Aging Process
PRELIM | NCM 113 | Clinical Instructor: Arlene G. Oropel RN , MN
Terminologies
 Gero - elders
 Geron/geras - old man/old age
 Logy/Logia - the study of
“ Cultural values and attitudes can shape people’s experience of
aging"
A. Perspective on Aging –
 the ability to understand how a situation appears to another
person and how that person is reacting cognitively to the
situation.
 In other words, it’s ability to put ourselves in the place of
someone else while recognizing their point of view,
experience, and beliefs.
Gerontology
 is the study of the physical aspects of aging, as well as the
mental, social and societal implications of aging.
 is the science of aging.
 is a field of science that seeks to understand the process of
aging and the challenges encountered as seniors grow
older.
Geriatrics is a medical discipline :
 that deals with the diagnosis, treatment, care, rehabilitation
 also prevention of diseases in the elderly, which are, by
definition of the World Health Organization all persons
older than 65 years of age.Mar 25, 2016
 is the branch of medicine that deals with the diseases and
problems of old age Geriatrician
 a medical profession who specializes in geriatrics
GERONTOLOGIST
 study what it is like to be an older adult in a society and the
ways that aging affects members of a society
 investigate age, aging, and the aged
 Social gerontology refers to a specialized field of
gerontology that examines the social (and sociological)
aspects of aging
Professor Emeritus
James E. “Jim” Birren , 97
James E. "Jim" Birren, Ph.D.
(4 April 1918 – 15 January 2016)
 was an American gerontologist.
 was one of the founders of the organized
field of gerontology (1940s )
 was president of The Gerontological
Society of America
CAILAH SOFIA Y. SELAUSO
BS NURSING 3-E
 author of over 250 publications.
3 categories of aging created by:
Gerontologist James Birren:
1. Primary aging – The human body’s natural
deterioration throughout 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 functional status of older adults.
 planning and implementing health 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.
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.
GENERALIST NURSE ROLES
 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.
 is a registered nurse and at least a master’s degree
 functions as clinician, educator, consultant,
administrator, or researcher to plan care or improve
the quality of nursing carefor adults and their
families.
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PRELIM | NCM 113 | Clinical Instructor: Arlene G. Oropel RN , MN
 Today, they may be found practicing in acute care
hospitals, long term care or home care settings ,
or independent practices.
 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.
 conducts health assessments; identifies nursing dx;
plans, implements and evaluates nursing care for
adult and older patients.
 Acute care or primary care activities include
intervention for health promotion, maintenance and
restoration.
NURSE PRACTITIONER
 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 , sub-
acute care center, ambulatory care setting and long
term care setting.
 S/S ( what s/s do we expect in elderly having
osteoarthritis/rheumatoid
 Usual medication tx that patient might be receiving
 The type of rehabilitation methods/strategies we can
provide a quality life for our elderly.
2. Manager
 Act during everyday practice as they balance the
concern of the of patient, family, nursing and the rest
of the interdisciplinary /health team
 Plans and coordinate the care of the elder
 Develop skills in staff coordination, time
management, assertiveness, communication and
organization, leadership skill
3. Teacher
 Focus their teaching in modifiable risk factors and
health promotion.
 Organize and provide instructions on healthy aging,
disease detection, treatment and rehab to older pts
and families
 ocus: identifying modifiable factors of our elderly for
health promotion
 Many debilitating conditions of elderly can be
prevented through health teachings
4. Advocate
 Act on behalf of older adults to promote their best
interest and strengthen the autonomy and decision
making.
 Empowering pt: helping them remain independent
and retain dignity.
 Anger displacement : venting anger towards other
things.
5. Research Consumer
 GN must remain abreast of current research literature
CAILAH SOFIA Y. SELAUSO
BS NURSING 3-E
 Read and put into practice the results of reliable and valid
studies
 Assists with data collection and identification of
appropriate research sites
 Use evidenced based results.
RESPONSIBILITIES OF A GERONTOLOGIC NURSE
(EXAMPLE)
1. Administering medications to patients based on a care
plan.
2. Teaching family members about a patient’s condition and
how to promote self-care skills.
3. Assisting physicians during exams and procedures.
4. Performing patient medical tests-in-home or in a medical
office.
5. Establishing a patient care plan and setting health goals.
PRINCIPLE OF GERONTOLOGIC NURSING PRACTICES
 Aging is a natural process ( in evitable)
 Various factors influence the aging process
 Nursing of the Elderly requires unique information and
skills
 GN’s goal is to promote optimum levels of physical
psychological, social and spiritual health: multifactorial
influence in the aging process.
 There are common needs shared by Elderly &all ages
Maslow’s hierarchy of needs: ascending order
 Physiological
 Safety and security
 Love and belongingness
 Self-esteem
 Self- actualization
SETTING OF CARE
1. Acute care setting (hospital)
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: trauma accidents,
orthopedic injuries, serious circulatory /respiratory problems
 Facilities available includes: ER/AER, Blood bank, OR,
Pharmacy, Radiology Dept., Clinical laboratory, Pathology
Dept.
 The need to provide is the ACE ( acute care of elderly)
 Hospitalization is graeter in the elderly than any other age
group
 Study showed that the rate of hospitalization in the elderly
increased by 23% over the past 30 years: 65 yo and above
2. Immediate care or intermediate care facility
 Level of care- to provide 24- /day direct nursing contact
hours
 Considered to be an entry level into nursing home care
 Type of health care facility designed to provide care for
individuals who are unable to care for themselves because
of physical/mental problems but less intensive than
hospital care
 Admitted here are the non acutely ill- less intensive elderly
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PRELIM | NCM 113 | Clinical Instructor: Arlene G. Oropel RN , MN
 Another option of hospitalization/alternative to be in
hospital
3. Assisted Living
 Who wish to live in a community setting and need some
additional help with activities of ADL
 Assisting client in need of ADLs: clients with prob has
interference in their ability to care for themselves ( eg.
Amputee, diabetic)
4. Long Term Care Facility
 Nursing home- provides support to person of any age who
have lost their capacity.
 Common Dementia
 Non acutely ill still needs 24- hour nsg care
 Care provided: long term-term until patient dies
 Oversee numerous residents: 1:25/ 1:10
 Philippines: Public govt owned nsg home ( Mindanao 2) &
private
5. Skilled Care
 “skilled care units or skilled nursing facilities
 Chronically ill older adults
 Subacute or Transitional Care
 Patient who require more intensive nursing care than the
traditional nursing home can provide but less intensive
than acute care hospital
 “skilled care units or skilled nursing facilities
 Chronically ill older adults
 Subacute or Transitional Care
 Patient who require more intensive nursing care than the
traditional nursing home can provide but less intensive
than acute care hospital.
 Pt with NGT tubing, jejunostomy, debilitating, dementia
patient
b. Alzheimer’s Unit
 Units dedicated to the major phases of Alzheimer’s
 Dementing/illnesses due to advanced age:impaired
judgment
 Goal: to preserve the fuctional status of the demented
patient for them to have a sense of isolation,reduce
isolation
6. Home Health Care
 Caring for dying persons and their families
 Designed who are homebound due to severity of illness
and immobility
 Thearpies, personal care services, home care services,
durable medical equipment
 Provided by nurses who are from agencies ( home service
nurse) like PDN, institution( hosp base), organization etc.
7.Hospice Care
 Caring for dying person and families
 To help the dying person to “live until they die”
 Goal: provide interdisciplinary approach to help the dying
person to live until they die: dignified death
8. Rehabilitation
CAILAH SOFIA Y. SELAUSO
BS NURSING 3-E
 May be found in various degrees in several
settings,including the acte carehosp, subacute or
transitional care and long term care facilities
Goal:
To maximize indeoence
Promote optimum function
Preveny complication
Promote quality of life
9. Community Setting or Continuing Care Retirement
Community (CCRC) or Life Care Community (LCC)
 Goal: Independence
 Provides a continuum of care from independent living to
skilled care
 Setting is like a campus with levels of care adjusted to their
individual needs.
 GN work in order to promote health, help older adults
maintain independence as long as possible.
10.Independent Living
 Independent living arrangements take the form of senior
housing, such a apartment complexes exclusively devoted
to the elderly.
11.Foster Care Homes or Group Homes
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 or biological aging /cellular
 is the gradual deterioration of functional characteristics in
living organisms.
 - loss of a cell's power of division and growth.
 Cellular senescence - cells that stop dividing.
 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.
 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
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PRELIM | NCM 113 | Clinical Instructor: Arlene G. Oropel RN , MN
 Aging is a process of decline  0.4% the 80 years and older population is expected to
 The process of aging takes time increase by from 2010 to 2030 (Help Age Global Network,
 Stress and repair 2017b).
 By 2050, number of persons age 80 or over is projected to
Things to occur if the aging process speed up: increase more the threefold climbing from 127M to
 The effects of aging begin to be noticeable to the 425M .
individual.  The world’s population aged 60 and older is expected to
 The effects of aging an be measured by a physical total 2B, up from 900M in 2015
examination or testing.
 The older person becomes more susceptible to disease. There are two forces behind global aging:
 Is less able to recover from illness. 1. People are having fewer babies, and this decreases the
 Develops an acute or chronic disease. relative number of young
2. The rising life expectancy
Population aging affects economic growth, trade, migration,
Evolutionary perspective – the primary purpose disease patterns and prevalence and fundamental assumptions
of human’s life is to procreate and to be a carrier of DNA. about growing older
Biological perspective – all humans grow,
experience puberty, mature, and age as the course of a normal, Why is aging population important:
healthy life.  Population aging strains social insurance and pension
Humanistic perspective – aging is inextricably systems and challenges existing models of social support.
linked to death.  It affects economic growth, trade, migration, disease
Scientific perspective – the exploration of aging patterns and prevalence , and fundamentals assumptions
as a disease becomes complex. about growing older.
Countries that have high percentage of their citizens ages 65
THE AGING PROCESS years And over:
1. Germany
1. Genetic and Environmental Factors 2. Finland
2. Behaviors of a Healthy Lifestyle 3. Bulgaria
 Not smoking 4. Sweden
 Drinking alcohol in moderation 5. Latvia
 Exercising 6. Malta
 Getting adequate rest Major causes of aging
 Eating a diet high in fruits and vegetables  Oxidative stress
 Coping with stress & having a positive outlook  Glycation
3. Cellular Changes associated with Aging  Telomere shortening
4. Age also interferes with an important process called  Mutations
APOPTOSIS, which program cells to self- destruct or die at  Aggregations of proteins
appropriate times. How fast is the population aging?
5. Bodily Changes Associated with Aging Globally, the population aged 65 and over is growing faster
than all other age groups.
DEMOGRAPHY OF AGING According to data from World Population Prospects: the 2019
Revision, by 2050, one in six people in the world will be over
Global Aging age 65 (16%), up from one in 11 in 2019 (9%)
 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 IMPACT OF AGING IN THE FAMILY
382M. Role and Function of Families
 2050 the projected number of older person is expected to Demographic and social trends that affects families’ abilities to
double again, reaching 2.1B provide support includes:
 2030, older people are expected to outnumbered children
under age 10-14 (1B vs.1.35B) and eventually outnumber 1. Increasing aging population
the number of adolescents and youth globally  Since 1900 percentage of Americans 65+ has more than
 Global aging - Philippines tripled (from 4.1% in 1990 to 19.9% in 2015) the number
 there is a greater proportion of younger Filipinos in has increased more than 15x (from 3.1M to 47.8M)
comparison to older Filipinos 2. Living arrangements
 4.2% the 60 years and older population of the Philippines  In 2016, 59% of noninstitutionalized persons age 65 and
is expected to increase by 4.2%, older lived with their spouses or partner.
 29% lived alone
CAILAH SOFIA Y. SELAUSO 4
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Aging Process
PRELIM | NCM 113 | Clinical Instructor: Arlene G. Oropel RN , MN
 3.1% of the 65+ group lived in an institutional setting such
as nursing home or assisted living.
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 END-OF-LIFE HEALTH CARE DECISIONS
6. Mobility of families The main interests of patients nearing the end of life are:
7. Increase in blended families 1. Pain and symptom control
8. Older adults providing and receiving support 2. Financial and health decision planning
9. The state of the senior housing industry 3. Funeral arrangements
10. Caregiver workplace issues 4. Being at peace with God
5. Maintaining dignity and cleanliness
COMMON LATE-LIFE FAMILY ISSUES & DECISIONS 6. Saying goodbye
Common issues and difficult decisions families face are the
following: TYPES AND LEVELS OF FAMILY CAREGIVING
1. Changes in living arrangements
2. Nursing facility placement 1. Routine Care – regular assistance
3. Financial and legal concerns incorporated into the daily routine of
4. End-of-life health care decisions the caregiver.
5. Vehicle driving issues 2. Back-up Care – assistance with routine activities
6. Family caregiving provided only at the request of the main
CHANGES IN LIVING ARRANGEMENTS caregiver.
1. Deal with your relatives perceptions and feelings 3.Circumscribed Care – participation provided on
2. Approach your family member in a way that prevents him or a regular basis within boundaries set by the
her from feeling helpless. caregiver (ex. Taking Mom to get her hair and
3. Suggest only one change or service at a time. nails done every Saturday)
4. Suggest a trial period 4. Sporadic Care – irregular participation at the
5. Focus on your needs caregiver’s convenience
6. Consider who has “listening leverage” 5. Dissociation – potential caregiver does not
participate at all in care
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
5. End-of-life health care decisions
6. Vehicle driving issues
7. Family care giving

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

CAILAH SOFIA Y. SELAUSO 5

BS NURSING 3-E