NCM 114: CARE OF THE OLDER ADULT

Theories of
Aging

Prepared by:
MA. ALTHEA O. ILAO, RN
Instructor I
BatStateU ARASOF CONAHS
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 Learning Objectives:
° Identify the major theories of aging.
° Apply nursing theory to the care of older adults.
° Discuss several nursing implications for each of the major
biologic, sociologic and psychological theories of aging.
° Describe a general theoretical framework, taken from all of the
aging that will assist nurses in making clinical decisions in
gerontology.

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 Overview
Theories help make sense of a phenomenon; they provide a sense of
order and give a perspective from which to view facts.
Aging may be viewed as a continuum of events that occur from
conception to death (Ignatavicius, et al, 2018)
Theories that are validated through research can guide nurses in
helping elderly patients navigate the changes they experience.

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 Overview
“A good gerontological theory integrates knowledge, tells how and
why phenomena are related, leads to prediction, and provides process
and understanding. In addition, a good theory must be holistic and
take into account all that impacts a person throughout a lifetime of
aging.” (Haight, et al, 2002)
“Senescence” – defined as a change in the behavior of an organism with
age, leading to a decrease power of survival and adjustment.

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 Theories Related to Care
of the Older Adult

NURSING:
BIOLOGIC: SOCIOLOGIC: MORAL/
focused on the PSYCHOLOGICAL: Helps to describe
concerned with and explain SPIRITUAL:
answering basic roles and Influenced by both
phenomena;
relationships biology and sociology; Examines how an
questions regarding addresses how a
predicts and
physiologic process within which person responds to the
prescribes nursing individual seeks to
that occur in all living individuals engage interventions for explain and validate
tasks of his or her age.
organisms over time. the range of his or her existence.
in later life. different situations

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 STOCHASTIC THEORIES – or
statistical perspective, which identifies
episodic events that happen throughout
one’s life that cause random cell damage and
accumulate over time, thus causing aging.

BIOLOGICAL
NONSTOCHASTIC THEORIES –
which view aging as a series of
predetermined events happening to all
organisms in a timed framework.

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BIOLOGICAL: Stochastic Theories of Aging
1. Free – Radical • Accumulated damage caused by oxygen radicals
Theory causes cells and eventually organs to lose function
and organ reserve;
(Mitochondrial)
• The use of antioxidants and vitamins is believed
to slow this damage.
2. Error Theory • Suggests that over time, cells accumulate errors in
(Orgel Theory) their DNA and RNA protein synthesis that cause
the cells to die.
• Environmental agents and randomly induced
events can cause error, with ultimate cellular
changes. i.e. radiation exposure
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BIOLOGICAL: Stochastic Theories of Aging
3. Wear and Tear • Cells and organs have vital parts that wear out
Theory after years of use.
• Less efficient at repairing body malfunctions that
are caused by environmental assaults.
4. Connective • Also known as glycosylation theory of aging,
Tissue Theory attributes aging to chemical changes that happen in
(Cross-Link the body.
Theory) • An accumulation of cross-linked proteins resulting
from the binding of glucose (simple sugars) to protein
causes various problems.

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 BIOLOGICAL: Non-stochastic Theories
1. Programmed • As people age, more of their cells start to decide
Theory to commit suicide or stop dividing (apoptosis-
programmed cell death).
2. Gene/ • This theory explains that each cell, or perhaps the
Biological Clock entire organism, has a genetically programmed
aging code that is stored in the organism’s DNA.
Theory (Hayflick
• Comprising genetic influences that predict
Limit Theory) physical condition, occurrence of disease, cause
and age of death, and other factors the contribute
to longevity.

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 BIOLOGICAL: Non-stochastic Theories

3. Neuroendocrine • This theory describes a change in hormone

Theory secretion and how it influences the aging
process.
4. Immunologic/ • Describes the normal aging process of humans
Autoimmune and animals as being related to faulty
immunological function, which is linked to
Theory
general well-being.
• The term “immunosenescence” has been given
to this age-related decrease in function.
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Implications BIOLOGICAL THEORIES OF AGING
for Nursing
When interacting with the older population, caregivers must
relate the key concepts of the biologic theories to the care
being provided. Although these theories do not provide the
answer, they certainly can explain some of the changes seen in
the aging individual.
Aging and disease do not necessarily go hand in hand, and the
nurse caring for older adults needs to have a clear
understanding of the difference between age-related changes
and those that may actually be pathologic. Nurses must
remember that scientists are still in the process of discovering
what “normal” aging is.

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 Sociological Theories of Aging

PSYCHOSOCIAL

Psychological Theories of Aging

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SOCIOLOGICAL THEORIES OF AGING
1. Activity Theory • Aging successfully is related to staying active.
2. Disengagement • Gradual withdrawal from society and
Theory relationships serves to maintain social
equilibrium and promote internal reflection.
3. Subculture • The elderly prefer to segregate from society in
Theory an aging subculture sharing loss of status and
societal negativity regarding the aged. Health
and mobility are key determinants of social
status.

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SOCIOLOGICAL THEORIES OF AGING
4. Continuity • Personality influences roles and life satisfaction and
remains consistent throughout life. Past coping
patterns recur as older adults adjust to physical,
financial, and social decline and contemplate death.
Identifying with one’s age group, finding a residence
compatible with one’s limitations, and learning new
roles postretirement are major tasks.
• Four (4) Personality Types: Integrated, Armored-
defended, Passive Depended and Unintegrated.
• First sociological theory to acknowledge that
responses to aging differ among individuals.
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SOCIOLOGICAL THEORIES OF AGING
5. Age • Society is stratified by age groups that are the
Stratification basis for acquiring resources, roles, status, and
deference from others. Age cohorts are
influenced by their historical context and share
similar experiences, beliefs, attitudes, and
expectations of life – course transitions.
6. Person – • Function is affected by ego strength, mobility,
Environment – Fit health, cognition, sensory perception, and the
environment. Competency changes one’s ability
to adapt to environmental demands.

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SOCIOLOGICAL THEORIES OF AGING
7. Gerotranscendence • The elderly transform from a
materialistic/rational perspective toward
oneness with the universe. Successful
transformation includes an outward focus,
accepting impending death, substantive
relationships, intergenerational
connectedness, and unity with the universe.

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Implications SOCIOLOGICAL THEORIES OF AGING
for Nursing
Nurses need to be aware of the fact that whatever similarities exist
among the individuals of a cohort group, they are still individuals.
Older adults are not a homogeneous sociologic group, and care
needs to be taken not to treat them as if they were.
Older adults respond to current experiences on the basis of their
past life encounters, beliefs, and expectations. If their “typical”
reaction to stress, challenges, or fear is to disengage from
interactions, then, current situations often produce the same
responses. Because older adults are individuals, their responses
must be respected. However, it is within the nurse’s scope of
practice to identify maladaptive responses and intervene to protect
the integrity of the person.

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 PSYCHOLOGICAL THEORIES OF AGING
1. Human Needs • Five basic needs motivate human behavior in a
Theory lifelong process toward need fulfillment.

2. Theory of • Personality consists of an ego and personal and collective

unconsciousness that views life from personal or external
Individualism perspective. Older adults search for life meaning and
adapt to functional and social losses.
3. Stages of • Personality develops in eight sequential stages with
corresponding life developmental tasks.
Personality • The eight phase, integrity vs despair, is characterized by
Theory evaluating life accomplishments; struggles include letting
go, accepting care, detachment, and physical and mental
decline.
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 PSYCHOLOGICAL THEORIES OF AGING
4. Life-course/ • Life stages are predictable and structured by roles,
Life Span relationships, values, development, and goals.
Persons adapt to changing roles and relationships.
Age-group norms and characteristics are an
important part of the life course.
5. Selective • Individuals cope with aging losses through
Optimization activity/role selection, optimization and
compensation. Critical life points are morbidity,
mortality and quality of life. Selective optimization
with compensation facilitates successful aging.

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Implications PSYCHOLOGICAL THEORIES OF AGING
for Nursing
Older adults should be encouraged to engage in a “life review”
process; this may be accomplished using a variety of techniques
such as reminiscence, oral histories, and storytelling. Looking
back over life’s accomplishments or failures is crucial in assisting
older adults to accomplish developmental tasks (as in ego
integrity), to promote positive self-esteem, and to acknowledge
that one “did not live in vain.”
As nurses apply the psychologic theories to the care of older adults
in any setting, they help dispel many of the myths about old age.

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 Functional Consequences Theory

NURSING Theory of Thriving

Theory of Successful Aging

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 NURSING THEORIES OF AGING
1. Functional • Environmental and biopsychosocial consequences
Consequences impact functioning. Nursing’s role is risk
reduction to minimize age- associated disability in
Theory order to enhance safety and quality of living.
2. Theory of • Failure to thrive results from a discord between the
Thriving individual and his or her environment or
relationships. Nurses identify and modify factors
that contribute to disharmony among these
elements.

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 NURSING THEORIES OF AGING
3. Theory of • Proposed that aging well is defined by the extent
Successful Aging to which older adults adapt to the cumulative
physical and functional changes they experience.
• Floods proposed that: (1)aging is a progressive
process of adaptation; (2) aging may be successful
or unsuccessful, defending upon a person’s ability
to cope; (3) successful aging is influenced by a
person’s choice, and; (4) aging people experience
changes, which uniquely characterize their beliefs
and perspective in ways that differ from those
younger adults.

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Implications NURSING THEORIES OF AGING
for Nursing
Nursing theories of thriving and functionality
contribute to our understanding of aging; however,
neither encompass all of the holistic elements (cultural,
spiritual, geographic, psychosocioeconomic,
educational, environmental, and physical) of concern
to nursing. Flood’s theory of successful aging provides
more comprehensive framework to guide nursing
practice and has been validated by some authors;
however additional studies are needed to confirm this
theory.

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 MORAL AND SPIRITUAL DEVELOPMENT
THEORIES OF AGING
1. Kohlberg’s • Moral development is the process by which people
Theory of Moral develop the distinction between right and wrong
(morality) and engage in reasoning between the
Development two (moral reasoning).
• Kolhberg’s theory is broken down into 3 primary
levels: preconventional, conventional and post
conventional morality. In each instance, only a
small segment of the population reaches this
highest level of development, where their personal
needs are sublimated for the greater good of
society.
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 MORAL AND SPIRITUAL DEVELOPMENT
THEORIES OF AGING
2. Spirituality • No longer merely denotes religious
affiliation; it synthesizes a person’s
contemplative experience.
• Illness, a life crisis, or even the recognition
that one’s days on earth are limited may
cause a person to contemplate spirituality.
• Regardless of outcomes, nurses need to
address spirituality as a component in
holistic care

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 Summary
In conclusion, aging has many dimensions that have been explained
by multiple theoretical perspectives. Collectively, these theories
reveal that aging is a complex phenomenon still in need of research.
How one ages is a result of biopsychosocial factors. Nurses can use
this knowledge as they plan and implement ways to promote health
care to all age groups. Nursing research must continue to view
aging holistically and contribute to the literature in ways that help
confirm, develop or refute these theories. Ultimately theories that
can predict patient outcomes hold the greatest promise for guiding
nursing practice in ways that help each individual patient age
successfully.
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 Key Points
• No one theory explains the biologic, sociologic or psychologic aging process.
• An eclectic approach incorporating concepts from biology, sociology and psychology was
used in developing the aging theories.
• Biologic theories help the nurse understand how the physical body may change with
advancing years and what factors may increase older adults’ vulnerability to stress or
disease.
• Understanding sociologic theories broadens the nurse’s view of older adults and their
interactions with society.
• The psychologic theories provide an understanding of the values and beliefs an older
person may possess. These theories enable a nurse to understand the phases of the life
span and the developmental tasks faced by older adults.
• As the population continues to age, nurses with the capability to understand and apply the
theories of aging from several disciplines will be the leaders of gerontologic nursing.

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 “Old age is not a
disease – it is
strength and
survivorship,
triumph over all
kinds of
vicissitudes and
disappointments,
trials and illness. “
- Maggie Khun

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Thank You

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