2nd PPT Geria.pdf

Unit 2: Theories of Aging NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Intended Learning Outcomes (ILO) At the end of the unit, you are expected to: 1 Discuss the change in focus regarding learning about factors...

Unit 2: Theories of Aging NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Intended Learning Outcomes (ILO) At the end of the unit, you are expected to: 1 Discuss the change in focus regarding learning about factors influencing aging. 2 List the major biological theories of aging. 3 Describe the major psychosocial theories of aging. 4 Identify factors that promote a healthy aging process. 5 Describe the way in which gerontological nurses can apply theories of aging to nursing practice. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  1 Biological Theories of Aging NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Biological Theories of Aging Stochastic theories view the effects of aging as resulting from random assaults from both the internal and external environment over time. Nonstochastic theories see aging changes resulting from a complex, predetermined process. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Stochastic Theories Cross-Linking Theory Free Radicals and Lipofuscin Theories Wear and Tear Theories Evolutionary Theories Biogerontology NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Cross-Linking Theory proposes that cellular division is threatened as a result of radiation or a chemical reaction in which a cross-linking agent attaches itself to a DNA strand and prevents normal parting of the strands during mitosis. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Free Radicals and Lipofuscin Theories suggests that aging is due to oxidative metabolism and the effects of free radicals lipofuscin - is believed to have a role similar to that of free radicals in the aging process. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Wear and Tear Theories attribute aging to the repeated use and injury of the body over time as it performs its highly specialized functions body will function less efficiently with prolonged use and numerous insults (e.g., smoking, poor diet, and substance abuse). NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Evolutionary Theories hypothesize that the differences in the aging process and longevity of various species occur due to interplay between the processes of mutation and natural selection NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Evolutionary Theories 1. mutation accumulation theory 2. antagonistic pleiotropy theory 3. disposable soma theory NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Evolutionary Theories mutation accumulation theory suggests that aging occurs due to a declining force of natural selection with age. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Evolutionary Theories antagonistic pleiotropy theory suggests that accumulated mutant genes that have negative effects in late life may have had beneficial effects in early life NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Evolutionary Theories disposable soma theory proposes that aging is related to the use of the body’s energy rather than to genetics. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Biogerontology study of the connection between aging and disease processes Bacteria, fungi, viruses, and other organisms are thought to be responsible for certain physiologic changes during the aging process. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Nonstochastic Theories Programmed/Apoptosis Genetic Theories Autoimmune Reactions Neuroendocrine and Neurochemical Theories Radiation Theories Nutrition Theories Environmental Theories NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Programmed/Apoptosis Apoptosis is the process of programmed cell death that continuously occurs throughout life due to biochemical events NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Genetic Theories the programmed theory of aging proposes that animals and humans are born with a genetic program or biological clock that predetermines the life span NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Genetic Theories The error theory also proposes a genetic determination for aging. This theory holds that genetic mutations are responsible for aging by causing organ decline as a result of self-perpetuating cellular mutations. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Autoimmune Reactions The primary organs of the immune system, the thymus and bone marrow, are believed to be affected by the aging process. The immune response declines after young adulthood. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Autoimmune Reactions The weight of the thymus decreases throughout adulthood, as does the ability to produce T-cell differentiation. The level of thymic hormone declines after age 30 and is undetectable in the blood of persons older than 60 years. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Autoimmune Reactions The bone marrow stem cells perform less efficiently. The reduction in immunologic functions is evidenced by an increase in the incidence of infections and many cancers with age. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Autoimmune Reactions Some theorists believe that the reduction in immunologic activities also leads to an increase in autoimmune response with age. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Neuroendocrine and Neurochemical Theories suggest that aging is the result of changes in the brain and endocrine glands. Some theorists claim that specific anterior pituitary hormones promote aging. Others believe that an imbalance of chemicals in the brain impairs healthy cell division throughout the body. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Radiation Theories Repeated exposure to ultraviolet light is known to cause solar elastosis, the “old age” type of skin wrinkling that results from the replacement of collagen by elastin. Ultraviolet light is also a factor in the development of skin cancer. Radiation may induce cellular mutations that promote aging. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Nutrition Theories diet impacts health and aging obesity is shown to increase the risk of many diseases, accelerate the aging process, and shorten life good diet may minimize or eliminate some of the ill effects of the aging process NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Environmental Theories The ingestion of mercury, lead, arsenic, radioactive isotopes, certain pesticides, and other substances can produce pathologic changes in human beings. Smoking and breathing tobacco smoke and other air pollutants also have adverse effects. Crowded living conditions, high noise levels, and other factors are thought to influence how we age. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  2 Sociologic Theories of Aging NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Sociologic Theories of Aging Disengagement Theory Activity Theory Continuity Theory Subculture Theory Age Stratification Theory NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Disengagement Theory developed by Elaine Cumming and William Henry views aging as a process in which society and the individual gradually withdraw, or disengage, from each other, to the mutual satisfaction and benefit of both. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Activity Theory asserts that an older person should continue a middle-aged lifestyle, denying the existence of old age as long as possible society should apply the same norms to old age as it does to middle age and not advocate diminishing activity, interest, and involvement as its members grow old NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Continuity Theory (also called developmental theory) relates personality and predisposition toward certain actions in old age to similar factors during other phases of the life cycle NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Subculture Theory views older adults as a group with distinct norms, beliefs, expectations, habits, and issues that separate them from the rest of society NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Age Stratification Theory suggests that society is stratified by age groups Persons within a similar age group generally have similar experiences, beliefs, attitudes, and life transitions that offer them a unique shared history. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  3 Psychological Theories of Aging NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Psychological Theories of Aging Developmental Tasks Gerotranscendence NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Developmental Tasks The challenge of old age is to accept and find meaning in the life the person has lived; this gives the individual ego integrity that aids in adjusting and coping with the reality of aging and mortality. Feelings of anger, bitterness, depression, and inadequacy can result in inadequate ego integrity (e.g., despair). NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Developmental Tasks Three specific challenges facing the older adults (Robert Peck) that influence the outcome of ego integrity or despair: 1. Ego differentiation versus role preoccupation 2. Body transcendence versus body preoccupation 3. Ego transcendence versus ego preoccupation NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Developmental Tasks Robert Butler and Myrna Lewis (1998) outlined additional developmental tasks of later life: 1. Adjusting to one’s infirmities 2. Developing a sense of satisfaction with the life that has been lived 3. Preparing for death NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Gerotranscendence suggests aging entails a transition from a rational, materialistic metaperspective to a cosmic and transcendent vision less concerned with the physical bodies, material possessions, meaningless relationships, and self- interests NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  4 Nursing Theories of Aging  Nursing Theories of Aging Functional Consequences Theory Theory of Thriving Theory of Successful Aging NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Functional Consequences Theory for Promoting Wellness in Older Adults integrates theories from aging and holistic nursing holds that nurses can promote wellness by addressing individuals holistically, recognizing the interconnection of body, mind, and spirit. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Theory of Thriving proposes that everything that impacts people throughout their lives must be linked to create a holistic view of aging reinforces the importance of nurses considering the many factors that can impact health and quality of life for older adults NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN Theory of Successful Aging not only considers successful aging in terms of the older adult’s physical, mental, and spiritual well-being but also includes the individual’s self- appraisal  Theory of Successful Aging hypothesizes that people with high levels of personal control and a positive affect will experience higher levels of wellness in aging due to their ability to participate in health-promoting activities NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  5 Applying Theories of Aging to Nursing Practice NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Nurses must be sensitive to the tremendous impact their own attitudes toward aging can have on patients. Nurses who consider aging as a progressive decline ending in death may view old age as a depressing, useless period and foster hopelessness and helplessness in older patients. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  However, nurses who view aging as a process of continued development may appreciate late life as an opportunity to gain new satisfaction and understanding, thereby promoting joy and a sense of purpose in patients. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Assisting Individuals in Meeting the Psychosocial Challenges of Aging Overview Developmental tasks of older adults: Coping with losses and changes Establishing meaningful roles Exercising independence and control Finding purpose and meaning in life NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Assisting Individuals in Meeting the Psychosocial Challenges of Aging Goal Aging persons will express a sense of ego integrity and psychosocial well-being. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Assisting Individuals in Meeting the Psychosocial Challenges of Aging Actions Learn about patients’ life stories; ask about family backgrounds, faith, work histories, hobbies, achievements, and life experiences. Encourage patients to discuss these topics, and listen with sincere interest. Build on lifelong interests and offer opportunities for patients to experience new pleasures and interests. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Assisting Individuals in Meeting the Psychosocial Challenges of Aging Actions Accept patients’ discussions of their regrets and dissatisfactions. Help them to put these in perspective of their total lives and accomplishments. Encourage reminiscence activities between patients and their families. Help families and staff to understand the therapeutic value of reminiscence. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Assisting Individuals in Meeting the Psychosocial Challenges of Aging Actions Respect patients’ faith and assist them in the fulfillment of spiritual needs. Use humor therapeutically. If patients reside in an institutional setting, personalize the environment to the maximum degree possible. Recognize the unique assets and characteristics of each patient. NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN  Thank You! NCM 114: Care of Older Adults Caesar G. Balatero, RN, MN