Geriatric PowerPoint

Patient-Centered Care for the Geriatric Population

Overview of Aging

  • Aging is defined as a continual process of biological, cognitive, and psychosocial change that begins at conception.

  • Many adults possess the potential for years of interesting and productive life.

  • Most individuals do not mind growing older, particularly if they remain relatively healthy.

  • Overcoming myths about aging poses a significant challenge for healthcare professionals.

Myths About Older Adults

  1. Older adults are sick.

  2. Older adults cannot learn new things.

  3. It is too late for lifestyle changes to improve health.

  4. Genetics are the predominant factor in longevity.

  5. Older adults are not sexual.

  6. Older adults are a drain on society.

  7. Older adults are senile.

  8. Older adults are typically isolated from their families.

  9. Older adults usually live in nursing homes.

  10. Older adults are poor.

  11. Older adults are unhappy.

Theories of Aging

Biological Theories

  1. Biologic Clock Theory - Cells are programmed to live a specific amount of time, after which they break down and die.

  2. Free-Radical Theory - Proposes that cells are damaged by environmental toxins and metabolic waste products.

  3. Wear-and-Tear Theory - Suggests that organs wear out over time, similar to machinery.

  4. Immune System Failure Theory - States that the immune system fails to protect the body from diseases.

  5. Autoimmune Theory - Indicates that the body no longer recognizes its own tissues and begins to attack them.

Psychosocial Theories

  1. Disengagement Theory - Claims it is normal for older adults to withdraw from social interactions.

  2. Activity Theory - Asserts that individuals who remain active and engaged tend to live longer and enjoy life more.

  3. Continuity Theory - Proposes that individuals retain their personalities and cope with aging in ways similar to how they handled earlier stages of life.

Longevity

  • Life Span: 115 to 130 years.

  • Changes in longevity since 1900:
      - Average life span in 1900 - 47 years
      - Average life span in 2012 - 78.9 years

  • Factors impacting longevity include diet, lifestyle, stress management, exercise, personality (outlook on life), gender, marital status, and genetics.

Demographics

  • In 2013, 45 million individuals (14% of population) were over 65 years of age.

  • By 2060, the number is projected to rise to 98 million.
      - Young old: 65 to 74 years
      - Middle old: 75 to 84 years
      - Very old: 85 years and older

  • Centenarians are becoming increasingly common:
      - Approximately 72,000 in the U.S., predicted to rise to 1,000,000 by 2050.

Physical Changes

  • Benign Senescence: Refers to the normal physical changes associated with aging, often unnoticed until health issues arise.

Cardiovascular Changes:

  • Increased heart size

  • Decreased cardiac output

  • Less elastic blood vessels

Respiratory Changes:

  • Thickened alveolar walls

  • Weakening respiratory muscles

  • Decreased vital capacity

Musculoskeletal Changes:

  • Thinned intervertebral disks

  • Decreased bone calcium

  • Smaller muscle mass

  • Less elastic ligaments and tendons

Integumentary Changes:

  • Thinner, drier skin

  • Loss of subcutaneous fat

  • Slower hair and nail growth

Urologic Changes:

  • Decreased bladder capacity and tone

  • Loss of nephrons

  • Decreased sphincter control

Neurologic Changes:

  • Presbyopia

  • Cataracts

  • Decreased peripheral vision

  • Presbycusis

  • Decreased sensitivity of touch, smell, and taste receptors

  • Slowed reaction time, potential impact on balance

Endocrine Changes:

  • Slower production of hormones

  • Decreased metabolic rate

  • Delayed insulin response

Gastrointestinal Changes:

  • Decreased secretion of saliva and digestive enzymes

  • Slowed peristalsis

  • Slowed liver and pancreatic functions

  • Reduced nutrient absorption

Reproductive Changes:

  • Decreased hormone production

  • Atrophy of ovaries, uterus, and vagina

  • Benign prostatic hypertrophy in men

  • Slowed sexual responses

Health Concerns

  • Most individuals over 75 have at least one chronic health issue:
      - Hypertension (most common)
      - Arthritis (second most common)
      - Heart disease (third most common)
      - Obesity (can contribute to arthritis and hypertension)
      - Other issues include anemia, diabetes, cancer, malnutrition, cirrhosis, and mental illness.

  • Dementia affects a small percentage of older adults but is more prevalent with age. Incidence rates range from 5% to 15% of older adults, with 60% to 80% of these cases attributed to Alzheimer’s disease.

Mental Health

  • Mental health can be difficult to evaluate among older adults.

  • More than one million older adults experience depression.

  • Older adults with suicidal thoughts are at a higher risk of successfully acting on those thoughts than younger individuals.

  • Depression can serve as an early warning sign for dementia.

Health Promotion Behaviors: Physical

  1. Eat a healthy diet.

  2. Use seasonings to enhance flavor due to potential loss of taste.

  3. Take daily multivitamins.

  4. Engage in regular physical activity.

  5. Undergo regular physical examinations.

  6. Avoid smoking.

  7. Limit alcohol consumption.

Cognitive Aspects of Aging

  • Schaie’s Reintegrative Stage of Development: older adults become selective with how they spend their time.

  • Intelligence may be maintained into advanced years.

  • While the speed of thinking may slow, cognitive processes remain intact.

  • Visual or auditory deficits do not equate to cognitive dysfunction.

Wisdom and Learning

  • Older adults are often viewed as wise due to their depth of life experiences.

  • Wisdom is defined as making sound judgments based on accumulated knowledge.

  • Learning capabilities remain intact; older adults often exhibit greater patience in learning new skills, including technology such as computers.

Memory Issues

  • Short-term memory loss may affect some older individuals regarding recent events; however, long-term memory typically remains intact.

  • Severe memory losses or forms of dementia can arise due to circulatory changes, malnutrition, or other underlying issues.

Employment and Retirement

  • The decision to continue working or retire depends on an individual’s cognitive ability and desire to maintain a job.

  • Some individuals eagerly leave the workforce in their 50s or early 60s, while others prefer working beyond conventional retirement age.

Psychosocial Aspects

  • According to Erikson's Stage of Ego Integrity vs. Despair, older adults who are satisfied with their past life report higher happiness levels.

  • Family connections are important, and married older adults tend to live longer than their single counterparts, with a significant number of widows among the older population.

  • Social activities and community ties greatly contribute to well-being.

Living Arrangements

  • Many older adults prefer to live independently in their own homes.

  • Approximately 28% of non-institutionalized older adults live alone, with a higher percentage of women than men.

  • An increasing number of multigenerational households have emerged, with around 3% of individuals over 65 and 9% over 85 residing in institutional settings.

Health Promotion Behaviors: Cognitive

  • Encouraging a positive attitude.

  • Engaging in hobbies, religious activities, service groups, and volunteerism.

  • Utilizing the brain through reading, puzzles, computer usage, and writing helps to maintain neural connections.

When a Parent Needs Help

  • It may be challenging for adult children to accept when a parent requires help.

  • Discussions regarding potential assistance should occur proactively, including all siblings to ensure a unified approach.

  • Important information such as financial, medical, and insurance documents should be organized.

Signs That an Older Person Needs Help