1. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. CHAPTER Gerontological Nursing, Second Edition Patricia A. Tabloski Principles of Geronotology 1 Lecture Note PowerPoint Presentation

2. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. TabloskiGerontology Gerontology: Study of all aspects of aging and its consequences Ageism: when older adults are stereotyped Gerontologic nursing: specialized nursing with knowledge of illness and health of the aging

3. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. TabloskiAGEISM What are some stereotypic characteristics of the elderly that you have heard? Or believe? Dependent ? Frail ? Poor ? Lonely ? Unreliable d/t memory loss ? Rigid; narrow-minded ? Unable to learn ?

4. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Older Adult Young Old 60-74 Middle Old 75-84 Old Old 85 & older Presently: 12.8% of population 2030: will increase to 20% of population

5. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 1 Identify mortality data according to race, gender, and age.

6. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski The Goals of Gerontological Nursing Are to Study, Diagnose, and Treat Disease Principles include health promotion and health protection

7. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski The Gerontologic Nurse May Be Found in Skilled nursing facilities Retirement communities Adult day care Residential care facilities Transitional care units Rehabilitation hospitals Community based home care

8. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski All Nations Have an Aging Population The greatest increases will be in developing countries In 2005, 13% of the U.S. population was over age 60 –18.3 million aged 65–74 –12.9 million aged 75–84 –4.7% aged 85 or older

9. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Figure 1-1 Population over the age of 60, worldwide and developing regions.

10. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Feminization of Later Life Women comprise 55% of the older population Women have a longer life expectancy –The average life expectancy of women in the United States is 81 years –The average life expectancy of men in the United States is 75.2 years

11. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Figure 1-3 Number of males per 100 females by age, 2002.

12. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Feminization of Later Life Male exposure to risk factors may account for the differences Increases in female exposures to risk factors will reduce difference in life expectancy

13. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 2 Describe leading causes of disability among older adults.

14. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Epidemiology Study of health among populations

15. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Table 1-1 Top Causes of Death for People Age 65 and Over

16. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Chronic Conditions Develop Over Time Chronic disorders can start about age 20

17. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Nurses Can Intervene Using the Three Levels of Prevention Primary –Health promotion Secondary –Early diagnosis and prompt treatment Tertiary –Restoration and rehabilitation

18. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Chronic Conditions in Seniors 80% have at least one chronic condition Two of the three leading causes of death declined by one third –Heart disease and stroke

19. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Morbidity Two of the three leading causes of death declined by one third –Heart disease and stroke Leading causes –Hypertension –Heart disease –Diabetes –Respiratory disorders

20. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Seventy Percent of Physical Decline Related to Modifiable Risk Factors Smoking Poor nutrition Physical inactivity Failure to use preventative and screening services

21. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 3 Identify common myths of aging and their contribution to ageism.

22. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Fears of Aging Relate to Perception of Inevitable Disease Disability Decline

23. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Myths Can Lead to Ageism Reduced healthcare services Segregation (isolation) of elders from mainstream society Difficulty recruiting nurses to work with the elderly

24. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Common Aging Myths Old means being sick Older people cannot learn new things Health promotion is wasted on older people The elderly do not pull their own weigh. It is too late to change bad habits Older people have no interest in sex

25. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Role of the Gerontological Nurse Educate colleagues and peers

26. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 4 Describe the effects of chronic disease.

27. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski The Number of Individuals Impacted by Chronic Illness 125 million people in the United States One in ten people in the United States (30 million) have a related activity limitation.

28. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Financial Impact of Chronic Disease $470 billion in 1995 25% increase expected by 2030 Anticipated to be $864 billion in 2040

29. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Racial Differences Related to Chronic Disease African-Americans more likely to have limitations in ADLs Older African-Americans with arthritis more likely to have activity limitations 60% of older African-Americans report hypertension

30. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Racial Differences Related to Chronic Disease Increases in diabetes in African-Americans and Hispanics Life expectancy difference between African-American and White populations is 5.7 years

31. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Gender Differences Related to Chronic Disease Women report more help needed with ADLs than men –Need for assistance increases with age

32. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Impact of Chronic Disease on Emotional Health Women with a chronic condition rate health as poor African-Americans have least positive assessment of emotional well-being

33. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Challenges Faced Increased managed healthcare cost Providing accessible health care to all persons Recognizing differing healthcare needs

34. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Opportunities to Improve Older Adults’ Health and Quality of Life Healthy lifestyles Early disease detection Immunization Injury prevention Self-management techniques

35. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Healthy People 2010 Goals Increase quality and years of life Eliminate health disparities

36. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 5 Contrast several major theories of aging.

37. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Types of Aging Changes Benign and superficial –Graying hair –Wrinkles Senescence (or biological aging is the change in the biology of an organism as it ages after its maturity) –Progressive body system deterioration Plastic –Modifiable changes that can be slowed

38. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Organ Reserve Changes Reduced organ reserve with aging Homeostasis –Maintenance of body equilibrium Homeostenosis: refers to the body's ability to physiologically regulate its inner environment to ensure its stability in response to fluctuations in the outside environment and the weatherinner environment –Inability of body to restore homeostasis after environmental changes

39. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Aging Theories Biological –Programmed theories  Hypothesize that the body’s genetic codes contain instructions for regulation of cellular reproduction and death Programmed Longevity Endocrine Theory Immunological Theory

40. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Aging Theories Biological –Error theories  Hypothesize that environmental assaults and the body’s constant need to make energy and fuel metabolic activities cause toxic by- products Wear and Tear Theory Cross-Link Theory Free Radical Theory Somatic DNA Damage Theory Emerging Biological Theories

41. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Aging Theories Psychological aging theories –Coping or adaptive strategies must occur for a person to age successfully.  Jung’s Theory of Individualism  Erickson’s Developmental Theory

42. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski Aging Theories Sociological aging theories –Focus on roles and relationships that occur later in life  Disengagement Theory  Activity Theory  Continuity Theory

43. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski LEARNING OUTCOME 6 Evaluate the natural history of disease using principles of epidemiology.

44. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski National Institute on Aging Created by Congress in 1974

45. Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gerontological Nursing, Second Edition Patricia A. Tabloski History of Gerontology Past focus: study, diagnose, and treat disease Current focus: improvement of health holistically –Physical –Mental –Emotional –Spiritual well-being