Lecture #1 Flashcards
geron – greek for “old man”
The scientific study of the process of aging and the problems of aged persons including physical, mental, and social
Gerontology
the branch of medicine that deals with the disease and treatment of older people
Geriatrics
What is OLD?
Who? 50 yrs
United nations: 60+
Western countries: 65+
young-old: 65-74 yo
middle old: 75-84 yo
old-old: 85+ yo
elite old: 100+ yo
Older populations (65+) in 2016?
49.2 million in US
15 (17%) of US population
one of every 8 adults
10,000 adults turn 65 every day
gender –> 2013 ratio:
- 65+ = 128.1 women to every 100 men
- 85+ = 195.9 women to every 100 men
fastest growing older adult age group is 85 and older
Older populations (65 +) in 2030 and by 2035?
2030 =
72 million (projected)
over 20% of US population
one in every 5 adults
all baby boomers will be 65+
2035 =
more older adults than children
flat growth 25 and younger
3/4 of adults > 65 suffer from ___ ______ ____ chronic medical condition
rely on ________ ______ services far more than other segments of the population
______________ levels are increasing
at least one
health care
educational
____ % of all older women are widowed
live alone = 39% of women and ____ % men
poverty:
2015 = ______ % below poverty level and 5.6 at near-poor
_________ 11.6% and ______ 6.8%
highest poverty rates: older ________ _______ who live alone (45.4%)
34%
19%
8.8%
women ; men
hispanic women
90+ (the queen of the United Kingdom)
Nonagenarian
100+ (97K now, 601k by 2050)
most are female (85%)
30% have no evidence of dementia
Centenarian
Born 1956-1964
3-4 M born every year through 1964
began turning 65 in 2011
Baby Boomer
4 M in 2014 (9% of older population) and projected 12 M by 2060
African Americans
3.6 M in 2014 (8% of older population) and projected 21.5 M by 2060 (22% of older population)
Hispanic (of any race)
1.9 M in 2014 (8% of older population) and projected 8.5 M by 2060 (9% of older population)
Non-Hispanic Asian
Gerontological nursing roles
functions in variety of setting – hospital, home, subacute, and long term care facilities, community
advanced practice gerontological nurses
mission is to preserve function, enhance health, and enhance quality of life and dying
gerontological nurses will pay a significant role in research, innovations in care, and provision of services to the growing population of older adults in global society
Define Health and Wellness?
Health: absence of disease
Wellness: a concept of wellness incorporates all aspects of one’s being
Wellness incorporates all aspects of one’s being which includes
physical
emotional
intellectual
social
spiritual
cultural
environmental
What does the wellness model suggest?
that every person has an optimum level of functioning for each position on the wellness continuum to achieve a good and satisfactory existence
Primary prevention includes?
healthy lifestyle behaviors
stress management
active social engagement
cognitive stimulation
immunization (high dose flu vaccine = 60 mcg hemagglutinin per strain vs. 15 mcg)
Secondary prevention includes?
Evidence based screening guidelines
Annual wellness visits
Personalized prevention plan
What are the theories of aging?
Biological aging: programmed & error theories
Psychological theories: activity & continuity theory
What is programmed aging?
cells designed to age
what is error theories?
random errors in synthesis of DNA and RNA
- wear & tear theory
- cross-linkage theory
what is the wear & tear theory?
cells “wear out” or become damaged
what is the cross-linkage theory?
damage from errors with cross-linked proteins (glucose and cells begin to attach and break down those proteins)
what is the activity theory?
activity and “staying young” indicates successful aging
what is the continuity theory?
cont. roles, responsibilities, and activities for successful aging
What are the developmental theories?
Maslow and Tornstam
What is Maslow’s theory?
widely accepted by nursing
includes bio/psycho/social needs
hierarchy of needs
1.) physiological: breathing, food, water, sleep, homeostasis (bottom of pyramid)
2.) safety: security of body, employment, resources, morality, the family, health and property
3.) love/belonging: friendship, family, intimacy
4.) esteem: self- esteem, confidence, achievement, respect if others, respect by others
5.) self-actualization: morality, creativity, spontaneity, problem solving, lack of prejudice, and acceptance of facts (top of pyramid)
a persons motivation to reach his or her full potential. as shown in Maslow’s Hierarchy of Needs, a person’s basic needs must be met before self-actualization can be achieved.
self-actualization
What are theory-based interventions?
development of nursing philosophy of care comes from psychosocial and developmental theories
used as basis to develop policies
interventions to promote healthy aging from biological theories
prioritization of care (Maslow’s): basic needs and safety met first in order to assist client to progress to the next level
statistically minorities assume majority
emerging majority
differences in the state of health and in health outcomes between groups of persons
health disparity
excess burden of illness, or the difference between the expected incidence and prevalence and that which actually occurs in excess, in a comparison population groups
health inequity
the development of cultural proficiency with increased awareness of our own beliefs and attitudes and those commonly seen in the community of health care
cultural awareness
what the nurse brings to the caring situation and what the nurse leans about older adults, their families, their communities, their behaviors, and their expectations.
cultural knowledge
Gerontological “explosion”
worldwide number of older adults has increased significantly
in the US, % of persons of ethnic groups other than white of European descent has increased
older adults of color will still be outnumbered by their white counterparts for years to come, tremendous growth is anticipated
growth of minority groups in US
1970: 16%
1998: 27%
what are the types of health disparities in older adults?
barriers to quality care range from those related to:
geographical location to age
gender
race
ethnicity
sexual orientation
(Mexican-Americans: more likely to have diabetes)
(Native-Americans: increased chance of diabetes than white population)
recognize factors beyond culture
cultural awareness
essential understanding of way of life
cultural knowledge
shared/learned beliefs, expectations, and behaviors in group
culture
minority/marginalized person adopts majority culture
acculturation
social difference based on culture
ethnicity
What are the cultural beliefs about health, illness, and treatment?
Biomedical: western medical paradigm and focus on disease/abnormalities in body systems
Magico-religious: God or supernatural forces cause disease and good health is a blessing or reward
Naturalistic or holistic: health is a sign of balance and illness occurs with imbalance or disharmony.
What are the health disparity obstacles?
ethnocentrism: belief that ones system is superior
stereotyping: simplified and standardized conception of a group
what is ageism?
dont associate with other age groups (don’t feel old)
(listen and understand what they have to say)
How do you reduce health disparities?
Cultural skills:
appropriate use of communication and language is foundational skill.
communication is issue language and idiom, style, jargon, voice tone, inflection, body language
example: hard of hearing –> talk on their level, use proper english and be non-harsh
Unspoken communication:
handshake, eye contact, silence
Spoken communication:
official interpreter is best
fastest growing segment of the population
increased chance for no insurance
most likely to live alone ( increase in white people)
extended social network ( increase in doing activities with others)
Older women
not many left in the baby boomer generation
black persons of this gender have the shortest life span
assumptions made about social/economical status (corporate America/veterans)
Older men
Culturally and ethnically sensitive assessment:
listening is key to assessment
health beliefs
cultural beliefs
work with them!
Interventions for gerontological nursing:
promote healthy aging in cross-cultural situation
-mutually acceptable
-respect
-work “with” the client not “on” the client
What does the LEARN model consist of?
Listen
Explain
Acknowledge
Recommend
Negotiate
Listen =
carefully to what the elder is saying. verbal and non-verbal. meaning behind the stories
Explain =
your perception of the situation and the problems
acknowledge =
and discuss both the similarities and the differences between perceptions and goals
recommend =
a plan of action that takes both perspectives into account
negotiate =
a plan that is mutually acceptable
