Nursing Care for Older Adults

Older Adults: Theories of Aging and Individualized Aging

• Course Outcome: Describe principles of safe, patient-centered, evidence-based nursing care to adults at the basic level, guided by the Caritas philosophy.
• Competency: Describe principles of patient-teaching that reflect developmental, ethnic, social, and cultural considerations.
• Concept: Development: The sequential physical and psychological capacities that allow complex adaptation to the environment.
• Unit Outcomes:
  • Discuss teaching methods based on the adult and older adult developmental levels.
  • Discuss theories of aging.
  • Describe individualized aging.
• Variability Among Older Adults:
  • Physiological, cognitive, and psychosocial health
  • Levels of functional ability (e.g., ADL: Activities of Daily Living – Paying Bills, Dressing, Grooming, Toileting)
  • Dependence vs. independence
  • Strengths and abilities

Four Predominant Theories of Aging

• Wear-and-Tear: Repeated insults and accumulation of metabolic wastes cause cell wear-out and cessation of function.

• Genetic: Cells have a preprogrammed number of divisions that define their lifespan, leading to natural death.

• Cellular Malfunction: Cell malfunction causes DNA changes leading to altered cell replication and impaired normal cell function.

• Autoimmune Reaction: The immune system mistakenly identifies some cells as foreign, triggering an immune response to destroy the body's own cells.

• Theories of Aging: Most scientists view aging as a combination of the four theories, inherited traits, and responses to environmental stressors.

Genomics and Personalized Healthcare

• Genomics: Study of all genes in humans, including interactions with each other, environment, and psychological/cultural factors.
• Personalized Healthcare: Tailored medical treatments based on a patient's specific genetic code for a tailored approach; uses preventive, diagnostic and therapeutic interventions based on genetic tests and family history. Goal: improve health outcomes, healthcare delivery system, and individual quality of life.

Myths and Stereotypes About Older Adults

• Older adults are sometimes seen as:
  • Ill, disabled , unattractive
  • Forgetful, confused, rigid, boring, unfriendly
  • Unable to learn/understand new information
  • Not interested in sex or sexual activities
  • Important Note: This is not "always" true for all older adults

Communicating with Older Adults

• Communication Strategies: Sit or stand at eye level in front of the patient. Face the patient when speaking and do not cover mouth. Speak clearly. Use appropriate lighting (diffuse, bright, non-glare). Encourage use of assistive devices (e.g., glasses, magnifiers).

Individualized Aging Concepts

• Self-perception of Well-being: Defines perspective about quality of life.
• Older patients' concept of health: Revolves around their perceived ability to function.

Practice Question Example

• Scenario: When educating an older adult, what example would indicate the nurse has a stereotype against the patient?
• Possible examples:
  • "I should make sure and tell your husband..." (indicates doubt of patient's memory).
  • Statements that assume lack of understanding  or interest.

This quiz covers principles of safe and patient-centered nursing care specifically tailored for older adults. It explores various theories of aging, individualized aging practices, and methods for teaching that respect the developmental and cultural diversity of this population. Test your understanding of the physiological, cognitive, and psychosocial aspects of aging.