Gerontology and Geriatrics Overview

Geriatrics and Gerontology Definitions

• Geriatrics is medical care of older adults.
• Gerontology is a multidisciplinary field specializing in aging, including nursing, psychology, and social work.
• Geriatric nursing is specific care for sick elderly individuals.
• Gerontologic Nursing enhances general health, while preventing of illnesses to improve life quality for elderly.
• Ageism is stereotyping and discrimination of people based on age.
• Robert Neil Butler coined term ageism.

Senior Citizen Population Statistics (Philippines, 2020)

• A total of 9,222,672 senior citizens
• 4,102,594 males
• 5,120,078 females
• Female's life expectancy is longer than males
• Male life expectancy: 67.08 in 2019, projected to 71.88 in 2050
• Female life expectancy: 75.31 in 2019, projected to 79.5 in 2050

Myths of Aging

• Only 5% of older adults need long-term care.
• Most older adults with chronic illnesses can still function well.
• Older adults are open to learning new things to stay mentally active, and should be mentally challenged
• Challenging mental activities lowers risk of Alzheimer's.
• Starting healthy habits is beneficial at any age
• Quitting bad habits and starting healthy habits can lead to better health outcomes, even later in life
• Older adults contribute to society through the arts, volunteering, and by helping grandchildren.
• Productive paid work is not the only means of value, and older adults work into advanced age.
• Heart disease risk decreases after quitting smoking.
• Exercise improves physical fitness, muscle mass, and strength.
• While sexual activity may decrease, the need for physical and mental affection remains consistent.

Categories of Aging

• Young old age: 60-74 years
• Old age: 75-84 years
• Old-old age: 85-100 years
• Centenarians: Over 100 years

Ethnicity

• U.K. and U.S: Elderly individuals may live separately from family and friends, and move to retirement communities when health declines.
• Greek and Greek-American culture: Old age is honored, and elders are expected to pass learnings to younger family members.
• Korea: Younger family members have duty of caring for elders, celebrating the hwan-gap (60th birthday).
• China: Filial piety and respect for elders derives from Confucian tradition; placing parents in retirement homes is frowned upon.
• Japan: The elderly are highly respected, with many living well past 100.
• Ancient Rome: Elders were precious and expected to act with dignity.
• India: Many live in joint families, with family elders as heads, who are often the most religious and charitable.
• Philippines: Elders are highly respected and cared for, preferring to live in their own homes.

LEARN Model

• This is a tool for cultural assessment in Gerontological nursing.
• L: Listen to verbal and non-verbal communication.
• E: Explain perception of the situation.
• A: Acknowledge similarities and differences between goals.
• R: Recommend a plan that considers all perspectives.
• N: Negotiate a mutually acceptable plan.

Theories of Aging

• Biological/Physiological Aging Theory:
  • Wear and Tear Theory: Body wears out over time.
  • Strategies: Manage stressors and understand body reactions to stress.
  • Somatic Theory: Gene mutations lead to problems during cell reproduction.
  • Law of Entropy Theory: Disorder increases without intervention.
  • Decay happens faster with a soft deterioration
  • Addition of more particles increases entropy of the system.
  • Increasing a complexity of system results in larger entropy.
  • Passage of time increases system entropy
  • Random activities increase entropy.
  • Reducing decay: Exercise, stimulate the brain, eat low-calorie foods, and relax.
  • Nutrient Deprivation Theory: Cells do not have enough nutrients and oxygen because of compromised vascular changes.
  • Cross-Linking Theory: Proteins link, damaging cells and slowing bodily processes in tissues.
  • Free Radical Theory: Oxidative damage builds leads to functional decline.
  • Lessen damage: Eat more antioxidant foods and cut calorie intake.
  • Accumulative Waste Theory: By-products accumulate in non-dividing cells, causing dysfunction and toxicity.
  • Waste accumulation impacts cell structure: worsening damage due to toxicity.
  • Autophagy recycles proteins and organelles.
  • Increase autophagy: Use intermittent fasting, exercise, drugs, and supplements.
  • Rate of Living Theory: Metabolism influences lifespan.
  • Governed by genetics and metabolism rate determine length of life.
• Ways to boost Metabolism:
  • Drinking lots of water
  • Doing physical activities
  • Getting enough sleep (7-9 hours)
  • Autoimmune Theory: Immune system attacks body because function decreases.
  • As immune system declines, it becomes harder for the body cells to tell themselves apart from foreign cells.
  • Older get respiratory and urinary infections with often poor prognosis.
• Coping Strategies: Eat healthy, sleep, manage stress, and acknowledge triggers.
  • Error Theory: cells don't function, lead to breakdowns and death.
  • Aging alters DNA affects translation and transcription malfunctions.
• Genetic Therapy Technique: Aims to insert DNA into diseased cells causing them to die:
  • Stops cells from producing DNA products
  • Introduction of other gene expressions infectious and cancerous diseases

Physiological Aging Theory

• Stress Theory: Environmental stressors generating free radicals disrupt DNA.
• Adaptation Theory: Requires careful functional tuning at every level but absence of adaptive genomic aging.

Psychological Aging Theory:

• Theory components are disengagement where you disengage for less activity and activity where you maintain families and roles
• Continuity Theory: continuation of earlier parts of life

Psychological Aging Theory

• Carl Jung's Theory of Individualism is focus toward the inner experience
• Erikson's Development Theory speaks of accepting death, using his development model.