OLDER CLIENTS AS AGGREGATE

1. OLDER CLIENTS AS AGGREGATE

2. Theories of Aging • Stochastic theories • Genetic theories • Psychological theories • Sociological theories

3. Stochastic Theories • Somatic mutation theory: Prolonged exposure to background radiation of several types results in cell mutations that eventually lead to death. • Error theory: Environmental changes interfere with cell function and protein synthesis, thus causing errors in reproduced cells.

4. Genetic Theories - 1 • Neuroendocrine theory: Aging results from functional decrements in neurons and their hormones that are genetically programmed. • Intrinsic mutagenesis theory: A genetic constitution regulates the replication of genetic materials. Over time, regulatory activity diminishes, creating mutations in cells that result in the effects of aging.

5. Genetic Theories - 2 • Immunologic theory: Aging is an autoimmune process in which the body perceives aging cells as foreign bodies and destroys them. • Free radical theory: Free radicals, metabolic by-products, accumulate over time to cause cell damage.

6. Psychological Theories - 1 • Psychoanalytic theory: Aging is a time of developing self-awareness through reflective activity. • Interpersonal theory: The loss of interpersonal relationships over time results in a loss of interpersonal security and the consequent psychological aspects of aging.

7. Psychological Theories - 2 • Human needs theory: Physical aging and environmental changes contribute to difficulty in meeting basic human needs, which leads to the psychological effects of aging. • Theory of psychosocial development: The degree of success in accomplishing prior developmental tasks influences the accomplishment of the tasks of the older adult.

8. Sociological Theories - 1 • Disengagement theory: Older people begin a process of withdrawal from society that prevents social disruption when death occurs. • Activity theory: Older people continue their engagement with society and assume new roles and responsibilities.

9. Sociological Theories - 2 • Continuity theory: One’s behavior becomes more predictable with age.

10. Myths of Aging - 1 • Aging is a time of tranquility. • Senility is a universal experience of aging. • People become less productive with age. • Older people resist change. • Aging is a uniform process.

11. Realities of Aging • Aging may cause more problems with fewer resources to deal with them. • Many older people retain mental acuity. • Older people continue to be productive, but avenues of productivity change. • Older people are no more resistant to change than younger people. • Aging is a variable process.

12. Assessing Older ClientsGeneral Principles - 1 • Distinguish normal effects of aging from pathology. • Illnesses may have atypical presentations in the elderly. • Dysfunction in one system may cause problems in other systems.

13. Assessing Older ClientsGeneral Principles - 2 • Older people have strengths as well as problems. • Older people may have experienced a variety of losses. • Communication difficulties may influence assessment.

14. Biophysical Considerations • Maturation and aging • Retirement • Preparation for death • Physiologic function • Existing conditions • Functional ability • Immunity

15. Psychological Considerations • Cognitive assessment • Response to stress • Affective assessment • Suicide potential

16. Physical Environmental Considerations • Safety hazards in the home • Community safety hazards • Effects of weather, pollution, etc.

17. Sociocultural Considerations • Social support • Family roles and responsibilities • Employment and occupation • Economic factors • Potential for abuse

18. Behavioral Considerations • Diet (amount, type, preparation, etc.) • Physical activity and rest • Personal habits • Sexuality

19. Health System Considerations • Access to health care • Preventive services • Source of care • Financing of health care

20. Goals of Primary Prevention for Older Clients • Promoting healthy aging through • Selection of important aspects of life • Optimization in use of available resources • Compensation for lost abilities • Promoting self-care

21. Primary Prevention • Nutrition • Hygiene • Safety • Immunization • Rest and exercise • Maintaining independence • Life resolution and preparation for death

22. Secondary Prevention - 1 • Skin breakdown • Constipation • Urinary incontinence • Sensory loss • Mobility limitation • Pain • Confusion • Depression

23. Secondary Prevention - 2 • Social isolation • Abuse and neglect • Alcohol abuse • Inadequate financial resources • Chronic illness • Communicable diseases • Advocacy

24. Tertiary Prevention • Preventing complications of existing problems • Preventing recurrence of problems • Providing end-of-life care to clients and families

25. Health Education for Older Clients • Circumvent sensory losses • Repeat material frequently • Proceed at a slower pace • Set realistic, attainable goals • Limit the length of teaching sessions • Break learning into discrete tasks

26. Evaluation Considerations • Some problems may be the result of aging and not amenable to complete resolution. • The prognosis for one problem may be influenced by the occurrence or status of other problems. • Some problems may diminish while others increase. • Deterioration may result in additional problems.