Chapter Two The Aging Experience

Impact of Aging on Nursing 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 Are a powerful political force Want more say in the health-care services that they receive

Which statement is true regarding health care of the older adult? They do not question physicians’ orders. They are capable of making decisions. They want to be told the “right way.” They are noncompliant in treatment plans.

Answer B. They are capable of making decisions.

Attitudes Toward Aging Many myths, stereotypes, and prejudices about old age exist in our culture. These lead to discrimination against older people.

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 and respecting those who survive it. Determine if you are ageist.

What is ageism? The respectful behavior toward older adults The prejudice directed against older adults The glorification of the older adult The fear of getting older

Answer B. The prejudice directed against older adults

Theories of Aging Scientific effort to understand what contributes to aging in a positive or negative manner Physiological and psychological theories

Physiological Theories of Aging Genetic factors Genetic program that determines life span Wear and tear Body parts show the effects of the work the body does through the years. Nutrients Aging depends on a person’s nutrition intake over his or her life span.

Psychological Theories Developmental tasks Erikson’s ego development Integrity vs. despair Subculture theory Older people are their own subculture. Have their own cultural norms and standards

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

Which theory discusses that aging is based on genetic and lifestyle choices? Subculture theory Continuity theory Physiological theory Developmental task theory

Answer C. Physiological theory

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. Interplay of physical, social, and environmental influences

Normal Aging Process (cont’d) Normal aging and disease are separate entities. Includes gains and losses and does not necessarily indicate decline Successful adaptation to the aging process is accomplished by most older adults.

Normal Physiological Changes According to Body Systems The term function refers to an older adult’s ability to perform activities of daily living (ADLs) and independent activities of daily living (IADLs).

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

The changes related to which system are often the most concerning to the older adult? Nervous Gastrointestinal Genitourinary Musculoskeletal

Answer B. Gastrointestinal

Changes to which body system are the most symbolic for older adults? Respiratory Reproductive Cardiovascular Integumentary

Answer D. Integumentary

True or False Changes in all of the body systems that occur with aging can contribute to their increased risks for falls.

Answer True

True or false Dementia and memory impairment is a normal part of aging.

Answer False