NCM114-n LEC – ALIMOSA K.

WEEK 1: Introduction to Gerontology Nursing  any resident citizen of the Philippines

Foundations  at least sixty (60) years old
 aka elderly
History
 RA 9994 - Expanded Senior Citizens Act
 care of older adults was an unpopular branch of 2010
of nursing practice
Life Expectancy
 gerontology was missing from most nursing
curriculums  the length of time that a person can be
 an appeal to the ANA - promote the status of predicted to live
gerontology nursing  people are living longer
 1966 - gained full recognition as a nursing
specialty (Division of Geriatric Nursing) Life Span
 1969 - development of Standards for  the maximum years that a person has the
Geriatric Nursing Practice (1970 first potential to live
publication)
Comorbidity
Geriatrics
 the simultaneous presence of multiple
 Gr. geras - old age chronic conditions
 the branch of medicine that deals with the
diseases and problems of old age Compression of morbidity
 generally not used when describing the  hypothesis that serious illness and decline
nursing care of older adults can be delayed or postponed so that an
Gerontology extended life expectancy results in more
functional, healthy years
 Gr. geron - old man
 the scientific study of the process of aging Gender and Marital Status
and the problems of older adults  women live longer than men
 includes biologic, sociological,  older women live alone
psychological, and economic aspects.
Race and Ethnicity
Gerontology Nursing
Living Arrangements
 the specialty of nursing
 assessing the health and functional status of  most older adults prefer to live in their own
older adults, planning and implementing homes and communities
health care and services to meet identified
Geographic Distribution
needs, and evaluating the effectiveness of
such care  most older adults are less likely to change
 gerontology/gerontologic nurse residences
Education
Nursing Characteristics of the Older Population  educational level has been increasing
Older Adults Income & Poverty
 individuals aged 65 years and older  social security
 Youngest-old: 65 to 74 years  benefits
 Middle-old: 75 to 84 years  family households
 Oldest-old: 85+  lifestyle changes
 health-related expenses
Senior Citizen
NCM114-n LEC – ALIMOSA K.
Employment WEEK 2&3: The Aging Process Theories of
Aging
 decreasing capacity to be employed
 types of jobs Aging
 maximize health and prevent diseases
 the process of growing older
 cost of living
 begins at birth
 other resposibilities
 no single known factor causes or prevents
aging
 a highly individualized process,
Implications of an Aging Population
 demonstrated by the differences between
Baby Boomers persons of similar ages.
 aging process varies not only among
 those born between 1946 and 1964 individuals but also within different body
 began entering their senior years in 2011 and systems of the same person.
will continue to do so until 2030
 have children Biological Theories
 next generations have low birth rate means  Stochastic theories - view the effects of
that they will have fewer biologic children or aging as resulting from random assaults from
grandchildren available to assist them in old both the internal and external environment
age over time.
 better educated than preceding generations  Nonstochastic theories - see aging changes
 household incomes tend to be higher resulting from a complex, predetermined
 most own their own homes process
 favor a more casual dress code than do
previous generations of older adults. Sociological Theories
 enamored with “high-tech” products - are  Disengagement Theory
likely to own a computer, and spend several  Activity Theory
hours online daily
 Continuity Theory
 leisure time is scarcer than other adults
 Subculture Theory
 more likely to report feeling stressed at the
 Age Stratification Theory
end of the day
 they could be exercising more frequently Psychological Theories
than do other adults.
 Developmental Tasks
 could be given special considerations at work
 Gerotranscendence
that poses a strain towards younger workers
Ageism Nursing Theories

 Functional Consequences Theory

 the deep and profound prejudice in
(American) society against older adults  Theory of Thriving
(Butler, 1969)  Theory of Successful Aging
 stereotyping and discrimination

The Aging Process Biological Theories of Aging

(Stochastic Theories)
Stochastic Theories
1) Cross-Linking Theory
2) Free Radicals and Lipofuscin Theories
3) Wear and Tear Theories
4) Biogerontology
NCM114-n LEC – ALIMOSA K.
 the body will function less efficiently with
prolonged use and numerous insults
1) Cross-Linking Theory
(e.g., smoking, poor diet, and substance
 propose that cellular division is threatened as
abuse)
a result of radiation or a chemical reaction in
 stresses to the body can have adverse
which a crosslinking agent attaches itself to
effects and lead to conditions such as
a DNA strand and prevents normal parting of
gastric ulcers, heart attacks, thyroiditis,
the strands during mitosis.
and inflammatory dermatoses
 as these cross-linking agents accumulate,
they form dense aggregates that impede 4) Biogerontology
intracellular transport
 the study of the connection between aging
 ultimately, the body’s organs and systems
and disease processes (Miller, 1997)
fail
 could be caused by bacteria, fungi, viruses,
 e.g. cross-linking on collagen
and other organisms
 these pathogens may be present in the body
2) Free Radicals and Lipofuscin Theories
for decades before they begin to affect body
 suggests that aging is due to oxidative
systems
metabolism and the effects of free radicals
(Hayflick, 1985; Sousa-Victor, Neves, &
Jasper, 2016)
The Aging Process Biological Theories of
 free radicals - highly unstable, reactive
Aging (Nonstochastic Theories)
molecules containing an extra electrical
charge that are generated from oxygen Nonstochastic (Predetermined) Theories
metabolism
 free radical molecules can damage proteins, 1) Programmed/Apoptosis
enzymes, and DNA by replacing molecules 2) Genetic Theories
that contain useful biological information with 3) Autoimmune Reactions
faulty molecules that create genetic disorder 4) Neuroendocrine and
 free radicals are self-perpetuating (they 5) Neurochemical Theories
generate other free radicals 6) Radiation Theories
7) Nutrition Theories
 physical decline occurs as the damage from
8) Environmental Theories
these molecules accumulates over time
 lipofuscin “age pigments” - a lipoprotein by-
product of oxidation that can be seen only
under a fluorescent microscope 1) Programmed Apoptosis
 lipofuscin - associated with the oxidation of  the process of programmed cell death
unsaturated lipids that continuously occurs throughout life
 lipofuscin - believed to have a role similar to due to biochemical events (Sodhi &
that of free radicals in the aging process. Madan, 2020)
 the cell shrinks and there is nuclear
 as lipofuscin accumulates - interferes with
and DNA fragmentation, although the
the diffusion and transport of essential
metabolites and informationbearing membrane maintains its integrity
molecules in the cells.  according to this theory, this
 a positive relationship exists between an programmed cell death is part of the
individual’s age and the amount of lipofuscin normal developmental process that
in the body continues throughout life.

3) Wear and Tear Theories

 attribute aging to the repeated use and 2) Genetic Theories
injury of the body over time as it performs  programmed theory of aging - animals
its highly specialized functions and humans are born with a genetic
NCM114-n LEC – ALIMOSA K.
program or biological clock that
predetermines the life span (Hayflick,
1965)
 e.g., studies have shown a positive
relationship between parental age and
filial life span
 error theory - genetic mutations are
responsible for aging by causing organ
decline as a result of self-perpetuating
cellular mutations leading to decline in
body functions
3) Autoimmune Reactions
 the thymus and bone marrow are
believed to be affected by the aging
process.
 immune response declines after young
adulthood
 the level of thymic hormone declines
after age 30 and is undetectable in the
blood of persons older than 60 years
(Palmer, 2013)
Sociologic Theories
4) Neuroendocrine and Neurochemical
Theories
 suggest that aging is the result of
changes in the brain and endocrine
glands
 specific anterior pituitary hormones
promote aging
 others believe that an imbalance of
chemicals in the brain impairs healthy
cell division throughout the body.
5) Radiation Theories
 repeated exposure to ultraviolet light is
known to cause solar elastosis, the “old
age” type of skin wrinkling that results
from the replacement of collagen by
elastin
 radiation may induce cellular mutations
that promote aging.
6) Nutrition Theories
 diet impacts health and aging.
 obesity is shown to increase the risk of
many diseases, accelerate the aging
process, and shorten life
 The quality of diet is as important as the
quantity.
 deficiencies of vitamins and other
nutrients and excesses of nutrients
 the influence of nutritional supplements
on the aging process; vitamin E, bee
pollen, ginseng, gotu kola, peppermint,
and curcumin are among the nutrients
believed to promote a healthy, long life
7) Environmental Theories
 several environmental factors are known
to threaten health and are thought to be
associated with the aging process
 ingestion of mercury, lead, arsenic,
radioactive isotopes, certain pesticides,
and other substances
The Aging Process Sociologic Theories of
Aging
1) Disengagement Theory
2) Activity Theory
3) Continuity Theory
4) Subculture Theory
5) Age Stratification Theory
1) Disengagement Theory
 developed by Elaine Cumming and
William Henry
 views aging as a process in which
society and the individual gradually
withdraw, or disengage, from each
other, to the mutual satisfaction and
benefit of both
 The benefit to individuals is that they
can reflect and be centered on
themselves
2) Activity Theory
 asserts that an older person should
continue a middle-aged lifestyle,
denying the existence of old age as
long as possible
NCM114-n LEC – ALIMOSA K.
 suggests ways of maintaining activity
in the presence of multiple losses
associated with the aging process
3) Continuity Theory
 aka developmental theory
 relates personality and predisposition
toward certain actions in old age to
similar factors during other phases of
the life cycle (Neugarten, 1964).
 Personality and basic patterns of
behavior are said to remain
unchanged as the individual ages.
4) Subculture Theory
 views older adults as a group with
distinct norms, beliefs, expectations,
habits, and issues that separate them
from the rest of society (Rose, 1965).
 a response to the negative attitudes
and treatment by society
 older persons are accepted by and
are more comfortable among, those
of their own age group.
5) Age Stratification Theory
 suggests that society is stratified by
age groups (Riley, Johnson, & Foner,
1972)
 persons within a similar age group
generally have similar experiences,
beliefs, attitudes, and life transitions
that offer them a unique shared
history.
The Aging Process Psychological Theories of
Aging
Psychological Theories
 Developmental Tasks
 Gerotranscendence
2) Gerotranscendence
1) Developmental Tasks
 integrity vs despair (Erik Erikson)
 the challenge of old age is to accept
and find meaning in the life the
person has lived
 ego integrity that aids in adjusting and
coping with the reality of aging and
mortality
 Feelings of anger, bitterness,
depression, and inadequacy can
result in inadequate ego integrity
(e.g., despair).
 three specific challenges facing the
older adults that influence the
outcome of ego integrity or despair
(Robert Peck, 1968):
a. Ego differentiation versus role
preoccupation: to develop
satisfactions from oneself as a
person rather than through
parental or occupational roles
Body transcendence versus body
preoccupation: to find
psychological
b. Body transcendence versus body
preoccupation: to find
psychological pleasures rather
than become absorbed with
health problems or physical
limitations imposed by aging
c. Ego transcendence versus ego
preoccupation: to achieve
satisfaction through reflection on
one’s past life and
accomplishments rather than be
preoccupied with the finite
number of years left to live
 additional developmental tasks of
later life (Robert Butler and Myrna
Lewis, 1998) :
1) Adjusting to one’s infirmities
2) Developing a sense of
satisfaction with the life that
has been lived
3) Preparing for death
 a recent theory that suggests
aging entails a transition from a
rational, materialistic
metaperspective to a cosmic and
transcendent vision (Tornstam,
2005)
 as people age, they are less
concerned with their physical
NCM114-n LEC – ALIMOSA K.
bodies, material possessions,  integrates Roy’s adaptation model with
meaningless relationships, and the theory of gerotranscendence and
self-interests and instead desire a other aging literature,
life of more significance and a  Adaptation Model of Nursing (Sister
greater connection with others. Callista Roy) - saw the individual as a
biopsychosocial being that continuously
interacts with and adapts to the
The Aging Process Nursing Theories of Aging changing internal and external
environment; health on a continuum and
Nursing Theories of Aging involves the person becoming an
 Functional Consequences Theory integrated, whole individual
 Theory of Thriving  consider successful aging in terms of the
 Theory of Successful Aging older adult’s physical, mental, and
spiritual well-being but also includes the
1) Functional Consequences Theory individual’s self-appraisal
 integrates theories from aging and  people with high levels of personal
holistic nursing control and a positive affect will
 nurses can promote wellness by experience higher levels of wellness in
addressing individuals holistically, and aging due to their ability to participate in
health promoting activities.
recognizing the interconnection of body,
mind, and spirit  higher levels of physical health
 consequences of age-related changes contribute to deeper spirituality; these
and risk factors can result in either factors contribute to greater life
positive or negative functional satisfaction and the aging individual’s
consequences positive perception of his or her status
 nurses can help aging individuals to
have a positive view of their lives, which
in turn can promote their ability to cope
2) Theory of Thriving
and achieve greater life satisfaction with
 everything that impacts people
age.
throughout their lives must be linked to
create a holistic view of aging
 based on the failure to thrive concept as
it relates to older adults in nursing homes
 failure to thrive: disconnectedness,
inability to find meaning in life, problems
with social relationships, and physical
and cognitive dysfunction
 thriving is possible when harmony exists
between individuals and their physical
and human environments.
 process of thriving is continuous and
enables aging individuals to find
meaning in life and adapt to changes.
 nurses consider the many factors that
can impact health and quality of life for
older adults.

3) Theory of Successful Aging