Week 1 - Older Adults

Student Learning Objectives

• Discuss theories of aging.

• Understand the cultural and spiritual impacts on elder health and wellness.

• Differentiate normal physiological changes from pathological changes due to aging.

• Explore different models of elder healthcare.

Variability Among Older Adults

• Physiological, cognitive, and psychosocial health differ widely.

• Levels of functional ability: some older adults are fully independent, while others may experience dependence.

• Identifying the unique strengths and abilities each individual possesses is crucial.

Myths and Stereotypes

• Common stereotypes about older adults include:

  • Illness, disability, and unattractiveness.

  • Forgetfulness and confusion.

  • Inability to learn new information.

  • Disinterest in sex or sexual activities.

• Such stereotypes perpetuate ageism, which is discrimination based on age.

Nurses’ Attitudes Toward Older Adults

• Nurses should recognize ageism and challenge negative stereotypes.

• Importance of respecting older adults and involving them in care decisions and activities.

Developmental Tasks for Older Adults

• Loss of friends, retirement, and financial changes.

• Redefining relationships as health and capability shift.

• Self-acceptance issues, grappling with integrity versus despair as they evaluate their lives.

Cultural Competency

• Recognize personal belief systems.

• Use interpreters when necessary to ensure clear communication.

• Perform cultural assessments instead of making assumptions.

• Be aware that LGBT older adults may often be invisible within healthcare contexts.

Community-Based and Institutional Health Care Services

• Older adults are encountered in various settings:

  • Private homes, apartments, retirement communities, and assisted living.

• Importance of involving older adults in decisions regarding appropriate healthcare services.

PACE (Program of All-Inclusive Care for the Elderly)

• A federal program that allows seniors to receive care in their community instead of a facility.

• Focus on integrating medical and supportive services to enhance the quality of life.

Assessing the Needs of Older Adults: Age-Specific Approach

• Relationship between physical and psychosocial aspects of aging.

• Consider effects of disease and disabilities on older adult functional status.

• Recognize the alterations in health response and lack of standards for health norms in this age group.

Older Adult Interview Techniques

• Maintain eye-level interaction and clear visibility of mouth while speaking.

• Use good lighting and encourage the use of assistive devices for communication.

Assessment in Older Adults

• Caution in interpreting signs, symptoms, and lab values.

• Early identification of acute illness is crucial; many changes may be drug-related.

• Nurses play a key role in identifying and addressing health issues in older adults.

Physiological Changes

• Quality of life is determined by older patients' perception of their functioning capacity.

• Awareness of normal age-related changes is vital in healthcare provision.

• Distinguish between physiological changes that are normal versus those that indicate pathology.

Functional Changes

• Functional status defined by the completion of activities of daily living (ADLs).

• Changes in functionality often correlate with chronic illnesses.

• Occupational and physical therapists are critical in assessing ADLs comprehensively.

Psychosocial Changes

• Significant factors affecting older adults:

  • Retirement leading to lifestyle changes.

  • Risks associated with social isolation.

  • Considerations of housing and environment.

  • Challenges posed by the reality of death.

Older Adults and Acute Care Setting

• Acute care poses many risks:

  • Delirium, dehydration, malnutrition, and infections are common issues.

  • Older adults also face risks of urinary incontinence and falls.

Older Adults and Restorative Care

• Care types aimed at:

  • Continuing recovery from acute illnesses and managing chronic conditions.

  • Goal: to restore or improve prior independence levels, particularly in ADLs and instrumental ADLs (IADLs).

Theories of Aging – Biological Theories

• Free Radical Theory: Damage from free radicals leads to aging.

• Mitochondrial Decay Theory: Decline in mitochondrial function with age.

• Telomere Shortening: Shortening of telomeres at the end of chromosomes impacts cellular aging.

Theories of Aging – Psychological Theories

• Erikson's Theory: Focuses on integrity versus despair in late life.

• Peck's Theory: Suggests mental and social capacities may increase despite physical decline.

• Various theories of lifespan and development examine roles, continuity, activity, and social exchange.

The Opposite of Ageism

• Celebrating remarkable individuals in older populations:

  • Examples include 91-year-old gymnasts and Olympic athletes who challenge stereotypes.