 American Nurses Association American Nurses Association Silver Spring, Maryland 2015 3rd Edition Scope and Standards of PracticeNursing The American Nurses Association (ANA) is a national professional association. This ANA publication, Nursing: Scope and Standards of Practice, Third Edition, reflects the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of nursing, while Nursing: Scope and Standards of Practice, Third Edition, guides nurses in the application of their professional knowledge, skills, and responsibilities. American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring, MD 20910-3492 1-800-274-4ANA http://www.Nursingworld.org Published by Nursesbooks.org The Publishing Program of ANA http://www.Nursesbooks.org Copyright ©2015 American Nurses Association. All rights reserved. Reproduction or transmission in any form is not permitted without written permission of the American Nurses Association (ANA). This publication may not be translated without written permission of ANA. For inquiries, or to report unauthorized use, email [email protected] ana.org. Cataloging-in-Publication Data on file with the Library of Congress ISBN-13: 978-1-55810-620-8 SAN: 851-3481 07/2015 First published: July 2015 http://www.Nursingworld.org http://www.Nursingworld.org mailto:copyright%40ana.org?subject= mailto:copyright%40ana.org?subject= Contents  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  iii Contents Contributors vii Overview of the Content xi Essential Documents of Professional Nursing xi Additional Content xi Audience for This Publication xii Scope of Nursing Practice 1 Definition of Nursing 1 Professional Nursing’s Scope and Standards of Practice 1 Description of the Scope of Nursing Practice 2 Development and Function of the Standards of Professional Nursing Practice 3 Standards of Practice 4 Standards of Professional Performance 5 The Function of Competencies in Standards 6 Integrating the Art and Science of Nursing 6 The What and How of Nursing 7 Tenets Characteristic of Nursing Practice 7 The How of Nursing 9 The Art of Nursing 11 The Science of Nursing 13 When Nursing Occurs 16 Nursing Knowledge, Research, and Evidence-based Practice 16 The Where of Nursing Practice 19 Healthy Work Environments for Nursing Practice 21 Safe Patient Handling and Mobility (SPHM) 22 Fatigue in Nursing Practice 22 Workplace Violence and Incivility 22 Optimal Staffing 23 Supports for Healthy Work Environments 23 High-Performing Interprofessional Teams 27 Key Influences on the Quality and Environment of Nursing Practice 28 iv  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Contents Societal, Cultural, and Ethical Dimensions Describe the Why and How of Nursing 31 Model of Professional Nursing Practice Regulation 33 The Code of Ethics for Nurses 36 Specialty Practice in Nursing 37 Professional Registered Nurses Today: The Who of Nursing 38 Statistical Snapshot 38 Licensure and Education of Registered Nurses 41 Advanced Practice Registered Nurse Roles 42 Professional Competence in Nursing Practice 43 Evaluating Competence 45 Professional Trends and Issues 45 Creating a Sustainable Nursing Workforce 46 Nursing Education 47 Technological Advances 48 Population Focus: Redefining Health and Well-being for the Millennial Generation 48 Baby Boomers: Health and Chronic Illness 48 Summary of the Scope of Nursing Practice 49 Standards of Professional Nursing Practice 51 Significance of Standards 51 Standards of Practice 53 Standard 1. Assessment 53 Standard 2. Diagnosis 55 Standard 3. Outcomes Identification 57 Standard 4. Planning 59 Standard 5. Implementation 61 Standard 5A. Coordination of Care 63 Standard 5B. Health Teaching and Health Promotion 65 Standard 6. Evaluation 66 Standards of Professional Performance 67 Standard 7. Ethics 67 Standard 8. Culturally Congruent Practice 69 Standard 9. Communication 71 Standard 10. Collaboration 73 Standard 11. Leadership 75 Standard 12. Education 76 Standard 13. Evidence-based Practice and Research 77 Standard 14. Quality of Practice 79 Standard 15. Professional Practice Evaluation 81 Standard 16. Resource Utilization 82 Standard 17. Environmental Health 84 Contents  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  v Glossary 85 References and Bibliography 91 Appendix A: Nursing: Scope and Standards of Practice, 2nd Edition (2010) 99 Appendix B: Nursing’s Social Policy Statement: The Essence of the Profession (2010) 175 Appendix C: ANA Position Statement: Professional Role Competence (2014) 213 Appendix D: The Development of Essential Nursing Documents and Professional Nursing 223 Appendix E: Selected Nurse Theorists 227 Appendix F: Culturally Congruent Practice Resources 229 Index 235 Contributors  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  vii Contributors Nursing: Scope and Standards of Practice, Third Edition, is the product of exten- sive thought work by many registered nurses and a three-step review process. This document originated from the decisions garnered during a significant number of telephone conference calls and electronic mail communications of the diverse workgroup members and an intensive two-day in person week- end meeting. The first review process, a 30-day public comment period, fol- lowed. All workgroup members reviewed every comment, resulting in further workgroup refinements of the draft document. The official American Nurses Association (ANA) review process included evaluation by the Committee on Nursing Practice Standards and final review and approval by the ANA Board of Directors in June 2015. The list of endorsing organizations that completes this section reflects the broad acceptance of this resource within the profession. Nursing Scope and Standards Workgroup, 2014–2015 Elizabeth Thomas, MEd, RN, NCSN, FNASN, Chairperson Chad Allen, RN Sheri-Lynne Almeida, DrPH, MSN, MED, RN, CEN, FAEN Carolyn Baird, DNP, MBA, RN-BC, CARN-AP, CCDPD, FIAAN Nancy Barr, MSN, RN Patricia Bartzak, DNP, RN, CMSRN Mavis Bechtle, MSN, RN Jennifer Bellot, PhD, MHSE, RN, CNE Tom Blodgett, PhD, MSN, GCNS, RN-BC Patricia Bowe, MS, BSN, RN Katreena Collette-Merrill, PhD, RN viii  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Contributors Kahlil Demonbreun, DNP, RNC-OB, WHNP-BC, ANP-BC Sheila Eason, MS, BSN, RN, CNOR Tim Fish, DNP, MBA, RN, CENP Matthew French-Bravo, MSN, RN Heather Healy, MS, APRN, FNP-BC, NEA-BC Susan Howard, MSN, RN-BC Brenda Hutchins, DNP, ANP-BC, GNP-BC Lorinda Inman, MSN, RN, FRE Donna Konradi, PhD, RN, CNE Mary Ann Lavin, ScD, APRN, ANP-BC, FNI, FAAN Carla Mariano, EdD, RN, AHN-BC, FAAIM Lucy Marion, PhD, RN, FAANP, FAAN Deborah Maust Martin, DNP, MBA, RN, NE-BC, FACHE Cindy McCullough, MSN, CMSRN, AGCNS-BC Kris A. McLoughlin, DNP; APRN; PMH-CNS, BC; CADC-II, FAAN Joyce Morris, MSN, RN-BC Sandra J. Fulton Picot, PhD, RN, CLNC, FGSA, FAAN Deborah Poling, PhD, RN, FNP-BC, CNE Lori L. Profata, DNP, RN, NE-BC Karen Rea-Williams, MS, FNP ShyRhonda Roy, MSN, RN Debbie Ruiz, RN Kathryn Schroeter, PhD, RN, CNE, CNOR Melida Shepard, RN, BSN, CPHQ Suzanne Sikes-Thurman, BA, BSN, RN Janice Smolowitz, EdD, DNP, RN, ANP-BC Lynn Tomascik, MSN, RN Linda Wagner, MA, RN, NE-BC Contributors  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  ix Acknowledgment of Special Contribution Marilyn (Marty) Douglas, PhD, RN, FAAN ANA Committee on Nursing Practice Standards Richard Henker, PhD, RN, CRNA, FAAN: co- chair 03/2014–12/2015 Tresha (Terry) L. Lucas, MSN, RN: co- chair 07/2011–12/2014 Danette Culver, MSN, APRN, ACNS-BC, CCRN Deborah Finnell, DNS, PMHNP-BC, CARN-AP, FAAN Renee Gecsedi, MS, RN Deedra Harrington, DNP, MSN, APRN, ACNP-BC Maria Jurlano, MS, BSN, RN, NEA-BC, CCRN Carla A. B. Lee, PhD, APRN-BC, CNAA, FAAN, FIBA Verna Sitzer, PhD, RN, CNS ANA Staff, 2014-2015 Carol J. Bickford, PhD, RN-BC, CPHIMS, FAAN – Content editor Mary Jo Assi, DNP, RN, FNP-BC, NEA-BC Maureen E. Cones, Esq. – Legal Counsel Eric Wurzbacher, BA – Project editor Yvonne Humes, MSA – Project assistant About the American Nurses Association The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 3.4 million registered nurses through its constituent member nurses associations and its organiza- tional affiliates. ANA advances the nursing profession by fostering high stan- dards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on healthcare issues affecting nurses and the public. x  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Contributors About Nursesbooks.org, The Publishing Program of ANA Nursesbooks.org publishes books on ANA core issues and programs, includ- ing ethics, leadership, quality, specialty practice, advanced practice, and the profession’s enduring legacy. Best known for the Essential documents of the profession on nursing ethics, scope and standards of practice, and social policy, Nursesbooks.org is the publisher for the professional, career-oriented nurse, reaching and serving nurse educators, administrators, managers, and research- ers as well as staff nurses in the course of their professional development. Overview of the Content  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  xi Overview of the Content Essential Documents of Professional Nursing Registered nurses practicing in the United States have two contemporary pro- fessional resources that inform their thinking and decision-making and guide their practice. First, the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association, 2015) lists the nine succinct provisions and accompanying interpretive statements that establish the ethical framework for registered nurses’ practice across all roles, levels, and settings. Secondly, the 2015 Nursing: Scope and Standards of Practice, Third Edition, outlines the expectations of professional nursing practice. The scope of practice statement presents the framework and context of nursing practice and accompanies the standards of professional nursing practice and their associated competencies that identify the evidence of the standard of care. Additional Content For a better appreciation of the history, content, and context related to Nursing: Scope and Standards of Practice, Third Edition, readers will find the additional content of the six appendices useful: •  Appendix A. Nursing: Scope and Standards of Practice, Second Edition (2010) •  Appendix B. Nursing’s Social Policy Statement: The Essence of the Profession (2010) •  Appendix C. ANA Position Statement : Professional Role Competence (2014) •  Appendix D. The Development of Essential Nursing Documents and Professional Nursing •  Appendix E. List of Selected Nurse Theorists •  Appendix F. Culturally Congruent Practice Resources xii  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Overview of the Content Audience for This Publication Registered nurses in every clinical and functional role and setting constitute the primary audience of this professional resource. Students, interprofessional colleagues, agencies, and organizations also will find this an invaluable refer- ence. Legislators, regulators, legal counsel, and the judiciary will also want to examine this content. In addition, the individuals, families, groups, communi- ties, and populations using nursing and healthcare services can use this docu- ment to better understand what constitutes the profession of nursing and how registered nurses and advanced practice registered nurses lead within today’s healthcare environment. Scope of Nursing Practice  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  1 Scope of Nursing Practice Definition of Nursing The following contemporary definition of nursing has been slightly modified from that published in the 2003 Nursing’s Social Policy Statement, Second Edition, and included in the 2004 and 2010 editions of Nursing: Scope and Standards of Practice, with the inclusion of “facilitation of healing” and “groups”: Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, allevia- tion of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations. This definition serves as the foundation for the following expanded descrip- tions of the Scope of Nursing Practice and the Standards of Professional Nursing Practice. Professional Nursing’s Scope and Standards of Practice A professional organization has a responsibility to its members and to the public it serves to develop the scope and standards of practice for its profes- sion. The American Nurses Association (ANA), the professional organization for all registered nurses, has long assumed the responsibility for developing and maintaining the scope of practice statement and standards that apply to the practice of all professional nurses and also serve as a template for evalua- tion of nursing specialty practice. Both the scope and standards do, however, belong to the profession and thus require broad input into their development and revision. Nursing: Scope and Standards of Practice, Third Edition describes a competent level of nursing practice and professional performance common to all registered nurses. 2  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Scope of Nursing Practice Description of the Scope of Nursing Practice The Scope of Nursing Practice describes the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice. Each of these questions must be answered to provide a complete picture of the dynamic and complex practice of nursing and its evolving boundaries and membership. The definition of nursing pro- vides a succinct characterization of the “what” of nursing. Registered nurses and advanced practice registered nurses comprise the “who” constituency and have been educated, titled, and maintain active licensure to practice nursing. Nursing occurs “when”ever there is a need for nursing knowledge, wisdom, caring, leadership, practice, or education, anytime, anywhere. Nursing occurs in any environment “where” there is a healthcare consumer in need of care, information, or advocacy. The “how” of nursing practice is defined as the ways, means, methods, and manners that nurses use to practice professionally. The “why” is characterized as nursing’s response to the changing needs of society to achieve positive healthcare consumer outcomes in keeping with nursing’s social contract with an obligation to society. The depth and breadth in which individual registered nurses and advanced practice registered nurses engage in the total scope of nursing practice is dependent on their education, experience, role, and the population served. These definitions are provided to promote clarity and understanding for all readers: Healthcare consumers are the patients, persons, clients, families, groups, com- munities, or populations who are the focus of attention and to whom the regis- tered nurse is providing services as sanctioned by the state regulatory bodies. This more global term is intended to reflect a proactive focus on health and wellness care, rather than a reactive perspective to disease and illness. Registered nurses (RNs) are individuals who are educationally prepared and licensed by a state, commonwealth, territory, government, or regulatory body to practice as a registered nurse. “Nurse” and “professional nurse” are syn- onyms for a registered nurse in this document. Graduate-level prepared registered nurses are registered nurses prepared at the master’s or doctoral educational level; have advanced knowledge, skills, abil- ities, and judgment; function in an advanced level as designated by elements of the nurse’s position; and are not required to have additional regulatory oversight. Advanced practice registered nurses (APRNs) are registered nurses: •  Who have completed an accredited graduate-level education pro- gram preparing the nurse for one of the four recognized APRN roles [certified registered nurse anesthetist (CRNA), certified nurse Scope of Nursing Practice  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  3 midwife (CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP)]; •  Who have passed a national certification examination that measures APRN-, role-, and population-focused competencies and maintain continued competence as evidenced by recertification in the role and population through the national certification program; •  Who have acquired advanced clinical knowledge and skills prepar- ing the nurse to provide direct care to patients, as well as a compo- nent of indirect care; however, the defining factor for all APRNs is that a significant component of the education and practice focuses on direct care of individuals; •  Whose practices build on the competencies of registered nurses (RNs) by demonstrating a greater depth and breadth of knowledge, a greater synthesis of data, increased complexity of skills and inter- ventions, and greater role autonomy; •  Who are educationally prepared to assume responsibility and accountability for health promotion and/or maintenance as well as the assessment, diagnosis, and management of patient problems, which includes the use and prescription of pharmacologic and non-pharmacologic interventions; •  Who have clinical experience of sufficient depth and breadth to reflect the intended license; and •  Who have obtained a license to practice as an APRN in one of the four APRN roles: certified registered nurse anesthetist (CRNA), certi- fied nurse midwife (CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP) (APRN Joint Dialogue Group, 2008). Development and Function of the Standards of Professional Nursing Practice The Scope of Practice Statement is accompanied by the Standards of Professional Nursing Practice. The standards are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. The standards published herein may serve as evidence of the standard of care, with the understanding that applica- tion of the standards depends on context. The standards are subject to change with the dynamics of the nursing profession, as new patterns of professional practice are developed and accepted by the nursing profession and the public. In addition, specific conditions and clinical circumstances may also affect the application of the standards at a given time, e.g., during a natural disaster or epidemic. As with the scope of practice statement, the standards are subject to formal, periodic review, and revision. 4  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Scope of Nursing Practice The Standards of Professional Nursing Practice consist of the Standards of Practice and the Standards of Professional Performance. Standards of Practice The Standards of Practice describe a competent level of nursing care as demonstrated by the critical thinking model known as the nursing process. The nursing process includes the components of assessment, diagnosis, out- comes identification, planning, implementation, and evaluation. Accordingly, the nursing process encompasses significant actions taken by registered nurses and forms the foundation of the nurse’s decision-making. Standard 1. Assessment The registered nurse collects pertinent data and information relative to the healthcare consumer’s health or the situation. Standard 2. Diagnosis The registered nurse analyzes the assessment data to determine actual or potential diagnoses, problems, and issues. Standard 3. Outcomes Identification The registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Standard 4. Planning The registered nurse develops a plan that prescribes strategies to attain expected, measurable outcomes. Standard 5. Implementation The registered nurse implements the identified plan. Standard 5A. Coordination of Care The registered nurse coordinates care delivery. Standard 5B. Health Teaching and Health Promotion The registered nurse employs strategies to promote health and a safe environment. Scope of Nursing Practice  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  5 Standard 6. Evaluation The registered nurse evaluates progress toward attainment of goals and outcomes. Standards of Professional Performance The Standards of Professional Performance describe a competent level of behavior in the professional role, including activities related to ethics, cultur- ally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice, professional practice evaluation, resource utilization, and environmental health. All registered nurses are expected to engage in professional role activities, including leadership, appropriate to their education and position. Registered nurses are accountable for their professional actions to themselves, their healthcare consumers, their peers, and ultimately to society. Standard 7. Ethics The registered nurse practices ethically. Standard 8. Culturally Congruent Practice The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles. Standard 9. Communication The registered nurse communicates effectively in all areas of practice. Standard 10. Collaboration The registered nurse collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Standard 11. Leadership The registered nurse leads within the professional practice setting and the profession. Standard 12. Education The registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. 6  •  Nursing: Scope and Standards of Practice, 3rd Ed.  •  Scope of Nursing Practice Standard 13. Evidence-based Practice and Research The registered nurse integrates evidence and research findings into practice. Standard 14. Quality of Practice The registered nurse contributes to quality nursing practice. Standard 15. Professional … There are 2 documents attached which are the recommended resources. NRSE_4560_M1_IM_Profile_of_older_Americans_2016 Nursing scope of practice Overview Many in the nursing profession would argue that there is a significant shortage of gerontological nurses. This observation is startling considering the National Institute on Health reports a "gerontological explosion" of older adults in the United States and around the world. Gerontological nursing is an often-neglected area in basic nursing education. In this discussion topic, we will look at the reasons why gerontological nursing is an underserved area of practice. After reading and viewing the required instructional materials, draft a response to the following questions: 1.    What does the term "gerontological nurse" mean to you? 2.    Why do you think so few students choose gerontological nursing as a specialty? 3.    What would increase interest in this area of nursing? 4.    What is the relationship between A Profile of Older Americans: 2016 and the ANA Standards and Scope of Practice  Nursing? Your initial post must be posted before you can view and respond to colleagues, must contain minimum of two (2) references, in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts. References: · Initial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references. Words Limits · Initial Post: Minimum 200 words excluding references (approximately one (1) page) · Response posts: Minimum 100 words excluding references. RUBRIC: DISCUSSION BOARD (30 pts) Last updated: 1/31/2020 © 2020 School of Nursing - Ohio University Page 1 of 1 NOTE: No direct quotes are allowed in the discussion board posts. *Peer-reviewed references include professional journals (i.e. Nursing Education Perspectives, Journal of Professional Nursing, etc. – see library tab on how to access these from database searches), professional organizations (NLN, CDC, AACN, ADA, etc.) applicable to population and practice area, along with clinical practice guidelines (ECRI Institute - https://guidelines.ecri.org). All references must be no older than five years (unless making a specific point using a seminal piece of information) References not acceptable (not inclusive) are UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases. **Since it is difficult to edit the APA reference in the Blackboard discussion area, you can copy and paste APA references from your Word document to the Blackboard discussion area and points will not be deducted because of format changes in spacing. Criteria Levels of Achievement Meets Expectations Needs Improvement Unsatisfactory Characteristics of initial post 10 to 10 Points • Provided response with rationale. • The post is substantive and reflects careful consideration of the literature. • Examples from the student’s practice/experience are provided to illustrate the discussion concepts. • Addressed all required elements of the discussion prompt. • Well organized and easy to read. 3 to 9 Points • Provided response missing either substantive rationale, consideration of the literature, or examples from the student’s practice/experience to illustrate the discussion concepts. • Addresses all or most of required elements. • Somewhat organized, but may be difficult to follow. 0 to 2 Points • Provided response with minimal rationale. • Does not demonstrate thought and provides no supporting details or examples. • Provides a general summary of required elements. Support for initial post 5 to 5 Points • Cited minimum of two references: at least one (1) from required course materials to support rationale AND one (1) from peer-reviewed* references from supplemental materials or independent study on the topic to support responses. • The initial post is a minimum of 200 words excluding references. 2 to 4 Points • Missing one (1) required course reference AND/OR one (1) peer-reviewed reference to validate response. • Post has at least 200 words. 0 to 1 Points • Missing 1 or more of the correct type (course or peer-reviewed) or number of references to support response. • Post is less than 200 words or there’s no post. Responses to Peers 10 to 10 Points • Responses to colleagues demonstrated insight and critical review of the colleagues’ posts and stimulate further discussion • Responded to a minimum of two (2) peers and included a minimum of one (1) peer-reviewed* or course materials reference per response. • Responses are a minimum of 100 words and are posted on different days of the discussion period by the due date. 4 to 9 Points • Responses to colleagues are cursory, do not stimulate further discussion and paragraph could have been more substantial. • Responses missing one of the following: o insight/critical review of colleague’s post, o OR respond to at least two peers, o OR a peer reviewed*or course materials reference per response • Responses are a minimum or less than 100 words and posts were on the same date as initial post. 0 to 3 Points • Responses to colleagues lack critical, in depth thought and do not add value to the discussion. • Responses are missing two or more of the following: o insight/critical review of colleagues’ post o AND/OR response to at least two peers o AND/OR a peer reviewed* reference per response. • Responses are less than 100 words, posted same day as initial post. APA format*; Spelling/ Grammar/ Punctuation 5 to 5 Points • APA format** is used for in-text citations and reference list. • Posts contain grammatically correct sentences without any spelling errors. 2 to 4 Points • APA format is missing either in-text or at end of the reference list. • Posts contain some grammatically correct sentences with few spelling errors. 0 to 1 Points • Not APA formatted OR APA format of references has errors both in-text and at end of reference list. • Post is grammatically incorrect. https://guidelines.ecri.org/ A Profile of Older Americans: 2016 Administration on Aging Administration for Community Living U.S. Department of Health and Human Services Table of Contents HIGHLIGHTS* ............................................................................................................................................... 1 THE OLDER POPULATION ........................................................................................................................ 2 FUTURE GROWTH ....................................................................................................................................... 3 FIGURE 1: NUMBER OF PERSONS 65+: 1900-2060 (NUMBERS IN MILLIONS) .................................................................. 3 MARITAL STATUS ........................................................................................................................................ 4 FIGURE 2: MARITAL STATUS OF PERSONS 65+, 2016 ..................................................................................................... 4 LIVING ARRANGEMENTS.......................................................................................................................... 5 FIGURE 3: LIVING ARRANGEMENTS OF PERSONS 65+: 2016 .......................................................................................... 5 RACIAL AND ETHNIC COMPOSITION ................................................................................................... 6 GEOGRAPHIC DISTRIBUTION ................................................................................................................. 6 FIGURE 4: PERSONS 65+ AS A PERCENTAGE OF TOTAL POPULATION, 2015 ................................................................... 7 FIGURE 5: PERCENT INCREASE IN POPULATION 65+, 2005 TO 2015 ............................................................................... 7 FIGURE 6: THE 65+ POPULATION BY STATE, 2015 .......................................................................................................... 8 INCOME ........................................................................................................................................................... 9 FIGURE 7: PERCENT DISTRIBUTION BY INCOME: 2015 .................................................................................................... 9 POVERTY ...................................................................................................................................................... 10 HOUSING ....................................................................................................................................................... 11 EMPLOYMENT ............................................................................................................................................ 11 EDUCATION ................................................................................................................................................. 11 HEALTH AND HEALTH CARE ................................................................................................................ 11 HEALTH INSURANCE COVERAGE ........................................................................................................ 13 FIGURE 8: PERCENTAGE OF PERSONS 65+ BY TYPE OF HEALTH INSURANCE COVERAGE, 2015 ................................... 13 DISABILITY AND ACTIVITY LIMITATIONS ....................................................................................... 14 FIGURE 9: PERCENTAGE OF PERSONS 65+ WITH A DISABILITY, 2015 ............................................................................ 14 CAREGIVING ............................................................................................................................................... 15 NOTES ............................................................................................................................................................ 16 Highlights* • Over the past 10 years, the population 65 and over increased from 36.6 million in 2005 to 47.8 million in 2015 (a 30% increase) and is projected to more than double to 98 million in 2060. • Between 2005 and 2015 the population age 60 and over increased 34% from 49.8 million to 66.8 million. • The 85+ population is projected to triple from 6.3 million in 2015 to 14.6 million in 2040. • Racial and ethnic minority populations have increased from 6.7 million in 2005 (18% of the older adult population) to 10.6 million in 2015 (22% of older adults) and are projected to increase to 21.1 million in 2030 (28% of older adults). • The number of Americans aged 45-64 – who will reach 65 over the next two decades – increased by 14.9% between 2005 and 2015. • About one in every seven, or 14.9%, of the population is an older American. • Persons reaching age 65 have an average life expectancy of an additional 19.4 years (20.6 years for females and 18 years for males). • There were 76,974 persons aged 100 or more in 2015 (0.2% of the total 65+ population). • Older women outnumber older men at 26.7 million older women to 21.1 million older men. • In 2015, 22% of persons 65+ were members of racial or ethnic minority populations--9% were African-Americans (not Hispanic), 4% were Asian or Pacific Islander (not Hispanic), 0.5% were Native American (not Hispanic), 0.1% were Native Hawaiian/Pacific Islander, (not Hispanic), and 0.7% of persons 65+ identified themselves as being of two or more races. Persons of Hispanic origin (who may be of any race) represented 8% of the older population. • Older men were much more likely to be married than older women---70% of men, 45% of women. In 2016, 34% older women were widows. • About 29% (13.6 million) of noninstitutionalized older persons live alone (9.3 million women, 4.3 million men). • Almost half of older women (46%) age 75+ live alone. • The median income of older persons in 2015 was $31,372 for males and $18,250 for females. Median money income (after adjusting for inflation) of all households headed by older people increased by 4.3% (which was statistically significant) between 2014 and 2015. Households containing families headed by persons 65+ reported a median income in 2015 of $57,360. • The major sources of income as reported by older persons in 2014 were Social Security (reported by 84% of older persons), income from assets (reported by 62%), earnings (reported by 29%), private pensions (reported by 37%), and government employee pensions (reported by 16%). • Social Security constituted 90% or more of the income received by 33% of beneficiaries in 2014 (21% of married couples and 43% of non-married beneficiaries). • Over 4.2 million older adults (8.8%) were below the poverty level in 2015. This poverty rate is statistically different from the poverty rate in 2014 (10.0%). In 2011, the U.S. Census Bureau also released a new Supplemental Poverty Measure (SPM) which takes into account regional variations in living costs, non-cash benefits received, and non-discretionary expenditures but does not replace the official poverty measure. In 2015, the SPM shows a poverty level for older persons of 13.7% (almost 5 percentage points higher than the official rate of 8.8%). This increase is mainly due to including medical out-of-pocket expenses in the poverty calculations. *Principal sources of data for the Profile are the U.S. Census Bureau, the National Center for Health Statistics, and the Bureau of Labor Statistics. The Profile incorporates the latest data available but not all items are updated on an annual basis. 1 The Older Population The population age 65 years or older numbered 47.8 million in 2015 (the most recent year for which data are available). They represented 14.9% of the U.S. population, about one in every seven Americans. The number of older Americans increased by 11.1 million or 30% since 2005, compared to an increase of 5.7% for the under-65 population. Between 2005 and 2015, the number of Americans aged 45-64 (who will reach age 65 over the next two decades) increased by 14.9% and the number of Americans age 60 and over increased by 34.2% from 49.8 million to 66.8 million. In 2015, there were 26.7 million older women and 21.1 million older men, or a sex ratio of 126.5 women for every 100 men. At age 85 and over, this ratio increases to 189.2 women for every 100 men. Since 1900, the percentage of Americans 65+ has more than tripled (from 4.1% in 1900 to 14.9% in 2015), and the number has increased over fifteen times (from 3.1 million to 47.8 million). The older population itself is increasingly older. In 2015, the 65-74 age group (27.6 million) was more than 12 times larger than in 1900 (2,186,767); the 75-84 group (13.9 million) was more than 17 times larger (771,369), and the 85+ group (6.3 million) was 51 times larger (122,362). In 2015, persons reaching age 65 had an average life expectancy of an additional 19.4 years (20.6 years for females and 18 years for males). A child born in 2015 could expect to live 78.8 years, more than 30 years longer than a child born in 1900 (47.3 years). Much of this increase occurred because of reduced death rates for children and young adults. However, the period of 1990-2007 also has seen reduced death rates for the population aged 65-84, especially for men – by 41.6% for men aged 65-74 and by 29.5% for men aged 75- 84. Life expectancy at age 65 increased by only 2.5 years between 1900 and 1960, but has increased by 4.2 years from 1960 to 2007. Nonetheless, some research has raised concerns about future increases in life expectancy in the US compared to other high-income countries, primarily due to past smoking and current obesity levels, especially for women age 50 and over (National Research Council, 2011). In 2015, 3.5 million persons celebrated their 65th birthday. Census estimates showed an annual net increase between 2014 and 2015 of 1.6 million in the number of persons age 65 and over. Between 1980 and 2015, the centenarian population experienced a larger percentage increase than did the total population. There were 76,974 persons aged 100 or more in 2015 (0.2% of the total 65+ population). This is more than double the 1980 figure of 32,194. ----- Sources: U.S. Census Bureau, Population Division, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2015. Release Date: June 2016; Table 1. Intercensal Estimates of the Resident Population by Sex and Age for the United States: April 1, 2000 to July 1, 2010. Release Date: September 2011; Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2015. Release Date: July 1, 2016; 2010 Census Special Reports, Centenarians: 2010, C2010SR-03, 2012; Hobbs, Frank and Nicole Stoops, Census 2000 Special Reports, Series CENSR-4, Demographic Trends in the 20th Century, Table 5. Population by Age and Sex for the United States: 1900 to 2000, Part A; National Center for Health Statistics, Xu JQ, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. NCHS data brief, no 267. Hyattsville, MD: 2016; and National Research Council, Crimmins EM, Preston SH, Cohen B, editors. Explaining Divergent Levels of Longevity in High-Income Countries. Panel on Understanding Divergent Trends in Longevity in High-Income Countries, 2011. 2 Future Growth The older population will continue to grow significantly in the future (Figure 1). This growth slowed somewhat during the 1990's because of the relatively small number of babies born during the Great Depression of the 1930's. But the older population is beginning to burgeon as the first wave of the "baby boom" generation is reaching age 65. The population age 65 and over has increased from 36.6 million in 2005 to 47.8 million in 2015 (a 30% increase) and is projected to more than double to 98 million in 2060. By 2040, there will be about 82.3 million older persons, over twice their number in 2000. People 65+ represented 14.9% of the population in the year 2015 but are expected to grow to be 21.7% of the population by 2040. The 85+ population is projected to more than double from 6.3 million in 2015 to 14.6 million in 2040. Racial and ethnic minority populations have increased from 6.7 million in 2005 (18% of the older adult population) to 10.6 million in 2015 (22% of older adults) and are projected to increase to 21.1 million in 2030 (28% of older adults). Between 2015 and 2030, the white (not Hispanic) population 65+ is projected to increase by 43% compared with 99% for older racial and ethnic minority populations, including Hispanics (123%), African-Americans (not Hispanic) (81%), American Indian and Native Alaskans (not Hispanic) (82%), and Asians (not Hispanic) (90%). Figure 1: Number of Persons 65+: 1900-2060 (numbers in millions) Note: Increments in years are uneven. Source: U.S. Census Bureau, Population Estimates and Projections. ----- Sources: U.S. Census Bureau, Population Division, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2015, Release Date: June 2016; Intercensal Estimates of the Resident Population by Sex and Age for the United States: April 1, 2000 to July 1, 2010. Release Date: September 2011; Intercensal Estimates of the White Alone Resident Population by Sex and Age for the United States: April 1, 2000 to July 1, 2010; 2014 National Population Projections: Summary Tables, Table 3. Projections of the Population by Sex and Selected Age Groups for the United States: 2015 to 2060, released December 10, 2014; and NP2014_D1: Projected Population by Single Year of Age, Sex, Race, and Hispanic Origin for the United States: 2014 to 2060. 3.1 4.9 9 16.2 25.5 35 47.8 56.4 82.3 98.2 0 20 40 60 80 100 120 1900 1920 1940 1960 1980 2000 2015 2020 2040 2060 Year (as of July 1) Figure 1: Number of Persons 65+, 1900 to 2060 (numbers in millions) 3 Marital Status In 2016, older men were much more likely to be married than older women--70% of men, 45% of women (Figure 2). Widows accounted for 34% of all older women in 2016. There were more than three times as many widows (8.8 million) as widowers (2.6 million). Divorced and separated (including married/spouse absent) older persons represented only 14% of all older persons in 2016. However, this percentage has increased since 1980, when approximately 5.3% of the older population were divorced or separated/spouse absent. Figure 2: Marital Status of Persons 65+, 2016 Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement. ----- Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, Table A1. Marital Status of People 15 Years and Over, by Age, Sex, and Personal Earnings: 2016. 45% 34% 16% 5% 70% 12% 13% 5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Married Widowed Divorced or Separated/ Spouse Absent Single (never married) Figure 2: Marital Status of Persons 65+, 2016 Women Men 4 Living Arrangements Over half (59%) of older noninstitutionalized persons age 65+ lived with their spouse (including partner) in 2016. Approximately 15.5 million or 73% of older men, and 12 million or 47% of older women, lived with their spouse (Figure 3). The proportion living with their spouse decreased with age, especially for women. Only 34% of women 75+ years old lived with a spouse. About 29% (13.6 million) of all noninstitutionalized older persons in 2016 lived alone (9.3 million women, 4.3 million men). They represented 35% of older women and 20% of older men. The proportion living alone increases with advanced age. Among women aged 75 and over, for example, almost half (46%) lived alone. A relatively small number (1.5 million) and percentage (3.1%) of the 65+ population in 2015 lived in institutional settings. Among those who did, 1.2 million lived in nursing homes. However, the percentage increases dramatically with age, ranging (in 2015) from 1% for persons 65-74 years to 3% for persons 75-84 years and 9% for persons 85+. Figure 3: Living Arrangements of Persons 65+: 2016 Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement. ----- Sources: U.S. Census Bureau, American Community Survey; Current Population Survey, Annual Social and Economic Supplement 1967 to present; Table AD3. Living arrangements of adults 65 to 74 years old, 1967 to present; Table AD3. Living arrangements of adults 75 and over, 1967 to present. 5 Racial and Ethnic Composition In 2015, 22% of persons age 65+ were members of racial or ethnic minority populations—9% were African- Americans (not Hispanic), 4% were Asian or Pacific Islander (not Hispanic), 0.5% were Native American (not Hispanic), 0.1% were Native Hawaiian/Pacific Islander, (not Hispanic), and 0.7% of persons age 65+ identified themselves as being of two or more races. Persons of Hispanic origin (who may be of any race) represented 8% of the older population. Only 9% of all the people who were members of racial and ethnic minority populations were 65+ in 2015 compared with 19% of non-Hispanic whites. The percentage of people age 65 and over within each racial and ethnic minority group are as follows: 11% of African-Americans (not Hispanic), 12% of Asians (not Hispanic), 8% of Native Hawaiian and Other Pacific Islanders (not Hispanic), 10% of American Indian and Native Alaskans (not Hispanic) and 7% of Hispanics. ----- Source: U.S. Census Bureau, Population Division, Annual Estimates of the Resident Population by Sex, Age, Race, and Hispanic Origin for the United States and States: April 1, 2010 to July 1, 2015. Release Date: June 2016. Geographic Distribution The proportion of older persons in the population varies considerably by state with some states experiencing much greater growth in their older populations (Figures 4 and 5). In 2015, more than half (54%) of persons 65+ lived in 10 states: California (5.2 million); Florida (3.9 million); Texas (3.2 million); New York (3.0 million); Pennsylvania (2.2 million); Ohio (1.8 million); Illinois (1.8 million); Michigan (1.6 million); North Carolina (1.5 million); New Jersey (1.3 million); and Georgia, Virginia, Arizona, Massachusetts, Washington and Tennessee each had well over 1 million (Figure 6). Persons 65+ constituted approximately 18% or more of the total population in three states in 2015: Florida (19.4%); Maine (18.8%); and West Virginia (18.2%). In 5 states, the 65+ population increased by 50% or more between 2005 and 2015: Alaska (63%); Nevada (55%); Colorado (54%); Georgia (50%); and South Carolina (50%). The 10 jurisdictions with poverty rates over 10% for older adults during 2015 were: District of Columbia (15.2%); Louisiana (12.8%); Mississippi (12.5%); Kentucky (11.2%); New York (11.2%); New Mexico (11.1%); Arkansas (10.3%); Florida (10.3%); Rhode Island (10.3%); and Texas (10.3%). Older adults are less likely to change residence than other age groups. From 2015 to 2016, only 3% of older persons moved as opposed to 13% of the under 65 population. Most older movers (62%) stayed in the same county and 22% remained in the same state (different county). Only 16% moved out-of-state or abroad. ----- Sources: Administration for Community Living agid.acl.gov. Data Source: Population Estimates 2005, accessed December 12, 2016. U.S. Census Bureau, American Community Survey; Current Population Survey, Annual Social and Economic Supplement; Table 1. General Mobility, by Race and Hispanic Origin, Region, Sex, Age, Relationship to Householder, Educational Attainment, Marital Status, Nativity, Tenure, and Poverty Status: 2015 to 2016; Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States, States, Counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2015. Release date June 2016. 6 Figure 4: Persons 65+ as a Percentage of Total Population, 2015 Figure 5: Percent Increase in Population 65+, 2005 to 2015 7 Figure 6: The 65+ Population by State, 2015 State Number of Persons 65 and Older (1) Percent of All Ages Percent Increase from 2005 to 2015 Percent Below Poverty 2015 (2) US Total (50 States + DC) 47,760,852 14.9% 30.3% 8.8% Alabama 764,162 15.7% 27.1% 9.9% Alaska 72,837 9.9% 63.0% 4.5% Arizona 1,120,054 16.4% 48.0% 9.0% Arkansas 477,149 16.0% 24.2% 10.3% California 5,188,754 13.3% 35.2% 9.9% Colorado 711,625 13.0% 53.8% 7.0% Connecticut 566,806 15.8% 19.3% 7.2% Delaware 160,515 17.0% 43.2% 6.2% District of Columbia 77,004 11.5% 15.8% 15.2% Florida 3,942,468 19.4% 32.3% 10.3% Georgia 1,304,924 12.8% 50.2% 9.7% Hawaii 236,914 16.5% 35.4% 7.8% Idaho 243,494 14.7% 47.8% 8.7% Illinois 1,830,277 14.2% 20.6% 8.5% Indiana 966,127 14.6% 24.4% 7.2% Iowa 502,877 16.1% 15.1% 7.0% Kansas 426,410 14.6% 19.6% 7.3% Kentucky 672,765 15.2% 27.5% 11.2% Louisiana 653,094 14.0% 22.7% 12.8% Maine 250,536 18.8% 30.7% 8.8% Maryland 849,571 14.1% 33.1% 7.3% Massachusetts 1,045,222 15.4% 23.1% 9.2% Michigan 1,570,671 15.8% 25.1% 7.8% Minnesota 805,643 14.7% 29.7% 6.9% Mississippi 439,701 14.7% 23.5% 12.5% Missouri 954,922 15.7% 23.5% 8.5% Montana 178,011 17.2% 37.3% 7.6% Nebraska 278,711 14.7% 18.9% 7.4% Nevada 422,118 14.6% 55.3% 8.4% New Hampshire 218,942 16.5% 38.6% 6.1% New Jersey 1,343,626 15.0% 20.0% 7.9% New Mexico 330,405 15.8% 39.7% 11.1% New York 2,964,315 15.0% 19.0% 11.2% North Carolina 1,516,824 15.1% 43.2% 9.2% North Dakota 107,281 14.2% 13.7% 8.9% Ohio 1,842,952 15.9% 20.7% 7.6% Oklahoma 576,250 14.7% 23.4% 8.4% Oregon 660,876 16.4% 40.4% 7.3% Pennsylvania 2,179,788 17.0% 15.5% 7.8% Rhode Island 169,976 16.1% 14.5% 10.3% South Carolina 794,795 16.2% 48.9% 9.3% South Dakota 134,420 15.7% 22.6% 8.3% Tennessee 1,016,552 15.4% 35.3% 9.8% Texas 3,225,168 11.7% 42.9% 10.3% Utah 307,867 10.3% 44.0% 6.8% Vermont 109,893 17.6% 34.4% 6.6% Virginia 1,188,393 14.2% 38.0% 7.3% Washington 1,036,046 14.4% 45.0% 7.4% West Virginia 336,288 18.2% 19.8% 8.5% Wisconsin 902,134 15.6% 24.3% 7.1% Wyoming 84,699 14.5% 36.1% 8.0% Puerto Rico 626,962 18.0% 27.4% 41.0% Notes: (1) Population Estimates (2) Poverty data for US are from the Current Population Survey, Poverty data for States and Puerto Rico are from the American Community Survey. Data Sources: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement; Population Estimates; and American Community Survey. 8 Income The median income of older persons in 2015 was $31,372 for males and $18,250 for females. From 2014 to 2015, median money income (after adjusting for inflation) of all households headed by older people increased by 4.3% which was statistically significant. Households containing families headed by persons 65+ reported a median income in 2015 of $57,360 ($60,266 for non-Hispanic Whites, $42,334 for Hispanics, $43,855 for African-Americans, and $64,688 for Asians). About 5% of family households with an older adult householder had incomes less than $15,000 and 72% had incomes of $35,000 or more (Figure 7). Figure 7: Percent Distribution by Income: 2015 Note: Percentages may not add to 100 due to rounding. Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement. 2% 3% 9% 13% 16% 19% 37% 0% 20% 40% 60% 80% 100% Under $10,000 $10,000 - $14,999 $15,000 - $24,999 $25,000 - $34,999 $35,000 - $49,999 $50,000 - $74,999 $75,000 and over Family Households 65+ Householder, 2015 $57,360 median for 16.6 million family households 65+ 4% 11% 16% 23% 13% 12% 21% 0% 20% 40% 60% 80% 100% Under $5,000 $5,000 - $9,999 $10,000 - $14,999 $15,000 - $24,999 $25,000 - $34,999 $35,000 - $49,999 $50,000 and over Persons 65+ Reporting Income, 2015 $22,887 median for 45.9 million persons 65+ reporting income 9 For all older persons reporting income in 2015 (45.9 million), 15% reported less than $10,000 and 46% reported $25,000 or more. The median income reported was $22,887. The major sources of income as reported by older persons in 2014 were Social Security (reported by 84% of older persons), income from assets (reported by 62%), earnings (reported by 29%), private pensions (reported by 37%), and government employee pensions (reported by 16%). In 2014, Social Security benefits accounted for 33% of the aggregate income1 of the older population. The bulk of the remainder consisted of earnings (32%), asset income (10%), pensions (21%) and other (4%). Social Security constituted 90% or more of the income received by 33% of beneficiaries (21% of married couples and 43% of non-married beneficiaries). ----- Sources: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, FINC- 01. Selected Characteristics of Families by Total Money Income in 2015; PINC-01. Selected Characteristics of People 15 Years Old and Over by Total Money Income in 2015, Work Experience in 2015, Race, Hispanic Origin, and Sex; and U.S. Census Bureau, Income and Poverty in the United States: 2015, Current Population Reports, P60-256(RV), issued September 2016. Social Security Administration, “Fast Facts and Figures About Social Security, 2016.” Poverty Over 4.2 million people age 65 and over (8.8%) were below the poverty level in 2015.2 This poverty rate is statistically different from the poverty rate in 2014 (10.0%). Another 2.4 million or 5% of older adults were classified as "near-poor" (income between the poverty level and 125% of this level). Just over 2.4 million older Whites (alone, not Hispanic) (6.6%) were poor in 2015, compared to 18.4% of older African-Americans (alone), 11.8% of older Asians (alone), and 17.5% of older Hispanics (any race). Older women had a higher poverty rate (10.3%) than older men (7%) in 2015. Older persons living alone were much more likely to be poor (15.4%) than were older persons living with families (5.7%). The highest poverty rates were experienced among older Hispanic women who lived alone (40.7%). In 2011, the U.S. Census Bureau released a new Supplemental Poverty Measure (SPM). The SPM methodology shows a significantly higher number of older persons below poverty than is shown by the official poverty measure. For persons 65 and older this poverty measure shows a poverty level of 13.7% in 2015 (almost 5 percentage points higher than the official rate of 8.8%). Unlike the official poverty rate, the SPM takes into account regional variations in the cost of housing etc. and, even more significantly, the impact of both non-cash benefits received (e.g., SNAP/food stamps, low income tax credits, and WIC) and non-discretionary expenditures including medical out-of-pocket (MOOP) expenses. For persons 65 and over, MOOP was the major source of the significant differences between these measures. The SPM does not replace the official poverty measure. ----- Sources: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement; POV01: Age and Sex of All People, Family Members and Unrelated Individuals Iterated by Income-to- Poverty Ratio and Race: 2015; "Income and Poverty in the United States: 2014," P60-256, issued September, 2016; Poverty Thresholds for 2015 by Size of Family and Number of Related Children Under 18 Years; and “The Supplemental Poverty Measure: 2015,” P60-258(RV), revised September 2016. 1 Aggregate income refers to the total income of couples and nonmarried persons aged 65 or older. 2 The poverty threshold in 2015 was $11,367 for householders age 65 and over living alone. 10 Housing Of the 11.9 million households headed by persons age 75 and over in 2015, 76% were owners and 24% were renters. The median family income of older homeowners was $31,000. The median family income of older renters was $17,400. In 2015, almost 44% of older householders spent more than one-third of their income on housing costs - 36% for owners and 78% for renters. For older homeowners age 75 and over in 2015, the median construction year was 1969 compared with 1978 for all homeowners. Among the homes owned by people age 75 and older, 3.5% had moderate to severe problems with plumbing, heating, electric, wiring, and/or upkeep. In 2015, the median value of homes owned by older persons was $150,000 (with a median purchase price of $53,000). In comparison, the median home value all homeowners was $180,000 (with a median purchase price of $127,000). About 78% of older homeowners in 2015 owned their homes free and clear. ----- Source: …