NCMB314 PRELIMS

Medieval times

gave rise to strong feelings regarding the superiority of youth; these feelings were expressed in uprisings of sons against fathers.

Four ways to adopt a Lifespan Perspective on Aging at work

Recognize age-related changes in abilities, Understand age-related difference in life situations, Acknowledge temporal dynamics in individual differences, advocate for the design of work systems that optimally integrate various age-related changes, differences and dynamics

The Graying of America Percent of Total U.S. Population

over 65 in 2030

Nursing Care of Older Adults

Gerontological nursing is provided in acute care, skilled and assisted living, the community, & home settings

Provider of care

Should be educated about disease processes & syndromes commonly seen in the older population

Teacher/ Educator

Should focus their teaching on modifiable risk factors & health promotion through

Psychosocial Theories of Aging

Attempt to explain aging in terms of behaviour, personality and attitude change.

Activity theory

Havighurst and Albrecht (1953), Remaining occupied and involved is necessary to satisfy late life.

Disengagement Theory

Cumming and Henry (1961), Gradual withdrawal from society and relationships serves to maintain social equilibrium and promote internal reflection.

Subculture Theory

Rose (1965), The elderly prefer to segregate from society in an aging subculture sharing loss of status and societal negativity regarding the aged.

Continuity Theory

Havighurst (1960), also known as Development Theory

Age Stratification Theory

Riley (1960) Society is stratified by age groups that are the basis for acquiring resources, roles, status and deference from others.

Person-Environment Fit Theory

Lawton (1982) Function is affected by ego strength, mobility, health, cognition, sensory perception and the environment.

Psychological theories

Explain aging in terms of mental processes, emotions, attitudes, motivation, and personality development that is characterized by life stage transitions.

Human needs

Maslow's (1954) Five basic needs motivate human behaviour in a lifelong process toward need fulfilment. Self - Actualization

Individualism Theory

Jung (1960) Personality consists of an ego and personal and collective unconsciousness that views life from a personal or external perspective.

Perspective of Older Adults through History

Today older adults are viewed with positivism rather than prejudice, knowledge rather than myth, and concern rather than neglect. This positive view was not always the norm.

In the time of Confucius,

there was a direct correlation between a person's age and the degree of respect to which he or she was entitled.

Life expectancy

the average number of years that a person can be expected to live

Average life expectancy

47 years (2004)

Geriatrics

From Greek - Geras, meaning "old age," branch of medicine & deals with the diseases & problems of old age.

Gerontology

from the Greek Geron, meaning "old man," is the scientific study of the process of aging and the problems of aged persons

Older Age Group

Young old - ages 65-74, Middle Old - ages 75-84, Old Old - 85 and up

Young old

ages 65-74

Middle Old

ages 75-84

Old Old

85 and up

Age Discrimination

emotional prejudice among the older adult.

Ageism

dislike of the aging and the older adult. Prejudice against the old just because they are old.

Senescence

Defined as a change in the behavior of an organism with age, leading to a decreased power of survival and adjustment, occur as well.

Gerontology Nursing

This specialty of nursing involves assessing the health & functional status of older adults, planning and implementing health care & services to meet the identified needs, and evaluating effectiveness of such care.

Barbara Davis

She is the first nurse to speak before the American Geriatric Society.

Goals of nursing care for older adults include:

Promoting & maintaining functional status, and Helping older adults identify & use their strengths to achieve optimal independence.

Manager

They balance concerns of the patient, family, nursing & the rest of the interdisciplinary team Must be skilled in: Leadership, Time management, Building relationships, Communication & Managing change, They may also supervise other nursing personnel

Advocate

Acts on behalf of the older adults to: Promote their best interests & Strengthen their autonomy & decision making

Research Consumer

Must remain abreast of current research literature, reading & putting into practice the results of reliable & valid studies

Aging Well

72% of seniors report having good to excellent health, Numbers living in nursing homes has declined

Aging Theories

Cultural, spiritual, regional, socioeconomic, educational, environmental factors, and health status impact the older adults perceptions and choices about their health care needs

Sociological Theories

changing roles, relationship, status and generational cohort impact the older adult's ability to adapt.

Stages of Personality Development

Erikson (1963) Personality develops in eight sequential stages with corresponding life tasks. The eighth phase, integrity versus despair, is characterized by evaluating life accomplishments; struggles include letting go, accepting care, detachment, and physical and mental decline.

Life-course/Lifespan Development

Life stages are predictable and structured by roles, relationship, values and goals.

Biological Theories of Aging

Explains that physiologic processes that change with aging.

Stochastic Theories

Based on random events that cause cellular damage that accumulates as the organism ages.

Free Radical Theory

Membranes, Nucleic acids and proteins are damaged by free radicals which causes cellular injury,

Orgel/ Error Theory

Errors in DNA and RNA synthesis occurs with aging.

Wear and Tear Theory

Cells wears out and cannot function with aging. Like a machine which losses function when its parts wears off.

Connective Tissue Theory / Cross link theory

With aging, proteins impede metabolic processes and cause trouble with getting nutrients to cells and removing cellular waste products.

Non-Stochastic Theories of Aging

Based on the genetically programmed events that cause cellular damage that accelerates aging of the organism.

Programmed Theory

Cells divide until they are no longer able to and this triggers to apoptosis or cell death

Gene/ Biological Clock Theory

Cells have a genetically programmed aging code.

Neuroendocrine theory

Problems with the hypothalamus-pituitaryendocrine gland feedback system causes disease, Increased insulin growth factor accelerates aging.

Immunologic/ Autoimmune Theory

Aging is due to faulty immunological function, which is linked to general well-being.

Physiologic Changes in Aging

Integumentary Effect, Muskulo-skeletal, Respiratory, Cardiovascular / Hematopoietic & Lymphatic, Hematopoietic & Lymphatic, Gastrointestinal, Urinary, Nervous, Special senses, Endocrine, Reproductive,

Personality

Drastic changes in basic personality normally do not occur as one age. The kind and gentle old person was most likely that way when young

Memory

The three type of memory are short term, lasting from 30 seconds to 30 minutes

Intelligence

In general, it is wise to interpret the findings related to intelligence and the older population with much caution because results may be biased from the measurement tool or method of evaluation used.

Crystallized intelligence,

which is the knowledge accumulated over a lifetime and arises from the dominant hemisphere of the brain

Fluid intelligence,

involving new information and emanating from the nondominant hemisphere

Learning

Although learning ability is not seriously altered with age, other factors can interfere with the older person's ability to learn, including motivation, attention span, delayed transmission of information to the brain, perceptual deficits, and illness.

Attention Span

Older adults demonstrate a decrease in vigilance performance (i.e. the ability to retain attention longer than 45 minutes).

Assessment

Assess potential health hazard to identify risk factors for illness and injury

Risk Factors

Habits, lifestyle patterns, Personal and family medical histor, Environmental conditions

Comprehensive Geriatric Assessment (CGA):

Physical health, Mental health, Functional status, Social functioning, Environment

Functional Status Assessment

Functional status is considered a significant component of an older adult's quality of life. Assessing functional status has long been viewed as an essential piece of the overall clinical evaluation of an older person.

The Katz Index

A useful tool to describe the client's functional level, Katz Index of Independence in Activities of Daily Living, commonly referred to as the Katz ADL, is the most appropriate instrument to assess functional status as a measurement of the client's ability to perform activities of daily living independently.

MiniMetal State Examination

is a widely used test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual spatial skills.

PAR-Q AND YOU

a common method of uncovering health and lifestyle issues prior to an exercise programmed starting. The questionnaire is short and easy to administer and reveals any family history of illness.

Self-Perception/ Self-Concept Pattern

This pattern encompasses a sense of personal identity; body language, attitudes, and view of self in cognitive, physical, and affective realms; and expressions of sense of worth and emotional state.

Roles/ Relationship Pattern

This pattern encompasses the achievement of expected developmental tasks.

Health Perception/ Health Management Pattern

This pattern encompasses the perceived level of health and current management of any health problems.

Nutritional / Metabolic Pattern

This pattern encompasses evaluation of dietary and other nutrition-related indicators.

Coping/ Stress-Tolerance Pattern

This pattern encompasses the client's reserve and capacity to resist challenges to self-integrity, and his or her ability to manage difficult situations.

Cognitive/ Perceptual Pattern

This pattern encompasses self-management of pain, presence of communication difficulties, and deficits in sensory function.

Value/ Belief Pattern

This pattern encompasses elements of spiritual wellbeing that the older adult perceives as important for a satisfactory daily living experience and the philosophic system that helps him or her function within society.

Activity/ Exercise Pattern

This pattern encompasses information related to health promotion that encourages the older adult to achieve the recommended 30 minutes daily of physical activity on most days of the week.

Rest and Sleep Pattern

This pattern encompasses the sleep and rest patterns over a 24-hour period and their effect on function.

Sexuality/ Reproductive Pattern

This pattern encompasses the older adult's behavioral expressions of sexuality

Elimination Pattern

This pattern encompasses bowel and bladder excretory functions.

Planning

Exploring older adults' personal ideas and beliefs concerning health needs

Implementation

Adopting a proactive stance toward an action plan for health promotion of the older individual, Activities, locations, and means of disseminating health promotion

Evaluation

Determining effectiveness of care plan, Check established goals, Establish appropriate and realistic revised goals and realistic steps to achieve them

Healthy People Initiative

An initiative of the US Department of Health and Human Services that set forth health care objectives designed to increase the quality and quantity of years of healthy life of Americans and to eliminate health disparities.

Components of Health Promotion for the Elderly

Exercise, Nutrition, Mental health,

Exercise

Regular exercise and physical activity can improve health in a variety of ways: Reduction in Heart Disease, Diabetes, High Blood pressure, Colon CA, Depression, Anxiety, Excess weight, falling, bone thinning, muscle wasting and joint pain.

Nutrition

Eating and drinking habits have been implicated in 6:10 leading cause of death in the elderly. Older adults are more prone to Obesity and Malnutrition.

Mental Health

Decrease life satisfaction due to, Decrease Income (50%), Increase emotional losses

Model Health Promotion Programs for Older Adult

Programs that have received federal funding and foundation supports to evaluate their effectiveness and to encourage their replication.

Health wise

provides information and prevention tips on 190 common health problems.

Chronic Disease Self-Management Program

Founded by Nurse Researcher Kate Lorig,

Project Enhance

Enhance Fitness and Enhance Wellness.

Ornish Program for Reversing Heart Disease

Founded by Dr. Dean Ornish, Enhancement of Elderly Nutrition

Body Medical Institute

Dr. Herbert Benson, Combination of Relaxation: Nutrition, Exercise, and Reframing from Negative thinking patterns.

Strong for life Model

exercised program for disabled and nondisabled older adults

Re-Engagement Instead of Retirement

The likely alternative to retirement blessed with longevity, education, health and positive attitude towards remaining engaged.

Green House

Founded by Dr. William Thomas, An Innovative and home-like alternative to nursing homes.

Safety

Falls leading cause of unintentional injury death in older adult.

Fall-risk Assessment: "I HATE FALLING

I - nflammation of joints or joint deformity.

H - ypotension (Orthostatic Blood pressure changes) • A - uditory and Visual Impairments

T - remors

E - quilibrium problems.

F - oot problems.

A - rrythmias, heart block, valvular disease.

L - eg Discrepancy

L - ack of conditioning (General Weakness)

I - llness

N - utrition

G - ait disturbance

Disease Prevention

Helps prevent functional decline.

Levels of Disease Prevention

Primary, secondary, tertiary

Primary Prevention

designed to completely prevent a disease from occurring.

Secondary Prevention

early detection and management of disease.