The elderly Flashcards
Categories of aging
Young-old: 65-74 yrs Old: 75-84 Old-old: 85-99 Elite-old: over 100 each category has distinct set of interests and HC needs
65 years and over population
grown twice as fast, US census in 2000 found that of 35 million 1/8 were >65, by 2030 in a population of 70 million 1/4 will be >65,
85 years and older population
most rapidly increasing age group, projected to reach 9.6 million in 2030, in 2002 the population was 6 million
Baby-boomers
turning 65 placing greater demands on health care, born within 1946-1964
Four basic characteristics of aging process
Universal, progressive, intrinsic in nature, and affected by extrinsic factors
Senescence
the process of growing old
Biological
progressive loss of function, multifactor process, quality of life while increasing life span, slow or reverse age related changes, and researched to reverse effects of aging
Two categories of biological aging theories:
Stochastic (aging is due to chance) and nonstochastic theory (age related molecular and cellular events)
Stochastic theories
Genetic, Free radical, cross-link theories
Genetic theory
determines life expectancy, internal mechanism determines senescence, faulty synthesis of DNA, thought to be primary cause, somatic/intrinsic/transcription
Free Radical theory
unstable free radicals, causes biochemical changes (cells cannot regenerate), byproducts of cellular processes and environment (atherosclerosis, cataracts, and cancer)
Cross-link theory
chemical reactions as cells age, loss of elasticity, stiffness, loss of function and rigid, fragile tissue
Nonstochastic theory
Neuroendocrine, immunity theory, programmed theory, telomere-telomerase hypothesis, and stress theory
Neuroendocrine
efficiency of signals between mechanisms is lost or altered, changes in hypothalamic-pituitary system
Immunity theory
reduced resistance to infectious diseases and viruses-possibly related to genetics, environment, or endocrine factors
Programmed theory
biological clock triggers specific cell behaviors @ specific times, specific # of cell divisions and specific life span, impairment in ability of cell to continue dividing
Telomere-telomerase hypothesis
limits number of times cell can divide, strong relationship between aging and cancer
Stress theory “wear and tear”
cells wear due to internal and external stressors (trauma, chemicals, metabolic waste products, nutrient deprivation) Leads to organ malfunction, and body wears out like an automobile with time leading to aging and death
Psychosocial theories
supports the concept that lifestyle, personality, and environmental factors influence aging
Personality theory
each individual is unique, persons characteristics, habits, behavior, and other qualities
Adult development
definable, predictable, sequential patterns, physical and psychosocial growth undergo reorganization, normative activities in each stage,
Disengagement theory
process of elders withdraw from roles and responsibilities. Four main concepts.
Four main concepts of disengagement theory:
1: aging person and society mutually withdraw
2: withdrawal process is systematic and inevitable
3: necessary for successful aging by providing time for reflection and coming to terms with unfulfilled expectations
4: beneficial for society- an orderly transfer of power from old to young
Activity theory
belief that the way to age successfully is to stay active,
continuity or developmental theory
predict how person will adjust to aging, personality traits remain the same as aging occurs
Aging
normal physical and behavioral changes that occur under normal environmental conditions as people mature and advance in age
Geriatrics
branch of medicine that deals with problems and diseases of old age/aging
Gerontology
study of all aspects of the aging process and its consequences
Safety issues
care of the patient (apply non-skid shoes/socks), accidents(fallophobia, presbyopia, reduced sense of touch, decreased reaction time), protective device usage ( restraints), alternative restraints (close obs., assess pain/comfort, educate/med. review, family conference, bed alarm, and decrease stimulation)
Therapeutic communication
nurse (respect the older adults uniqueness, special considerations: sensory deficits, listen, touch, orientation, reminiscence), sensory deficits (sensory losses change mentation, isolate, create comm. barrier), sensory deprivation (sensory deficit from sight/hearing loss), listening ( very important), reminiscence (recall past to assign new meanings to experience), reality orientation (person, place, time, and circumstance), barriers to communication (uncomfortable, med. effect, psychosocial function, contact with reality, culture/lang. differ., prejudices/stereotypes), environment (lighting, face to face, private)
Guidelines for reality orientation
realism (don’t reinforce delusions), independence (promote independence), individualized (allow them to have familiar objects), reinforcement (positive), repetition (repeat info), and clarity/consistency (clear short directions)
Skin care for the elderly
integumentary changes (increased dryness, pallor, fragility, loss of elasticity, wrinkling, sagging, alopecia, thick- britle nails), positioning (turn q2 hrs), bathing (great time to assess), hydration risk (encourage fluids unless contraindicated), prevent trauma (falls, fires, MVAs most common cause of accidental death), mental health (assess for all basic needs), incontinence (keep dry and clean)
Driving safety
MVA most common cause of injury related death in young old population
sundown syndrome
agitation, confusion occurs late in day/when sun goes down
depression
mood disorder, use geriatric depression scale
dementia
slow insidious loss of cognitive function (chronic state)
delirium
usually transient condition disorganized thinking, loss of concentration (acute state)
Eriksons stages of development
each stage has a specific developmental task based on successful attainment of previous developmental tasks (ego integrity vs despair, >65 yrs)
Sense of wholeness
can accept death as a part of life, sense of unique life, sense of self
Behaviors reflecting problems
fear for future and dying
Causes of older adult malnutrition
lack of transportation, inappropriate foods, inability to carry bags, loneliness, diminished sense of taste and smell, and tooth loss/ill fitting dentures
How to improve eating habits
educate, allow time for meals, check dentures, make food look attractive, favorite foods, smaller more frequent meals, time meals around favorite TV shows
Teaching older adults
peer educators, simplicity repetition, support belief that change is helpful and worth the effort of increased learning (Ex: meds., nutrition, hygiene, mobility, support services, when/how to seek help)
