Chapter 13 Flashcards
The Older Population
Older population defined:
- Young old = 65 – 75
- Middle old = 75 – 85
- Old old = 85 +
The older population in the United States currently represents
16.5% of the US population.
The Older Population
By 2060,
nearly one in four Americans is projected to be an older adult.
by 2060 will over
than double to 98.2 million
The Older Population growth
Fastest growing segment of the US population
The Older Population
Geographic representations
in the South and
Northeast
The Older Population
The heaviest users
of the health care system
The Older Population
Most of us have stereotypes of old age
but almost every generality about the older person is quickly countered by personal experience with an older adult.
Rapid societal changes taking place around older adults
actively involved outside of the home as employers, employees, volunteers, or members of community organizations.
Aging in its broadest sense refers to the
“changes that occur during an organisms’ life-span.”
Aging
differes from
individual to individual
Aging
The result of interactions of
genetics,
environment, lifestyle and disease processes
Biological Theories aging
two main types of biological aging theories
genetic (programmed theories) and stochastic (damage theories)
Biological Theories aging
Genetic theories
“aging is genetically determined and organisms have an internal clock that programs longevity.”
Biological Theories aging
Stochastic or damage theories propose
“chance error and the accumulation of damage over time cause aging. Stochastic theories include wear and tear, error catastrophe, free radical theory, DNA damage hypothesis, loss of adaptive cellular mechanism, and the mitochondrial theory.”
Social Theories of Aging
life-course approach
“recognizes the social, cultural, and structural contexts of a person’s lifelong development.”
Social Theories of Aging
According to societal theory
it is also essential to recognize the contribution of agency to health.
Agency
Ability to control their own life and make decisions about their own care
Psychological Theories of Aging
Social sciences research
adopting a more optimistic view of aging which focuses on the potential of human development.
Psychological Theories of Aging
Successful aging is thought to be defined by three criteria
(1) low risk of disease and disability,
(2) high physical and cognitive functioning, and, lastly,
(3) active engagement with close personal relationships and involvement in activities.
PLOF
Prior Level Of Function
Psychological Theories of Aging
(selection, optimization, and compensation)
increased attention paid to human beings’
ability to adapt.
Psychological Theories of Aging
(selection, optimization, and compensation)
The individual also focuses on acquiring resources to improve function (optimization)
or compensates when previously available resources are lost.
Healthy Aging
- Optimizing physical, cognitive, and mental
health, and facilitating social engagement - Emphasis on QOL and maintaining independence
developmental challenge of old age—that of integrity.
In this last stage of human development, the person “understands, accepts, and loves the life he [or she] has led.”
Community health programming such as exercise programs, fall prevention, and yoga for the older adult
all support the healthy aging model.
Social capital is described as
a resource that is accessed via social networks
Many persons lose a valuable source of natural physical contact and companionship with the diminution of friendship and family ties
whereas others remain actively integrated into family and community circles.
Friendships
Many people who have depended on lifelong friendships
find it difficult to make new acquaintances at 70 or 80 years of age.
Conversely, a distant friendship may thrive after retirement
may thrive after retirement because energy once directed elsewhere can now be devoted to the friend.
older person whose friendships are centered on their occupational relationships
may find that, after retirement, the friend is very much alive, but their friendship is dead.
Friendships have been demonstrated to influence a person’s psychological well-being and health outcomes.
In working with patients, you can understand some important things by exploring who the person’s friends are and how friendships are generated and sustained
Family
Being in a relationship that is now changed due to the aging process can pose challenges for the older adult.
When one partner can no longer perform an essential role because of illness or injury, the other partner may become overwhelmed by the need to complete additional tasks.
Family
both family caregivers and informal ones
families provide most of the care for older relatives. Many families struggle to provide this care
High levels of caregiver stress
can sometimes lead to elder abuse.
Elder abuse often is not reported or is underreported
because the older person (or others) fear retaliation or believe that nothing will be done to change the situation
Social isolation older
Low income, poor health, lack of transportation, and infrequent information access are linked to social isolation
Where Elders Live
Aging in place
the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.”
Where Elders Live
Key components of independent living
- Physical health
- Functional ability
- Social ability
- Transportation and access to community
- Security
Where Elders Live
Retirement / intentional communities
housing alternatives for persons who do not remain in their own homes (or move in with or near relatives) but that allow them to age in place.
Where Elders Live
Assisted Living
inability to perform activities of daily living.
Where Elders Live
SNF
SNF admission are dementia and stroke
Where Elders Live
Transitional issues
self-respect and the power to command the respect of others depend in part on remaining independent.
dependence with a capital D
A Changing Self-Image
retirement from any long-held job or career focus often poses a threat to self-image
(and, subsequently, to self-esteem) in many older adults.
They might even see themselves as has-beens questioning their value in society
Physical Changes of Aging
The most common functional limitations in older adults
reduced strength and endurance, joint problems, and increased risk for falls and household accidents.
Physical Changes of Aging
Examples of physiologic age-related changes include
bone loss, cartilage thinning, decreased cardiac reserve capacity, muscle weakness, sensory changes, and changes in touch, temperature, and pain perception.
Physical Changes of Aging
cognitive changes
decreased memory, attention, and a general decline in fluid intelligence
Physical Changes of Aging
Visual changes
declines in acuity, speed of focusing, and accommodation, adaptation to darkness
Physical Changes of Aging
Hearing losses
greatest in the high-frequency range and are more prevalent in men than women.
Physical Changes of Aging
kinesthesia
steady loss in perception of body movement
Regular activity can reverse
the decreased mobility that contributes to disease and disability.. cognitive improvement too.
Self-efficacy when linked with activity
helps maintain cognitive function, resilience, and social engagement.
Mental Changes of Aging
Being able to count on an established schedule
is also a way for an older adult to maintain a proper orientation to the environment.
Mental Changes of Aging
older person’s sense of security, control, and orientation
can be further enhanced if, in addition to being treated at the same time each day, the routine of a treatment or test is kept reasonably stable from one day to the next.
Mental Changes of Aging
Anxiety can greatly decrease the person’s performance
and have a detrimental effect on both the relationship with you and the patient’s progress
Older Adults with Cognitive Impairment
Various forms of cognitive loss
(1) medication/health management,
(2) money/financial management,
(3) telephone management/communication device use, and
(4) transportation management.
Older Adults with Cognitive Impairment
Respect requires that the confused person
should always be treated kindly.
Older Adults with Cognitive Impairment
Acute confusion or disorientation can be caused by a variety of factors
such as an infection, a fluid or electrolyte imbalance, or a cerebral vascular accident. – don’t call it just “being old”
Older Adults with Cognitive Impairment
communicating with patients with dementia
use broad opening statements or questions, try to establish commonalities,
speak to them as equals,
speak at a normal rate and without exaggerated intonation,
eliminate distractions,
repeat when necessary and according to whether the listener misunderstood versus forgot what was said,
and try to recognize themes in what the patient is trying to share with you.
10 good things about getting older
1.I’ve become less emotional and more thoughtful with my decisions.
2.I no longer sweat the small stuff.
3.I can go shopping for what I need in my favorite store: my basement.
4.I’ve become kinder to myself.
5.Liking myself.
6.I no longer drool over—or covet—fashion must-haves.
7.I have so many good stories to tell.
8.All my years of living make me sound smart.
9.I no longer need to keep up with the Joneses.
10.It’s safe (and fun) to flirt.
Security, both financial and physical
may also be highly prized by older adults because, again, for many of them the hold on it is more tenuous.
