GERON: THEORY OF SUCCESSFUL AGING

- Sister Callista Roy in 1976

- views the individual as a holistic, adaptive system striving to maintain balance amid a constantly changing environment

Adaptation Model

- Sr. Calista Roy's Adaptation Model

- is defined as "an individual's perception of a favorable outcome in adapting to the cumulative physiologic and functional alterations associated with the passage of time, while experiencing spiritual connectedness, and a sense of meaning and purpose in life"

Successful aging

With the conceptual definition of successful aging in mind, Flood (2005) integrated concepts from:

- ____ (RAM)

- ____

in the development of the Theory of Successful Aging.

- Roy's Adaptation Model

- Lars Tornstam's 1989 Sociological Theory of Gerotranscendence

The theory identifies three coping mechanisms that describe the older adult's response to their environment:

1. ____

2. ____

3. ____

- This response provides feedback within these identified mechanisms, promoting gerotranscendence.

1. Adaptation of functional performance mechanisms

2. intrapsychic factors

3. spirituality

- How the individual handles physical tasks.

Ex: an older adult has difficulty walking for a long distance, they may use a cane, walker, or take more frequent breaks. The important thing is that they adapt to their physical changes instead of simply giving up.

Adaptation of functional performance

- Internal psychological processes (older adult's thoughts, feelings, beliefs, and inner psychological processes).

- It involves how they understand and accept the changes that come with aging.

Ex: instead of becoming frustrated about not being able to do something as easily as before, an older adult may learn to accept the change and focus on what they are still capable of doing.

Intrapsychic factors

- The connection to a higher sense of meaning, purpose, faith, or connection to something greater than oneself.

- It can help older adults cope with challenges and changes.

Ex: an older adult may find comfort in prayer, faith, family, or reflecting on the meaning of their life.

Spirituality

The theory challenges conventional Western views of aging—which often equate success with remaining highly active or productive—by arguing that human development

- is a lifelong process that naturally transitions toward a cosmic and transcendent meta-perspective in old age

Theory of Gerotranscendence

- is a coping process in which an older person experiences a major change in how they view themselves, other people, and the world.

- The person begins to think differently about their place in the world and their relationships with others.

Gerotranscendence

- "a coping process that occurs when there is a major shift in the person's worldview, where a person examines one's place within the world and in relation to others ...

- includ[ing] decreased death anxiety, engagement in meaningful activities, changes in relationships, self-acceptance and wisdom" (Flood, 2005, p. 38).

- In turn, the feedback loop centered on the three coping mechanisms, and ____ facilitates successful aging.

Gerotranscendence

Roles & Responsibilities of Nurses:

___ - Assess and monitor patient conditions

___ - Teach patients and families

___ - Collaborate with medical teams

___ - Ensure patient rights and safety

___ - Manage care plans and decisions

- Care Provider

- Educator

- Communicator

- Advocate

- Leader

Application to Nursing

The Theory of Successful Aging guides the gerontologic nurse in the provision of:

- ___

- ___

- ___

- mental

- physical

- spiritual nursing interventions

- By Nola Pender (1996)

- Identifies health as a dynamic state directed at improving the person's overall sense of well-being.

Health Promotion Model

In this model, health is not viewed as simply the absence of disease, but is multidimensional and influenced by the environment.

Health Promotion Model

The ____ are:

(1) the unique characteristics and experiences of the person that affect subsequent actions;

(2) the person's behavior and cognitive affect, which provide motivation and can be modified through nursing interventions; and

(3) behavioral outcomes which should result in optimum health and functional ability, and improved quality of life

3 components comprising health

- The theory recognizes the importance of patient involvement in identifying their needs

- Has direct application for gerontologic nurses who practice in medical/surgical environments, as well as those in hospice and palliative care.

- Comfort theory

Sub-Concepts of HPM: Personal Factors

____ - Include variables such as age, gender, body mass index, pubertal status, aerobic capacity, strength, agility, or balance.

____ - Include variables such as self-esteem, self-motivation, personal competence, perceived health status, and definition of health.

____ - Include variables such as race, ethnicity, acculturation, education, and socioeconomic status.

- biological factors

- psychological factors

- socio-cultural factors

- is a midrange nursing theory

- developed by Katharine Kolcaba during the 1990s

- Defined as "the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience:

(___, ___, ___, ___)

- Comfort theory

- physical, psychospiritual, social, and environmental

is the holistic outcome of nursing interventions

Comfort

Comfort is composed of three components:

(1) ___ - occurs when specific comfort needs are met;

(2) ___ - is the absence of discomfort

(3) ___ - occurs when a patient can rise above their discomfort when it cannot be completely relieved.

- relief

- ease

- transcendence

Four Contexts of Comfort:

____ - Refers to the body and physical sensations.

Example: relieving pain, providing comfortable positioning, managing nausea

____ - Refers to a person's mind, emotions, self-esteem, and spiritual beliefs.

Example: reducing anxiety, giving emotional support, allowing prayer.

____ - Comfort from family, friends, relationships, and social support.

Example: A patient feels lonely, so the nurse allows family members to visit and provide emotional support.

____ - Comfort related to the surroundings, such as cleanliness, temperature, noise, and lighting.

Example: A patient is having difficulty sleeping, so the nurse reduces noise, adjusts the lighting, and keeps the room comfortable.

- PHYSICAL COMFORT

- PSYCHOSPIRITUAL COMFORT

- SOCIAL COMFORT

- ENVIRONMENTAL COMFORT

- is the process through which individuals develop their understanding of right and wrong, ethical principles, values, and responsibilities.

Moral development

He developed the Theory of Moral Development, which explains how a person's moral reasoning develops through different stages.

Lawrence Kohlberg

LEVEL OF MORAL DEVELOPMENT:

PRE-CONVENTIONAL

CONVENTIONAL

POST-CONVENTIONAL

STAGES OF MORAL DEVELOPMENT:

PRE-CONVENTIONAL:

1.

2.

CONVENTIONAL:

3.

4.

POST-CONVENTIONAL:

5.

6.

1. Obedience & Punishment

2. Individualism & Exchange

3. Good Interpersonal Relationships

4. Law & Order

5. Social Contract

6. Universal Ethical Principles

- Right and wrong are based on avoiding punishment.

- An older adult may follow treatment mainly because they fear complications or punishment.

1. Obedience & Punishment

- Decisions are based on personal benefit.

- May cooperate with care when they see a direct benefit to themselves.

2. Individualism & Exchange

- Behavior is influenced by approval from family and others.

- May follow health recommendations because they want to please or avoid disappointing family.

3. Good Interpersonal Relationships

- Rules, duties, and social expectations guide behavior.

- May value following healthcare rules, religious practices, or family responsibilities.

4. Law & Order

- Recognizes that laws should promote the welfare and rights of people.

- Important when discussing autonomy, informed consent, advance directives, and healthcare choices.

5. Social Contract

- Decisions are guided by principles such as justice, dignity, and human rights.

- Older adults may make decisions based on deeply held values even when these differ from family or healthcare preferences.

6. Universal Ethical Principles

- refers to how an older adult's beliefs, values, sense of meaning, and connection to others or a higher power develop throughout later life.

- Aging often encourages life reflection, meaning-making, acceptance, and preparation for mortality.

- Spirituality may provide hope, comfort, purpose, and inner peace.

Spiritual Development Theory

extends beyond religious affiliation to synthesize contemplative experiences, often catalyzed by illness, life crises, or limited time

Spirituality