The Aging Population: End-of-Life Planning and Advanced Directives

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The number of Americans aged 65 and older is projected to more than double by 2060. As long-term care costs increase and chronic diseases and illnesses plague America’s aging population, many individuals are failing to plan ahead and prepare for end-of-life needs. To learn more, check out the infographic below created by Bradley University’s Online Nurse Practitioner Program.

Infographics on the End-of-life Planning and Advanced Directives for The Aging Population in the USA

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America’s Aging Population and Chronic Diseases

Currently, more than 10 million older Medicare recipients are living with five or more chronic conditions. Up to 92 percent of these older adults have at least one chronic disease. This group not only puts an emotional and financial weight on their families and communities but also accounts for 75 percent of the money that America spends on health care.

Chronic Diseases Plaguing Older Americans

Cardiovascular Diseases

Cardiovascular diseases can take many forms, including high blood pressure, stroke, arrhythmias and coronary artery diseases. Older Americans are at risk of cardiovascular diseases due to a lack of activity. Over time, the heart’s walls thicken and the arteries may harden, which stifles the heart’s ability to pump blood throughout the body.


A large bulk of cancers occurs in people over the age of 65. This frequency is due to the accumulation of cancer-causing mutations that tend to come with age, as well as the changing features of cellular tissue that inadvertently promote higher cancer rates in older individuals. Treating cancer in older Americans can be particularly tricky, as they usually have another disability or disease.


Strokes also tend to affect older Americans, with some of the more important risk factors being hypertension, diabetes, smoking, heart disease, hypercholesterolemia and obesity — presets that many elderly Americans identify with. Once an elderly American experiences a stroke, he or she has an increased chance of experiencing consecutive strokes in the future.


Diabetes affects 12.2 million Americans over the age of 60. There are two types of diabetes, with Type 2 diabetes being the most common for older Americans, especially those who are inactive or overweight. With Type 2 diabetes, the body still is able to create insulin, but it doesn’t convert it the right way. Diabetes also inflames and proliferates other chronic diseases like stroke, cholesterol accumulation and eye problems.

Planning for End-of-Life Goals

A 2000 survey of more than 1,400 patients, family members and medical professionals who were involved with end-of-life care revealed some of the more critical points when making end-of-life plans, including the importance of pain and symptom management; the proper preparation for death; the treatment of the elderly as full, complex human beings and achieving a sense of autonomy and completion.

Pain and symptom management is integral to the comforts of elderly Americans, many of who battle with different types of chronic diseases and may have a difficult time speaking about pain. This challenge may be due to a chronic disease that prevents them from properly communicating their needs or that they simply have accepted their pain. Caretakers must be cognizant of the telltale signs of pain, which include verbal cues and strange physical manifestations like bedsores and inflamed skin, as well as grabbing of the chest, head and other extremities. Applying pressure to a particular part of a body also can be indicative of an underlining ailment like a tumor or some other kind of growth.

It is important that an elderly individual is treated as a whole person. This need not only means managing physical pain but also managing emotional discomfort. Regardless of the chronic diseases that may plague the elderly, they are still aware of their bodies and their surroundings, and their hierarchy of needs must be met. Elderly people need to feel connected to a larger cause. A sense of community can ease the discomfort of loneliness and improve levels of autonomy.

Autonomy is a human’s ability to feel like he or she has a direct influence on his or her body, surroundings and emotional well-being. People don’t want to feel like they’re a burden or that their existence is limited to trips to the hospital or medical demands. Individuals can improve levels of independence by doing simple yet effective acts that give power back to the elderly person, which may include choosing the clothes that they wear, having the chance to use a cane or the proper tools to walk instead of relying on a wheelchair, enjoying nature or having the ability to associate with people that they relate to.

Preparation for Death

Preparation for death is a frustrating and emotionally taxing aspect of elderly care; however, it is a necessary step. Caretakers, family members, close friends and the elderly person should be included in and made aware of the discussions surrounding preparation for death.

Why Should You Make End-of-Life Planning a Priority?

End-of-life planning offers the aging population:

  • home versus hospital flexibility
  • public versus private facility selections
  • the ability to save for care in advance, giving them more options
  • the ability to preserve quality of life longer
  • a greater sense of independence and staying at home or receiving community services for as long as possible