Older Adult
Content
Chapter 20 The Aging Adult
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Theories of Aging
• Genetic—genes control ―genetic clocks‖ • Immunity—focuses on the functions of the immune system
• Cross-linkage—chemical reaction produces damage to the DNA and cell death
• Free radical—molecules with separated high-energy electrons have adverse effects on adjacent molecules
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Which one of the following theories of aging focuses primarily on cell metabolism and function? A. Genetic theory
B. Immunity theory
C. Cross-linkage theory D. Free radical theory
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: D. Free radical theory Rationale: The focus of the free radical theory is the free radicals formed during cellular metabolism that have adverse effects on adjacent molecules. The genetic theory focuses on genetic inheritance. The immunity theory of aging focuses on the functions of the immune system. The focus of the cross-linkage theory is a chemical reaction damaging the DNA and causing cell death.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Development of the Middle Adult
• Physiologic—gradual internal and external physiologic changes occur • Cognitive—little change from young adulthood
• Psychosocial—time of increased personal freedom, economic stability, and social relationships
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: A. Continue an established lifestyle or reorganize one’s life in a period of transition Rationale:
According to Levinson, middle adults may continue or reorganize their lifestyle.
It is the role of the older adult to adapt to, and face, already completed tasks. Choosing a vocation and developing an ethical system as a guide to behavior are developmental tasks for adolescents and young adults.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Developmental Tasks of Middle Adulthood
• Establish and guide the next generation. • Accept middle-age changes. • Adjust to the needs of aging parents. • Re-evaluate one’s goals and accomplishments.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Middle Adult Years Characterized by Expanded Family Roles
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Leading Causes of Death in Middle Adulthood
• Malignant neoplasms • Cardiovascular disease • Unintentional injury including poisoning, motor vehicle accidents, and falls • Diabetes mellitus • Cerebrovascular causes (CDC, 2009)
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false. Both acute and chronic illnesses are more likely to occur in middle adulthood, and recovery takes longer.
A. True
B. False
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: A. True Both acute and chronic illnesses are more likely to occur in middle adulthood, and recovery takes longer.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Major Health Problems
• Cardiovascular and pulmonary disease • Cancer • Rheumatoid arthritis • Diabetes mellitus • Obesity • Alcoholism • Depression
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Role of the Nurse in Promoting Health
• Teach the dangers of substance abuse, smoking, and alcohol consumption. • Teach adults to eat a diet low in fat and cholesterol.
• Teach the importance of regular exercise.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Life Changes of the Middle Years
• Employment • Relationship with a spouse • Relationships with adult children • Relationships with aging parents • Midlife transition
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Development of the Older Adult
• Physiologic—all organ systems undergo some degree of decline, body less efficient • Cognitive—does not change appreciably, may take longer to respond and react • Psychosocial—self-concept is relatively stable throughout adult life • Disengagement theory
• Erikson—ego integrity versus despair and disgust; life review
• Havighurst—major tasks are maintenance of social contacts and relationships
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false. Fundamental to ageism is the view that older people are the same as younger people; therefore, they experience the same desires, needs, and concerns as other age groups. A. True B. False
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: B. False Fundamental to ageism is the view that older people are different than younger people; therefore, they do not experience the same desires, needs, and concerns as other age groups.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Common Myths of the Older Adults (Ageism)
• Old age begins at 65 years. • Most older adults are in nursing homes. • Older adults are sick, and mental deterioration occurs. • Older adults are not interested in sex. • Older adults do not care how they look and are lonely. • Bladder problems are a problem of aging. • Older adults do not deserve aggressive treatment for illnesses.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Changes of Older Adulthood
• Physical strength and health • Retirement and reduced income • Health of spouse • Relating to one’s age group • Social roles • Living arrangements • Family and role reversal
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Moral and Spiritual Development of Older Adults
• Kohlberg—older adults have completed their moral development and most are at a conventional level • Spiritually, an adult may be at earlier level, often at individuative-reflective level • Many adults demonstrate conjunctive faith and trust in a greater power • Self-transcendence is characteristic of later life
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Basis for Teaching Plan for Older Adults
• Chronic illness limits activities in almost half of older adults. • Meeting expenses of healthcare is often difficult.
– Medication costs, hospitalization costs, and costs of special equipment and supplies
• Family members must learn to cope with needs of the ill person. • Family members must adapt to psychological stressors.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Causes of Accidental Injuries in Older Adults
• Changes in vision and hearing • Loss of mass and strength of muscles • Slower reflexes and reaction time • Decreased sensory ability • Combined effects of chronic illness and medications • Economic factors
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Mental Impairment in Older Adults
• Dementia • Alzheimer’s disease • Sundowning syndrome • Cascade iatrogenesis
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false. Sundowning syndrome is a temporary state of confusion that can last from hours to weeks, and resolves with treatment. A. True B. False
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: B. False Delirium is a temporary state of confusion that can last from hours to weeks and resolves with treatment.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Goal of Nursing Care
• Promote independent function. • Support individual strengths. • Prevent complications of illness. • Secure a safe and comfortable environment. • Promote return to health.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Interventions for Hospitalized Older Adults Prevent Complications
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Housing Options for Older Adults
• Home modifications • Homesharing • Accessory apartments
• Elderly cottage housing opportunities
• Senior retirement communities • Continuing care retirement communities
• Assisted living
• Board and care homes • Nursing homes
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Theories of Aging
• Genetic—genes control ―genetic clocks‖ • Immunity—focuses on the functions of the immune system
• Cross-linkage—chemical reaction produces damage to the DNA and cell death
• Free radical—molecules with separated high-energy electrons have adverse effects on adjacent molecules
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Which one of the following theories of aging focuses primarily on cell metabolism and function? A. Genetic theory
B. Immunity theory
C. Cross-linkage theory D. Free radical theory
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: D. Free radical theory Rationale: The focus of the free radical theory is the free radicals formed during cellular metabolism that have adverse effects on adjacent molecules. The genetic theory focuses on genetic inheritance. The immunity theory of aging focuses on the functions of the immune system. The focus of the cross-linkage theory is a chemical reaction damaging the DNA and causing cell death.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Development of the Middle Adult
• Physiologic—gradual internal and external physiologic changes occur • Cognitive—little change from young adulthood
• Psychosocial—time of increased personal freedom, economic stability, and social relationships
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: A. Continue an established lifestyle or reorganize one’s life in a period of transition Rationale:
According to Levinson, middle adults may continue or reorganize their lifestyle.
It is the role of the older adult to adapt to, and face, already completed tasks. Choosing a vocation and developing an ethical system as a guide to behavior are developmental tasks for adolescents and young adults.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Developmental Tasks of Middle Adulthood
• Establish and guide the next generation. • Accept middle-age changes. • Adjust to the needs of aging parents. • Re-evaluate one’s goals and accomplishments.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Middle Adult Years Characterized by Expanded Family Roles
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Leading Causes of Death in Middle Adulthood
• Malignant neoplasms • Cardiovascular disease • Unintentional injury including poisoning, motor vehicle accidents, and falls • Diabetes mellitus • Cerebrovascular causes (CDC, 2009)
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false. Both acute and chronic illnesses are more likely to occur in middle adulthood, and recovery takes longer.
A. True
B. False
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: A. True Both acute and chronic illnesses are more likely to occur in middle adulthood, and recovery takes longer.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Major Health Problems
• Cardiovascular and pulmonary disease • Cancer • Rheumatoid arthritis • Diabetes mellitus • Obesity • Alcoholism • Depression
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Role of the Nurse in Promoting Health
• Teach the dangers of substance abuse, smoking, and alcohol consumption. • Teach adults to eat a diet low in fat and cholesterol.
• Teach the importance of regular exercise.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Life Changes of the Middle Years
• Employment • Relationship with a spouse • Relationships with adult children • Relationships with aging parents • Midlife transition
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Development of the Older Adult
• Physiologic—all organ systems undergo some degree of decline, body less efficient • Cognitive—does not change appreciably, may take longer to respond and react • Psychosocial—self-concept is relatively stable throughout adult life • Disengagement theory
• Erikson—ego integrity versus despair and disgust; life review
• Havighurst—major tasks are maintenance of social contacts and relationships
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false. Fundamental to ageism is the view that older people are the same as younger people; therefore, they experience the same desires, needs, and concerns as other age groups. A. True B. False
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: B. False Fundamental to ageism is the view that older people are different than younger people; therefore, they do not experience the same desires, needs, and concerns as other age groups.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Common Myths of the Older Adults (Ageism)
• Old age begins at 65 years. • Most older adults are in nursing homes. • Older adults are sick, and mental deterioration occurs. • Older adults are not interested in sex. • Older adults do not care how they look and are lonely. • Bladder problems are a problem of aging. • Older adults do not deserve aggressive treatment for illnesses.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Changes of Older Adulthood
• Physical strength and health • Retirement and reduced income • Health of spouse • Relating to one’s age group • Social roles • Living arrangements • Family and role reversal
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Moral and Spiritual Development of Older Adults
• Kohlberg—older adults have completed their moral development and most are at a conventional level • Spiritually, an adult may be at earlier level, often at individuative-reflective level • Many adults demonstrate conjunctive faith and trust in a greater power • Self-transcendence is characteristic of later life
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Basis for Teaching Plan for Older Adults
• Chronic illness limits activities in almost half of older adults. • Meeting expenses of healthcare is often difficult.
– Medication costs, hospitalization costs, and costs of special equipment and supplies
• Family members must learn to cope with needs of the ill person. • Family members must adapt to psychological stressors.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Causes of Accidental Injuries in Older Adults
• Changes in vision and hearing • Loss of mass and strength of muscles • Slower reflexes and reaction time • Decreased sensory ability • Combined effects of chronic illness and medications • Economic factors
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Mental Impairment in Older Adults
• Dementia • Alzheimer’s disease • Sundowning syndrome • Cascade iatrogenesis
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
Tell whether the following statement is true or false. Sundowning syndrome is a temporary state of confusion that can last from hours to weeks, and resolves with treatment. A. True B. False
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
Answer: B. False Delirium is a temporary state of confusion that can last from hours to weeks and resolves with treatment.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Goal of Nursing Care
• Promote independent function. • Support individual strengths. • Prevent complications of illness. • Secure a safe and comfortable environment. • Promote return to health.
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Interventions for Hospitalized Older Adults Prevent Complications
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Housing Options for Older Adults
• Home modifications • Homesharing • Accessory apartments
• Elderly cottage housing opportunities
• Senior retirement communities • Continuing care retirement communities
• Assisted living
• Board and care homes • Nursing homes
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
