1. Chapter Two
The Aging Experience

2. 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.

3. 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.

4. 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

5. 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.

6. 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

7. 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

8. 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!

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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.

17. 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.

18. 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

19. 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.

20. 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

21. 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

22. 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.

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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.

29. 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.

30. 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.

31. 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.

32. 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

33. 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.

34. 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.

35. 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

36. Questions?