Nursing Care for Older Adults - Vocabulary Flashcards

Health & Aging

  • Key Questions:

    • Who is the largest consumer of healthcare resources?

    • What are the major health impacts and diseases?

Demographics

  • Historical perspective: As little as 2% of the global population were older adults in past decades

  • Significant increase in life expectancy during the 20th century (Ebersole)

  • By 2020: 60+ population exceeded children under 5 years

  • By 2050: 80% of older adults will live in low- and middle-income countries (WHO)

  • Challenges for all countries in adapting health and social systems to demographic shifts

Demographics – Canada

  • Proportion of Canadians over 65 has increased since the 1970s:

    • In 1966, older adults represented 7.7% of the population

    • In 2015, this increased to 16.1%

  • Factors: Low fertility rates and increased life expectancy (Statistics Canada, 2016a)

  • Life expectancy for Canadian women: 84 years; for men: 80 years (Statistics Canada, 2018)

  • By 2031: Anticipated demographic shifts

    • 1 in 4 Canadians will be immigrants

    • 1 in 3 will belong to visible minority groups (Stats Can, 2015)

  • Only 8% of Indigenous people are seniors, but they face significant health challenges (Statistics Canada, 2016b)

Evolution of Healthcare

  • Reference to "Being Mortal" by Atul Gawande

  1. Examination of healthcare prior to hospitalization and evolution of care settings

  2. Historical change influenced by scientific advancements making aging and dying medical events managed by professionals

    • A shift from a passive patient model to active management

  • Nursing homes became essential in transitioning care for older adults from hospitals (Gottlieb)

Types of Aging

  • Aging conceptualized through multiple dimensions:

    • Chronological Age: Years lived

    • Biological Age: Physical health and functioning of vital organ systems

    • Psychological Age: Reflected through cognitive functions like memory, learning, emotion, and judgment

    • Social Age: Measured by socially accepted roles and behaviors aligning with expectations in society

  • Acknowledgment that these aging types may not align uniformly

Theories of Aging

  • Biological Theories: Evolved from studies on life span changes

    • Lack of consensus on aging causes

    • Two approaches:

    • Stochastic Theories: Changes result from DNA errors; e.g., oxidative stress/influence of free radicals

    • Non-stochastic Theories: Changes arise from pre-programmed processes

  • Both acknowledge cellular disorganization and death leading to organism demise

  • Aging as a unique, individualized experience significantly influenced by social determinants

Ageism

  • Definition: Prejudice against older adults displayed through attitudes and actions (Ebersole)

  • Aspects: Stereotypes, prejudice (emotions), and discrimination based on age

    • Can manifest in institutional, interpersonal, or self-form (WHO)

  • Notably prevalent in Western cultures, associated with negative feelings surrounding aging

  • Consequences of ageism in healthcare: Negative perceptions deter healthcare workers from entering long-term care (LTC) fields (Ebersole)

Impact of Ageism

  • Consequences outlined by WHO:

    • Linked to shortened lifespans and decreased physical/mental health

    • Increases social isolation and loneliness among older individuals

    • Affects expression of sexuality, raises risk of violence, and contributes to poverty in older age

    • Significant financial implications for societies experiencing ageism

    • Reduces younger people's workplace commitment

Strategies to Combat Ageism

  • Policy and Law: Protection against age-based discrimination under the Ontario Human Rights Code (for ages 18 and above)

  • Education: Educational initiatives aimed at dispelling myths and reducing prejudice

  • Intergenerational Contact: Encourages diversity of understanding and reduces stereotypes through interactions

Hearing Impairment

  • Significance of hearing loss:

    • Detrimental to communication, more serious than visual impairment per Sacks (1989)

    • Communication barriers lead to social isolation, depression, safety risks

    • Common in Canadians aged 60+, tied to diminished quality of life (Nordvik et al., 2018)

    • Misdiagnosis risks due to misunderstood communication in older adults

Communication

  • Communication as the foremost human ability

    • Facilitates expression of thoughts, feelings, and social needs

    • Vital need throughout life, regardless of age or impairments

    • Meaningful interaction encourages better health outcomes and longevity (Gasiorek et al., 2019)

  • Maslow’s hierarchy: Affiliation needs rank high, only second to safety and survival (Maslow, 1943)

  • Barriers to effective communication include societal ageism and health provider attitudes

Elderspeak

  • Definition: A form of ageism where caregivers use simplified language assumed to be more understandable for older adults

  • Characteristics of Elderspeak:

    • Speaking slowly or loudly, using a singsong tone

    • Use of collective pronouns instead of direct address

    • Utilization of pet names in conversation

    • Answering questions for older adults instead of allowing independence

  • Importance of proper positioning when communicating to ensure respect and engagement