geriatrics- chapter 13 Flashcards
1
Q
aging
A
a continual process of biologic, cognitive, and psychosocial change that begins at conception
2
Q
overview of aging
A
- 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
3
Q
myths about older adults
A
- 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
4
Q
theories of aging
A
- some gerontologists claim that aging is primarily determined by genetics
- others believe environmental and lifestyle factors play key roles in aging
5
Q
biologic clock theory
A
cells programmed to live a certain amount of time, then break down and die
6
Q
free-radical theory
A
cells are damaged by toxins in the environment, including the waste products from metabolism
7
Q
wear-and-tear theory
A
organs eventually wear out, like machinery
8
Q
immune system failure theory
A
system loses ability to protect body from disease and becomes more susceptible to diseases that eventually kill us
9
Q
autoimmune theory
A
body no longer recognizes itself and begins to attack itself and break down
10
Q
disengagement theory
A
it is normal for older people to withdraw from each other
11
Q
activity theory
A
people who are active and interested continue to enjoy life and live longer
12
Q
continuity theory
A
individuals’ basic personalities remain constant; they cope with aging similar to how they coped with other stages of life
13
Q
longevity
A
- 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
14
Q
demographics
A
- 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
15
Q
benign senescence
A
- normal physical changes of aging
- begins occurring early in adulthood
- often goes unnoticed until a problem develops
16
Q
cardiovascular changes
A
- increased heart size
- decreased cardiac output
- less elastic blood vessels
17
Q
respiratory changes
A
- thickened alveolar walls
- weakened respiratory muscles
- decreased vital capacity
18
Q
musculoskeletal changes
A
- thinned intervertebral disks
- decreased bone calcium
- smaller muscle mass
- less elastic ligaments and tendons
19
Q
integumentary changes
A
- thinner, dryer skin
- loss of subcutaneous fat
- slower rate of hair and nail growth
20
Q
urologic changes
A
- decreased bladder capacity and tone
- loss of nephrons
- decreased sphincter control
21
Q
neurologic changes
A
- presbyopia
- cataracts
- decreased peripheral vision
- presbycusis
- decrease in touch, smell, and taste receptors
- slowed reaction time
- balance may be affected
22
Q
endocrine changes
A
- slowed production of all hormones
- decreased metabolic rate
- delayed insulin response
23
Q
gastrointestinal changes
A
- decreased secretion of saliva and other digestive enzymes
- slowed peristalsis
- slowed liver and pancreatic functions
- reduced absorption of nutrients
24
Q
reproductive changes
A
- decreased hormone production
- atrophy of ovaries, uterus, and vagina
- benign prostatic hypertrophy
- slowed sexual responses
25
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
26
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
27
MMSE
- mini mental status exam
- can screen for early dementia
28
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
29
cognitive aspects of aging
- Schaie’s reintegrative stage of development
- older adults selective about how
they spend their time
- 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
30
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
31
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
32
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
33
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
34
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
35
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
36
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
37
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
