Patient Retirement and Health Care

Health Care Issues and Retirement 

What is Retirement,Retirement Concept World Wide,Theories of Aging and Retirement Age,Retirement and Health Benefits,Women and Retirement Plan,Retirement Planning,Psycho Social Changes,Retirement and Nursing Care.

What is Retirement

    The increased birth rate of the mid-1900s and longer life expectancies have resulted in an increase in the number of persons who are, or are soon going to be, retired (Anderson & Weber, 1993). In addition, the concept of retirement has changed. 

    While retirement may simply mean the cessation of employment at a given age, the term is generally considered to be much more complex. In pre-industrial times, people did not retire; they simply continued to work until their physical capabilities would no longer allow them to continue (Mulley, 1995). 

    Many current older workers want to continue to work, or have “bridge employment” (Kim, S., & Feldman, 2000), but they often want a new career or to work on different terms (AARP, 2003). As a result, determining what retirement is and who is “retired” can be difficult, and the numbers can be equally misleading. 

Retirement Concept World Wide

    The Social Security Administration (2003) provided an estimate of 29.4 million retirees in June 2003, based on the number of people receiving retired worker benefits. This is indeed a substantial population. Another indicator of the number of retirees is the number of people in the civilian workforce by age group. 

    In 2000, of the 281,421,906 US population, the Administration on Aging (2000) estimates that 34,991,753 people were 65 years of age or older. 

    In a trend analysis for years 1950-2005, workforce “participation rates of men aged 50 and older have been falling for all ages, and the rates for women have been rising sharply for those aged 50 to $4 and 55 to 59” (Bureau of Labor Statistics, 1992), but little change was noted for women over 65. 

    The labor force of workers who are 55 and older is expected to grow by about 8.5 million by 2010, and the 55–64-year-old group is expected to increase by 7.2 million (Fullerton & Toossi, 2001). The retirement age is declining, with or without social security benefits (Bureau of Labor Statistics, 2001).

    This is particularly important when examining the overall characteristics of older citizens as well as the changes that have occurred over the last several decades. 

    In A Profile of Older Americans: 2002 (Administration on Aging, 2002), it was reported that in 2000 there were 35.0 million Americans who were 65 years or older, and they represented 12.4% of the US population. 

    In the same year, the 65-74 age group (18.4 million) was eight times larger than it was in 1900, and the 75-84 age group (12.4 million) was 16 times larger. Nearly one-half (46%) of all older women in 2001 were widows and there were four times as many widows as widowers. 

    The American Association of Retired Persons (AARP, 1999a) reports, “Outliving men by an average of seven years, women typically have to finance those longer lives with lower wages, fewer benefits, and no pensions. The result? Three quarters of the older Americans living in poverty are women.” 

    In 1997 approximately 1 in 7 (14.2%) households that had an elderly head of the family had an income of less than $15,000, and in 1995 older citizens accounted for approximately 40% of all hospital stays (Administration on Aging, 1998). 

    These data have major implications not only for retirees and their families and friends, but also for the health care delivery system and the rising costs of health care. For those who are mobile, states are actively recruiting retirees with sufficient incomes to positively impact the state's economy (Duncombe, Robbins, & Wolf, 2003).

Theories of Aging and Retirement Age

    Several theories of aging have been used to better understand retirement and as framework works for retirement research. The major ones include continuity theory, activity theory, role theory, disengagement theory, and political economy theory. Each has its own set of criticisms as well as contributions to the overall understanding of the retirement phenomenon. 

    Continuity theory suggests that people develop habits and preferences that become an integral part of them and that persist into their retirement years (Atchley, 1977). According to activity theory, people adjust most effectively in older age when they maintain previously established activities (Friedman, E., & Havighurst, 1954). 

    Role theories suggest that society is structured around various roles that provide both norms and expectations regarding a person's attitudes and behavior (Richardson, 1993). Disengagement theory is based on the premise that people tend to withdraw from some of the roles and activities as they age and enter retirement (Cumming & Henry, 1961). 

    Political economy theory (Estes, C., Linkins, & Binney, 1996) posits that retirement is the result of decisions on the part of business and industry to reduce the workforce; As a result, retirement adjustment would depend on the personal resources of the individual.

Retirement and Health Benefits

    Retirement marks a transition into the later stages of life (Floyd et al., 1992), and as a part of the Normative Aging Study, researchers suggest that retirement is now a normative event, not the unplanned occurrence it used to be ( Bossé, Aldwin, Levenson, Spiro, & Mroczek, 1993). Increased longevity and a greater number of healthy older adults have changed expectations for retirement. 

    Retirement may be a time for new recreational pursuits, such as travel, and presents an opportunity to develop new routines (Watts, 1987); However, economic constraints may place limits on these activities, and changes in the health of the retiree or significant other may interfere with previous plans.

    Upon retirement, relationships with coworkers are terminated (van Tilburg, 1992). and this has an impact on the life of the retiree. As noted earlier, some retirees continue working after their initial retirement. In fact, eight out of ten “baby boomers” reported that they plan to work at least part time after retirement (AARP, 1999b). 

    M. Carter and Cook (1995) noted that retirement is a time of redefining roles. Retirement can also have an impact on marital relationships. The retirement of one partner in a marriage suggested a reorganization of roles as the couple begins the transition to full-time retirement (Henretta, O'Rand, & Chan, 1993), and differences have been found in the division of household tasks among retirees. 

    Non-retirees (Szinovacz & Harpster, 1994). During retirement, spouses have been found to become increasingly aware of their partners faults (Johnston, T., 1990), and women may have problems of infringement when has bands spend more time at home (Vinick & Ekerdt, 1989). 

    Lee and Shehan (1989) found no beneficial effects of retirement on marital satisfaction among husbands and wives. T. Gall, Evans, and Howard (1997) found that while interpersonal satisfaction and psychological health peaked 1 year after retirement, it declined significantly by the 6th or 7th years. Yet, they never fell below pre-retirement levels.

Women and Retirement Plan

    In recent years there have been a number of studies on retirement among women (Slevin & Wingrove, 1995). “Because of the prevailing “myth among women that they will he cared for in old age and women's fear of growing old, women often do not aggressively plan for their retirement” (Perkins, K., 1992, p. 526). 

    Some studies suggest that women who have had recent employment are healthier in their later years than women who have not been employed (Hib bard, 1995). Keddy and Singleton (1991) found that among the women they studied, the primary concerns related to finances, the use of leisure time, and keeping a positive attitude in retirement. Women's adaptation to retirement may be more affected by life events than men's (Szinovacz & Washo, 1992).

Retirement Planning 

    Retirement is frequently treated as a point in time rather than a complex process (Siegel & Rees, 1992); Yet planning for retirement was the second strongest predictor of retirement satisfaction among male respondents in a study by Dorfman (1989). 

    Pre-retirement planning tends to focus primarily on financial planning without taking into account all of the psycho-social adjustment factors (Rosenkoetter, Garris, & Engdahl, 2001). Among the elderly, a leisure repertoire is of concern due to the abundance of free time that accompanies retirement (Mobily, Lemke, & Gisin, 1991). 

    Differences have been noted across race. K. Allen and Chin-Sang (1990) used a qualitative research approach to study older black women and found that they continued their history of self-reliance in the context of leisure experiences and service to others in old age.

Psycho Social Changes 

    Numerous psychosocial changes have been found to occur with retirement (Rosenkoetter & Garris, 1998), and depression is a factor for at least some retirees (Rosenkoetter, Garris, & Hendricksen, 1997). 

    The effect of retirement on mental health and health behaviors was investigated in the Kaiser Permanente Retirement Study (Midanik, Soghikian, Ransom, & Tekawa, 1995). Atkinson(1990) found that problem drinking in the elderly is a public-health problem of moderate proportion, and that many geriatric cases are not properly identified.

Retirement and Nursing Care

    Retirement is an important concept for both nursing practice and nursing research; yet it receives little emphasis in the nursing literature as a significant life event, transition, stressor, or component of routine nursing assessments and interventions. 

    While marriage, divorce, childbearing, and the like have received much attention not only as events but as transitions, considerably less attention has been directed toward retirement. Greater emphasis is needed on the impact of retirement on health and health care and its implications for nursing. 

    Nurses need to be attending to the issues of retirement when working with retirees and their significant others, as well as with those who are in the preretirement phase. Assuming that retirement is a positive experience may not be appropriate or in the best interests of clients and their families or friends.