1. Chapter Two
The Aging Experience

2. 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.

3. 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

4. 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.

5. Answer
B. They are capable of making decisions.

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

7. 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.

8. 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.

9. 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

10. Answer
B. The prejudice directed against older adults

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

12. 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.

13. 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

14. 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

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

16. Answer
C. Physiological theory

17. 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

18. 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.

19. 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).

20. 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

21. 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

22. 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.

23. 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.

24. 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

25. 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.

26. 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

27. 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

28. 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.

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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.

35. 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.

36. 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.

37. 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.

38. 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

39. 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.

40. 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.

41. 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

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

43. Answer
B. Gastrointestinal

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

45. Answer
D. Integumentary

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

47. Answer
True

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

49. Answer
False