THEORIES OF AGING

After 4 hours of lecture, the students

will be able to:

1. Identify the major theories of aging.

LEARNING
OBJECTIVES
2. Compare and contrast Biological,
Sociological and Psychological Theories
of Aging.

3, Describe the process of Aging using

a biological , sociological or
psychological perspective.
GERIATRICS – FROM GREEK WORK “GERAS” – “OLD AGE”
❑ Branch of medicine that deals with the diseases and problems of old age

GERONTOLOGY - FROM GREEK WORK “GERON” – “OLD MAN”

❑ Scientific study of the process of aging and the problems of aged persons

Geriatrics deals with the care of the elderly and their needs, Gerontology is the study of aging and its impacts on
the population.
Gerontology uses a multidisciplinary approach to study the problems that the elderly face and seek out big-picture
solutions.
Geriatricians deal with the issues that their patients may be facing today.
GERONTOLOGIC NURSING - specialty of Nursing that involves assessing the health and functional status of older adults
GERONTIC NURSING - specialty of Nursing that involves beyond or not limited to diseases and scientific principles associated
with caring for aged persons
SENESCENSE – a change in behavior of an organism with age leading to decrease in power of services and adjustment
AGEISM – term coined by Butler in 1969 – describes the deep and profound prejudice in American Society against older
adults; it’s the process of stereotyping of and discrimination against people because they are old.
 AGING – viewed as a continuum of events that
occur from conception to death (Ignatavicius
and Workman, 2005)
 AGING is an irreversible, time-dependent,
functional decline that converts healthy adults
into frail ones, with reduced capacity to adjust to
everyday stresses, and increasing vulnerability
to most diseases, and to death (Miller, 1994).
 AGING – influenced by biologic, psychologic,
social, functional and spiritual factors.
 WHAT IS A THEORY OF AGING?
Theory – function to help make sense of a particular phenomenon; provide
sense of order and give perspective from which to view the facts; provide
springboard for discussion and research.

❑ There are many theories about the

mechanisms of age-related
changes.
❑ No one theory is sufficiently able to Theories of Aging have been around for more than 2000 years.
explain the process of aging, and o Galen (A.D. 129 –c. 199) -Thought that aging was due to changes in body humors (The
four body humors were, essentially, seen as the four basic elements which made up the
they often contradict one another.
human body. These are: blood, yellow bile, black bile and phlegm. Each humor is
❑ Theories of aging can be divided associated with a different element, season, organ, temperament and, importantly,
into two categories: different qualities) that began in early life -These changes caused a slow increase in
dryness and coldness of the body
1) those that answer the question “Why o Roger Bacon (c. 1220-1292) - One of the first to suggest a “wear and tear” theory -
do we age?” and Aging is the result of abuses and insults to the body system - Good hygiene might slow
2) those that address the question “How the aging process
do we age?” o Charles Darwin (1809-1892) - Attributed aging to the loss of irritability in the nervous
and muscular tissue
 BIOLOGIC THEORIES
Biologic Theories Biologic Theories – in summary states that the
 Explains the physiologic processes that decrease function of an organism may lead to
change with aging, in other words, how is complete failure of either an organ or an entire
aging manifested on the molecular level system
in the cells, tissues, and body systems.
According to these theories, all organs in any one
 Further it explains: organism do not age at the same rate, and any single
organ does not necessarily age at the same rate in
 Deleterious effects leading to decrease function of different individuals of the same species.
the organism
 Gradually occurring age-related changes that are
progressive over time
 Intrinsic changes that can affect all members of
species because of chronologic age
 BIOLOGIC THEORIES

o In the past, maximum life span (the maximum biological limit of life in an ideal environment) was not
thought to be subject to change with the process of aging considered non-adaptive, and subject to genetic
traits.
o In the early 1900s, a series of flawed experiments by researcher Alexis Carrel demonstrated that in an
optimal environment, cells of higher organisms (chickens) were able to divide continually, leading people
to believe that person cells potentially possess immortal properties.
o In the 1960’s Leonard Hayflick disproved this theory by identifying a maximal number of divisions a
human cell could undergo in culture (known as the Hayflick limit), which set the maximal life span at
around 115 years.
o Life span is the key to the intrinsic biological causes of aging, as these factors ensure an individual’s
survival to a certain point until biological aging eventually causes death.
 BIOLOGIC THEORIES

➢ Modern biological theories of aging in humans currently fall into two main categories:
programmed (Non- Stochastic) and damage or error (Stochastic) theories.
o The PROGRAMMED (NON-STOCHASTIC) THEORIES imply that aging follows a
biological timetable or series of predetermined events happening to all organisms in a timed
framework (regulated by changes in gene expression that affect the systems responsible for
maintenance, repair and defense responses);
o DAMAGE OR ERROR (STOCHASTIC) THEORIES or statistical perspective – identifying
episodic events that happen throughout one’s life that cause random cell damage and accumulate
over time, thus causing AGING; or Emphasize environmental assaults to living organisms that
induce cumulative damage at various levels as the cause of aging;
 PROGRAMMED (NON- STOCHASTIC) THEORIES

✓ Goldsmith (2004) suggests that aging is more likely to be an evolved beneficial characteristic and results from
a complex structured process and a series of random events.
✓ As people age, more of their cells start to decide to commit suicide or stop dividing. Therefore, it is thought
that cells have finite doubling potential and become unable to replicate after they have done so several times.
✓ Human cells age each time they replicate because of the shortening of the telomere.
✓ The enzyme Telomerase, also called a “cellular fountain of youth,” allows human cells grown in the
laboratory to continue to replicate long past the time they normally stop dividing.
✓ Normal human cells do not have telomerase. It was hypothesized that cancer or virus cells are not restricted,
having a seemingly infinite doubling potential, and are thus immortal cell lines. This is because they have
telomerase, which adds back DNA to the ends of the chromosomes.
 PROGRAMMED (NON- STOCHASTIC) THEORIES

Programmed Theory or Hayflick Limit Theory – also known as “Biologic

Clock Theory”, “Cellular Aging Theory” or “Genetic Theory”
➢ One of the 1st proposed biologic theories; completed by Hayflick and
Moorehead in 1961;
➢ Showed that functional changes do occur within cells and are responsible for
the aging of the cells and the organism (improper functioning of cells and
eventual loss of cells in organs or tissues is responsible for aging
phenomenon);
➢ Contradicted the experiment of Carrel and Ebeling (1912) that concluded
cells do not wear out, but continue to function normally forever (using chick
embryo cells that were kept alive indefinitely in a laboratory); Hayflick and
Moorehead (1961) found that freezing halt the biological cellular clock;
❖ According to Programmed Theory or Hayflick Limit Theory - life
expectancy was generally seen as preprogrammed, within a species-
specific range; that unlimited cell division do not occur; and immortality
of individual cells is abnormal rather than a normal occurrence.
 PROGRAMMED (NON- STOCHASTIC) THEORIES

Immunity Theory or Autoimmune Theory or

Immunological Theory
➢ which states that the immune system is programmed to decline over time,
leading to an increased vulnerability to infectious disease and thus aging and
death
➢ As a person ages, the immune system function less effectively
➢ IMMUNOSENESCENCE – means age-related decrease in
function
Different Changes in Cell-Mediated Immune Function As a Result of Aging
❑ Increased autoantibodies as a result of altered immune system regulation
predisposes a individual to autoimmune diseases such a lupus and
rheumatoid arthritis
❑ Low rate of T lymphocyte proliferation in response to a stimulus causes
older adults to respond more slowly to allergic stimulation
❑ Reduced response to foreign material, resulting in an increased number of
infections; This is a result of a decrease in cytotoxic or killer T cells
❑ Generalized T lymphocyte dysfunctions, which reduce the response to
certain viral antigens, allografts, and tumor cells. This result id an increased
incidence of cancer in older adults.
 PROGRAMMED (NON- STOCHASTIC) THEORIES

Neuroendocrine Control or Pacemaker Theory or Aging by Program or Endocrine

Theory, where biological clocks act through hormones to control the pace of aging.
❑ This theory elaborates on the wear and tear theory by focusing on the neuroendocrine system: a
complicated network of biochemicals that governs the release of the person’s hormones and
other vital bodily elements.
o When the person is young, their hormones work together to regulate many bodily
functions, including their responses to heat and cold, stress and sexual activity. As
well, it controls their metabolic rate, glucose secretion and water levels.
o Different organs release various hormones all under the governance of the
hypothalamus
o When the person is young, hormone levels tend to be high, accounting for (among
other things), menstruation in women and high libido in both sexes.
o As people age the body produces lower levels of hormones which can have
disastrous effects on their functioning.
o For instance, growth hormones and testosterone that help the person form muscle
mass drop dramatically as they age, so that even if an elderly person has not
gained weight, he or she has undoubtedly increased the ratio of fat-to-muscle.
 Neuroendocrine Control or Pacemaker Theory or Aging by Program or Endocrine Theory

o Hormones are vital for repairing and regulating the bodily functions, and
when aging causes a drop in hormone production, it can cause a decline in
the body's ability to repair and regulate itself.
o For example, type 2 diabetics have low insulin levels due to decreased
secretion by the pancreas. They rely on an exogenous supply of insulin to
maintain optimal levels of blood sugar
o Hormone production is highly interactive. The drop in production of any
one hormone is likely to have a feedback effect on the whole mechanism,
signaling other organs to release lower levels of other hormones which
will cause other body parts to release lower levels of yet other hormones.
o After menopause, when estrogen levels decline, biological aging appears
to accelerate in women, and estrogen replacement therapy seems to slow
down this process.
Hormone replacement therapy, a frequent component of many anti-aging treatments,
helps to reset the body's hormonal clock and so can reverse or delay the effects of
aging.
 PROGRAMMED (NON- STOCHASTIC) THEORIES

Gene Theory or Programmed Longevity Theory

▪ which considers aging to be the result of a sequential switching on-and-
off of certain genes, with senescence being defined as the time when
age-associated deficits are manifested.
▪ This theory attributed that aging is an innate genetic program, much like
a built-in biological clock.
▪ Findings that imply that cellular aging is programmed by the genes:
• Humans with long lived parents and grandparents live an average of 6 years longer
than those whose parents die before the age of 50.
• Human body cells grown in tissue cultures are able to divide only about 50 times,
after which they age and die.
• The reproductive capacity of cells taken from old animals is even more limited;
these cells can undergo only about one half as many divisions as those obtained
from young animals.
Because a direct relationship exists between the life span of a species and the capacity
of its cells to divide, this suggests that age related changes are programmed into the
genes of each species
 DAMAGE OR ERROR (STOCHASTIC) THEORIES

ERROR THEORY or ERROR CATASTROPHE THEORY- proposed by Orgel

in 1963
➢ as a cell ages, various changes occur naturally in its DNA and RNA
the building blocks of cell
➢ Errors can occur in the transcription in any step of protein
synthesis of DNA, and this eventually leads to either the aging or
the actual death of a cell
➢ ERRORS – cause reproduction of an enzyme or protein that was
not an exact copy of the original – next transcription would again
contain an error
➢ The effect of continued errors is diminished functional ability of
end product that do not resemble the original cell (Sonnebon,
1979)
 DAMAGE OR ERROR (STOCHASTIC) THEORIES

Mitochondrial Free Radical Theory Of Aging (MFRTA)

❑ The mitochondrial free radical theory of aging (MFRTA) states that as the
person age, the cells (in this case the mitochondria) accumulate free
radical damage over time.
❑ These free radicals are produced as by-products during normal
metabolism and are unavoidable.
❑ However in a normal healthy being, a balanced equilibrium exists among
oxidants, antioxidants and biomolecules.
❑ Excess generation of free radicals may overwhelm natural cellular
antioxidant defenses leading to oxidation and further contributing to
cellular functional impairment.
"Free radical" is a term used to describe any
❑ This theory proposes that superoxide and other free radicals cause molecule that differs from conventional
damage to the macromolecular components of the cell, giving rise to molecules in that it possesses a free electron, a
accumulated damage causing cells, and eventually organs, to stop property that makes it react with other molecules
in highly volatile and destructive ways.
functioning
 DAMAGE OR ERROR
(STOCHASTIC) THEORIES

Mitochondrial Free Radical Theory Of Aging (MFRTA)

 It is this idea that implies that interventions aimed at limiting or inhibiting
free radicals should be able to reduce the rate of formation of aging
changes with a consequent reduction of the aging rate and disease
pathogenesis.
 However, even when oxygen utilization is optimally efficient some free LIPOFUSCIN – indicative of chronologic
radical damage to the mitochondria inevitably occurs as a result of this age also known as “Age Spots” – found
process. to accumulate in older adult tissues;
If increase – healthy tissue slowly
 So, the longer a person is alive the more damage their mitochondria will deprived of oxygen and nutrient supply –
accumulate. leading to further degeneration of
surrounding tissues – causing actual
 As oxygen utilization inevitably loses efficiency, the rate of free radical death of tissue.
damage escalates, and ultimately leads to mitochondrial decay.
 This is the central process in aging and degenerative disease. It’s why a
person can’t live forever…more or less.
❑ DAMAGE OR ERROR (STOCHASTIC) THEORIES

NOTE:
✓ Substances that prevent the harmful effects of
oxidation are known as antioxidants.
✓ A person’s body does not have naturally
occurring antioxidants;
✓ According to Hayflick (1996) and Yu (1998) –
antioxidants have effect on the decrease of the
immune system and on degenerative neurologic
diseases; it postpones the appearance of
diseases such as cardiovascular disease or
cancer.
✓ Vitamin C, Vitamin E and beta carotene (the
substance that the body uses to produce vitamin
A) – inhibit the functioning of free radicals or
possibly their production.
 DAMAGE OR ERROR (STOCHASTIC) THEORIES

Cross-Linkage Theory (other name is Cognitive Tissue Theory) states that an

accumulation of cross-linked proteins damages cells and tissues and slowing
down bodily processes result in aging.
With age, the proteins, DNA and other structural molecules develop inappropriate attachments
or cross-links to one another.
These unnecessary links or bonds decrease the mobility or elasticity of proteins and other
molecules.
Proteins that are damaged or no longer needed are normally broken down by enzymes, but the According to this theory,
presence of cross-linkages inhibits the activity of the enzymes. normally separated molecular
These damaged and unneeded proteins, therefore, stick around and can cause problems. structure are bound together
This model posits that cross-linkages ultimately lead to severe nutrient/oxygen deficiency and through chemical reactions
impaired waste removal. - Primarily involve COLLAGEN –
Cross-linking of the skin protein collagen has been shown to be at least partly responsible for a relatively inert long-chain
wrinkling and other age-related changes in the skin. macromolecular produced by
Cross-linking of proteins in the lens of the eye is believed to play a role in age-related cataract fibroblasts.
formation.
Cross-linking of proteins in the walls of arteries or the filtering systems of the kidney account
for at least some of the atherosclerosis and age-related decline in kidney function observed in
older adults.
 DAMAGE OR ERROR (STOCHASTIC) THEORIES

Cross-Linkage Theory (other name is Cognitive Tissue Theory)

➢ As new fibers are created > enmeshed with old fibers > form
an actual chemical cross link > resulting to : increase density
of collagen molecule; decrease transport capacity for
nutrient and to remove waste products from the cells; >
decrease structure function
➢ Example – AGING SKIN – skin of baby is soft and pliable
Exercise and dietary restrictions – help
whereas aging skin loses much of its supplement and elasticity
inhibit the cross-link process;
CROSS-LINK AGENTS – found in unsaturated fats, polyvalent
metal ions like aluminun, zinc and magnesium; associated with Vitamin C prophylaxis as antioxidant
excessive radiation exposure; also found in medications like (Bjorkstein, 1976)
antacids and coagulants with aluminum also in baking powder.
Cross-link is the primary cause of
❑ Increase Blood glucose levels – cause increase amount of ARTERIOSCLEROSIS – or decrease
cross-linking- accelerates lens, kidney, and blood vessel efficiency of the immune system with
diseases (Schneider, 1992). age, the loss of elasticity in adult skin
DAMAGE OR ERROR (STOCHASTIC) THEORIES

Wear and Tear Theory, attributes that vital

parts in the person’s cells and tissues wear out
resulting in aging.
This theory attaches aging to progressive cell
damage caused by the internal and external
environment, rather than to an innate genetic Researcher reported that excessive wear and
program. tear caused by exercising may accelerate aging
With the passage of time, changes occur in the by increasing free radical production, which
cells that impair their effectiveness. Thus, supports the idea that no one theory of aging
aging is due to progressive damage. incorporates all the causes of aging, but rather
that a combination of factors is responsible.
Example – is the cells inability to repair
damaged DNA, as in the aging cell.
Aged cell have lost the ability to counteract
It is known that cells in heart muscle, neurons,
mechanical, inflammatory, and other injuries
striated muscle, and the brain cannot replace
due to their senescence (Aigner, Rose,
themselves after they are destroyed by wear
Martin, & Buckwalter, 2004).
and tear.
➢ It is important to remember that:
➢ When interacting with the older adults, nurses must relate the key concepts of the biologic theories to the care being provided.
➢ Aging and disease do not necessarily go together, the nurse caring for older adults needs to have a clear understanding of the
difference between age-related changes and those that may be pathologic.

➢ Nurses need to be aware that:

➢ To promote health for older persons:
➢ Nurses need to provide health education about effects of smoking. Alcohol, drug abuse, excessive exposure to sunlight,

➢ Suggest use of Vitamin C and E as supplements; suggest nutritious diets (Goldstein, 1993)

➢ Advise / encourage older adults to participate in activities (daily exercises, daily walking)

➢ Attention should be placed to various stress factors in an older person’s life and to promote healthy coping mechanisms during
health education for older adults.
➢ Teach older adult basic techniques of relaxation, guided imagery, visualization, distraction, and music therapy to facilitate a sense of
control over potential stress-producing situations.
 SOCIOLOGIC THEORIES
Focus on changing roles and relationships, various social
adaptations in the lives of older adults.

Disengagement theory views aging as a process of mutual

withdrawal in which older adults voluntarily slow down by
retiring, as expected by society.
▪ Proponents of disengagement theory (Cumming
and Henry, 1961) hold that mutual social
withdrawal benefits both individuals and society.
▪ Disengagement theory outlines a process of
disengagement from social life that people
experience as they age and become elderly. The
theory states that, over time, elderly people
withdraw, or disengage from, the social roles and
relationships that were central to their life in
adulthood.
 SOCIOLOGIC THEORIES
Activity theory or Developmental Task Theory, on the other
hand, sees a positive correlation between keeping active and
aging well.
▪ Proponents of activity theory (Havighurst et al, 1963)
hold that mutual social withdrawal runs counter to
traditional American ideals of activity, energy, and
industry.
▪ Essentially the person actively participates in a
continuous struggle to remain “Middle-Aged”
▪ This theory is based on 3 assumptions:

It is better to be active than inactive

It is better to be happy than unhappy
An older individual is the best judge of his / her own
success in achieving the first two assumptions
(Havighurst, 1972)
 SOCIOLOGIC THEORIES
Continuity Theory - The continuity theory of normal aging dispels
the premises of both the disengagement and activity theories.
o According to this theory, older adults will usually maintain the
same activities, behaviors, personalities, and relationships as
they did in their earlier years of life (Neugarten and Tobin,
1963).
▪ According to this theory, older adults try to maintain this
continuity of lifestyle by adapting strategies that are
connected to their past experiences; that the latter part of
life is a continuation of the earlier part and therefore an
integral component of the entire life cycle.
▪ This theory proposes that as a person age, they try to
maintain or continue previous habits, preferences,
commitments, values, beliefs, and all the factors that have
contributed to their personalities (Havighrust, Neugarten
and Tobin, 1963).
 SOCIOLOGIC THEORIES
Age Stratification Theory (Riley, Johnson, and Foner 1972) –
▪ This theory suggest that members of society might be stratified by
age, just as they are stratified by race, class, and gender.
▪ Because age serves as a basis of social control, different age groups
will have varying access to social resources such as political and
economic power.
▪ Within societies, behavioral age norms, including norms about roles
and appropriate behavior, dictate what members of age cohorts may
reasonably do.

▪ For example, it might be considered deviant for an elderly woman to

wear a bikini because it violates norms denying the sexuality of
older females. These norms are specific to each age strata,
developing from culturally based ideas about how people should
“act their age.”
 SOCIOLOGIC THEORIES
The Person-Environment Fit Theory – proposed by Lawton
(1982) – relates with individual’s personal competence
within the environment in which he/she interacts.
As person ages, there maybe changes or even decrease in
some of their personal competence which can influence
the individual’s ability to interrelate with the environment.
Ex – person with chronic disease or developing one such
as rheumatoid arthritis may be impaired or limited to work.
The Person-Environment Fit Theory (Kooij, 2015) - adopts
a “sustainability” perspective, arguing that to maintain
continuous person–job fit between dynamic person and
work characteristics is required for employees to age
successfully at work (i.e., to maintain their health,
motivation, and work ability).
➢ It is important to remember that:
➢ All older adults cannot be grouped collectively as just one segment of the population
➢ There are differences within the age population
➢ The YOUNG-OLD (ages 65 to 74), the MIDDLE-OLD (ages 75 to 84), the OLD-OLD (more than 85) and the ELITE-OLD
(more than 100 years old are four distinct cohort groups, and the individuals within each of these cohort groups have
their own history
➢ There is a variation among even the same cohort group based on culture, life experiences, gender, and health and
family status.

➢ Nurses need to be aware that:

➢ Whatever similarities exist among the individuals of a cohort group, they are still individuals.
➢ Older adults are not a homogenous sociologic group, and care needs to be taken not to treat them as if they were.
➢ Because older adults are individuals, their responses must be respected. However, it is within the nurse’s scope of
practice to identify maladaptive responses and intervene to protect the integrity of the person.
➢ Nurses need to be aware that:
➢ Withdrawal by older adults may be a manifestation of a deeper problem, such as depression.
➢ Using assessment skills and specific tools, nurses can further investigate and plan appropriate interventions to help resolve a
potentially adverse situation.
➢ Older adults may refuse to engage in a particular activity because of fear of failure or frustration at not being able to per form
the activity.
➢ Planning scheduled activities for a particular group is crucial to successful group interaction. And the successful completion of a
group activity provides an opportunity for increasing the older person’s self-confidence, whereas frustration over an impossible task
further promotes feelings of inadequacy and uselessness.
➢ By examining the past and being aware of significant events or even beliefs about health and illness, nurses can develop a
deeper understanding of why this particular older adult act or believe the way they do,
➢ This knowledge and insight can assist in planning not only activities but also meaningful client education.

➢ Helping older adults adjust to limitations, while accentuating positive attributes, may enable them to remain independent and
may perpetuate a high quality of life during later years.
 PSYCHOLOGIC THEORIES
Psychologic Theories – includes behavioral
changes and developmental aspects related to
the lives of older adults.
Basic assumption – development does not end
when a person reaches adulthood, but remains
a dynamic process throughout the life span.
➢ As a person passes from the middle to the
later life roles, abilities, perspectives, and
belief systems enter a stage of transition.
➢ The nurse, by providing holistic care, seeks
to employ strategies to enhance client’s
quality of life (Hogstel, 1995).
 PSYCHOLOGIC THEORIES
Theory Description
Maslow's All people strive toward self-
hierarchy of actualization through various
human needs stages
Jung's theory of Stages include old age,
individualism where one turns inward to
reflect for answers
Course of human Old age is a time for rest and
life review of one's life
Erikson's eight Ego must resolve a crisis in
stages of life each stage; in old age this
would involve a looking back
at life and accepting death
(ego integrity versus despair)
Implications for patient care
Patient will determine the important tasks for them; these are not
necessarily age-specific
Inner direction may mean that external factors of health are less important
to patient; motivation (eg., compliance) may have to come from within
Patient may view old age as a reward and expect commensurate treatment
Anxieties about issues such as death may be of extreme importance to the
patient and exacerbated due to the unknown that accompanies diagnostic
testing
An elder who has successfully resolved the crisis will be comfortable in
speaking about death; the technologist should not negate or ignore such
discussions
 PSYCHOLOGIC THEORIES
❑ Maslow's hierarchy of
human needs theory states
that all people strive
towards self-actualization;
once a stage is achieved,
the person works on
achieving the next stage;
❑ Maslow focused on
psychological positives and
believed each of us has a
strong desire to realize our
full human potential (what
he termed becoming fully
actualized).
❑ He developed a
psychological roadmap
which he felt helped or
inhibited us from reaching
personal self actualization.
 PSYCHOLOGIC THEORIES
Carl Jung’s Theory of Individualism (1960)
❑ This personality development theory states that an individual’s personality is composed of
the EGO, the personal unconsciousness, and the collective unconsciousness.
❑ According to this theory, a person’ personality is visualized as oriented either toward the
external world (extroversion) or toward subjective, inner experiences (introversion) .
❑ A balance between these two forces, which are present in every individual, is essential for
mental health.
❑ Jung proposes that at the onset of middle age, person begins to question values, beliefs,
and possible dreams left undone. (MIDLIFE CRISIS) = period of emotional, and sometimes
behavioral, turmoil that heralds the onset of middle age.
❑ At this period, the individual searches for answers, questioning whether a part of his/her
personality or “true self” has been neglected and whether the time is running out for the
completion of these quests. – maybe the first time this person becomes aware of the
effects of the aging process… the “rite of passage”--- for old age and end of the adult life.
 PSYCHOLOGIC THEORIES
Carl Jung's conception of Individuality
❑ As the person age chronologically, the
personality often begins to change from
being outwardly focused, concerned about
establishing oneself in society, to becoming
more inward, as the individual begins to
search for answers from within.
❑ Successful aging, when viewed from Jung’s
theory, is when a person looks inward and
values himself or herself for more than just
current physical limitations or losses. The
individual accepts past accomplishments
and limitations (Jung, 1960)
 PSYCHOLOGIC THEORIES
Eight Stages of Life
❑ Erikson (1999) proposed a theory pf psychologic development that reflects
cultural and societal influences.
❑ The major focus of development in this theory is with an individual’s ego
structure, or sense of self, especially in response to the ways in which society
shapes its development.
❑ In each of the eight stages identified by Erikson, a “crisis” occurs that affects the
development of the person’s ego.
❑ The manner in which a person masters any particular stage influences future
success or lack of success in mastering the next stage of development.
❑ The developmental task needing resolution is:
❑ Resolving conflict between generativity and stagnation – middle adulthood
❑ balancing the search for integrity and wholeness with a sense of despair -
older adults.
Generativity: adults’ desire to leave legacies of themselves to the next generation
Biological generativity
Parental generativity
Work generativity
Cultural generativity
Stagnation: develops when individuals sense that they have done nothing for the next generation
 PSYCHOLOGIC THEORIES
Eight Stages of Life
➢ Robert Peck (1968) expanded upon Erikson’s psychosocial development in middle and late adulthood.
➢ Erikson grouped all individuals together into “old age” beginning at age 65, not anticipating that a person could
live another 30-40 years beyond the milestone.
➢ Peck (1968) expanded the 8th stage, ego integrity versus despair, into 3 stages:
➢ Ego differentiation vs work role preoccupation;
➢ Body transcendence vs body preoccupation;
➢ Ego transcendence vs preoccupation (Ignatavicius and Workman, 2005).
➢ Peck identified psychological developments that he considered crucial for a healthy adaptation to aging
➢ Given that aging is a gradual process, psychological development in middle adulthood affect whether one
experiences successful aging.

❑ The first stage - During Ego differentiation vs work role preoccupation – task of older
adults is to achieve identity and feelings of worth from sources other than the work role.
❑ Here the onset of retirement and termination of the work role may reduce the feelings
of self-worth.
❑ In contrast, a person with a well-differentiated ego, who is defined by many dimensions,
can replace the work role as the major defining source for self-esteem.
 PSYCHOLOGIC THEORIES
The second stage - Body transcendence vs body preoccupation,
refers to the older person’s view of the physical changes that
occur as a result of the aging process.
❑ The task is to adjust to or transcend the declines that may
occur in order to maintain feelings of well-being.
❑ This task can be resolved by focusing on the satisfaction
obtained from interpersonal interaction and psychosocial
activities.

❑ The third stage –final task - Ego transcendence vs

preoccupation, involves acceptance of the individual’s
eventual death without dwelling on the prospect of it.
❑ Remaining actively with a future that extends beyond a
person’s mortality is the adjustment that must be made to
achieve ego transcendence.

GERONTOCRACY, a type of social structure wherein the power is

held by a society’s oldest members
 PSYCHOLOGIC THEORIES
Selective Optimization and Compensation -
proposed by Baltes (1987)
❑The theory’s central focus is that individuals develop
certain strategies to manage the losses of function
that occur over time.
❑This general process of compensation consists of 3
interacting elements:
❑Element of selection – refers to an increasing
restriction of ones’ life to fewer domains of
functioning because of an age-related loss
❑Optimization – reflects the view that people
engage in behavior to enrich their lives
❑Compensation – results from restrictions
caused by aging, requiring older adults to
compensate for any losses by developing
suitable, alternative adaptations (Schroots,
1996).
❑The lifelong process of selective optimization with
compensation allows people to age successfully.
➢ It is important to remember that:
➢ Older adults should be encouraged to engage in a “life review” process;
➢ Nurses can do this using variety of techniques like reminiscence, oral histories, and story telling.

➢ Looking back over life’s accomplishments or failures is crucial in assisting older adults to accomplish developmental tasks (as
in ego integrity), to promote positive self-esteem, and to acknowledge that one “did not live in vain”

➢ Nurses need to be aware that:

➢ Part of the developmental tasks appropriate for older adults include talking about retirement, worrying about physical living
space, or even planning for funeral arrangements.
➢ The nurse must understand that each stag of life has specific developmental tasks to achieve, instead of hampering, the nurse
should facilitate their achievement.
➢ Nurse should also need to keep in mind that their intellectual functioning remains intact. Listening to how they coped with life
experiences can help the nurse gain insights.
➢ In planning activities for older adults, nurses need to remember that all individual enjoy feeling needed and respected and
being considered contributing members of society.
 WATCH THIS VIDEO USING THE LINK PROVIDED

THEORIES OF AGING AND ITS NURSING IMPLICATIONS (HTTPS://YOUTU.BE/JC4YK0ZZ-CQ)

Assessment Task: Make a reflective journal about the video you just
watched. Impart lessons learned (you can also use the lectures given in
the power point presentation)
 REFERENCES

 Perry, T. E., Ruggiano, N., Shtompel, N., & Hassevoort, L. (2015). Applying Erikson's wisdom to self-management practices of
older adults: findings from two field studies. Research on aging, 37(3), 253–274. doi:10.1177/0164027514527974 ↵
 Håkan Nilsson, Pia H. Bülowac, Ali Kazemib (2015). Europe's Journal of Psychology, 2015, Vol. 11(3), doi:10.5964/ejop.v11i3.949.
Retrieved from https://ejop.psychopen.eu/article/view/949/html. ↵
 Håkan Nilsson, Pia H. Bülowac, Ali Kazemib (2015). Europe's Journal of Psychology, 2015, Vol. 11(3), doi:10.5964/ejop.v11i3.949.
Retrieved from https://ejop.psychopen.eu/article/view/949/html. ↵
 Havey, Elizabeth A. (2015). "What's Generativity and Why It's Good for You." Huffington Post. Retrieved
from https://www.huffpost.com/entry/whats-generativity-and-why-its-good-for-
you_b_7629174?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAISJrz_B9yl
ovtOxRuUNpAiqtA6GZvMM8nUxuyG0eL1AwbMX0F2fEIL6QyV_FFiZfAf4oNBhRfajbOpAJu1L8tGsPe1My9RCv7X-
hFjvhxNcr11Z5VRkfmmim1nxpi2cA-cF4SYXbn9OyhdIzXtdHB-UwJqn73I0rFzpLKpv35gT. ↵