Care of Older Adults

Topic 1: Concepts, Principles and Theories in the Care of Older Adults

A. Perspective on Aging
1. Aging is a Developmental Process
 Unstoppable, its normal everyone must undergo the phase of aging
 Aging reflects all the change taking place over the course of life
 This change starts from birth – one grows, develops and attains maturity
1. Aging is not a disease
2. Aging is a normal process of time related change, begins with birth
and continues throughout life: Developmental process
3. Aging is the process of growing old
Terminology:
Gerontology – study of aging
Geriatrics- medical care of the aged
Gerontological nursing- falls within the discipline of nursing and scope of
nursing practice
Gerontological nurse helps care of aging and elderly individuals
Gerontology > biopsychociocial
Subfields
Social Gn-
Geropsychology-
Geropharmacology-
Financial GN-
Gerontological nurse works with:
Healthy elderly person, acutely ill or disabled elders, chronically ill or
disabled elderly
SCOPE OF PRACTICE
 Includes adults from time of old age until death
 Roles – same as regular nurse
Who is old?
 Law 60 and up, benefits 65 and up
Classification of aging according to chronological(number) aging (WHO)
 Young old : 65 to 74
 Midle old: 75 to 84
 Old-old : 85+
 Centenrians or elite-old: 100+
AGING CAN BE CLASSIFIED AS
 Chronological age: birthday, age by year
  Biological or Physiological aging- subjectively, aging is marked by
gradual changes or deterioration of function characteristics. This
refers to the physical change that “slows us down”
 Functional aging- functionally, aging refers to the capabilities of the
individual to function in society. Ex elderly volunteering
 Psychological aging- involves changes in memory, learning,
intelligence, personality and coping. Ex forgetfulness, takes longer to
learn new things, they don’t rember info, slow recalling names, lose
things
 Social aging- refers to changes in roles and relationships as we age.
-consider the manifestation of both socially healthy and socially
unhealthy aging person. Ex. Healthy- enjoys life and stay connected
with friends. Unhealthy- cranky, sensitive, cannot get along with
others
 Cognitive aging- the decline in cognitive processing that occurs as
people get older.

B. Demography of Aging and Implications for Health and Nursing Care

Who facts: from 2015 to 2050 pop over 60 will go from 12% to 22%
By 2020 people age 60 and up will outnumber the age of under 5
In 2050 80% of older perope will be living in low and middle class
All countries face major challenges to ensure their health and social sytem
1. Global Aging
 Globally speaking people are living longer
 People living longer
 By 2050 age 60 and up is belived to total 2 billion
Life expectance- years a person will live
PH- 71.28
IMPACT OF GLOBAL AGING
 Unprecedented changes are occurring world wide as fertility and
morbidity changes
IMPLICATION OF Aging pop
 4 economic implication
1. Shrinking work force
2. Decreased social security implications
3. Increasing healthcare expenditures
4. Insufficient caretaker workforce
Multiple chronic conditions, the older the more chronic conditions
Need for homebased care. – will require more inhome care bc they cant handle task by
themselves

2. Aging in the Philippines

According to UP; senior cetizens 7.5% (7548769)
According to PSA ss is fastest growing
 PH Pop in aging:
 Young societies – less than 10% of pop age 60=
 Aging society- 10 to 19%
 High aging society- 20 to 29%
 Hyper aging society- 30%+
Female older population live longer but spend a greater part of their remaining life in
inactive state relative to work
Lola Francisca susano of Puerto princesa is a supercentenarian, 123 years old.
IMPLICATIONS
In the PH, OLDER people need care and support
HEALTH AND CARE
DSWD establish community based health services for older persons
RA9994 provide health care services for the poor older person such as free
medical service
THEREFORE :
Aging presents both challenges and opportunities
It will increase demand for primary health care and longterm care, requires larger and
better trained workforce and intensify the need for environments to be made more age
friendly.
Enable the many contributins of elder people
Healthy aging is the focus of WHO work on aging between 2015-2030, emphasizes the
needs.

C. Impact of Aging members in the Family

 Caring for aging parents has multiple impacts on your family life, includes emotional,
physical, financial and structural effects. The potential for challenges increase that
there will be a need to have a discussion with family on expected outcomes.
 Caring for your aging parents prompts a range of impulses and emotions that
common response
 Caring for children and aging parents at the same time can make you feel as if you do
not have emotional strength and resources for everyone
 Caring for aging parents often means extra cost related to home heath care, medical
expenses not covered by insurance and extra insurance premiums for services such as
long-term care.
POSIYIVE EMOTIONAL EFFECTS OF CARING for aging PARENTS
1. Enrichment that comes with relationships between grandparents and
grandchildren
2. Increase opportunity to pass on stories and knowledge to younger generations
3. The younger generations having a sense of being able to give back to parents and
grandparents, resulting in a “greater connection” between family members
AREAS TO CONSIDER BY AGING MEMBERS
 Accommodation – how long can you remain independent in your own
home or in seniors residence? What kind of support do you need to live in
your residence?
  Responsibility for maintenance around the house- is your family able to
help you out or should you hire someone to cut the grass and shovel the
walk?
 Finances – how much do you have in savings? Are family willing and
able, to contribute to home care? Do you have insurance
 Health and wellness- in the event of life-saving measures, what medical
interventions do you want in place?

D. Theories of Aging and its Nursing Implications
 Aging is a complex phenomenon that continues to be explained
from multiple theoretical point of views
 The theories of aging attempted to provide the framework to
understand aging process and each theory is useful to health
professionals
 The purpose of these theories of aging is to reviews
1. Biologic Theories
The biological theories of aging expound information regarding the
physiologic processes with aging
 Stochastic Theories
o Free radical – describes that membranes, nucleic acid, and proteins
are damaged by free radicals, which causes cellular injury and
aging
o Orgel/error – describes as errors in dna and rna synthesis occur in
aging
o Wear and tear theory- cells wear out and cannot function with
aging
o Connective tissue- describes that with aging, proteins impede
metabolic processes and cause trouble with nutrients to cells and
remove cellular waste products
 Nonstochastic
o Programmed longevity theory- describes that cells divide until they
are no longer able to, and this precipitate apoptosis or cell death
o Gene/biological clock theory- describes that cells have a
genetically programmed aging code
o Neuroendocrine theory-describes that problems with hypothalamus
– pituitary- endocrine- gland feedback system causes disease;
increased insulin growth factor accelerates aging
o Immunological theory-describes that aging is due to faulty
immunological function, which is linked to general wellbeing

2. PSYCHOSOCIAL THEORIES of Aging:

 These theories focus on the changes in behavior, personality, and attitude
as we age. Aging is a life long process characterized by transitions and
these transitions are related to personality or ego development and the
accompanying challenges associated with various life stages.
 These theories speak to how mental processes, emotion, attitudes,
motivations and personality influence adaption to physical and social
demands.
  Psychological Theories- these theories explain aging in terms of mental
processes, emotion, attitudes, motivations, and personality development
that is characterized by life stage transitions.
1. Human needs theory
2. Individualism theory
3. Stages of personality development theory
4. Life-course/ lifespan development theory
5. Selective optimization with compensation
 Sociological Theories- changing roles, relationships, status, and
generational cohort influence the older adults’ ability to modify
1. Activity theory
2. Age stratification theory
3. Disengagement theory
4. Pearson-environment theory
5. Subculture theory
6. Gerotranscendance Theory
7. Continuity theory
E. Physiologic Changes in Aging Affecting Various Systems
1. Integumentary
2. Musculo-skeletal
3. Respiratory
4. Cardiovascular
5. Hematopoietic and Lymphatic
6. Gastrointestinal
7. Urinary
8. Nervous
9. Special senses
10. Endocrine
11. Reproductive
F.