Week 1 Outline Flashcards
What is gerontology?
It is the scientific study of the process of aging, and the problems of each person that includes physical, mental, and social problems.
-“geron” greek for old man
What is geriatrics?
The branch of medicine that deals with the diseases and treatments of older people.
What is considered old? (7)
- WHO - 50 yrs
- United Nations - 60+
- Western countries - 65+ yrs
- Young-old: 65-74 yo
- Middle-old: 75-84 yo
- Old-old: 85+ yo
- Elite-old: 100+ yo
Older adults defined in the U.S. as someone 65 & older
What defines age? (4)
- Chronological - # of years lived
- Biological - age of organ systems
- Psychological - how old one feels
- Social - roles and relationships
age is a SUBJECTIVE term: varies with time, place, cohort and perception
Who is considered a nonagenarian?
A person who is 90-99
Example would be Queen Elizabeth
Who is considered a centenarian?
100+
- 97k now, 601k by 2050 – calling this a gerontological explosion
- most are female (77%)
- 30% have NO evidence of dementia; the older adult 100+ must be extremely hardy & healthy to have lived this long
Who are the baby boomers?
Born between 1946-1964
- 3.4 million born in 1946 then 3 million every year through 1964
- began turning 65 in 2011 (around 75-76 years old right now is the oldest )
Fastest growing age group is ____ and older
85
Descriptions of the older people?
- 80% of adults over age 65 rely more on healthcare services
- rely on health care services far more than other segments of the population because there is so many of them
- 34% of all older women are widowed
- 34% women & 21% men live alone
- educational levels are increasing
- Poverty: in 2019, 8.9% below poverty level
- women 10.3% & men 7.2%
- highest poverty rates: older hispanic women who live alone (45.4%); this is because older hispanic women may have immigrated from another country, have no formal education, or because they are highly focused on family throughout their lifetime & relied on spouse for income
What are the two types of life tables?
Cohort or generational
Period Or current
What is the most frequently used life table statistic?
Life expectancy (based on current age) (e) which is the average number of years of life remaining for x persons who have attained a given age (x).
What settings are used for older adults?
- Hospitals
- home care
- hospice
- long-term care facility
- assisted living
Advance practice for older adults?
Gerontological nurse practitioners
What is the mission for caring of our aging population?
Preserve function, enhanced health, and enhanced quality of life and dying experience for the older adult population.
(How well they can live with time they have left?)
What is the role of nurses in research for our older population?
Innovations in care, research, provision of services for growing populations
What are the hot topics for research in nursing? (6)
- Dementia
- reducing falls
- use of restraints
- pain management
- delirium
- end-of-life care.
What are the two issues with the care of our older aging population?
- We have a demand, and it is critical for geronological nursing as many baby boomers are starting to retire.
- We have a concern of lack of adequate staffing especially in nursing profession such as Techs, RNs, LPNs
What are the two AACNs that Dr. Walker mentioned?
- Geriatric competencies by AACN
2. Essentials for BSN by AACN
What is health?
The absence of a disease
What is wellness
The concept of wellness incorporates all aspects of one’s being Such as
- phsyical: ability to walk, feed self, general ADLs - emotional: living alone, lose and grief - intellectual: dementia - social: living alone - spiritual: faith/religion - cultural: are they still able to interact culturally - environmental: are they in a healthy living situation
What does the wellness models suggest?
That every person has an optimum level of functioning for each position on the wellness continuum to achieve a good and satisfactory existence.
What are the objectives set for healthy people 2030?
8
▪ Dementia ▪ Foodborne illness ▪ Infectious disease ▪ Injury prevention ▪ Oral conditions ▪ Osteoporosis ▪ Respiratory disease ▪ Sensory or communication disorders
A strong holistic health movement expands the definition of health as what?
Multifactorial, realizing the potential of the individual and how they function within the context of their environment
What is primary prevention
- healthy lifestyle behaviors -PREVENTATIVE; exercising, refraining from smoking/drinking
- stress management
- active social engagement
- cognitive stimulation
- immunizations
What is secondary prevention?
- evidence-based SCREENING guidelines -ex: screening an older adult for diabetes by checking BG & hgb A1c
- annual wellness visits -physical exam & labs
- personalized prevention plan - presenting a diabetic person with a diet plan
Biological aging is referred to as:
Senescence (latin - “to grow old”)
-Condition/process of deterioration with age
Biological theories of aging
- Cellular functioning: Survival of an an organism depends on successful cellular reproduction (mitosis)
- cells replicate, but not exactly the same. They become more complex/specific over time
- with increased replication, there’s increased accumulation of damage
- Programmed aging theories
- Error theories
-Cellular errors a result of “wearing out” over time from continued use
-A progressive decline in cellular function or increased cellular death- Cells aggravated by internal & external stressors: the sun is an external factor
responsible for aging of the skin
-Cells destroyed by mechanical and chemical injury
- Cells aggravated by internal & external stressors: the sun is an external factor
6 Psychosocial theories?
- Role
- successful aging = adapting to changing roles
- resistance may predict poor adjustment
- Activity
- successful aging = maintaining a productive life (physically & mentally); maintain involvement in activities/ hobbies that they have enjoyed all their life
- Disengagement
- successful aging = transfer control to younger generation
- society distances itself from the older adult and the older adult disengages from society
- now considered controversial
- Continuity
- successful aging = maintain & continue previous behaviors & roles or find replacements
- Age-stratification
- individuals of similar age (cohorts) have most similarities
- for example, baby boomers age similarly to other baby boomers
- Modernization
- older people lose power & status due to advances in technology, etc.
- widely challenged because older adults CAN learn new technologies, while others can feel left behind
Develpmental theories to know?
- Erikson
- Widely accepted by nursing - eight-stages
- Ego integrity vs. despair in older adults
- Later Erikson changed his either/or to suggest BALANCE
- Maslow
- Widely accepted by nursing
- Includes bio/psycho/social needs
- Hierarchy of needs (physiological, safety, love/belonging, esteem, self actualization)
What are the theory based interventions?
- interventions to promote healthy aging from biological theories
- we base out interventions on these theories
- they are used as a basis to develop policy
- basic needs and safety have to be met first to assist client and the it can progress (maslow’s theory)
What is emerging majority?
Statistically minorities assuming the majority
What is health disparity?
Differences in the state of health and in health outcomes between groups of persons
What is health inequity?
Excess burden of illness or the differences between the expected incidence and prevalence.
Excess burden prevalence in one group occurs higher than in another group
What is cultural awareness?
The development of cultural proficiency with increased awareness of our own beliefs and attitudes and those commonly seen in the community of healthcare. Respect others religions
What is cultural knowledge?
Knowledge means what the nurse brings to the caring situation and what the nurse learns about all older adults, their families, their communities, their behaviors, and their expectations.
What is culture
Shared and learned beliefs and exactions of the world
What is acculturation?
Person from minority/ marginalized culture adopts that of a majority/dominant culture.
What is ethinicty?
Social differentiation based in cultural criteria.
Types of barriers to quality care range from those realted to?
- geographical location
- age
- gender
- race
- ethnicity
- sexual orientation
African americans are ?
▪ 50% more likely to have stroke
▪ Transient ischemic attack: 62% fewer get anticoagulation
▪ 50% more likely to die of stroke
▪ 20% more likely to die of heart disease
▪ 1.5 times more likely to have hypertension
▪ 2.5 times more likely to have diabetes
▪ 30% more likely to have diabetes-related amputations
Mexican americans are:
▪ 2 times more likely to have diabetes mellitus (DM)
▪ Get 36% fewer prescriptions after myocardial infarction
Native americans are?
5.7 times more likely to have DM than whites
Reducing health disparities in cultural awareness?
Cultural awareness
Self-level… requiring self understanding of one’s experiences and values (how have your experiences shaped your perceptions?)
Ability to… work and build relationships with a member from another cultural groups
Recognition of… factors beyond culture — such as health, safety, poverty, things that affect members of a cultural group (social determinants of health)
Reducing health disparities in cultural knowledge?
Cultural knowledge
Both… what the nurse brings to the caring situation and what the nurse learns from the experience
Essential knowledge… includes elders way of life (the way they think, what they believe, and how they act)
What are three cultural beliefs about health, illnes, and treatment?
Biomedical: western medical paradigm; focuses on disease abnormalities in the body system
Magico-religious: god or supernatural forces cause disease (good health is a blessing or a reward)
Naturalistic or holistic: health is a sign of balance, illness occurs with imbalance and disharmony
What are obstacles about cultural beliefs?
Ethnocentrism: the belief that one’s system is superior, it can wreck your relationship with your patient
Stereotyping: simplified and standardized conception of a group
Ageism: discriminating against people for their age
Reducing health disparities:
Cultural skills: use of communication
Unspoken Communication: handshakes, eye contact, hugs (always ask their preferences). be aware that your body language, etc, are extremely communicative
Spoken Communication: jargon, idioms, inflection (always get a professional interpreter)
*Box 4-10 (guide for working with interpreters)
Older women:
- Fastest growing segment of the population
- Social status: most likely to live alone; women of color have higher social status within families; often have extended social networks in comparison to men
- Economic status: overall lower than men, especially in the older woman; more likely to be considered poor; consider their educational and job opportunities when they were younger
- Health status: tend to live longer than men, but more chronic disease and disability than men
- Women’s health issues… often studied more than men (no questions on this because Dr. Walker doesn’t believe that!)
- “Women’s Health Initiative” we promote enrolling women in research trials
- Higher risk of being without insurance due to divorce and death of a spouse (goes back to them not working/having lesser paying jobs)
Older men:
- most literature on aging focuses on women (still speculative)
- more older women than men
- black men with shortest life span
- we often make assumptions with social/economic status of older men
Implications for Gerontologica Nursing
- Culturally and Ethnically Sensitive Assessment
- Listening is key to assessment
- Box 4-14 (Culturally competent encounter) - Designing Interventions
What is the LEARN model
Listen to their perception of situations, the desired goals and ideas for treatment (verbal and nonververbal cues)
Explain your perception ( but always listen to them first)
Acknowledge and discuss both the similarities and differences between both perspectives
Recommend a plan of action that takes both perspectives into account
Negotiate a plan that is mutually acceptable
