geriatrics- chapter 13 Flashcards
aging
a continual process of biologic, cognitive, and psychosocial change that begins at conception
overview of aging
- many adults of the potential for years of interesting and productive life
- most people don’t mind growing older particularly f they are relatively healthy
- overcoming myths about aging can be a challenge for nurses
myths about older adults
- they are sick
- they cannot learn new things
- it’s too late for lifestyle changes to improve health
- genetics are the main factor in longevity
- they are not sexual
- they are a drain on society
- they are senile
- they are typically isolated from their families
- they usually live in nursing homes
- they are poor
- they are unhappy
theories of aging
- some gerontologists claim that aging is primarily determined by genetics
- others believe environmental and lifestyle factors play key roles in aging
biologic clock theory
cells programmed to live a certain amount of time, then break down and die
free-radical theory
cells are damaged by toxins in the environment, including the waste products from metabolism
wear-and-tear theory
organs eventually wear out, like machinery
immune system failure theory
system loses ability to protect body from disease and becomes more susceptible to diseases that eventually kill us
autoimmune theory
body no longer recognizes itself and begins to attack itself and break down
disengagement theory
it is normal for older people to withdraw from each other
activity theory
people who are active and interested continue to enjoy life and live longer
continuity theory
individuals’ basic personalities remain constant; they cope with aging similar to how they coped with other stages of life
longevity
- life span is 115 to 130 years
- avg. life span in 1900: 47
- avg. life span in 2012: 78.9
- diet, lifestyle, stress management, regular exercise, personality (outlook on life), gender, marital status, and genetics impact longevity
demographics
- in 2013, 45 million persons (14% of the population) were older than 65 years
- by 2060, 98 million persons will be older than 65 years
- young old: 65-74
- middle old: 75-84
- very old: 85+
- centenarians (100+) are becoming more common
- ~72,000 in U.S.
- predicted to increase to 1M by
2050
benign senescence
- normal physical changes of aging
- begins occurring early in adulthood
- often goes unnoticed until a problem develops
cardiovascular changes
- increased heart size
- decreased cardiac output
- less elastic blood vessels
respiratory changes
- thickened alveolar walls
- weakened respiratory muscles
- decreased vital capacity
musculoskeletal changes
- thinned intervertebral disks
- decreased bone calcium
- smaller muscle mass
- less elastic ligaments and tendons
integumentary changes
- thinner, dryer skin
- loss of subcutaneous fat
- slower rate of hair and nail growth
urologic changes
- decreased bladder capacity and tone
- loss of nephrons
- decreased sphincter control
neurologic changes
- presbyopia
- cataracts
- decreased peripheral vision
- presbycusis
- decrease in touch, smell, and taste receptors
- slowed reaction time
- balance may be affected
endocrine changes
- slowed production of all hormones
- decreased metabolic rate
- delayed insulin response
gastrointestinal changes
- decreased secretion of saliva and other digestive enzymes
- slowed peristalsis
- slowed liver and pancreatic functions
- reduced absorption of nutrients
reproductive changes
- decreased hormone production
- atrophy of ovaries, uterus, and vagina
- benign prostatic hypertrophy
- slowed sexual responses
common chronic health problems
- hypertension (most common)
- arthritis (second most common)
- heart disease (third most common)
- obesity (may contribute to arthritis and hypertension)
- other (anemia, diabetes, cancer, malnutrition, cirrhosis, mental illness)
- dementia (degeneration of brain tissue) in a small percentage of older adults
mental health
- mental health may be difficult to evaluate
- more than one million older adults experience depression
- older adults who have suicidal thoughts are more likely to act on them successfully compared with younger people with similar thoughts
- may begin giving away personal items
- depression is a risk factor and early sign of dementia
- dementia occurs in small percentage of older adults, but the incidence increases with age
- between 5% and 15% of older adults have dementia; 60% to 80% of these people have Alzheimer disease
MMSE
- mini mental status exam
- can screen for early dementia
health promotion behaviors
- eat healthy diet
- add seasonings to counter loss of taste
- take a daily multivitamin
- regular physical activity
- regular physical exams
- avoid smoking
- limit alcohol
cognitive aspects of aging
- Schaie’s reintegrative stage of development
- older adults selective about how
they spend their time
- older adults selective about how
- intelligence can be maintained into advanced years
- speed of thinking may be slow but thinking processes remain intact
- vision or hearing deficits are not cognitive dysfunction
wisdom and learning
- older adults are often regarding as wise because of their wealth of life experiences
- wisdom: having good judgment based on accumulated knowledge
- older adults are still capable of learning and often have more patience for learning
- many older adults have learned to operate computers
memory issues
- short-term memory loss: some older adults may have problems remembering recent events
- long-term memory usually remains intact
- severe memory losses and dementias may be the result of circulatory changes, malnutrition, or other underlying problems
employment and retirement
- ability and desire to keep a job an individual decision, depending on the cognitive ability of the older adult
- some people eager to leave a regular job and may retire in their 50s or early 60s
- other people enjoy working and want to continue beyond a traditional retirement age
psychosocial aspects
- stage of Ego Integrity vs. Despair (Erikson)
- older adults satisfied with past life usually happy
- families important to the older adult
- married older adults live longer than single adults; 39.9% of women and 12.7% of men older than 65 are widows
- most older adults live within 40 miles of at least one of their children
- older adults need to feel needed
- social activities and community ties are important
living arrangements
- many prefer to live in their own home
- about 28% of noninstitutionalized older adults lived alone (more women than men)
- about 2.2 million grandparents age 65 or over lived in households with grandchildren present
- increasing number of multigenerational households
- approximately, 3% of adults over age 65 and 9% of adults over age 85 live in institutional settings
health promotion behaviors (cognitive)
- encourage a positive attitude
- hobbies, religious and service groups, and volunteerism
- using the brain keeps the neural connections active and healthy
- reading, doing puzzles, using a
computer, and writing
- reading, doing puzzles, using a
when a parent needs help
- may be difficult for adult children to admit that a parent needs help
- discuss possibilities before a crisis occurs; include siblings in the discussions
- locate important information (financial, medical, insurance)
- safety is a basic need; observe for changes
signs that an older person needs help
- neglected personal hygiene, irregular dressing, soiled clothing
- significant weight loss
- home neglect
- inappropriate behavior
- frequent falls
- social isolation
- altered relationship patterns
- inability to find the right words
- unpaid bills, hoarding money
- confusion about medications
- making unusual purchases