GERONTOLOGIC NURSING┃PRELIMS ┃TRANS 1
INTRODUCTION TO AGING
MRS. RUBY CORAZON Y. EDIZA┃SEP 5 2021
TRANSCRIBED BY TOM CUENCA
● According to Eliopoulos (2017), families forget their older relatives.
Most people become senile in old age. Social security provides
every older person with a decent retirement income. Majority of
older people reside in nursing homes. Medicare covers all health-
care related costs for older people. These and other myths continue
to be perpetuated about older people. Misinformation about the
older population is an injustice not only to this age group but also to
persons of all ages who need accurate information to prepare
realistically for their own senior years. Gerontologic nurses must
know the facts about the older population to effectively deliver
services and educate the general public.
PERSPECTIVE ON AGING, ITS IMPLICATIONS AND IMPACT TO
HEALTH, NURSING CARE AND FAMILY
● “The end of life deserves as much beauty, care, and respect as the
beginning.”
● The beauty of care means applying then principles of nursing not
only as a science, but also as an art. Sister Simone Roach
recommended that nursing as an art must compose of the 6 C’s:
compassion, competence, confidence, commitment,
conscience, and comportment.
● End-of life is when an older adult faces a situation that require an
immense amount of tender and focused care to treat their chronic
illness which is incurable and or an advanced stage.
● The nursing care provided to the patients from admission until the
critical moment should ensure that such patients are given proper
care with due cooperation of the families and provide comfort and
security.
● End of life care can either be palliative or hospice care.
● Allow the patients to feel that they will die with dignity and honor.
INTRODUCTION
● A man’s life is normally divided into five main stages and these are:
1. Infancy
2. Childhood
3. Adolescence
4. Adulthood
5. Old age
● The old age is not without problems.
● With increasing age, we become old. Birth, development, decline
and death are the laws of life.
● Aging is not merely the passage of time.
● It is important to recognize that people age differently.
● As a general rule, slight or gradual changes are common and most
of these are not problems to the person who experiences them.
Sudden or drastic changes may indicate serious health problems.
DEFINITION OF TERMS
GERONTOLOGY VS. GERIATRICS:
● Scientific and medical disciplines, respectively, concerned with all
aspects of health and disease in the elderly and with the normal
aging process
● Gerontology: Concerned primarily with the changes that occur
between maturity and death and with the factors that influence these
changes. It addressed the social and economic effects of an aging
population and the physiological and psychological aspects of aging
to learn about the aging process and possibly minimize disabilities.
● Geriatrics: Deals with the prevention and treatment of diseases
once assumed to be inevitable in the elderly.
● Hence, both deal with aging but geriatrics focuses on the care of
aging people while gerontology is the actual study of the aging
process.
● A geriatrician or geriatric physician and gerontology nurse
works to promote health in the older adults while preventing and
treating diseases prone to them.
● Therefore, gerontology is the study of aging and or the age, this
includes the biopsychosocial of aging, while geriatrics related to the
medical care of the aged.
GERONTOLOGY
SUBFIELDS OF GERONTOLOGY
1. Geriatrics
2. Social gerontology
3. Geropsychology
4. Geropharmacology
5. Gerontological nursing
6. Gerontological rehabilitation nursing
GERONTOLOGICAL NURSING
● It is a disciple of nursing and scope of nursing practice which
involves nurses advocating for the health of the older adults at all
levels of prevention.
● A nurse who has specialization in geriatrics or in the care of old
people is called a geriatric nurse or gerontological nurse.
● A gerontological nurse work with healthy elderly persons in their
communities, acutely ill elders requiring hospitalization and
treatment, and chronically ill or disabled elders in long term facilities,
skilled care, home care, and hospice. The scope is from the time of
old age until death.
● Geriatric care is related to the disease process of old age and it
aims at keeping old persons at a state of self-dependence as far as
possible and to provide facilities to improve their quality of life.
PERSPECTIVE ON AGING
● Aging is the time-related deterioration of the physiological functions
necessary for survival and fertility.
● It is a normal process of time related change which begins with birth
and is continuous through-out life.
● Progeria (Hutchinson-Gilford syndrome) is a very rare genetic
disease that causes children to age rapidly. Children with progeria
appear to be healthy at birth but usually start to show signs of rapid
aging in the first two years of their life.
● Aging is the process of growing old or developing appearance and
characteristics of old age. It expresses the continuous pressure and
effect of time on our body, senses, and skin.
CLASSIFICATIONS OF AGING
1. Objectively, ageing is a universal process that begins at birth and
is specified by the chronological age criterion.
2. Subjectively, aging is marked by changes in behavior and self-
perception and reaction to biological changes.
3. Functionally, aging refers to the capabilities of the individual to
function in society.
(1) CHRONOLOGIC AGING
● Chronological age refers to the actual amount of time a person has
been alive. In other words, this refers to the number of days, months,
or years a person has been alive.
CATEGORIES AGE IN YEARS
Young Old 65-74
Middle Old 75-84
Old Old 85-100
Elite Old Over 100
(2) BIOLOGIC AGING
● Senescence or biological ageing is the gradual deterioration of
function and characteristics. This aging is also known as
physiologic aging.
● Furthermore, biological aging refers to the physical changes that
“slow us down” as humans get into middle and older years.
1
● For example, arteries might clog up or problems with lungs might
make it more difficult for us to breathe.
(3) PSYCHOLOGIC AGING
● Psychological aging refers to the psychological changes, including
those involving mental functioning and personality that occur as
humans age.
● Some people who are 65 can look and act much younger than some
who are 50.
● Psychological ageing may be seen as continuous struggle for
identity like the sense of coherence and meaning in thoughts,
feelings and actions.
● Success depends on a lucky synchronization of changes through
life in different parts of the personal self.
(4) SOCIAL AGING
● Social aging refers to changes in a person’s roles and
relationships, both within their networks of relatives and friends and
in formal organizations such as the workplace and houses of
worship.
● Social aging differ from one individual to another.
● It is also profoundly influenced by perception of aging that is part of
a social culture.
(5) COGNITIVE AGING
● Cognitive aging is the decline in cognitive processing that occurs
as people get older.
● Age-related impairments in reasoning, memory and processing
speed can arise during adulthood and progress into the elder years.
● The concept of cognitive aging, a term that describes a process of
gradual longitudinal changes in cognitive functions that accompany
the aging process.
SENIOR CITIZEN OR ELDERLY
● Refers to any Filipino citizen who is a resident of the Philippines and
who is sixty (60) years old and above. It may apply to senior citizens
with “dual citizenship” status provided they prove their Filipino
citizenship and have at least six (6) months residency in the
Philippines.
OLDER ADULT
● Most developed world countries have accepted the chronological
age of 65 years as a definition of “elderly” or older person.
● While this definition is somewhat arbitrary, it is many times
associated with the age at which one can begin to receive pension
benefits.
● At the moment, there is no United Nations standard numerical
criterion, but the UN agreed cutoff is 60+ years to refer the older
population.
ATTITUDES TOWARD AGING
● Attitudes toward aging may be affected by observations of family
members, friends, neighbors, and your own experience with older
adults.
● It may be also affected by media like newspaper, film industry,
commercials in magazines and on television.
● Ageism: Negative attitude toward aging or older adults.
● Examine to:
a. Take a look at the myths and realities
b. Separate fact from fiction
c. Gain a value for the wisdom of lifetime that older adults have to
offer
● As nurses, we are encouraged to examine our own thoughts,
values, feelings and attitudes about aging and the elderly. We also
have to build on our positive attitude and consider devoting your
time and efforts to the field of gerontological nursing.
● If we have negative thought on aging, we need to reexamine our
feelings thru arming ourselves with the facts and some positive
experiences with older adults as it may just change our mind.
GERIATRIC OR GERONTOLOGIC NURSING
● It is a field of nursing that specializes in the care of the elderly.
● Florence Nightingale and Doreen Norton provided early insights
into the care of the aged.
● The American Nurses Association (ANA) established the division of
geriatric nursing practice in 1966 with a goal to create standards for
quality nursing care for the aged.
● The standards and scope of gerontological nursing practice were
developed in 1969 by ANA.
● The term gerontological nursing replaced the term geriatric nursing
in the 1970s.
● Geriatric nursing is bound to be part of our professional future.
● Older adults are the core business of health care representing the
majority visits, hospital admissions, and long-term care residents.
THE AGING (GRAYING) POPULATION
WORLD POPULATION AGING
● The global population aged 60 years or over numbered 962 million
in 2017, more than twice as large as in 1980 when there were 382
million older persons worldwide. The number of older persons is
expected to double again by 2050, when it is projected to reach
nearly 2.1 billion.
● In 2030, older persons are expected to outnumber children under
age 10 (1.41 billion vs. 1.35 billion); In 2050, projections indicate
that there will be more older persons aged 60 or over than
adolescents and youth at ages 10-24 (2.1 billion vs. 2.0 billion).
● The number of persons aged 80 years or over is projected to
increase more than threefold between 2017 and 2050, rising from
137 million-425 million.
● Two-thirds (2/3) of the world’s older persons live in the developing
regions, where their numbers are growing faster than in the
developed regions. In 2050, it is expected that nearly 8 in 10 of the
world’s older persons will be living in the regions.
● Each of the 201 countries or areas with at least 90,000 inhabitants
in 2017 is projected to see an increase in the proportion of persons
aged 60 or over between 2017 and 2050.
AGING IN THE PHILIPPINES
● The country consists of approximately 103 million inhabitants, with
less than 5% of the population 65 years and older. (Central
Intelligence Agency, 2016)
● The age structure of the Philippines resembles many other
developing countries. There is a great number of young Filipinos, in
comparison to older Filipinos.
● Despite the larger number of young Filipinos, the 60 years and older
population is expected to increase by 4.2%, whereas the 80 years
and older is expected to increase by 0.4% from 2010-2030. (Help
Age Global Network, 2017)
● In contrast, the 60 years and older population of the United States
will increase 5.4% from 2010 to 2030. (Help Age, 2015)
● The Philippines’ population increased by over 35% over the last two
decades with the older adult population (60 years and older)
expected to overtake those aged 0-14 years old by 2065. (Help Age
Global Network, 2017)
● Currently, life expectancy of Filipinos is 57.4 years for males and
63.2 years for females. Females are projected to expect an increase
of 4.0 years in life and males have an increase of 4.7 years in life by
2030.
CATEGORIES OF WORLD OR POPULATION AGING
1. Young: <7% of population is aged 65 or older.
2. Aging: 7-13% of population is aged 65 or older
3. Aged: 14-20% of population is aged 65 or older
4. Super Aged: >21% of population is aged 65 or older
Examples by stage of aging:
Young: Philippines
Aging: China (11.72% are 65+ as of 2019)
Aged: Republic of Korea (15% are 65+ as of 2019)
Super Aged: Japan (27.9% are 65+ as of 2019)
● Population ageing – the inevitable increase in the share of older
persons.
● By mid-21st century, old people will outnumber young for the first
time in history.
2
REASONS FOR THE INCREASE OF OLDER ADULTS
1. Increasing Life Expectancy
● Due to advancement in medical care, disease control and health
technology and implementation of preventative health services.
● Due to lower infant and child mortality rates
● Due to improved sanitation
● Due to better living conditions
1. DECLINE FERTILITY
● Baby boom after WW2 (1946-1964)
● From 2.4-3.5 children per household
● Older population will explode between 2010-2030 when baby
boomers reach age 65 starting 2011
● The anticipated increase has been called both a demographic tidal
wave (silver or gray tsunami or wave) and a pig in a python
IMPLICATIONS OF THE AGING POPULATION
IMPACT OF THE BABY BOOMERS (1946-1964)
● Impact is referred as a demographic tidal wave
● Gerontological nurses must consider the realities of the baby
boomers
● They are informed consumers of health care and desire a highly
active role in their care
● Their blended families may need special assistance due to potential
caregiving demands
● Communication tips when interacting with baby boomers:
1. It is important that you have to ask their preferred style of
communication (email, telephone, or traditional) when doing
procedures such as assessment.
● Provision of and Payment for Services:
- The government has become the source of payment for many of
the services older adults need.
- Baby boomers have higher rates of hospitalization, surgery, and
physician visits
- Less than 5% of older adults is in a nursing home, assisted living
community or other institutions
- Society will face an increasing demand for the provision and
payment for services for these growing population
- Therefore, gerontological nurses must be actively involved in
discussions and decisions pertaining to the rationing of services so
that the rights of older adults are expressed and protected. Likewise,
gerontological nurses must assume leadership in developing cost-
effective methods of care delivery that do not compromise the
quality of services to older adults.
- Gerontological nurses need to be advocates in ensuring that cost-
containment efforts do not jeopardize the welfare of older adults.
INCREASING EFFECTS ON HEALTH CARE
● There will be an increase of incidences of cancer, dementia and
heart disease
● Increased number of falls
● Increased incidences of diabetes and obesity
● Increase prevalence of disability
● Resource needs will continue to increase across all healthcare
settings
● The incidence of obesity will continue to increase
● A shortage of health care professionals is expected
● The diversity of caregiver lags behind the growing diversity of
patients
● Care will be focus on a single disease versus addressing
comorbidity
● The sustainability and structure of federal programs in relation to the
increasing aging population are a concern
● Adapting and adjusting to the universal health care (UHC)
IMPACT OF AGING MEMBERS IN THE FAMILY
1. Emotional Effect
● Common emotions: “Guilt for not being able to do more for parents;
anger for having to set your own needs or shift your priorities; and
fear and anxiety, including anticipatory grief and fear of financial
strain.”
● Caring for children and aging parents at the same time can make
you feel as if you do not have the emotional strength and resources
for everyone.
● “Enrichment that comes with relationships between grandparents
and grandchildren; increase opportunity to pass on stories and
knowledge to younger generations; and the younger generations
having a sense of being able to give back to parents and
grandparents, resulting in a greater connection between family
members.”
2. Financial Effect
● Caring for aging parents often means extra costs related to home
health care, medical expenses not covered by insurance and extra
insurance premiums for services such as long-term care.
● You also may need to take off extra time from work.
● Some families explore options for financial support that can make
family life more enjoyable, emphasizing that “there is no shame in
utilizing what support is out there.”
3. Structural Effect
● When you live with your aging parents or assume a high amount of
daily care for them, you experience a change in your family roles.
● Thomas and Segur describes this as a “shift in family structure and
hierarchy related to matriarch or patriarch no longer being in their
role.” When this occurs, “someone new has to take their place.”
● This shift can cause guilt and stress, as family members work to find
a place in the new family dynamic, but it can also result in more open
communication among family members.
● The family structure shifts to being less hierarchical and more
cooperative.
4. Structural Effect
● Prioritizing parent’s care can ease their pain and worry, but might
impact your health.
● The time and effort of keeping up with parents’ care means you may
visit your doctors less, resulting in undiagnosed problems or
conditions getting worse.
● Caregiving for a parent with dementia can cause chronic stress and
illness.
● Time pressure might result in caregivers and their children skipping
exercise and eating more convenience foods which contribute to
poor fitness and weight gain.
5. Positive Effect
● “Our thoughts frame our emotional state.”
● This in turn affects your family life, creating an environment of
bitterness and resulting in more criticism and complaining.
● However, some families have the opposite experience by creating
a positive “wiring” in their brains to produce more potentially positive
outcomes.
● These people reflect on what makes them feel good for caring for
their aging parents.
● They consider what moments in their days make them smile.