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Unit 1: Concepts, Principles, and Theories in The Care of Older Adults
Unit 1: Concepts, Principles, and Theories in The Care of Older Adults
Introduction
Getting old is inevitable, no matter how you want to escape with it, this is part of the age developmental
process. The older adults feel pain, sadness, boredom, loneliness, and sensitivity in some situations. As nursing
students, you may be allowed to handle older persons to be taken care of in the actual setting. As future nurse
practitioners, you may analyze the factors affecting older people's normal functions concerning their socio-
cultural uniqueness as an older person.
Objectives/Competencies
Upon completion of this module, you may expect to:
1. Compare and contrast sociological theoretical perspectives in aging.
2. Differentiate the different theories related to the care of older adults.
3. Discuss the factors influencing the demographics of aging.
4. Discuss the techniques and principles of a comprehensive geriatric assessment.
5. Identify the impact of an aging population on professional nursing.
Definition of Terms
1. Gerontology – the aging process that draws from the biological, psychological, and sociological
sciences. Study of all aspects of aging and its consequences.
2. Geriatrics – is the practice that focuses on the physiology, pathology, diagnosis and management of
older adults' disorders and diseases.
3. Aging – is the advanced generalized impairment of function resulting in a loss of adaptive response
to stress and a growing risk of morbidity and mortality.
4. Gerontologic nursing is related to assessing, planning, implementing and evaluating older adults in
all environments, including acute, intermediate, and skilled care, and within the community.
5. Chronological age - is the number of years since someone was born.
6. Biological aging – the physical changes that "slow us down" as we get into our middle and older
years, our arteries might clog up, or our lungs' problems might make it more difficult for us to breathe.
7. Psychological aging includes psychological changes involving mental functioning and personality that
occur as we age.
8. Social aging – is the changes in a person's roles and relationships, both within their networks of
relatives and friends and informal organizations such as the workplace and worship houses.
Principles in caring for an adult
1. The patient’s presentation is frequently involved.
2. The patient verbalized multiple chronic conditions, mental health issues, medication-related
problems, and social vulnerability.
3. Common diseases present unusually in this age group.
a. I am presenting Myocardial Infarction with NO chest pain, but with dyspnea or weakness.
b. May be considered cardiac causes.
4. Comorbid diseases may confound the presentation.
a. Comorbidity – is the presence of more than one disorder in the same person.
b. These are the examples of Comorbidity; Hypertension, Diabetes Mellitus, and auto-immune
disease, then cardiac diseases.
c. Chief complaints such as syncope, altered mental status, and fever may be caused or
influenced by these conditions.
5. Polypharmacy – is a practice among the elderly.
a. Polypharmacy is the simultaneous use of multiple drugs to treat a single ailment or condition.
b. Polypharmacy can cause by various factors, including Self-medicating, without an accurate
understanding of effects and reactions.
6. Alteration in drug actions, metabolism, and clearance occurs due to physiologic changes of aging.
7. Recognition of possible cognitive impairment is essential.
a. 30 – 40% of elderly patients experienced cognitive impairment.
b. Failure of the nurse to recognize cognitive impairment may result in inadequate work-up and
improper disposition.
c. Mental status assessment should be a routine part of the examination of geriatric patients.
8. Some diagnostic tests may have different typical standards.
9. These are issues in unmovable, and commonly abnormal laboratory values in the elderly can prevent
costly mistakes due to false assumptions.
10. The likelihood of decreased functional reserve must anticipate.
a. There is a decline in cardiac output with age.
b. The immune system may become sluggish in response to infection.
c. Special senses of touch, sight, hearing, taste, and smell can diminish when getting old.
11. Inadequate social support systems so the older adults may need to rely on caregivers.
a. Discharging someone to a low home environment is a sure way to guarantee a return back to
your urgent care.
b. An elderly with no definite source for food to eat, dress to wear, and how to make follow-up
visits may influence your decision.
12. Functional status –is essential for evaluating new complaints.
a. Data obtained from the patient, family, primary care physician, and old records can establish
data.
b. The patient with confusion, aphasia, weakness, or acute delirium has always been that way
can lead to missed diagnoses and unwise disposition.
13. Evaluate the health condition of the older person related to psychosocial change.
a. The highest rate of successful suicide occurs in older men.
b. Keep on monitoring for depression, anxiety, alcohol, and substance abuse, even in the
population of the elderly.
2. Activity Theory
● Describes that activity levels and social involvement are critical to this process, and it is the key to
happiness in life.
● It also explains that the more active and involved an older adult is, the happier life.
★ Criticisms of this theory point out that access to social opportunities and activity is not
equally available.
★ The theory's reforms suggest that participation in informal activities, such as hobbies, most
affects later life satisfaction (Lemon, Bengtson, and Petersen 1972).
3. Continuity Theory
- the older adult makes specific choices to maintain consistency in interpersonal structure, beliefs) and
external systems (relationships), remaining active and involved throughout their more senior years.
● What I wanted myself to be when I reached that age.
● Will I continue with what I am doing now till I get old?
This question is an attempt to maintain social equilibrium and stability by making future decisions
based on already developed social roles (Atchley 1971)
★ One criticism of this theory is its emphasis on so-called “normal” aging, which marginalizes
those with chronic diseases such as Alzheimer’s.
• Aging is a gradual, continuous process of natural change that begins in early adulthood.
• It is a life course, from birth to death, including a sequence of predictable life events such as physical
maturation.
• During early middle age, many bodily functions begin to decline gradually.
• People do not become old or elderly at any specific age.
• Traditionally, age 65 has designated as the beginning of old age.
• Old age is breaking into three stages:
o Young old (55–65 years of age)
o Middle old (66–85)
o 85 years and older.
o Old old (85 and older).
• The bones become brittle when they lose calcium and other minerals.
• Aging is a normal stage of life in which our bodies begin to function less effectively, making us more
vulnerable to disease. (Meilaender,2011)
• The process of aging is unavoidable and unrelenting in human beings.
• Growing older or chronological aging is a relentless and unstoppable process that happens to all
humans.
• As we grow older, we must be aware that we have to pass through different phases or stages of life.
• A life course is from womb to tomb, a sequence of predictable life events such as physical
maturation.
• Each stage has different responsibilities and expectations, vary by individual and culture.
b. Secondary aging occurs due to controllable factors such as lack of physical exercise and a low diet.
(Whitbourne and Whitbourne, 2010).
• The way people perceive physical aging is mostly dependent on how they were socialized.
• If people can accept their bodies' changes as a natural aging process, the changes will not seem
frightening.
3. SOCIAL AGING refers to the changes in a person's roles and relationships as age advances.
• Social change refers to how older adults deals society (rather than an individual)
• Develops over time to replace beliefs
• Changes Attitudes and behavior in new norms and expectations.
Key facts
•All countries face significant challenges to ensure that their health and social systems are ready to
make the most of this demographic shift.
• By 2030, projected that more than 60% of this generation would be managing more than one chronic
condition.
• Also, by 2050, the number of people 65 years or older is expected to outnumber children younger
than five.