LECTURE 1 (Basic Skill for Gerontologic Nursing)
GERIATRIC • The branch of psychology concerned with
“GERAS” means old age, and “IATRO” means medical
treatment.
• is a medical specialty that deals with the
physiology of aging and with the diagnosis and
treatment of diseases affecting older adults
GERONTOLOGY
“GERO” means old age, and “OLOGY” means the study
of.
• is the study of all aspects of the aging process,
including the clinical, psychologic, economic,
and sociological problems of older adults and
society
GERONTOLOGIC NURSING
The specialty of nursing involves:
• Assessing the health and functional status of
older adults
• Planning and implementing health care and
services to meet the identified needs and
• Evaluation of the effectiveness of such care
GERONTIC NURSING
• Connotes the nursing of older persons – the art
and practice of nurturing, caring, and
comforting.
• It encompasses a holistic view of aging with the
goal of increasing health, providing comfort, and
caring for older adults needs.
SOCIAL GERONTOLOGY
• Concerned mainly with the social aspects of
aging versus the biological or psychological.
SOCIAL GERONTOLOGIST –a person who seeks to
understand how the biological processes of aging
influence the social aspects of aging.
Uson, Paulene B.
BSN – 3A
NCM 114 – Care of the Older Person (Lecture)
GEROPSYCHOLOGY
helping older persons and their families
maintain well-being, overcome problems, and
achieve maximum potential during later life.
GEROPHARMACOLOGY
• The study of pharmacology as it relates to older
adults.
• CGP – certified geriatric pharmacist
FINANCIAL GERONTOLOGY
• Another emerging subfield that combines
knowledge of financial planning and services
with special expertise in the needs of older
adults
GERONTOLOGICAL REHABILITATION NURSING
• Combine expertise in gerontological nursing
with rehabilitation concepts and practice
• Care for older adults with chronic illness and
long-term-functional limitations such as stroke,
head injury, multiple sclerosis, Parkinson’s
disease, spinal cord injury, arthritis, joint
replacement, and amputations
PURPOSE:
• To assist older adults to regain and maintain the
highest level of function and independence
possible while preventing complications and
enhancing the quality of care
OLD
• Having lived or existed for a long time
AGING
CHRONOLOGIC AGE – the number of years a person has
lived
• Most often used when we speak of aging
because it is the easiest to identify and
measure.
• It is not the most meaningful measurement of
aging
 • chronologically young but physically or
functionally old
• Individuals remain physically fit, stay
mentally active, and are productive
members of society
GERONTOPHOBIA
• Fear of aging and the refusal to accept older
adults into the mainstream of society
• Results in very odd behavior
Two extreme gerontophobia
AGEISM
• Disliking of aging and older adults based on the
belief that aging makes people unattractive,
unintelligent, and unproductive
• It is an emotional prejudice or discrimination
against people based solely on age
• Is a negative belief pattern that can result in
irrational thoughts and destructive behaviors
• Have a negative effect on the way health care
providers relate to older patients, which in turn,
can result in poor health care outcomes in these
individuals
Two Ways to Fight Ageism
• Increased positive interactions with older adults
• Improved professional training designed to
address misconceptions regarding aging
AGE DISCRIMINATION
• Reaches beyond emotions and leads to actions;
older adults are treated differently simply
because of their agent
• It is illegal
• Some older adult responds to age discrimination
with passive acceptance, whereas others are
banding together to speak up for their rights
Epidemiology – the study of health among populations
Uson, Paulene B.
BSN – 3A
NCM 114 – Care of the Older Person (Lecture)
BIG 10 BASIC PRINCIPLES OF GERIATRICS
1. Aging is not a disease
2. Medical conditions in geriatric patients are
commonly chronic, multiple, and multifactorial
3. Reversible and treatable conditions are often
under-diagnosed and under-treated in geriatric
patients
4. Functional ability and quality of life are critical
outcomes in the geriatric population
5. Social history, social support, and patient
preferences are essential aspects of managing
geriatric patients
6. Geriatric care is multidisciplinary
7. Cognitive and affective disorders are prevalent
and commonly undiagnosed at early stages
8. Iatrogenic illnesses are common and many are
preventable
9. Geriatric care is provided in a variety of settings
ranging from the home to long-term care
institutions
10. Ethical issues and end-of-life care are critical
aspects of the practice of geriatrics
EXISTING MEASURES PROTECTING AND PROMOTING
THE HUMAN RIGHTS OF THE ELDERLY
• Establishment of homes for the aged in various
regions
• Passage of RA 7432 which provides for the
establishment of Senior Citizen’s affairs in the
cities and municipalities.
• Passage of RA 7876 known as the Senior
Citizens Acts established day care centers for
senior citizens in every municipality
REPUBLIC ACT NO. 9994 “Expanded Senior Citizens Act
of 2010”
• An act granting additional benefits and
privileges to senior citizens, further amending
republic act no. 7432, as amended, otherwise
known as “an act to maximize the contribution
of senior citizens to nation building, grant
benefits and special privileges and for other
purposes
 LECTURE 2 (Theories of Aging)
THEORIES OF AGING
• Attempts to explain the phenomenon of aging
as it occurs over the lifespan
• Aging is viewed as a total process that begins at
conception
Senescence – a change in the behavior of an organisms
with age leading to a decreased power of survival and
adjustment
Types
Biologic
– concerned with answering basic questions regarding
the physiological processes that occur in all living
organisms as they chronologically age.
Explanations of:
• deleterious effects leading to decreasing
function of the organisms
• Gradually occurring age-related changes that
are progressive over time
• Intrinsic changes that can affect all members of
a species because of chronological age
Divisions (Category of Biologic): Stochastic &
Nonstochastic
Stochastic – explain aging as events that occur
randomly and accumulate over time
Nonstochastic: view aging as certain
predetermined, timed phenomena
Theories (Stochastic):
❖ Error Theory (1963)
1. errors can occur in the transcription in any step
of the protein synthesis of DNA
2. errors cause the reproduction of an enzyme or
protein that is not an exact copy
3. as transcription errors occur, the end product
would not even resemble the original cell,
thereby compromising its functional ability
Uson, Paulene B.
BSN – 3A
NCM 114 – Care of the Older Person (Lecture)
❖ Free Radical Theory
1. free radicals are byproducts of metabolism –
can increase as a result of environmental
pollutants
2. when they accumulate, they damage the cell
membrane, decreasing its efficiency
3. the body produces antioxidants that scavenge
the free radicals
4. In animal studies, the administration of
antioxidants postpones the appearance of
diseases such as cardiovascular disease and CA
5. Free radicals are also implicated in the
development of plaques associated with
Alzheimer’s
❖ Cross-Linkage Theory
1. Some proteins in the body become cross-linked,
thereby not allowing for normal metabolic
activities.
2. Waste products accumulate
3. Result: tissues do not function at optimal
efficiency
4. Some research supports a combination of
exercise and dietary restrictions in helping to
inhibit the cross-linkage process
❖ Wear & Tear Theory
1. Proposed by German biologist, Dr. August
Weismann, in 1882
2. Cells simply wear out over time because of
continued use-rather like a machine
3. This would seem to be refuted by the fact that
exercise can actually make MS more functional,
not less
Theories (Nonstochastic):
❖ Programmed ((Hayflick Limit) Theory
1. Based on lab experiments on fetal fibroblastic
cells and their reproductive capabilities in 1961
2. Cells can only reproduce themselves a limited
number of times
3. Life expectancies are seen as preprogrammed
within a species-specific range
❖ Immunity Theory
1. Immunosenescence – age-related functional
diminution of the immune system
2. Lower rate of T-lymphocytes (killer cells)
proliferation in response to a stimulus
3. And therefore a decrease in the body’s defense
against foreign pathogens
4. Change include a decrease in humoral immune
response, often predisposing older adults to:
• Decreased resistance to a tumor cell challenge
and the development of cancer
• Decreased ability to initiate the immune process
and mobilize defenses in aggressively attaching
pathogens
• Increased susceptibility to auto-immune diseases
Sociologic Theories of Aging
❖ Disengagement Theory (Cumming & Henry 1961)
1. aging is seen as a developmental task in and of
itself with its own norms & appropriate patterns
of behavior
2. “appropriate” behavior patterns involved a
mutual agreement between older adults and
society on a reciprocal withdrawal
3. No longer supported
4. Older individuals are seen as limiting their social
life spaces in response to societal pressures and
in order to prepare for the final phase of their
lives
❖ Activity Theory (developmental task theory)
1. Havinghurst, Neugarten, Tobin, 1963)
2. Activity is viewed by this theory as necessary to
maintain a person’s life satisfaction and a
positive self-concept
3. Theory based on assumptions:
• it is better to be active than inactive
• It is better to be happy than unhappy
❖ Continuity Theory
1. How a person has been throughout life is how
that person will continue through the remainder
of life
2. Old age is not a separate phase of life, but
rather a continuation and thus an integral
component
Uson, Paulene B.
BSN – 3A
NCM 114 – Care of the Older Person (Lecture)
❖ Age Stratification (Riley 1985)
1. Is a system of conferring power and respect
onto certain age groups. The people and roles in
these cohorts change and influence each other,
as does society at large.
❖ Person-Environment Fit Theory (Lawton, 1982)
1. Individuals have personal competencies that
assist in dealing with the environment (ego
strength, level of motor skills, individual biologic
health, and cognitive & sensory-perceptual
capacities
2. As a person ages, there may be changes in
competencies and these changes alter the
ability to interrelate with the environment
Psychologic Theories of Aging
❖ Maslow’s Hierarchy of Human Needs (1954)
1. Each individual has an innate internal hierarchy
of needs that motivates all human behaviors
2. Depicted as a pyramid; the ideal is to achieve
self-actualization, having met all the “lower”
level needs successful
3. Only about 1% of us are truly ideal self-
actualized persons
❖ Jung’s Theory of Individualism
1. Carl Jung 1960
2. Self-realization is the goal of personality
development
3. The process of self-realization is the discovery
and experience of meaning and purpose in life;
the means by which one finds oneself and
becomes who one really is
4. As individual ages, each is capable of
transforming into a more spiritual being
❖ Erikson’s Eight Stages of Life 1993
1. Stages throughout the life course. Each
represents a crisis to be resolved
2. For OA’s
• 40 to 65 (middle adulthood):
generativity versus self-absorption or
stagnation
• 65 to death (older adulthood): ego
integrity versus despair
❖ Selective Optimization

3 interacting elements

• Selection – increasing restriction of one’s life to

fewer domains of functioning
• Optimization – people engage in behaviors to
enrich their lives
• Compensation – developing suitable,
alternative adaptations

Uson, Paulene B.
BSN – 3A
NCM 114 – Care of the Older Person (Lecture)