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.

robot