Chapter Two The Aging Experience

Impact of Aging on Nursing People 65 yrs old & older constitute 13% of the population in the United States. Let’s review 2 other important pieces of demographic information listed on pg. 20 What’s the fastest growing segment of the population? Pg. 21 65% of all patients in acute-care hospitals are 65 or older. 83% of those in home care are 65 or older. 92% of those in nursing homes are 65 or older.

Impact of Aging on Nursing (cont’d) As a group, older adults Are more educated They want & expect to have a say in the kind of healthcare they receive Are a powerful political force They influence the actions of Congress and the President on health-related issues Survived the Great Depression, two world wars, the Holocaust, the Korean and Vietnam Wars, and rock and roll! Nurses must consider this large group of older adults in a new way.

Attitudes Toward Aging Many myths, stereotypes, and prejudices about old age exist in our culture. Old age conjures up images of rocking chairs, dentures, memory loss, and incontinence These lead to discrimination against older people. Today’s adults have grown up in this culture of glorifying youth, what are some examples of how this happened? Pg. 23

Ageism Systematic stereotyping of and discrimination against people simply because they are old Allows the younger generation to see older people as different Negative attitudes exist subtly, covertly, and unconsciously. Negative images of the nursing home are examples of ageism.

Ageism (cont’d) Thinking that one older adult is just like another is an expression of ageism. Society has kept most of us from knowing about the aging process & respecting those who survive it. As a society we are outraged by acts of racism & sexism; we accept ageism as the norm Determine if you are ageist. Are you patient or impatient? Are you able to talk to “unhurriedly” to older adults? What does the author tell her students? Pg.24

Theories of Aging Scientific effort to understand what contributes to aging in a positive or negative manner Physiological and psychological theories As a nurse why is it important to understand these theories? Pg.24

Physiological Theories of Aging Genetic factors Genetic program that determines life span The aging of your body is also inherited (*Let’s review some examples listed on pg. 25) What is the most important aspect of this theory? Wear and tear Body parts show the effects of the work the body does through the years. What are some examples of this listed on pg.25? Nutrients This theory states that aging depends on a person’s nutrition intake over his or her life span. Evaluate our patient’s eating habits but also ours!

Psychological Theories Developmental tasks Erikson’s ego development According to Eric Erikson, what is the developmental task of old age? Pg.26 What happens if older adults do not achieve integrity? Pg.26 Help them to see what they have contributed to the world. Subculture theory Older people are their own subculture. Have their own cultural norms and standards Observe older adults & note their similarities but understand they are strongly individualized

Psychological Theories (cont’d) Continuity theory Basic personality and behavioral patterns do not change as a person ages. Recognizes unique and individualized characteristics of people and their ways of adapting to aging Why do we need to talk to the older person and the family members about what type of person your patient was in his or her youth or adulthood? Pg.26

Normal Aging Process Alterations in body structure and function that occur gradually throughout life Aging is a normal developmental event. Patterns of aging vary dramatically among older adults. As individuals age, they become more diverse Normal physiological aging reflects this diversity pg.28 The range of “normal” aging characteristics is wide Interplay of physical, social, and environmental influences Older adults often have a chronic/acute illness superimposed on age-related changes Is development of disease a normal part of aging? Pg.28

Normal Physiological Changes According to Body Systems Older adults experience functional changes as a result of physiological alterations. What does the term function refer to? Pg.28 *Point of Interest on pg.29

Normal Physiological Changes According to Body Systems Homework 2: Break up into groups of 4 (15 mins to answer approx. 8 Qs) Group 1: Cardiovascular & Gastrointestinal System Group 2: Integumentary & Nervous System Group 3: Urinary System & Special Sense Organs Group 4: Respiratory, Musculoskeletal, & Reproductive System Last few minutes of class: each group will present their findings to the rest of the class

Normal Physiological Changes According to Body Systems (cont’d) Normal Physiological Changes According to Body Systems (cont’d) Cardiovascular system Loses its efficiency with age Heart Decreased cardiac muscle strength Heart valves thicken and become rigid. Sinoatrial node less efficient

Normal Physiological Changes According to Body Systems (cont’d) Cardiovascular (cont’d) Blood vessels Arteries become less elastic. Capillary walls thicken and slow the exchange process. Greater rigidity of vascular walls

Normal Physiological Changes According to Body Systems (cont’d) Cardiovascular (cont’d) Blood Reduced blood volume Reduced bone marrow activity Respiratory Minimal age-related decline Skeletal Rib cage becomes rigid. Thoracic spine shortens.

Normal Physiological Changes According to Body Systems (cont’d) Respiratory (cont’d) Accessory muscles Abdominal muscles weaken. No change in diaphragm Intrapulmonary Lung elastic recoil is decreased. Functioning alveoli decreases. Alveolus-capillary membrane thickens.

Normal Physiological Changes According to Body Systems (cont’d) Respiratory (cont’d) Functional changes Less ventilation at base of lungs Less effective cough reflex Diminished oxygen saturation

Normal Physiological Changes According to Body Systems (cont’d) Musculoskeletal system Alterations in posture, changes in range of motion, and slowed movement Bone structure Loss of bone mass Vertebral column may compress. Muscle strength Muscle wasting Muscles lose flexibility and endurance.

Normal Physiological Changes According to Body Systems (cont’d) Musculoskeletal system (cont’d) Joints Range of motion limited Cartilage thins Functional changes Increased risk for fractures Decrease in overall function of individual

Normal Physiological Changes According to Body Systems (cont’d) Integumentary system Changes symbolic of the aging process more than those of any other system Skin Loses elasticity Subcutaneous fat diminishes Melanocytes cluster

Normal Physiological Changes According to Body Systems (cont’d) Integumentary system (cont’d) Hair Decreased activity of hair follicles Decreased rate of melanin production Women may develop hair on chin or upper lip.

Normal Physiological Changes According to Body Systems (cont’d) Integumentary system (cont’d) Nails Decreased blood flow to nailbed Sweat glands Decreases in size and number occur

Normal Physiological Changes According to Body Systems (cont’d) Integumentary system (cont’d) Functional changes Increased risk for skin injury and infection Impaired body temperature regulation

Normal Physiological Changes According to Body Systems (cont’d) Gastrointestinal system Common gastrointestinal problems greatly affect functional status. Oral cavity Reabsorption of bone in the jaw Esophagus Gag reflex weakens. Smooth muscle weakness

Normal Physiological Changes According to Body Systems (cont’d) Gastrointestinal system (cont’d) Stomach Decreased gastric acid secretions Intestines Peristalsis decreases. Weakening of sphincter muscles

Normal Physiological Changes According to Body Systems (cont’d) Gastrointestinal system (cont’d) Functional changes Delayed gastric emptying Reduced gastric acid secretions Nutritionally inadequate diet

Normal Physiological Changes According to Body Systems (cont’d) Genitourinary system Renal function Renal blood flow decreases. Reduced ability to concentrate urine Bladder Loss of muscle tone and incomplete emptying Capacity decreases.

Normal Physiological Changes According to Body Systems (cont’d) Genitourinary system (cont’d) Micturition Functional changes Urinary frequency, nocturia, retention of urine Infection, urgency, and incontinence Enlargement of prostate may lead to urinary retention, frequency, overflow incontinence, and eventual kidney damage.

Normal Physiological Changes According to Body Systems (cont’d) Nervous system Involves vascular response, mobility, coordination, visual activity, and cognitive ability Neurons Steadily lost in the brain and spinal cord Brain mass is lost progressively.

Normal Physiological Changes According to Body Systems (cont’d) Nervous system (cont’d) Movement Kinesthetic sense is less efficient. Balance may be impaired. Reaction time decreases. Sleep Insomnia and increased night wakening may occur. Deep sleep (stage IV) and rapid eye movement sleep decrease.

Normal Physiological Changes According to Body Systems (cont’d) Nervous system (cont’d) Functional changes Decrease in reaction time Increased risk for falls Impaired balance

Normal Physiological Changes According to Body Systems (cont’d) Special sense organs Sensory organs of sight, hearing, taste, touch, and smell facilitate communication with the environment. Vision Ability to focus on close objects is diminished. Increased density of lens occurs. Tear production decreases. Pupils decrease in size and become less responsive to light.

Normal Physiological Changes According to Body Systems (cont’d) Special sense organs (cont’d) Hearing Ability to hear high-frequency tones decreases. Cerumen hardens. Taste Ability to perceive bitter, salt, and sour tastes diminishes. Touch Ability to feel light touch, pain, or different temperatures may decrease.

Normal Physiological Changes According to Body Systems (cont’d) Special sense organs (cont’d) Functional changes Vision for low-tone colors may be difficult. Irritation and infection to eyes Inability to hear high-pitched tones

Questions?