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Since 1900, the percentage of Americans 65 years and older has tripled, from 4.1 percent in 1900 to 12.6 percent in 1991, and the actual number has increased more than tenfold, from 3.1 million to 31.8 million (American Association of Retired Persons [AARP], 1992). The growth of the elderly population is expected to continue for some time to come, with the most dramatic and rapid growth expected to occur between the years 2010 and 2030, when the elderly population could increase to over 65 million (U.S. Bureau of the Census, 1993). This shift in the age structure has precipitated increasing concern for how the health care needs of this ever-growing population will be ...