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Gerontology. NUR101 FALL 2010 LECTURE # 20 K. BURGER, MSEd, MSN, RN, CNE PPP By Sharon Niggemeier RN MSN Rev kburger1207. Gerontology. Gerontology: Study of all aspects of aging and its consequences Ageism: when older adults are stereotyped
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Gerontology NUR101 FALL 2010 LECTURE # 20 K. BURGER, MSEd, MSN, RN, CNE PPP By Sharon Niggemeier RN MSNRev kburger1207
Gerontology • Gerontology: Study of all aspects of aging and its consequences • Ageism: when older adults are stereotyped • Gerontologic nursing: specialized nursing with knowledge of illness and health of the aging
AGEISM • What are some stereotypic characteristics of the elderly that you have heard? Or believe? Dependent ?Frail ?Poor ?Lonely ?Unreliable d/t memory loss ?Rigid; narrow-minded ?Unable to learn ?
Older Adult • Young Old 60-74 • Middle Old 75-84 • Old Old 85 & older • Presently: 12.8% of population • 2030: will increase to 20% of population
Biological Theories of Aging • Programmed Aging theory- genetics and heredity responsible for how an individual ages • Cross-Linkage Theory- deterioration of organs/cells causing decreased mobility • Somatic Mutation Theory- DNA changes result in physical decline • Stress Theory-causes structural & chemical changes thru the lifespan
Theories of Aging • Most experts believe that a combination of genetic and stochastic (random) events are responsible for aging. • Any single limited theory is insufficient.
Psychosocial Theories of Aging • Disengagement Theory- withdrawn, introspective, self-focused – Older theory; not widely accepted. • Continuity theory-characteristics, values remain constant thru life… repeat behaviors that brought success in the past • Activity Theory- satisfaction depends on involvement in new interests /activities or maintenance of high levels of functioning.
Psychosocial Theories of Aging • Erikson - ego integrity vs despairLife review or reminiscenceAcceptance and happiness with past life • Havighurst - maintenance of social contacts & relationships… be flexible & adaptSuccessful aging = ability to adapt to the changes associated with aging.
Cognitive Changes • Ability to perceive and understand one’s world • Mild short term memory loss • Long term memory remains intact • Slower responses and reactions • Dementia= Abnormal agingSevere cognitive loss & memory loss
Cognitive Changes – Abnormal Aging • Confusion and depression • Alzheimer’s disease • Sundowning syndrome
Theories about Sundowning Possible Causes for increasing confusion: • Person can’t see well in dimming light • Hormone imbalances r/t biological clock • Person tired @ end of day; decreased coping • Restlessness because daytime activities are decreasing • Caregivers communicate their own fatigue & stress to clients
General Physiological Changes • All systems decline in overall functioning • Decreased physiological reserves • Modified pace & more frequent rest periods
Integumentary Changes • Decreased skin elasticity-wrinkling • Increased dryness • Thickened nails • Thinning of hair (baldness)
Musculoskeletal Changes • Stiff joints & less flexibility • Mobility slows & posture stoops • Muscle mass & strength decrease • Bone demineralization
Neurological Changes • CNS responds slower • Rate of reflex response decreases • Sense of balance declines • Night sleep shortens • Temp. regulation & pain perception less efficient
Special Senses Changes • Diminished vision • Diminished hearing • Decreased taste & smell
Cardiopulmonary Changes • Blood vessels less elastic • Fatty plaque deposits occur • Cardiac reserve decreases • Less efficient lung clearing • Increased resp. rate, diminished depth
Gastrointestinal Changes • Digestive juices & nutrient absorption decrease • Malnutrition & anemia common • Decreased peristalsis resulting in constipation & indigestion
Dentition Changes • Tooth decay continues • Missing teeth or ill fitting dentures effect eating habits
Genitourinary • Renal blood flow decreases • Waste products excreted more slowly • Fluid/Electrolyte balance is fragile • Bladder capacity decreases 50% • Hypertrophy of prostate gland • Atrophy, decreased secretions & thinning of female genital tract
Adjusting to Changes of Aging • Rest more • Curtail driving • Cane/walker for mobility • Diet changes • Ageism
Adjusting – Older Adult is making many psychosocial adjustments • Retirement • Reduced income • Spouse’s health • Social roles • Living arrangements • Role reversal
Common health problems • Heart disease, cancer, stroke • Poly-Pharmacy • Accidents, falls • Arthritis • Chronic illness • Elder Abuse
Elder Abuse • Any deliberate action or negligence that harms elderly individuals:-physical-sexual-psychological-emotional-financial
Role of the Nurse in Promoting Health: Teaching • Nutrition • Exercise • Immunizations • Annual Physicals • Medications
Nursing Dx • Risk for loneliness • Altered dentition • Risk for falls • Knowledge deficit • Confusion • Sexual dysfunction • Wandering
Summary • Nurses have to provide care to an increasing geriatric population. • Geriatric patients have specific needs due to physiological and cognitive changes. • Nursing care needs to be tailored to the those needs.