Basic Geriatric Nursing
to the body’s parts, overall functioning
There is no single universally accepted definition
of aging. Aging is best looked at as a series of changes
that occur over time, contribute to loss of function, and
ultimately result in the death of a living organism.
No one has identified a single unified rationale
for why we age and why different people live lives of
different lengths.
Although there is no question that aging is a
biologic process, sociologic and psychological
components play a significant role. All of these areas—
genetic, biologic, environmental, and psychosocial—
have produced theories that attempt to explain the
changes seen with aging.
Biologic theories of aging attempt to explain the
physical changes of aging. It is known that all members
of a species suffer a gradual, progressive loss of function
over time because of their biologic structure. Many of
the biologic theories of aging overlap because most
assume that the changes that cause aging occur at a
cellular level.
Some biologic theories look at aging from a
genetic perspective.
• Programmed theory - proposes that everyone
has a “biologic clock” that starts ticking at
conception. In this theory, each individual has a
genetic “program” specifying an unknown but
predetermined number of cell divisions. As the
program plays out, the person experiences
predictable changes such as atrophy of the
thymus, menopause, skin changes, and graying
of the hair.
• Runout-of-program theory - proposes that every
wear-and-tear theory presumes that the body is
similar to a machine, which loses function when
its parts wear out. As people age, their cells,
tissues, and organs are damaged by internal or
external stressors. When enough damage occurs
decreases person has a limited amount of
genetic material that will run out eventually
• Rate of living theory - proposes that individuals
have a finite number of breaths or heartbeats
that are used up over time.
• Gene theory - proposes the existence of one or
more harmful genes that activate over time,
resulting in the typical changes seen with aging
and limiting the life span of the individual.
The molecular theories propose that aging is
controlled by genetic materials that are encoded to
predetermine growth and decline.
• Error theory - proposes that errors in ribonucleic
acid protein synthesis cause errors to occur in
cells in the body, resulting in a progressive
decline in biologic function.
• Somatic mutation theory - similar but proposes
that aging results from deoxyribonucleic acid
(DNA) damage caused by exposure to chemicals
or radiation and that this damage causes
chromosomal abnormalities that lead to disease
or loss of function later in life.
Cellular theories propose that aging is a process that
occurs because of cell damage.
• Free radical theory - provides one explanation
for cell damage. Free radicals are unstable
molecules produced by the body during the
normal processes of respiration and metabolism
or following exposure to radiation and pollution.
These free radicals are suspected to cause
damage to the cells, DNA, and the immune
system.
• Crosslink or connective tissue theory - which
proposes that cell molecules from DNA and
connective tissue interact with free radicals to
cause bonds that decrease the ability of tissue to
replace itself. This results in the skin changes
typically attributed to aging such as dryness,
wrinkles, and loss of elasticity.
• Wear-and-tear theory - presumes that the body
is similar to a machine, which loses function
 when its parts wear out. As people age, their
cells, tissues, and organs are damaged by
internal or external stressors. When enough
damage occurs to the body’s parts, overall
functioning decreases
• Reliability theory of aging and longevity - a
complex mathematical model of system failures
first used to describe failure of complex
electronic equipment. It is used as a model to
describe degradation (disease) and failure
(death) of human body systems.
• Neuroendocrine theory focuses on the
complicated chemical interactions set off by the
hypothalamus of the brain. Stimulation or
inhibition of various endocrine glands by the
hypothalamus initiates the release of various
hormones from the pituitary and other glands,
which, in turn, regulate bodily functions,
including growth, reproduction, and
metabolism. With age, the hypothalamus
appears to be less precise in regulating
endocrine function, leading to age-related
changes such as decreased muscle mass,
increased body fat, and changes in reproductive
function.
• Immunologic theory proposes that aging is a
function of changes in the immune system.
According to this theory, the immune system—
an important defense mechanism of the body—
weakens over time, making an aging person
more susceptible to disease.
Psychosocial theories of aging do not explain the
physical changes of aging; rather they attempt to explain
why older adults have different responses to the aging
process.
• Disengagement theory - developed to explain why
aging persons separate from the mainstream of
society. This theory proposes that older people are
systematically separated, excluded, or disengaged
from society because they are not perceived to be of
benefit to the society.
• Activity theory - proposes that activity is necessary
for successful aging. Active participation in physical
and mental activities helps maintain functioning well
into old age
These theories trace personality and personal
adjustment throughout a person’s life. Many of these
theories are specific in identifying life-oriented tasks for
the aging person.
• Erikson’s theory - identifies eight stages of
developmental tasks that an individual must
confront throughout the life span: (1) trust
versus mistrust; (2) autonomy versus shame and
doubt; (3) initiative versus guilt; (4) industry
versus inferiority; (5) identity versus identity
confusion; (6) intimacy versus isolation; (7)
generativity versus stagnation; and (8) integrity
versus despair.
• Havighurst’s theory - details the process of aging
and defines specific tasks for late life, including:
(1) adjusting to decreased physical strength and
health; (2) adjusting to retirement and
decreased income; (3) adjusting to the loss of a
spouse; (4) establishing a relationship with one’s
age group; (5) adapting to social roles in a
flexible way; and (6) establishing satisfactory
living arrangements.
• Newman’s theory identifies the tasks of aging as:
(1) coping with the physical changes of aging; (2)
redirecting energy to new activities and roles,
including retirement, grandparenting, and
widowhood; (3) accepting one’s own life; and (4)
developing a point of view about death.
• Jung’s theory proposes that development
continues throughout life by a process of
searching, questioning, and setting goals that are
consistent with the individual’s personality.
Thus, life becomes an ongoing search for the
“true self.”
Nursing can help individuals achieve the longest,
healthiest lives possible by promoting good health
maintenance practices and a healthy environment.
Understanding all of these theories can help
nurses recognize problems and provide nursing
interventions that will help aging individuals successfully
meet the developmental tasks of aging.
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 2. Hippocampus
3. Hypothalamus
1) A friend asks the nurse what could be done to 4. Anterior pituitary gland
improve the chance of a long life. Using current 7) The nurse in the long-term care facility frequently
biologic theories of aging, the nurse recommended observes older adults being separated from their
that her friend discuss this first with her physician, Seleniumfriends and family and excluded from
but advises that the approach more likely to cause society. This phenomenon is described in which
harm than good is which one? psychosocial theory of aging?
1. Intake of antioxidants, such as vitamins A, B6, 1. Activity theory
B12, C, and E 2. Life-course theory
2. Replacing of hormones, such as HGH, DHEA, 3. Developmental theory
and estrogen 4. Disengagement theory
3. Calorie-restricted diet 8) The nurse in the long-term care facility who cares for
4. Intake of herbal and nutritional supplements primarily older adults knows these adults are in
2) The same friend asks how long humans can live. which stage of Erikson's developmental tasks?
What is the nurse’s best reply? 1. Trust versus mistrust
1. 100 years 2. Integrity versus despair
2. 105 years 3. Industry versus inferiority
3. 110 years 4. Generativity versus stagnation
4. 120 years 9) The student nurse studying aging knows which
3) According to Erikson, what is the primary theory was originally used to describe failures in
developmental task of the older adult population? electronic equipment?
1. Generativity versus stagnation 1. Error theory
2. Trust versus mistrust 2. Wear-and-tear theory
3. Intimacy versus isolation 3. Run-out-of-program theory
4. Integrity versus despair 4. Reliability theory of aging and longevity
4) A friend tells you she thinks her father is 10) The nurse working with aging individuals knows the
experiencing a “midlife crisis,” because he purchased use of antioxidants to slow the aging process
a new red sports car, started wearing trendy corresponds to which theory?
clothing, and is considering a career change. Whose 1. Crosslink theory
theory explains this behavior? 2. Free radical theory
1. Newman’s 3. Somatic mutation theory
2. Jung’s 4. Connective tissue theory
3. Havighurst’s 11) The patient in the clinic tells the nurse she has heard
4. Erikson’s about the dangers of free radicals and requests more
5) The patient in the clinic tells the nurse she can "feel information. The nurse bases his response on an
her biologic clock ticking." The nurse knows the understanding that free radicals have been
patient views aging based on which theory? associated with which age-related change(s)? (Select
1. Gene theory all that apply.)
2. Programmed theory 1. Hypothyroidism
3. Rate of living theory 2. Atherosclerosis
4. Somatic mutation theory 3. Rheumatoid arthritis
6) The aging patient requests information on the causes 4. Type 2 diabetes mellitus
for the age-related changes he sees in his body. In 5. Peripheral vascular disease
order to educate the patient using the 6. Chronic obstructive pulmonary disease (COPD)
neuroendocrine theory of aging, the nurse should 12) The patient requests information on ways to prevent
discuss which structure in the brain? the damage associated with free radicals.
1. Cerebellum
3|Dablio, Nikka
 Information on which antioxidants would be most 3. Decreased interest and involvement in social
appropriate for the nurse to include? (Select all that interactions
apply.) 4. Adjustment to retirement and loss of income
1. Zinc 17) The nurse is designing a group activity for a group of
2. Copper older women who have mild loss of
3. Selenium self-esteem and a reluctance to socialize. None have
4. Vitamin A serious cognitive or physical impairments.
5. Vitamin C Based on the activity theory, which activity will the
6. Vitamin B12 nurse suggest?
13) The nurse working in the long-term care facility plans 1. A weekly knitting group to make hats for
care based on Havighurst's theory of aging. Which premature infants
task(s) should the nurse facilitate his patients to 2. A daily game of unfolding and refolding a stack
achieve? (Select all that apply.) of towels
1. Adjusting to the loss of a spouse 3. A weekly activity to sort buttons into different
2. Preserving and increasing strength color groups
3. Adjusting to a decrease in income 4. A daily group discussion about local politics
4. Stabilizing one's self in one's social roles 18) According to Jung's theory, which statement by an
5. Looking back on one's life with pride and older adult indicates successful aging?
contentment 1. "I have a strong belief that there is life after
14) The nurse is doing patient teaching for a 50-year-old death. So, I am not afraid of dying"
woman. Based on the application of the 2. "I never experienced travel around the world,
programmed theory of aging, which brochure is the but I traveled in my imagination"
nurse most likely to offer the patient? 3. "I lost my wife several years ago; I still miss her,
1. "Perimenopause and Menopause: Most but I focus on the good memories"
Frequently Asked Questions" 4. "Well, when I look back at my life, I am happy
2. "Do the Benefits Outweigh the Risks of to say that I did it my way"
Antioxidant Supplements?"
3. "Exercise, Food, Sleep, and Fun: Healthy Lifestyle
Tips for Older Adults"
4. "Healthy Nutrition Is More Than Just Counting
Calories and Losing Weight"
15) Two nursing students are exhausted after studying
about the biologic theories of aging. They
decide to have some fun and perform an action that
is based on the rate of living theory. Which
action do they perform?
1. Go for a leisurely walk in the sunshine
2. Hold their breath for as long as they can
3. Share an apple and an orange
4. Give each other a facial and then use anti-aging
cream
16) According to the disengagement theory, what is the
nurse most likely to observe while
assessing an older adult?
1. Dryness of the skin with wrinkles and loss of
elasticity
2. Decreased muscle mass and increased body fat

4|Dablio, Nikka