Chapter - 007 Social, Psychological, Spiritual and Cognitive Aspects of Aging

Chapter 7
Social, Psychological, Spiritual and

Cognitive Aspects of Aging
Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 7-1
Lifespan Development Approach
• Development is lifelong.
• Development depends on history and context.
• Development is multidimensional and multidirectional and
involves a balance of growth and decline.
• Development is malleable and influenced by external
conditions.
Types of Aging
• Chronological age
• Biological age
• Psychological age
• Social age
Sociological Theories of Aging
• Disengagement Theory
• Old age is a time when both the older person and society engage
in mutual separation, as in the case of retirement.
• Activity Theory
• Based on the belief that remaining as active as possible
contributes to successful aging
• Continuity Theory
• Continuity strategies are used to adapt to the changes of normal
aging.
• People are motivated toward inner psychological continuity as
well as outward continuity of social behaviour and circumstances.
• Continuity is a fluid concept and does not imply that people do
not change; rather there is coherence and consistency of patterns
over time.
(cont’d)
• Social Exchange Theory
• Based on consideration of cost-benefit model of social
participation
• Withdrawal or social isolation is the result of an
imbalance in the social exchanges between older
persons and younger members of society.
• The balance determines the older person’s personal
satisfaction and social support at any point in time.
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Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 5
(cont’d)
• Age-Stratification Theory
• Goes beyond the individual to the age structure of
society
• Social institutions such as workplaces or families are
partly organized by age, with segregation of older and
younger people within these social institutions.
• Older people can be understood as members of specific
“birth” cohorts (e.g., baby boomers), in which people of
the same cohort have shared similar historical periods in
their lives.
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Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 6
(cont’d)
• Modernization Theory
• Attempts to explain social changes result in devaluing of
both contributions of elders and of older people
themselves.
• The status, and therefore the value, of older people is
lost in society when their labours are no longer
considered useful.
• Symbolic Interaction Theories
• Propose that the kind of aging process people
experience is a result of interactions between the
environment, the individual, and the meaning the
person attributes to his or her activities.
Psychological Theories of Aging
• Jung’s Theories of Personality

• Personality is either extroverted and oriented toward
the external world, or introverted and oriented to the
subjective inner world of the individual.
• The development of the psyche and the inner person is
accomplished by a search for personal meaning and the
spiritual self.
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Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Psychological Theories of Aging
(cont’d)
Developmental Theories
• Erikson – theorized predetermined order of development and
specific tasks associated with specific periods in one’s life course
• Havighurst – developmental tasks to be accomplished in middle
age and later maturity
• See Box 7-2 in text
• Peck – expanded on original work of Erikson with identification
of discrete tasks of late life that, when taken together, their
achievement would result in ego integrity
• Ego differentiation versus work role preoccupation
• Body transcendence versus body preoccupation
• Ego transcendence versus ego preoccupation
Theory of Gerotranscendence
• A high degree of life satisfaction
• Midlife patterns and ideals are no longer prime
motivators
• Complex and active coping patterns
• A greater need for solitary philosophizing, meditation,
and solitude
• Social activities are not essential to well-being
Theory of Gerotranscendence
(cont’d)
• Satisfaction with self-selected social activities
• Less concern with body image and material possessions
• Decreased fear of death
• Affinity with past and future generations
• Decreased self-centredness and increased altruism
Spirituality and Aging
• The spiritual aspect of people’s lives transcends the
physical and psychosocial to reach the deepest
individual capacity for love, hope, and meaning.
• Nurses must be knowledgeable and respectful of
the rites and rituals of various religions, cultural
beliefs, and values.
• Spirituality must be considered a significant factor
in understanding healthy aging.
Importance of Spirituality in the
Lives of Older Canadians
From Statistics Canada. (2002). Canadian community health survey. Retrieved from
http://www.statcan.gc.ca/pub/89-519-x/2006001/t/4122073-eng.htm.
Spiritual Nursing Responses
• Relief of physical discomfort, which permits focus on the
spiritual
• Comforting touch, which fosters nurse–patient connection
• Authentic presence
• Attentive listening
• Knowing the patient as a person
• Listening to life stories
• Sharing fears and listening to self-doubts or guilt
Spiritual Nursing Responses
(cont’d)
• Fostering forgiveness and reconciliation
• Sharing caring words and love
• Fostering connections to that which is held sacred by the
person
• Respecting religious traditions and providing for access to
religious objects and rituals
• Referring the person to a spiritual counsellor
• See Box 7-4 in text for Identifying Older People at Risk for Spiritual
Distress
Cognition and Aging
• Cognition is the process of acquiring, storing, sharing, and
using information
• Cognitive reserve (CR) based upon concept of
neuroplasticity
• Cognitive function includes the following 12 categories:
1. Attention Span 7. Concentration
2. Intelligence 8. Judgement
3. Learning Ability 9. Memory
4. Orientation 10. Perception
5. Problem-solving 11. Psychomotor Ability
6. Reaction Time 12. Social Intactness
Cognition and Aging
• Fluid and Crystallized Intelligence
• Fluid intelligence: consists of skills that are biologically
determined, independent of experience or learning
• Crystallized intelligence: comprised of knowledge and
abilities that the person acquires through education and
life
• Memory
• Defined as the ability to retain or store information and
retrieve it when needed
• For complaints of memory loss, a comprehensive geriatric
evaluation should be done, as memory impairment may
be related to a reversible and treatable condition.
Learning in Late Life
• Geragogy is the application of adult learning principles to
teaching interventions for older persons.
• Basic intelligence remains unchanged with increasing years.
• Older persons should be provided with opportunities for
continued learning.
• Teaching situations for older persons should be relevant;
new learning should be related to what is already known
and emphasize concrete and practical information.
• Barriers to Learning
• Hearing and vision losses
• Cognitive impairment
• See Box 7-6: Strategies to Enhance Learning of Older Persons
Health Literacy
• Ability of individuals to access and use health information to
make appropriate health decisions and maintain basic
health
• Factors affecting healthy literacy include:
• the person’s basic literacy skills and culture
• the situations encountered in the health care system
• the cultural competence and communication skills of health care providers
• Six out of 10 adult Canadians do not have proficient health
literacy.
• Health literacy experts recommend the Teach-Back Method
of health education
• See Box 7-8: Ten Elements of Teach-Back Method of Health
Education
Implications for Gerontological
Nursing and Healthy Aging
• Provide the gerontological nurse with useful information
and a background for enhancing healthy aging and
adaptation.
• Knowledge about the process of lifespan development can
assist gerontological nurses in understanding the meaning of
healthy aging for each individual.
• Understanding and appreciating the social, psychological,
spiritual, and cognitive aspects of aging provides a
foundation for nursing interventions.

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Chapter 7

Social, Psychological, Spiritual and

• Jung’s Theories of Personality

Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

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