NCM 114 Gerontology - WeeK 1

CCOLEGIO SAN AGUSTIN-BACOLOD COLLEGE OF
HEALTH AND ALLIED PROFESSIONS

B.S. Aquino Drive, Bacolod City
August 16-20,2021
Gerontology - Is the study of the physical aspects

of aging, as well as the mental, social
and societal implications of aging.
Gero is Greek for “elders”, and logy
means “the study of”.
- from the Greek geron “old man”
and logia “study of”
- This field is distinguished from

GERIATRICS – which is the branch of
medicine that specializes in the
treatment of existing disease in older
adults.
• Three categories of aging created by Gerontologist James

Birren:
1. Primary aging – The human body’s natural deterioration
throughouta lifespan.
2. Secondary aging – Illnesses that quicken the aging
and deterioration process.
3. Tertiary aging – A sudden increase in mental and
physical deterioration at the end of an individual’s life.
What does a Gerontologist do?

1. Conduct research on gerontology.
2. Work with older adults.
3. Care for older individuals.
4. Collaborate with health care professionals.
5. Meet with caregivers.
6. Improve social policy.
7. Stay updated on gerontology advancement.
8. Understand legal resources for older people.
GERONTOLOGICAL NURSING
- Is the specialty of nursing involves assessing the health and
functionalstatus of older adults, planning and
implementinghealth care and services to meet identified
needs and evaluating the effectiveness of such care.
- Replaced the term Geriatric nursing in the 1970’s .
- Is important to meet the health needs of an aging population
- It requires complex care to fulfill their needs.
Geriatrics
• from the Greek geras, meaning “old age”
• Is the branch of medicine that deals with the diseases and problems of old age
Geriatrician – a medical profession who specializes in geriatrics
Gerontology – from the Greek geron, meaning “old man”
- is the scientific study of the process of aging and the
problems of older adult.
Gerontic Nursing – this term was developed by Gunter and Estes in 1979
- is meant to be more inclusive than geriatric or gerontological
nursing because it is not limited to diseases or scientific
principles
ROLES Generalist Nurse

- Is a registered nurse or Licensed
Practical Nurse.
- Identify older adults’ strengths and
assist them to maximize their
independence.
- Consults with the advanced practice
nurse and other inter disciplinary
health care professionals for assistance
in meeting the complex care needs of
older adults.
ROLES Clinical Nurse Specialist
- Is a registered nurse and at least a

master’s degree
- Functions as clinician, educator,
c o n s u l ta n t , a d m i n i st ra t o r, o r
researcher to plan care or improve
the quality of nursing carefor adults
and their families.
- To d ay, t h e y m ay b e fo u n d
practicing in acute care hospitals,
long term care or home care
settings , or independent practices.
ROLES Nurse Practitioner

- Conducts health assessments;
identifies nursing diagnoses; and
plans, implements and evaluates
nursing care for adult and older
patients.
- Has knowledge and skills to
detect and manage limited acute
and chronic stable conditions;
coordination and collaboration with
other health care providers is a
related essential function.
- Acute care or primary care
activities include intervention for
health promotion, maintenance
and restoration.
• Provides acute or primary ambulatory care in an

independent practice or in a collaborative practice
with a physician.
• They practice in settings across the continuum of
care, including the acute care hospital , subacute
care center, ambulatory care setting and long term
care setting.
Responsibilities of a
Gerontological Nurse
1. Assisting physicians during exams and procedures.
2. Performing patient medical tests-in-home or in a medical office.
3. Establishing a patient care plan and setting health goals.
4. Administering medications to patients based on a care plan.
5. Teaching family members about a patient’s condition and how
to promote self-care skills.
Settings of Care
Acute care Setting
a. Short -term acute care setting – is usually administered in a
hospital, which has all the medical care personnel, staff and
facilities needed to diagnose, treat and care for patients with acute
conditions like short term injuries.
Facilities available includes:
- Operating room - Pharmacy
- Emergency room - Clinical laboratory
- Blood bank
- Radiology department
- Pathology department
Settings of Care
b. Long-term acute care – is administered to patients after their acute
care treatment.
- necessary for patients who have medically
complex needs and need specialized care.
Facility includes:
- Hospitals
- Hospices
- Inpatient rehabilitation centers
- Skilled nursing facilities
- In the home and other settings
Issues in Gerontological Nursing

1. A fragmented, uncoordinated health care delivery system, especially
for older adults with chronic illnesses.
2. An insufficient number of nursing faculty with geriatric training and
the need for more geriatric content in undergraduate curricula.
3. The need for geriatric knowledge among non-gerontological nurses.
4. The need for more advanced practice preparation in gerontological
nursing.
PERSPECTIVE ON AGING
Aging in Developmental Process

AGING- is a normal stage of life in which our bodies begin to function
less effectively, making us more vulnerable to disease
Meilaender (2011)
- refer this process as senescence ( Evolutionary biologist )
Senescence-
- causes diseases of aging. Even if the person ages well,
because of senescence that person will still ultimately
die of some cause ( Gems 2011).
Aging Process
• Is the gradual , decreased ability of the body to function and to heal
itself. This definition is simple. But aging is not simple and to understand
what aging is and what it means to people experiencing requires
consideration of these points.
- Aging is not the same as being old
- Aging is a process of decline
- The process of aging takes time
- Stress and repair
Things to occur if the aging process speed up:
1. The effects of aging begin to be noticeable to the

individual
2. The effects of aging an be measured by a physical
examination or testing
3. The older person becomes more susceptible to disease
4. The older person is less able to recover from illness
5. The older person develops an acute or chronic disease
- Evolutionary perspective – the primary purpose of

human’s life is to procreate and to be a carrier of DNA.
- Biological perspective – all humans grow, experience
puberty, mature, and age as the course of a normal, healthy life.
- Humanistic perspective – aging is inextricably linked to
death.
- Scientific perspective – the exploration of aging as a
disease becomes complex.
The Aging Process

1.Genetic and Environmental Factors
2. Behaviors of a Healthy Lifestyle
- Not smoking
- Drinking alcohol in moderation
- Exercising
- Getting adequate rest
- Eating a diet high in fruits and vegetables
- Coping with stress
- Having a positive outlook
3. Cellular Changes associated with Aging
The Aging Process

4. Age also interferes with an important process
called APOPTOSIS, which program cells to self-
destruct or die at appropriate times.
5. Bodily Changes Associated with Aging

DEMOGRAPHY OF AGING
Demography of Aging
• Global Aging
In 2017 global population aged 60 years and older reached more than
962 M; more than twice the number of 1980, when the worldwide
population of older persons was 382M.
By 2050 the projected number of older person is expected to double
again, reaching 2.1B
By 2030, older people are expected to outnumbered children under
age 10-14 (1B vs.1.35B) and eventually outnumber the number of
adolescents and youth globally
Global Aging
By 2050, number of persons age 80 or over is projected to increase
more the threefold , climbing from 127M to 425M .By 2050, the
world’s population aged 60 and older is expected to total 2B,
up from 900M in 2015
There are two forces behind global aging:

1. People are having fewer babies, and this decreases the relative number of
young
2. The rising life expectancy

Population aging affects economic growth, trade, migration, disease
patterns and prevalence and fundamental assumptions about growing
older
Why is aging population important

• Population aging strains social insurance and pension systems and
challenges existing models of social support.
It affects economic growth, trade, migration, disease patterns and
prevalence , and fundamentals assumptions about growing older.
Countries that have high percentage of their citizens ages 65 years

And over:
1. Germany 3. Bulgaria 5. Latvia
2. Finland 4. Sweden 6. Malta
Major causes of aging

• Oxidative stress
• Glycation
• Telomere shortening
• Mutations
• Aggregations of proteins
How fast is the population aging?

• Globally, the population aged 65 and over is growing faster
than all other age groups.
According to data from World Population Prospects: the
2019 Revision, by 2050, one in six people in the world will
be over age 65 (16%), up from one in 11 in 2019 (9%)
IMPACT OF AGING IN THE
FAMILY
Role and Function of Families

Demographic and social trends that affects families’ abilities to provide
support includes:
1. Increasing aging population

-Since 1900 percentage of Americans 65+ has more than tripled
(from 4.1% in 1990 to 19.9% in 2015)
- the number has increased more than 15x (from 3.1M to 47.8M)
2. Living arrangements
- In 2016, 59% of noninstitutionalized persons age 65 and older
lived with their spouses or partner.
- 29% lived alone
- 3.1% of the 65+ group lived in an institutional setting such as
nursing home or assisted living.
Role and Function

3. Disability and activity
- Activities of daily living (ADLs) include bathing, dressing, eating
and ambulation
- Instrumental activities od daily living (IADLs) include preparing
meals, shopping, managing money, using the telephone, house-
work and taking medication.
4. Decrease in birth rate
5. Increase in employment of women
6. Mobility of families
7. Increase in blended families
8. Older adults providing and receiving support
Role and Function

9. The state of the senior housing industry
10. Caregiver workplace issues
COMMON LATE-LIFE FAMILY ISSUES AND DECISIONS

Common issues and difficult decisions families face are the following:
1. Changes in living arrangements
2. Nursing facility placement
3. Financial and legal concerns
4. End-of-life health care decisions
5. Vehicle driving issues
6. Family caregiving
Changes in Living Arrangements

1. Deal with your relatives perceptions and feelings
2. Approach your family member in a way that prevents him
or her from feeling helpless.
3. Suggest only one change or service at a time
4. Suggest a trial period
5. Focus on your needs
6. Consider who has “listening leverage”
Deciding About a Care Facility

Guilt – is a common feeling that families express
when faced with care facility placement.
Sources of guilt includes:
1. Pressure and comments from others
2. Family tradition and values
3. The meaning of nursing facility placement
4. Promises
Financial and Legal Concerns

Major financial issues some families face include:
1. Paying for long-term care
2. Helping an older person who has problems managing money
3. Knowing about and assessing resources for the older family
member whose income is not sufficient
One of the most important things a nurse can do is to become

knowledgeable about the community resources that can help families
faced with financial and legal concerns, eligibility requirements for
programs, programs access issues and options for older persons who
need assistance in managing their finances
End-of-Life Health Care Decisions

The main interests of patients nearing the end of life are:
1. Pain and symptom control
2. Financial and health decision planning
3. Funeral arrangements
4. Being at peace with God
5. Maintaining dignity and cleanliness
6. Saying goodbye
Family Caregiving
Types and levels of family caregiving
1. Routine Care – regular assistance incorporated into the daily
routine of the caregiver
2. Back-up Care – assistance with routine activities provided only at
the request of the main caregiver
3. Circumscribed Care – participation provided on a regular basis
within boundaries set by the caregiver (ex. Taking
Mom to get her hair and nails done every Saturday)
4. Sporadic Care – irregular participation at the caregiver’s convenience
5. Dissociation – potential caregiver does not participate at all in care

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CCOLEGIO SAN AGUSTIN-BACOLOD COLLEGE OF

HEALTH AND ALLIED PROFESSIONS

Gerontology - Is the study of the physical aspects

- This field is distinguished from

• Three categories of aging created by Gerontologist James

What does a Gerontologist do?

ROLES Generalist Nurse

ROLES Clinical Nurse Specialist

- Is a registered nurse and at least a

ROLES Nurse Practitioner

• Provides acute or primary ambulatory care in an

Issues in Gerontological Nursing

Aging in Developmental Process

Things to occur if the aging process speed up:

1. The effects of aging begin to be noticeable to the

- Evolutionary perspective – the primary purpose of

The Aging Process

The Aging Process

5. Bodily Changes Associated with Aging

There are two forces behind global aging:

2. The rising life expectancy

Why is aging population important

Countries that have high percentage of their citizens ages 65 years

Major causes of aging

How fast is the population aging?

Role and Function of Families

1. Increasing aging population

Role and Function

Role and Function

COMMON LATE-LIFE FAMILY ISSUES AND DECISIONS

Changes in Living Arrangements

Deciding About a Care Facility

Financial and Legal Concerns

One of the most important things a nurse can do is to become

End-of-Life Health Care Decisions

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