Theories and Developmental Tasks of Aging Lecture notes (completed)

Overview of Aging and Scholarly Perspectives

  • Definition and Perception of Aging

    • Aging is a universal process that individuals experience regardless of desire.

    • Perception changes across the lifespan:

      • Children: Barely aware of the process.

      • Adolescents: Seek to rush the process to reach adulthood.

      • Adults: Attempt to slow the progress of aging.

    • Aging is ultimately a process that individuals are powerless to influence in terms of its progression.

  • Dimensions of Aging Definitions

    • Chronological: Defined by the number of years lived since birth.

    • Biological/Functional: Defined by physical changes and the efficiency of organ systems.

    • Psychological: Defined by adaptive capacities and self-perception.

    • Social: Defined by roles and expectations within a society or culture.

Biological Theories of Aging

  • Biological theories

    • These theories state that breakdown at the molecular and cellular levels leads to the decline, aging, and eventual death of the cell. This cellular decline results in the aging of the entire organism.

  • Psycho-Social Theories

    • Attempt to explore and explain the behavioral (or emotional), personality (or cognitive), and social processes of the aging individual.

  • Categories of Biological Theories

    • Stochastic: Suggests that aging occurs as a random event and accumulates over time.

    • Non-Stochastic: Suggests that aging is a predetermined and timed phenomenon; it is non-random and follows a "programmed" schedule.

  • Specific Stochastic (Error) Theories

    • Free Radical / Oxidative Stress Theory: Aging is the result of cumulative damage caused by free radicals (unstable molecules) produced during metabolism.

    • Cross-link or Collagen Theory: Aging results from the accumulation of cross-linked proteins (specifically collagen) which damages cells and tissues, slowing down bodily processes.

    • Wear and Tear Theory: Proposes a gradual deterioration of cells and tissues over time due to repeated use and the various stresses placed on the body.

  • Specific Non-stochastic (Programmed) Theories

    • Autoimmune / Immunity Theory: The functions of the immune system, specifically controlled by BB and TT lymphocytes, decrease over time. This leads to an increased risk of infection, cancer, autoimmune disorders, and mortality.

    • Neuroendocrine Control or Pacemaker Theory: Suggests there is a decline or cessation in components of the nervous, endocrine, and immune systems over the lifespan. Current research focuses on the effect of specific hormones on neuroendocrine functioning, specifically DHEA and melatonin.

  • Progeria

    • A specific medical condition that causes accelerated physical aging in children.

Psycho-Social Theories of Aging

  • Goal of Psycho-Social Theories

    • These theories attempt to explore and explain the mental, emotional, and social processes of the aging individual.

  • Key Psycho-Social Theories

    • Disengagement Theory (Cummings & Henry, late 1950s1950s): Aging is viewed as an inevitable, mutual withdrawal or disengagement. This results in decreased interaction between the aging person and the social system to which they belong.

    • Activity Theory (Robert Havighurst, 1960s1960s): Supports the maintenance of regular activities, roles, and social pursuits. It suggests that individuals who achieve "optimal aging" are those who stay active. When physical ability declines, the individual should substitute new activities for those they can no longer perform.

    • Continuity Theory (Havighurst and co-workers): Proposed in reaction to the Disengagement Theory. It asserts that an individual's basic personality, attitudes, and behaviors remain constant throughout the life span.

    • Role Theory: Focuses on the adaptation of the individual to changing roles over their lifetime (e.g., transitioning from employee to retiree or parent to grandparent).

    • Age Stratification Theory (Riley et al., 19711971): Aging is best understood by considering the experiences of individuals as members of cohorts (groups born around the same time) who share similarities with others in that same group.

    • Modernization Theory (Max Weber): Attempts to explain social changes due to societal modernization that resulted in the "devaluing of the elderly."

Relevance of Aging Theories to Nursing Practice

  • Foundation for Care: Serve as a backdrop for the development of a nurse's philosophy of care and the creation of senior programs.

  • Insight: Provide insight into the factors that impact the aging process.

  • Education: Provide information on age-related changes and pathology, which nurses should use to educate patients.

  • Healthy Aging: Shed light on the unique ways older adults achieve healthy aging and how they respond differently to illness.

  • Framework: Theories may be used as a framework for addressing various issues and initiating clinical programs.

Developmental tasks of aging

  • Erikson’s Developmental Stages

    • Young Adulthood (21−3921-39): Stage of Intimacy vs. Isolation.

    • Middle Adulthood (40−6540-65): Stage of Generativity vs. Stagnation.

    • Older Adulthood (65+65+): Stage of Ego Integrity vs. Despair.

  • Peck’s Developmental Tasks of Aging (19681968)

    • Ego Differentiation vs. Work-Role Preoccupation: Finding identity beyond one's former career.

    • Body Transcendence vs. Body Preoccupation: Overcoming physical discomfort and decline by focusing on social or mental activities.

    • Ego Transcendence vs. Ego Preoccupation: Accepting death by contributing to the future of others.

  • Havighurst’s Developmental Tasks of Aging

    • Adjusting to decreasing physical strength and health.

    • Adjusting to retirement and reduced income.

    • Establishing an affiliation with one’s own age group.

    • Meeting civic and social obligations.

    • Establishing satisfactory living arrangements.

    • Adjusting to the death of a spouse.

  • Maslow’s Hierarchy of Needs

    • Combines biological, psychological, and social needs.

    • Order of Needs (Lowest to Highest):

      1. Physiological Needs: Breathing, food, water, shelter, clothing, sleep.

      2. Safety and Security: Health, employment, property, family, and social stability.

      3. Love and Belonging: Friendship, family, intimacy, sense of connection.

      4. Self-Esteem: Confidence, achievement, respect of others, the need to be a unique individual.

      5. Self-Actualization / Gerotranscendence: Inner potential, morality, creativity, spontaneity, acceptance, and achieving wisdom through personal transformation.

    • Lower level needs must be met before higher levels can be achieved. This theory is considered to be less culturally biased than others.

Wellness and Health Promotion Strategies

  • Healthy People 20302030 Goal

    • To improve health and well-being for older adults.

  • Nursing Interventions for Wellness

    • Identify individual strengths and assist with developmental tasks.

    • Promote Lifestyle Modifications: Foster physical activity, healthy eating, healthy sleep, and control of health problems (Biological Wellness).

    • Functional Wellness: Ensure the physical environment promotes healing and encourages independence at the highest possible level.

    • Social Wellness: Facilitate activities and encourage interactions with others.

    • Resources: Educate and provide access to necessary resources and services.

  • Recommended Health Screenings & Exams

    • Annual:

      • Physical exam (Blood Pressure & complete blood work).

      • Vision and Dental exam (Dental cleaning every 66 months).

      • Prostate exam, Digital Rectal Exam, and PSA for men.

    • Periodic:

      • Hearing: Every 2−52-5 years.

      • Colonoscopy: Every 1010 years (Every 55 years if there is a family history).

      • Mammogram (Women): Every 1−21-2 years.

      • Pelvic Exam & Pap (Women): Annually (HCP may discontinue after 33 consecutive negative results).

      • Bone Density: Once post-menopause and as needed (PRN).

      • Breast Exam (Women): Monthly self-exam.

  • Immunizations

    • Influenza Vaccine: Annually.

    • Pneumonia Vaccine: Once after age 6565, with a possible booster every 55 years.

    • Tetanus, Diphtheria, Pertussis (Tdap): Every 1010 years.

    • Herpes Zoster (Shingles): Two doses administered 2−62-6 months apart.

    • Hepatitis A & B: For those at risk.

    • Varicella: If immunity is lacking and risk for exposure is significant.

    • COVID-19: Possibly annually.