MEDICAL SURGICAL 3

GERONTOLOGIC NURSING
PREPARED BY:
CAROLINE V. SAN DIEGO
 TERMINOLOGIES
 GERONTOLOGY
 OLD
 GERIATRICS
 SOCIAL GERONTOLOGY
 GEROPSYCHOLOGY
 GEROPHARMACOLOGY
 FINANCIAL GERONTOLOGY
 TERMINOLOGIES
 GERONTOLOGICAL
REHABILITATION NURSING
 GERONTOLOCICAL NURSING
 ROLES OF G. NURSE

1. PROVIDER OF CARE (ROLE OF

CAREGIVER)
2. TEACHER TERMINOLOGIES
3. MANAGER
4. ADVOCATE
5. RESEARCH CONSUMER
 THEORIES OF AGING
I. Biologic Theories
– Stochastic
– Non-stochastic
II. Sociologic Theories
III.Psychologic Theories
IV.Moral/Spiritual Theories
 BIOLOGIC THEORIES

• concerned with answering basic

questions regarding the physiologic
processes that occur in all living
organisms as they chronologically age
 Biologic Theories

• View aging as occurring from molecular,

cellular or even to a systems point of view
• The decreasing function of an organism
may lead to a complete failure of an
either an organ or an entire system.
 Biologic Theories
• All organs in any one organism do not
age at the same rate and any single
organ, does not necessarily age at the
same rate in different individuals of the
same species.
 FOCI OF BIOLOGIC
THEORIES
a. Deleterious effects leading to decreasing
function of the organism
b. Gradually occurring age-related
changes that are progressive overtime
c. Intrinsic changes that can affect all
members of a species because of
chronologic age
 STOCHASTIC THEORIES
• Explains aging as events that occur
randomly and accumulate overtime.
• Subdivisions:
1. Error theory
2. Free Radical theory
3. Wear and Tear theory
4. Cross-linkage theory
 1. Error theory

– Based on the idea that errors can occur in

the transcription in any step in the protein
synthesis of DNA and this eventually leads
to aging or the actual death of a cell
therefore systems will no longer function at
the optimum level.
 2. Free Radical Theory

– Byproducts of metabolism
– When these byproducts accumulate (as a
result of environmental pollutant) they
damage the cell membrane which decreases
its efficiency
 3. Wear and Tear Theory

– Organs and tissues have a preprogrammed

amount of available energy and wear out the
allotted energy is expended which eventually
lead to the death of the entire organism
– Death occurs because a worn out tissue
cannot forever renew itself
 4. Cross-linkage Theory
– With age, some proteins become increasingly
cross-linked or enmeshed and may impede
metabolic processes by obstructing the
passage of nutrients and wastes between the
intracellular and extracellular
compartments
– As person ages and the immune system
becomes less efficient, the body’s defense
mechanism cannot remove the cross-linking
agent before it become securely established
 NONSTOCHASTIC
THEORIES
• View aging as predetermined, timed
phenomena
• Subdivisions:
1. Programmed theory
2. Gene / Biological clock theory
3. Neuroendocrine theory
4. Immunological theory
 1. Programmed Theory
• As people age ,cell’s start to decide to
commit suicide or stop dividing
• “Hayflick limit theory”-fibroblast
replicate senescence
• Normal cells divide a limited number of
times
• Cumulative effect of improper
functioning of cells and eventual loss of
Cont.
• cells in organs and tissues are responsible
for the aging phenomenon
II.Gene / Biological Clock Theory
- Explains that each cell or the entire
organism has genetically programmed
aging code that is stored in the organisms
DNA.
III. Neuroandocrine theory

• - Theory describe a change in hormone

secretion, releasing hormones of the
hypothalamus and the stimulating hormones of
• pituitary gland.
 2. Immunity Theory

• As the person ages, the immune system

functions less effectively and this
predisposes the individual more
vulnerable to the disease
• “Immunosenscence”= age-related
decrease in immune system function
EMERGING THEORIES OF
AGING
• NEUROENDOCRINE CONTROL
• METABOLIC THEORY
• DNA RELATED RESEARCH
 Neuroendocrine Control or
Pacemaker Theory
• The neuro-endocrine system controls
many essential activities with regard to
growth and development
• Scientists are studying the roles that the
hypothalamus and the hormones DHEA
and Melatonin play in the aging process
 Metabolic theory of aging /
Caloric Restriction
• All organisms have a finite metabolic
lifetime and the organisms with a higher
metabolic rate have a shorter lifespan
 DNA Related Research
• 2 developments:
• Process of mapping or identification of
human genome which may play a role in
the aging process
• Discovery of the telomeres at the end of
the chromosomes which may function as
the cell’s biologic clocks
 SOCIOLOGIC THEORIES
• Focused on the roles and relationships
within which individuals engage in later
life
 Subdivisions:
• Disengagement Theory
• Developmental Task Theory
• Continuity Theory
• Age Stratification Theory
• Person-Environment Fit Theory
 Disengagement Theory
• Older adults preferred to withdraw from
society and to voluntarily decrease their
interactions with others and the society
supports this withdrawal
 Activity/Developmental Task
Theory
• Activity is necessary to maintain a person’s
life satisfaction and positive self-concept
• 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 2 assumptions
 Continuity Theory
• Proposes that how a person has been
throughout life, is how the person will
continue to be through the remainder of life
• The latter part of life is a continuation of
the earlier part and therefore an integral
part of the life cycle
 Continuity Theory

• Therefore: as people age, they try to

maintain or continue previous habits,
preferences, commitments, values, beliefs
and all of the factors that have
contributed to their personalities
 Age Stratification Theory

• Views the aging person as an individual

element of society and also as a member ,
with peers interacting in a social process
Person-Environment Fit Theory
• Each individual has personal
competencies that assist the person in
dealing with the environment. These
competencies (ego strength, motor skills,
individual biologic health, cognitive and
sensory perceptual capacities) may
change with aging, thus affecting older
person’s ability to interrelate with the
environment
PSYCHOLOGIC THEORIES
• Maslow’s Hierarchy of Human Needs
• Jung’s Theory of Individualism
• Erickson’s Theory
 Maslow’s Hierarchy of Human
Needs
• Human motivation is viewed as a
hierarchy of needs that are critical to the
growth and development of all people.
• Individuals are viewed as active
participants in life, striving for self-
actualization
Jung’s Theory of Individualism

• Development is viewed as occurring

throughout adulthood, with self-
actualization as the goal of personality
development.
• As an individual ages, he or she is
capable of transforming into a more
spiritual being
Erickson’s Eight Stages of Life
• All people experience 8 psychosocial
stages of a lifetime
• Each stage represents a crisis, where the
goal is to integrate physical prepares
maturation and psychosocial demands
• At each stage, the person has the
opportunity to resolve the crisis
Erickson’s Eight Stages of Life
• Successful mastery prepares an
individual for continued development
• Individuals always have within
themselves an opportunity to rework a
previous psychosocial stage into a more
successful outcome
Peek’s Expansion of Erickson’s
Theory
• 7 Development Tasks are identified as
occurring during Erickson’s final two
stages
• The final three of these developmental
tasks identified for old ages:
 The Final Three Of These
Developmental Tasks Identified
For Old Ages:
• Ego differentiation vs work
preoccupation
• Body transcendence vs body
preoccupation
• Ego transcendence vs ego preoccupation
 Ego Differentiation Vs Work Role
Preoccupation

• Task: to achieve identity and feelings of

worth from sources other than the work
role
• A person with a well-differentiated ego
can replace the work-role as the major
defining source for self-esteem
 Body Transcendence Vs Body
Preoccupation
• Older person’s view of the physical
changes that occur as a result of the aging
process
• Task: adjust to or transcend the declines
that may occur in order to maintain
feelings of well-being which can be
successfully resolved by focusing on the
satisfaction obtained from interpersonal
interactions and psychosocial activities
 Ego Transcendence Vs Ego
Preoccupation
• Involves acceptance of the individual’s
eventual death without dwelling on the
prospect of it
 Selective Optimization with
Compensation
• Physical capacity diminishes with age. An
individual who ages successfully
compensates for these deficits through
selection, optimization and compensation
 MORAL/SPIRITUAL
THEORIES
• Examine how an individual seeks to
explain and validate his/her existence