Geria Quiz 1 PDF

CARE OF OLDER ADULTS THEORIES OF AGING AND ITS NURSING IMPLICATIONS BIOLOGIC THEORIES OF AGING  Environmental agents and randomly induced events can caus...

CARE OF OLDER ADULTS THEORIES OF AGING AND ITS NURSING IMPLICATIONS BIOLOGIC THEORIES OF AGING  Environmental agents and randomly induced events can cause error, with ultimate cellular The biological theories of aging are concerned in changes. It is well known that large amounts of X- answering basic questions about physiologic changes as all ray radiation cause chromosomal abnormalities. living organisms chronologically age.  This theory proposes that aging would not occur if The Foci of Biological Theories of Aging: destructive factors such as radiation did not exist and cause “error” such as mutations and regulatory 1. Deleterious effects leading to decreasing function disorders. of the organism 2. Gradually occurring age-related changes that are WEAR AND TEAR THEORY progressive over time.  The wear and tear theory proposes that aging is 3. Intrinsic changes that can affect all the members of primarily the result of accumulated damage to the species because of chronologic age. tissues and organs that occurs as a consequence All organs in any organism do not age at the same rate. of normal daily use. Any single organ does not necessarily age at the same  It suggests that the body's ability to repair and rate in different individuals of the same species. replace damaged cells and tissues gradually TWO CATEGORIES OF BIOLOGIC THEORIES becomes less efficient overtime, leading to the signs and symptoms of aging. STOCHASTIC THEORIES  This theory emphasizes the importance of lifestyle factors, such as diet, exercise, and exposure to A stochastic or statistical perspective, which identifies environmental stressors, in accelerating or episodic events that happen throughout one’s life that decelerating the aging process. cause random cell damage and accumulate over time, thus causing aging. CROSS LINKAGE/CONNECTIVE TISSUE THEORY Studies of animals reflect that the effects of aging are  This theory proposes that overtime, biochemical primarily due to genetic defects, development, processes create connections between structures environment, and the inborn aging process. (Harman, not normally connected 2006; Goldsmith, 2011).  Note: No research has identified anything that FREE RADICAL THEORY could stop these cross links from occurring. Elastin drives up and cracks with age; hence, skin with less  This theory postulates that aging is due to oxidative elastin tends to be drier and wrinkled. Over time, metabolism and the effect of free radicals, which because of decreased extracellular fluid, numerous are the end products of oxidative metabolism. deposits of sodium, chloride, and calcium build up  Free radicals are produced when the body uses in the cardiovascular system. oxygen, such as with exercise. This theory  Crosslinking refers to the formation of chemical emphasizes the significance of how cells use bonds between these proteins, which leads to the oxygen. loss of flexibility and function in tissues. Over time,  Free radicals are thought to react with proteins, the accumulation of these cross links in various lipids, deoxyribonucleic acid (DNA) and ribonucleic organs and tissues impairs their normal functioning acid (RNA), causing cellular damage. This damage and contributes to the aging process. This theory accumulates over time and is thought to accelerate emphasizes the role of structural changes in the aging. extracellular matrix and how they affect the overall  Exogenous Sources of Free Radicals aging phenotype. - Tobacco smoke - Organic solvents Theory Description - Ozone Stochastic Theories Based on random events that cause cellular damage that - Pesticides accumulates as the organism - Radiation ages. - Selected Medications Free Radical Theory Membranes, nucleic acids,  Free radicals are highly reactive molecules that are and proteins are damaged by generated as byproducts of various metabolic free radicals, which causes processes, environmental factors, and lifestyle cellular injury and aging. choices. These molecules can cause damage to Orgel/Error Theory Errors in DNA and RNA cellular components such as DNA, proteins, and synthesis occurs with aging. lipids. Over time, this damage accumulates and Wear and Tear Theory Cells wear out and cannot leads to aging and age-related diseases. function with aging. Connective tissue/ With aging, proteins impede ERROR/ORGEL THEORY cross-linking Theory metabolic processes and cause trouble with getting  This theory suggests that, over time, cells nutrients to cells and removing accumulate errors in their DNA and RNA protein cellular waste products. synthesis that cause the cells to die. (Orgel, 1970)  CARE OF OLDER ADULTS THEORIES OF AGING AND ITS NURSING IMPLICATIONS NON-STOCHASTIC THEORIES biological clock genes, are responsible for controlling this clock. As the clock ticks, it triggers The non-stochastic theories, which view aging as a changes in gene expression and cellular processes series of predetermined events happening to all that ultimately lead to aging. organisms in a timed framework. NEUROENDOCRINE THEORY The non-stochastic theories of aging are founded on a program perspective that is related to genetics or one’s The following major hormones are involved with aging: biological clock. Goldsmith (2004) suggests that aging is more likely to be an evolved beneficial characteristic  Estrogen decreases the thinning of bones, and and results from a complex structured process and not when women age, less estrogen is produced by the a series of random events. ovaries. As women grow older and experience menopause, adipose tissues become the major PROGRAMMED THEORY source of estrogen.  Growth hormone is part of the process that  The program's theory of aging proposes that the increases bone and muscle strength. Growth aging process is genetically programmed and hormone stimulates the list of insulin like growth follows a predetermined biological timeline. factor produced by the liver.  As people age, more of their cells start to decide to  Melatonin is produced by the pineal gland and is commit suicide or stop dividing. The Hayflick thought to be responsible for you are generating phenomenon, or human fibroblast replicative seasonal adaptations in the body senescence model, suggests that cells divide until they can no longer divide, whereupon the cells  The neuroendocrine theory of aging proposes that infrastructure recognizes this ability to further divide changes in the neuroendocrine system, which and triggers the apoptosis sequence or death of the includes the interplay between the nervous system cell. and hormonal regulation, play a significant role in the aging process.  According to this theory, there are specific genes and mechanisms within our cells that control the  According to this theory, aging is the is caused by aging process and determine the lifespan of an the dysfunction and decline in the neuroendocrine organism. These genes are believed to regulate system over time. This dysfunction leads to various cellular processes such as the DNA repair, imbalances in hormone levels, which subsequently cell division, and cell death. Overtime, the program affect various physiological processes and changes in gene activity leads to the progressive contribute to the aging phenotype. decline in cellular function and ultimately result in IMMUNOLOGIC/AUTOIMMUNE THEORY aging.  This theory proposed 40 years ago and describes GENE/BIOLOGICAL CLOCK THEORY the normal aging process of humans and animals  This theory explains that each cell, or perhaps the as being related to faulty immunological function. entire Organism, has a genetically programmed  According to this theory, the immune system aging code that is stored in organisms DNA. weakens overtime, making an aging person more  Slagboom and associates describe this theory as susceptible to disease. It also proposes that the comprising genetic influences that predict physical increase in autoimmune diseases and allergies condition, occurrence of disease, cause and age of seem with aging is caused by changes in the death, and other factors that contribute to longevity. immune system.  This theory indicates that there may be genes that Theory Description trigger youth and general well-being as well as Non-stochastic Based on genetically other genes that accelerate cell deterioration. Why Theories programmed events that do some people have Gray hair in their late 20s and cause cellular damage that others live to be 60 or beyond before graying accelerates aging of the occurs? It is known that melanin is damaged with Organism ultraviolet light and is the ingredient that keeps Programmed Theory cells divide until they are no humanity skin resilient and unwrinkled. People who longer able to, and this have extensive sun exposure have wrinkles earlier triggers apoptosis or cell in life due to damage to collagen and elastin. But death. why, if we know that people have a program gene Gene/biological clock Cells have a genetically or genes that trigger aging, wouldn't we prevent the Theory programmed aging code. gene from causing the problems they are intending Neuroendocrine Theory problems with the hypothalamus pituitary to promote? endocrine gland feedback  The gene or biological clock theory suggest that system cause disease; aging is controlled by an internal biological clock or increased insulin growth factor genetic clock that ticks away at a predetermine accelerates aging. rate. Immunological Theory Aging is due to faulty  This clock regulates the timing and pace of immunological function, which developmental processes and aging in organisms. is linked to general well-being. It is believed that specific genes known as  CARE OF OLDER ADULTS THEORIES OF AGING AND ITS NURSING IMPLICATIONS PSYCHOSOCIAL THEORIES OF AGING JUNG’S THEORY OF INDIVIDUALISM It is the dynamic interaction both internal (psychological) and  Development is viewed as occurring throughout external (social) factors and how they jointly affect an adulthood, with self realization as the goal of personality individual’s well-being and development. development. As individuals age, they can transform PSYCHOLOGICAL THEORIES into a more spiritual being  according to this theory, person's personality is The basic assumption of the psychological theories of visualized as oriented either toward the external world aging is that development does not end when a person (extroversion) or towards subjective, inner experiences reaches adulthood but remains a dynamic process (introversion). A balance between these two forces throughout the lifespan. As people age, various which are present in every individual is essential for adaptive changes help them cope with or accept some mental health. of the biologic changes.  Applying his theory to individuals as they progress Some of the adaptive mechanisms include memory, through life, Jung proposed that it is at the onset of learning capacity, feelings, intellectual functioning, and middle age that the person begins to question values, motivations to perform or not perform activities. beliefs, and possible dreams left unrealized. The phrase Psychological aging, therefore, includes not only midlife crisis, popularized by this theory, refers to a behavioral changes but also developmental aspects period of emotional, and sometimes behavioral, turmoil related to the lives of older adults. that heralds the onset of middle age. This may last for several years, with the exact time and duration varying MASLOW’S HIERARCHY OF NEEDS from person to person.  As the person is just chronologically, the personality  Human motivation is viewed as a hierarchy of needs often begins to change from being outwardly focus, critical to the growth and development of all people. concerned about establishing oneself in society, to Individuals are viewed as active participants in life, becoming more inward, as the individual begins to striving for self actualization. search for answers from within. Successful aging,  Maslow’s fully developed, self actualized person according to Jung’s theory, is when a person looks displays high levels of all the following characteristics: inward and values himself or herself for more than just – Perception of reality current physical limitations or losses. The individual – acceptance of self others and nature accepts past accomplishments and limitations. – spontaneity – problem solving ability ERIKSON’S EIGHT STAGES OF LIFE – self direction – detachment and the desire for privacy  All people experience 8 psychosocial stages during a – freshness of peak experiences lifetime. Each stage represents a crisis, where the goal – identification with other human beings is to integrate physical maturation and psychosocial – satisfying and changing relationships with other demands. At each stage, the person can resolve the people crisis. Successful mastery prepares an individual for – a democratic character structure continued development. Individuals always have within – creativity themselves an opportunity to rework a previous – sense of values psychosocial stage into a more successful outcome.  Maslow’s ideal self-actualized person is probably only  Because people were living longer, an obvious need attained by about 1% of the population (Thomas and arose to identify additional stages for older adults. Pic Chess, 1977). Nevertheless, the person developing in expanded the eighth stage, ego integrity versus despair, a healthy way is always moving toward more self- into 3 stages: fulfilling levels. 1) Ego differentiation versus work role preoccupation: - During the stage of ego differentiation versus work role preoccupation, the task for older adults is to achieve identity and feelings of worth from sources other than the work role. The onset of retirement and termination of the work role may reduce feelings of self-worth. In contrast, a person with well-differentiated ego, who is defined by many dimensions, can find other roles to replace the work role as the major defining source for self-esteem. 2) Body transcendence versus body preoccupation: - The second stage, but the transcendence versus badi be occupation, refers to the older person's view of the physical changes that occur because of the aging process. The task is to adjust or transcend the declines that may occur to maintain feelings of well-being. This task can be successfully resolved by focusing  CARE OF OLDER ADULTS THEORIES OF AGING AND ITS NURSING IMPLICATIONS on the satisfaction of being from interpersonal interactions and psychosocial activities. 3) Ego transcendence versus ego preoccupation - The third and final task, ego transcendence versus ego preoccupation, involves acceptance of the individual's eventual death without dwelling on the prospect of it. Remaining actively involved with a future that extends beyond a person's mortality is the adjustment that must be made to achieve ego transcendence. Selective Optimization with Compensation Physical capacity diminishes with age. An individual who ages successfully compensates for these deficits through selection, optimization, and compensation. These concepts of selection, optimization, and compensation can be applied to any aspect of older adulthood to demonstrate successful coping with declining functions.  CARE OF OLDER ADULTS IMPACT OF AGING MEMBERS IN THE FAMILY IMPACT OF AGING MEMBERS IN THE FAMILY KEY IMPLICATION FOR FAMILIES 1. Emotional Impact on Family Caregivers Emotional Toll: Caregivers face emotional stress that can Providing care for an aging family member can be develop into more severe mental health conditions if proper emotionally draining. Family caregivers often experience support is not available. a range of emotions, including stress, frustration, and sadness. Watching a loved one’s health deteriorate can Caregiver Burnout: Caregivers often experience burnout, be distressing, leading to feelings of helplessness. Over characterized by emotional, mental, and physical exhaustion. time, emotional strain can lead to conditions such as The constant demands of caregiving, coupled with emotional depression and anxiety, particularly if caregivers do not attachment to the aging family member, can make it difficult to have adequate support or respite. maintain balance in their personal lives 2. Financial Strain Financial Strain: The rising costs of medical care, long-term Caring for an older family member can lead to financial care, and reduced household income place financial stress on difficulties. Medical expenses, such as medication, families, often resulting in difficult decisions about care options assistive devices, and specialized care, often add up quickly. Additionally, some family members may need to reduce their working hours or quit their jobs to provide full time care, further straining the family’s finances. 3. Physical Strain Physical Health: The physical demands of caregiving can Caregiving often requires significant physical effort, lead to health complications for the caregiver, particularly if especially for elderly individuals with limited mobility. they lack proper training or support. Family members may be responsible for tasks like lifting, bathing, or dressing, which can cause physical strain and Physical Exhaustion: Lack of sleep, high levels of activity, injuries, particularly if caregivers are older or have health and constant caregiving duties contribute to physical fatigue, issues themselves which can further affect a caregiver’s health over time. 4. Social Impact and Isolation Social Isolation: Caregivers may experience social isolation Providing care for an elderly family member often limits due to their caregiving duties, which can contribute to the caregiver’s social life. Time-consuming caregiving depression and loneliness. responsibilities can lead to a decline in social interactions, resulting in social isolation for the caregiver. This isolation Social Isolation: Caregivers may find it difficult to maintain can contribute to feelings of loneliness and emotional relationships or participate in social activities, resulting in stress feelings of loneliness and alienation from friends and extended family. 5. Changing Family Dynamics Balancing Caregiving Responsibilities with Work and The addition of caregiving responsibilities can shift the Personal Life: Family caregivers often struggle to balance roles within the family, sometimes causing tension. Adult their personal and professional lives with caregiving duties. children may find themselves in a caregiving role for their This balance is difficult to maintain, leading to increased stress parents, creating a reversal of the traditional parent-child and work absenteeism. relationship. Family conflicts may arise when caregiving responsibilities are unequally distributed, or when decisions about the elderly family member’s care are not mutually agreed upon ROLES OF NURSES IN SUPPORTING FAMILIES Nurses and healthcare professionals can provide essential support to family caregivers. By offering education on caregiving techniques, they help reduce the emotional and physical burdens on families. Nurses also connect families with resources such as support groups, respite care, and community services to assist with caregiving. Moreover, nurses can monitor the health of both the aging individual and the caregiver, ensuring that both receive the care they need. Education and Training: Nurses can teach caregivers how to handle daily care tasks, manage medications, and recognize early signs of health complications in older adults. Emotional Support: Providing caregivers with emotional support and counseling can help alleviate the stress of caregiving, reducing the risk of burnout. Resources: Nurses can connect families with external resources, such as respite care and support groups, which can ease the burden of caregiving  CARE OF OLDER ADULTS PERSPECTIVE OF AGING GERONTOLOGY  Successful aging must ultimately be about what older adults value, rather than the chimera of  is the study of the aging processes and individuals younger adult health in an older adult body (Glass, as they grow from middle age through later life. 2003 as cited by Martin, Kelly, Kahana, Kahan,  It includes: Willcox, Willcox and Poon, 2015) - the study of physical, mental and social changes in older people as they age CONCEPTUALIZING AGING - the investigation of the changes in society resulting from our aging population Aging can be seen from 3 dimensions: - the application of this knowledge to policies 1. Decline and programs (Association for Gerontology in  By age 70 we identify only 50% of the smells Higher Education, n.d.)  Night vision declines...by age 80 few can drive at GERIATRICS night  By age 90 50% cannot use public transportation  the study of health and disease in later life  the comprehensive health care of older persons 2. Change and the well-being of their informal caregiver  Hair, waistline, skin...change (Association for Gerontology in Higher Education,  Making love shifts from 3/week to 2/month n.d.)  Our ability to love and be loved does not diminish  Our capacity for joy is undiminished GERONTOLOGIST 3. Development  Are people who improve the quality of life and  At 70 we are more patient, accepting of affect in promote the well-being of persons as they age ourselves, likely to tolerate paradox within their families, communities and societies through research, education and application of interdisciplinary knowledge of the aging process and aging populations (Association for Gerontology in Higher Education, n.d.) AGEING/AGING  Decline or loss (a “de-tuning”) of adaptation with increasing age, caused by a time progressive decline of Hamilton’s forces of natural selection (Flatt, 2012).  Hamilton’s forces of natural selection – is an evolutionary theory for mortality rate plateaus – “Aging does indeed stop.” (Shahrestani, Mueller & Rose, 2016). It suggests the possibility that the physiology of adults undergoing aging may be substantially different from the physiology of life after aging. Active Aging: is the process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age (World Health Organization, 2016). Positive Aging: is described based on four characteristics: 1. The mobilization of latent resources 2. Psychological flexibility 3. An affirmative decision-making style 4. the propensity to generate optimistic response to stressors inherent in age-related decline  Employ intervention research on employing gratitude, forgiveness and altruism to preserve subjective well-being. Successful Aging: Aging has been viewed through various lenses throughout history, and over the last 50 years the definition of successful aging has evolved from early theories of activity and disengagement to theoretical approaches with a more direct focus