Gerontology

NUR101FALL 2008LECTURE # 20K. BURGER, MSEd, MSN, RN, CNE

PPP By Sharon Niggemeier RN MSN

Gerontology Gerontology: Study of all aspects

of aging and its consequences Ageism: when older adults are

stereotyped

Gerontologic nursing: specialized nursing with knowledge of illness and health of the aging

AGEISM What are some stereotypic

characteristics of the elderly that you have heard? Or believe?

Dependent ?Frail ?Poor ?Lonely ?Unreliable d/t memory loss ?Rigid; narrow-minded ?Unable to learn ?

Older Adult Young Old 60-74 Middle Old 75-84 Old Old 85 &

older

Presently: 12.8% of population

2030: will increase to 20% of population

Biological Theories of Aging

Programmed Aging theory- genetics and heredity responsible for how an individual ages

Cross-Linkage Theory- deterioration of organs/cells causing decreased mobility

Somatic Mutation Theory- DNA changes result in physical decline

Stress Theory-causes structural & chemical changes thru the lifespan

Theories of Aging Most experts believe that a

combination of genetic and stochastic (random) events are responsible for aging.

Any single limited theory is insufficient.

Psychosocial Theories of Aging

Disengagement Theory- withdrawn, introspective, self-focused – Older theory; not widely accepted.

Continuity theory-characteristics, values remain constant thru life… repeat behaviors that brought success in the past

Activity Theory- satisfaction depends on involvement in new interests /activities or maintenance of high levels of functioning.

Psychosocial Theories of Aging

Erikson - ego integrity vs despairLife review or reminiscenceAcceptance and happiness with past life

Havighurst - maintenance of social contacts & relationships… be flexible & adaptSuccessful aging = ability to adapt to the changes associated with aging.

Cognitive Changes Ability to perceive and

understand one’s world Mild short term memory

loss Long term memory

remains intact Slower responses and

reactions

What does it mean to “grow old gracefully”

“Grow old along with me! The best is yet to be. The last of life, for which the first was made”. - Browning

“Even the oldest tree some fruit may bear:And as the evening twilight fades away, the sky is filled with stars, invisible by day”. - Henry Wadsworth Longfellow

Cognitive Changes – Abnormal Aging

Confusion Alzheimer’s disease Sundowning syndrome The 3 D’s: 1. Dementia Severe cognitive loss &

memory loss

2. Depression 3. Delirium

Theories about Sundowning

Possible Causes for increasing confusion: Person can’t see well in dimming light Hormone imbalances r/t biological clock Person tired @ end of day; decreased

coping Restlessness because daytime activities

are decreasing Caregivers communicate their own

fatigue & stress to clients

General Physiological Changes

All systems decline in overall functioning

Decreased physiological reserves Modified pace & more frequent rest

periods

Integumentary Changes Decreased skin

elasticity-wrinkling Increased dryness Thickened nails Thinning of hair

(baldness) Decreased SQ fat

Musculoskeletal Changes Stiff joints & less

flexibility Mobility slows &

posture stoops Muscle mass, tone

& strength decrease

Bone demineralization

Neurological Changes CNS responds

slower Rate of reflex

response decreases Sense of balance

declines Night sleep shortens Temp. regulation &

pain perception less efficient

Special Senses Changes Diminished

vision Night blindness Diminished

hearing Decreased

taste & smell

Cardiopulmonary Changes Blood vessels less

elastic Fatty plaque deposits

occur Cardiac reserve

decreases Less efficient lung

clearing Increased resp. rate,

diminished depth

Gastrointestinal Changes Digestive juices &

nutrient absorption decrease

Malnutrition & anemia common

Decreased peristalsis resulting in constipation & indigestion

Decreased insulin and thyroid production

Dentition Changes Tooth decay

continues

Missing teeth or ill fitting dentures effect eating habits

Genitourinary Renal blood flow decreases Waste products excreted more slowly Fluid/Electrolyte balance is fragile Bladder capacity decreases 50% Hypertrophy of prostate gland Atrophy, decreased secretions & thinning

of female genital tract Decreased estrogen and testosterone

levels

Adjusting to Changes of Aging Rest more Curtail driving Cane/walker

for mobility Diet/nutritional

changes Ageism

Adjusting – Older Adult is making many psychosocial adjustments

Retirement Reduced income Spouse’s health Social roles Living arrangements Role reversal

Common health problems Heart disease,

cancer, stroke Poly-Pharmacy Accidents, falls Arthritis Chronic illness Elder Abuse

Elder Abuse Any deliberate action or

negligence that harms elderly individuals:-physical-sexual-psychological-emotional-financial

Role of the Nurse in Promoting Health: Teaching Nutrition Exercise Immunizations Annual Physicals Medications

Nursing Dx Risk for loneliness Altered dentition Risk for falls Knowledge deficit Confusion Sexual dysfunction Wandering

Summary Nurses have to provide care to an

increasing geriatric population. Geriatric patients have specific

needs due to physiological and cognitive changes.

Nursing care needs to be tailored to the those needs.