Course Title: CARE OF THE CHRONICALLY ILL
AND THE OLDER PERSON people involving gender, race, national origin and
◼ Course Description : It deals with the concepts,
principles and techniques of nursing care
management of those with chronic illness and the
older persons.
CARE OF THE CHRONICALLY ILL &
THE OLDER PERSON
A. Introduction to Aging
• Definition of Terms:
◼ Gerontology: Study of all aspects of aging and its
consequences.
◼ Gerontologic Nursing: specialized nursing with
knowledge of illness and health of the aging.
◼ Geragogy: practices & processes used in educational
settings for older learners.
◼ Gerontology is the study of the aging process and
individuals as they grow from middle age through
later life. It includes:
◼ The study of physical, mental, social
changes in older people as they age.
◼ The investigation of the changes in society
resulting from our aging population.
◼ The application of this knowledge to
policies and programs.
◼ Geriatrics is… The study of health and disease in later
life. The comprehensive health care of older persons
and the well-being of their informal caregiver.
◼ Older Adult
• Young Old 65-74
• Middle Old 75-84
• Old 85 & older
• Presently: 12.8% of population
• 2030: will increase to 20% of population
◼ Aging is a developmental process that begins at
conception and ends at death. Is a multidisciplinary
field.
◼ This means that the study of aging combines or
integrates information from several separate areas of
study.
o Biology
o Sociology
o Psychology
◼ AGEISM
Discrimination against persons of a certain age group.
A tendency to regard older persons as debilitated,
unworthy of attention, or unsuitable for employment.
◼ Accdg. To Robert Butler(1968) AGEISM –
prejudices and stereotypes that are applied to older
people on the basis of their age.
◼ Ageism: when older adults are stereotyped.
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- Stereotypes are characteristics ascribed to groups of
other factors.
- Stereotyping is a form of prejudice that can form
damaging images of people because of a particular
characteristic without having any knowledge of the
person.
- 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 ?
◼ GERONTOPHOBIA
Unreasonable fear and/or irrational hatred of older
people.
Ageism and Gerontophobia are outcomes of
modernization. It is likely that the increased emphasis
on the negative and debilitative aspects of old age
corresponds to a change in perception of the
usefulness of older people brought about by
urbanization & industrialization.
◼ 1-Chronic Illness
✓ Illnesses not caused by infectious agents but instead
are strongly related to lifestyles.
✓ Long –lasting effects accompanied by irreversible
pathology.
✓ It does not go away.
◼ Chronic illnesses are those that are prolonged, do not
resolve spontaneously, and are rarely cured
completely. Most chronic conditions may be viewed
as a trajectory with overlapping phases, in which an
individual move from a level of optimum functioning,
with the illness in good control, to a period of
instability in which they may need assistance.
◼ Chronic diseases can limit a person's ability to
perform daily activities, cause them to lose their
independence, and result in the need for institutional
care, in-home caregivers, or other long-term services
and supports.
◼ The quality of life in chronic illnesses can vary with
age, especially for senior adults. Chronic conditions
affect seniors' mobility and consequently their
physical and functional status, emotional balance,
and self-esteem decline because of their dependence
on others.
Characteristics of Chronic Illness as They Impact the
Social Work Role
◼ Three important characteristics of chronic illnesses
among older adults need to be considered as they
affect the social work role and function.
1. The trajectory for many serious illnesses has changed
from an acute terminal course to a much longer chronic
period, with episodes of exacerbations and remissions
interspersed with extended periods of good functioning.
 2. The trajectory of advanced chronic and terminal
illnesses has changed from a relatively brief period to a
longer period in which both curative and palliative
treatments are combined. Research suggests that a long,
advanced chronic illness can be highly stressful for both
patients and their families.
3. The increase in the total number of older people with
advanced chronic and terminal illnesses will require more
curative and palliative care being provided in the home,
with greater reliance on provision by family members.
Key Problem Areas Experienced By Patients With Chronic
Illness
What are some effects of a chronic illness?
Chronic illnesses have disease-specific symptoms, but
may also bring invisible symptoms like pain, fatigue and
mood disorders. Pain and fatigue may become a frequent part
of your daily life.
What impact does chronic illness have on an individual and
their families?
Most chronic diseases have similar effects on family
members including psychological and emotional functioning,
disruption of leisure activities, effect on interpersonal
relationships, and financial resources.
◼ Review of the Pathophysiology of selected chronic
conditions: Heart Disease, Hypertension, Chronic
Obstructive Pulmonary Disease Diabetes, Cancer,
Dementia, Stroke
HEART DISEASE
Coronary artery disease is the most common form of
heart disease and the most common cause of heart failure. The
disease results from the buildup
of fatty deposits in the arteries, which reduces blood flow and
can lead to heart attack. A heart attack occurs suddenly when a
coronary artery becomes completely blocked.
HYPERTENSION
The pathophysiology of hypertension involves the
impairment of renal pressure natriuresis, the feedback
system in which high blood pressure induces an increase in
sodium and water excretion by the kidney that leads to a
reduction of the blood pressure.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
The cardinal pathophysiologic feature of COPD
is airflow limitation caused by airway narrowing and/or
obstruction, loss of elastic recoil, or both.
For people with COPD, this starts with damage to the
airways and tiny air sacs in the lungs. Symptoms progress from
a a cough with mucus to difficulty breathing. The damage done
by COPD can't be undone.
DIABETES
The pathophysiology of diabetes is related to the
levels of insulin within the body, and the body's ability to
utilize insulin. There is a total lack of insulin in type 1 diabetes,
while in type 2 diabetes, the peripheral tissues resist the effects
of insulin.
CANCER
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Cancer cells differ from normal cells in size, structure,
function, and growth rate. These malignant cells lack the
normal controls of growth seen in healthy cells, and grow
uncontrollably. This uncontrolled growth allows the cancer
cells to invade adjacent structures and then destroy surrounding
tissues and organs.
DEMENTIA
Dementia is a symptom of a variety of specific
structural brain diseases as well as several system
degenerations. Alzheimer's disease presently is the
commonest cause in the developed world, causing a cortical-
subcortical degeneration of ascending cholinergic neurons and
large pyramidal cells in the cerebral cortex.
STROKE
Ischemic stroke is caused by deficient blood and
oxygen supply to the brain due to a narrowed or blocked vein.;
hemorrhagic stroke is caused by bleeding or leaky blood
vessels. Ischemic occlusions contribute to around 85% of
casualties in stroke patients, with the remainder due to
intracerebral bleeding.
Specific assessment focus and management of the above
conditions
Assessment for hypertension
The evaluation of hypertension involves
accurately measuring the patient's blood pressure,
performing a focused medical history and physical
examination, and obtaining results of routine laboratory studies.
A 12-lead electrocardiogram should also be obtained.
Management for hypertensive patients
First-line medications used in the treatment of
hypertension include diuretics, angiotensin-converting
enzyme (ACE) inhibitors or angiotensin receptor blockers
(ARBs), beta-blockers, and calcium channel blockers (CCBs).
Some patients will require 2 or more antihypertensive
medications to achieve their BP target.
Assessments performed for a patient with COPD
Tests may include:
• Lung (pulmonary) function tests. These tests measure
the amount of air you can inhale and exhale, and
whether your lungs deliver enough oxygen to your
blood.
• Chest X-ray. A chest X-ray can show emphysema,
one of the main causes of COPD
• CT scan.
• Arterial blood gas analysis.
• Laboratory tests.
How is COPD managed?
◼ Treatments include: stopping smoking – if you have
COPD and you smoke, this is the most important thing
you can do.
◼ inhalers and tablets – to help make breathing easier.
◼ pulmonary rehabilitation – a specialized program of
exercise and education.
What should be the main focus of the management and
treatment of COPD?
 The goal of COPD management is to improve a
patient's functional status and quality of life by preserving
optimal lung function, improving symptoms, and preventing
the recurrence of exacerbations.
Assessment for diabetes
A diabetes-focused examination includes vital signs,
funduscopic examination, limited vascular and neurologic
examinations, and a foot assessment. Other organ systems
should be examined as indicated by the patient's clinical
situation
Diagnosis and diagnostic criteria
1. If patient is symptomatic, check a random glucose. If greater
than 11.1 mmol/litre, a diagnosis of diabetes is confirmed.
What is diabetes and its management?
Diabetes can affect almost every part of your body.
Therefore, you will need to manage your blood glucose levels,
also called blood sugar. Managing your blood glucose, as well
as your blood pressure and cholesterol, can help prevent the
health problems that can occur when you have diabetes.
How do you assess a cancer patient?
Imaging tests used in diagnosing cancer may include
a computerized tomography (CT) scan, bone scan, magnetic
resonance imaging (MRI), positron emission tomography
(PET) scan, ultrasound and X-ray, among others.
Biopsy. During a biopsy, your doctor collects a sample of cells
for testing in the laboratory.
What are the different management of cancer?
The most common treatments are surgery,
chemotherapy, and radiation. Other options include targeted
therapy, immunotherapy, laser, hormonal therapy, and others.
Surgery is a common treatment for many types of cancer.
The following procedures used to assess/ diagnose dementia:
• Cognitive and neurological tests. These tests are used
to assess thinking and physical functioning.
• Brain scans. These tests can identify strokes, tumors,
and other problems that can cause dementia
• Psychiatric evaluation
• Genetic tests
• Blood test
What is the management of dementia?
◼ Medications. The following are used to temporarily
improve dementia symptoms. Cholinesterase
inhibitors. These medications — including donepezil
(Aricept), rivastigmine (Exelon) and galantamine
(Razadyne) — work by boosting levels of a chemical
messenger involved in memory and judgment.1
Management of dementia involves care for the
cognitive changes, behavioral changes, functional changes, and
emotional issues. It also involves the management of other
illnesses in light of the dementia, consideration of the needs and
well-being of the caregiver, and particular attention to advanced
care planning.
There are multiple scales that are commonly used worldwide in
the assessment of stroke victims, including the four listed
below:
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◼ National Institutes of Health Stroke Scale (NIHSS)
◼ Cincinnati Prehospital Stroke Scale (CPSS)
◼ Face Arm Speech Test (FAST)
◼ Los Angeles Prehospital Stroke Screen (LAPSS), and.
Management of stroke
◼ An IV injection of recombinant tissue plasminogen
activator (tPA) — also called alteplase
(Activase) — is the gold standard treatment for
ischemic stroke. An injection of tPA is usually given
through a vein in the arm with the first three hours.
Sometimes, tPA can be given up to 4.5 hours after
stroke symptoms started.
Health Education in Chronic Illness
Why is health education important for patients?
◼ better understanding of treatment options, side effects
and toxicities.
◼ improved self-advocacy and greater empowerment to
make decisions related to their care.
◼ increased compliance with treatment regimens.
◼ decreased treatment related complications.
What is the first step in patient education?
✓ The FIRST STEP in patient education is the review
of the Admission Assessment for learning needs.
Then meet with the patient to determine what are
specific needs for that patient.
✓ Individualized Teaching: Is based on the patient
assessment, readiness to learn, and patient and family
needs.
✓ Behavioral Management in Chronic Illness
✓ Coping interventions for powerlessness,
hopelessness, sensory deprivation, sleeplessness, etc.
✓ DAY 4 PRESENTATION BY AOBALAGAPO
✓ Social Support System and Family in Chronic Illness
✓ PHYSICAL AND STRUCTURAL
ENVIRONMENT FOR HOLISTIC CARE OF
OLDER PERSON EDUQUE
✓ COMUNICATING WITH OLDER ADULTS BY
MANAHAN
◼ Causes of Population Aging
1. Demographic Transition- the growth of populations
over a long period of time is characterized by 3 stages:
1. Pre-transition-main distinguishing feature is high birth
and high death rates. High death rates mean people on average
live shorter lives.
2. Transition stage-decline in births and decline in deaths
but not at an equal pace.
- Deaths decline much faster than births, resulting in
explosive growth of the population.
3. The Post-transition stage where there is again very low
growth in population numbers because both birth and death
rates are equally low.
Stage 1 & 2 characterize young population, Stage 3 describes
an old or aging population.
Causes of Population Aging
 ◼ 15-24 years: 19.1% (male 10,107,717/female
9,753,268)
Mortality Decline. While births have been decreasing,
improvements in the human condition have also resulted in ◼ 25-54 years: 36.6% (male 19,065,843/female
declining deaths. 18,941,091)

Advances in food production, in public health & in medical ◼ 55-64 years: 5.6% (male 2,663,592/female
sciences all combine to significantly decrease the risk of death 3,102,247)
especially among the young.
◼ 65 years and over: 4.3% (male 1,948,152/female
A. Factors that affect normal functioning of the older 2,564,841) (2012 est.)
persons
The age structure of a population affects a nation's key
Demographics of Aging socioeconomic issues.

◼ Projections in the year 2030 estimate that people aged
65 years and older will represent about 20% of the
population.
◼ Another recent demographic phenomenon that affects
health care is the disproportionate increase in the
number of ”oldest old” in the US and in many
industrialized societies.
Between 2015 and 2050 the proportion of the world’s
population over 60 years will nearly double 12 to 22%. The
standards and scope of gerontological nursing practice is to
provide a specialist or generalist offering comprehensive
nursing care to elderly people by combining the basic needs and
providing of nursing process systematically such as assessment,
diagnosis, planning implementation and evaluation.
◼ Although the proportion of old to young people in the
US is partially influenced by diminishing birthrates,
the principal reasons for the recent surge in growth of
older population are a rising life expectancy and a
declining mortality rate.
◼ Drastic increases in the number of older adults in the
United States will increase the need for health care.
◼ The scope of gerontology includes the study of the
diseases associated with aging, and holistic health
management principles for the aged.
- Countries with young populations (high percentage
under age 15) need to invest more in schools, while
countries with older populations (high percentage ages
65 and over) need to invest more in the health sector.
- The age structure can also be used to help predict
potential political issues. For example, the rapid
growth of a young adult population unable to find
employment can lead to unrest.
Types of Aging Changes
◼ Benign and superficial
✓ Graying hair
✓ Wrinkles
◼ Senescence
- Progressive body system deterioration that can
increase the risk for mortality
◼ Plastic
- Modifiable changes that can be slowed by exercise,
good nutrition, and other elements of a healthy
lifestyle.
Types of Aging Changes
-Reduced organ reserve

◼ The number of persons over age 60 is projected to -Homeostenosis

double worldwide in the next 50 years.
◼ Inability of body to restore homeostasis after
◼ Thirteen percent of the population of the United environmental changes.
States is aged 60 or over.
Types of Aging Changes
◼ Fertility trends are credited for having the greatest
Normal aging consists of those universal changes that
influence on the age structure in the 20th century.
occur in all older people.
◼ Since 1950, the majority of the older adult population
◼ Aging is associated with a loss of organ reserve or the
worldwide is female.
ability of an organ to react quickly and efficiently to
◼ The term feminization of later life refers to the physiological stress.
predominance of women in the older adult age groups.
◼ The organ systems of the body synthesize
◼ The increased likelihood of men to be exposed to risk efforts to maintain equilibrium. Homeostasis
factors such as tobacco, alcohol, and occupational refers to the maintenance of equilibrium of
hazards may negatively impact male life expectancy. temperature, acid–base balance, body
chemicals, and other vital life components.
◼ If women begin to incur similar exposures to the same Loss of organ reserve is known as
risk factors as their male counterparts, the gender gap homeostenosis.
may be reduced.

◼ In the Philippines,
Theories of Aging
Age structure:
◼ Theories of aging will support the framework of
◼ 0-14 years: 34.3% (male 18,175,763/female treatment and management of elderly people with
17,452,488) different disease and with different symptoms.
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Theories of aging fall into several groups, including: Somatic Mutation Theory- DNA changes result in physical
decline.
✓ Biological
✓ Psychological Stress Theory-causes structural & chemical changes thru the
✓ Developmental lifespan.
✓ Sociological
✓ Nursing theories Psychosocial Theories of Aging

◼ Most experts believe that a combination of genetic and Sociological aging theories
stochastic (random) events are responsible for aging. ◼ Focus on roles and relationships that occur later in
◼ Any single limited theory is insufficient. life

Biologic Theories ✓ Disengagement Theory

✓ Activity Theory
◼ Decades of ages the body system also becoming ✓ Continuity Theory
defective and can no longer recognize and attack
foreign invaders. There is totally change in the body Disengagement Theory- withdrawn, introspective, self-
system because degenerative of tissue and cell make focused – Older theory; not widely accepted.
slow down the immune system so it is easy to tear and Continuity theory -characteristics, values remain constant thru
break down the body. life… repeat behaviors that brought success in the past.
Biological ◼ The latter part of life is just a “continuation” of
Programmed theories/Genetic Theories the earlier life.
◼ Programmed Aging theory- genetics and heredity ◼ As we age we try to maintain or continue previous
responsible for how an individual ages habits, commitments, values, beliefs, preferences.
◼ Hypothesize that the body’s genetic codes contain
instructions for regulation of cellular reproduction and Activity /Developmental Task Theory- satisfaction depends
death. on involvement in new interests/activities or maintenance of
✓ Programmed Longevity high levels of functioning.
✓ Endocrine Theory
✓ Immunological Theory ✓ It is better to be active than inactive.
✓ It is better to be happy than unhappy.
Biological ✓ An older person is the best judge of his or her own
success.
◼ Error theories - This is physical and intellectual. Even with illness we
◼ Hypothesize that environmental assaults and the can remain active.
body’s constant need to make energy and fuel
metabolic activities cause toxic by- products
• Coping or adaptive strategies must occur for a person
✓ Wear and Tear Theory
to age successfully.
✓ Cross-Link Theory
✓ C. Jung’s Theory of Individualism
✓ Free Radical Theory
✓ E. Erickson’s Developmental Theory
✓ Somatic DNA Damage Theory
✓ R. Havighurst Activity Theory
✓ Emerging Biological Theories
Jung’s Theory of Individualism
Biological Theories of Aging
- A key focus of Jung’s theory is the impact of an
✓ Wear and Tear Theory
inability to accept past accomplishments and failures
- Suggests that organisms have fixed amounts of energy
to promote successful aging.
available, and that they will wear out on a scheduled
basis. Erickson’s theory of aging suggests that ineffective meeting
of the tasks of each stage of life will result in maladjustment.
✓ Cross-Linkage Theory- deterioration of organs/cells
causing decreased mobility ◼ Generativity versus Stagnation
- New collagen fibers become enmeshed with old fibers Erikson’s Theory (Tasks of Middle Adulthood)
creating a dense field that decreases the cells capacity
to transport nutrients. ✓ Establish and guide the next generation
✓ Accept middle-age changes (Adjust to the needs of
✓ Free Radical Theory aging parents)
✓ Reevaluate one’s goals and accomplishments
◼ Oxygen metabolism “free radicals”

◼ Damages cell membranes Ego Integrity versus Despair

◼ Lipofuscin- is a lipid and protein enriched pigmented ◼ INTEGRITY
material that has been found to accumulate in older
adults tissues, and is commonly called “age spots” ◼ DESPAIR

What are antioxidants? Havighurst - Activity theory

Vitamins C and E

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 - The process of aging is greatly facilitated when ◼ confusing after dark
older people pursue hobbies and relationships, and
generally lead a more active lifestyle. ✓ The 3 Ds:

◼ maintenance of social contacts & relationships… 1. Dementia - Severe cognitive loss & memory loss

◼ Successful aging = ability to be flexible adapt to the 2. Depression

changes associated with aging.
◼ staying mentally and physically active will increase
happiness among older adults.
◼ Risk factors for chronic illness
◼ Risk factors such as smoking, high blood pressure,
cholesterol, obesity, nutrition, overweight and
obesity, physical inactivity and diabetes are
common to many of these chronic diseases. Primary
prevention of even a few of these factors could result
in an increase in disability-free years and ultimately, a
reduction in health care costs.
3. Delirium
Theories about Sundowning
Possible Causes for increasing confusion:
✓ Person can’t see well in dimming light
✓ Hormone imbalances r/t biological clock
✓ Person tired at end of day; decreased coping
✓ Restlessness because daytime activities are decreasing
✓ Caregivers communicate their own fatigue & stress to
clients
General Physiological Changes

Development Theories ✓ All systems decline in overall functioning

✓ Decreased physiological reserves
- In this theory, it indicates that the elderly people find
difficulty in adjusting or adapting to new social roles. ◼ illness…stress…risk for complex
Erikson and Havighurst, it is possible to identify the reactions…increased chance of
following developmental tasks for older adults: complications.
- Maintenance of self worth
✓ Modified pace & more frequent
- Conflict resolution
- rest periods
- Adjustment to the loss of dominant roles.
- Adjustment to the deaths of significant others. Integumentary Changes
- Environmental adaptation
- Maintenance of optimal levels of wellness ✓ Decreased skin elasticity-wrinkling
✓ Increased dryness
Sociologic Theories ✓ Thickened nails
✓ Thinning of hair (baldness)
◼ Sociologic theories of aging will help to predict and
✓ Decreased SQ fat
explain the social interaction and their role into the
society. The theory emphasizes the importance of Musculoskeletal Changes
environmental psychological factors in the
development and current functioning of the patient. ✓ Stiff joints & less flexibility
✓ Mobility slows & posture stoops
Nursing Theories ✓ Muscle mass, tone & strength decrease
✓ Bone demineralization- osteoporosis
◼ Miller has suggests that the nurse has to provide the
care which depend upon to the age wise and their Neurological Changes
problem. The nurse should understand the problematic
condition so the nurses are ready to alter the outcomes ✓ CNS responds slower
for patient through nursing interventions. Appropriate ✓ Rate of reflex response decreases
nursing innervations that have a positive impact on ✓ Sense of balance declines
patient outcomes for the elderly ✓ Night sleep shortens
✓ Temp. regulation & pain perception less efficient
◼ Myths and Realities of Aging
Special Senses Changes
◼ ASPECTS of Aging
✓ Diminished vision
Changes in the Older Person “Senior Moments” ✓ Night blindness
✓ Diminished hearing
✓ Cognitive Changes
✓ Decreased taste & smell
✓ Ability to perceive and understand one’s world
✓ Mild short term memory loss Cardiopulmonary Changes
✓ Long term memory remains intact
✓ Slower responses and reactions ✓ Blood vessels less elastic
✓ Fatty plaque deposits occur
Cognitive Changes – Abnormal Aging ✓ Cardiac reserve decreases
✓ Confusion ◼ body is less able to increase cardiac output
and heart rate with activity.
✓ Alzheimer’s disease
◼ Pulmonary elasticity & ciliary's action
◼ patchy area’s of the brain degenerate
decrease
✓ Sundowning syndrome
✓ Less efficient lung clearing
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 ✓ Increased resp. rate, diminished depth ✓ Annual Physicals
✓ Medications
Gastrointestinal Changes
Nursing Dx
✓ Digestive juices & nutrient absorption decrease
✓ Malnutrition & anemia common Nursing care of geriatric pt. Based on nursing dx:
✓ Decreased peristalsis resulting in constipation &
indigestion ✓ Risk for loneliness
✓ Decreased insulin and thyroid production ✓ Altered dentition
✓ Risk for falls
Dentition Changes ✓ Knowledge deficit
✓ Confusion
✓ Tooth decay continues ✓ Sexual dysfunction
✓ Missing teeth or ill fitting dentures effect eating habits ✓ Wandering
Genitourinary Summary
✓ Renal blood flow decreases ◼ Nurses have to provide care to an increasing geriatric
✓ Waste products excreted more slowly population.
✓ Fluid/Electrolyte balance is fragile
✓ Bladder capacity decreases 50% ◼ Geriatric patients have specific needs due to
✓ Hypertrophy of prostate gland physiological and cognitive changes.
✓ Atrophy, decreased secretions & thinning of female
genital tract ◼ Nursing care needs to be tailored to the those needs.
✓ Decreased estrogen and testosterone levels Listen to the aged………
Normal changes of aging For they will tell you about living and dying.
✓ Adjusting to Changes of Aging For they will enlighten you about problem-solving, sexuality,
✓ Rest more grief, sensory deprivation, and survival.
✓ Curtail driving
✓ Cane/walker for mobility For they will teach you how to be courageous, loving and
✓ Diet/nutritional changes generous.
✓ Ageism-prejudice vs the elderly
◼ What does it mean to “grow old gracefully”
Adjusting–Older Adult is making many psychosocial
What makes an individual grow old gracefully? It is the quality
adjustments
of coping with the struggles & crises. One comes out more on
✓ Retirement the gain side from having learned profitably from the trials &
✓ Reduced income challenges experienced. Struggles in life can either make us
✓ Spouse’s health grow gracefully or deter us from doing further in our growth &
✓ Social roles-need to feel valued needed and usefulness development.
continues . Can be difficult ..no longer employed…
“Grow old along with me! The best is yet to be. The last of
social isolation can be a problem.
life, for which the first was made”. - Browning
✓ Living arrangements-may need to move to a smaller
home, assisted living in with family. “Even the oldest tree some fruit may bear:
✓ Role reversal-family and friends may take on And as the evening twilight fades away, the sky is filled with
responsibilities once belonging to the aged. stars, invisible by day”. - Henry Wadsworth Longfellow
Common health problems

✓ Heart disease, cancer, stroke ECONOMIC & SOCIOCULTURAL IMPLICATIONS

✓ Poly-Pharmacy OF POPULATION AGING
✓ Accidents, falls
✓ Arthritis ◼ Objectives:
✓ Chronic illness
◼ Describe the economic implications of an
✓ Elder Abuse
aging population
Elder Abuse
◼ Describe the socio-cultural implications of an
✓ Any deliberate action or negligence that harms elderly aging population.
individuals:
- When can a person be considered old?
-physical
-sexual ◼ Culture may define one to be old, but the
-psychological concerns of older people are the same across
-emotional cultures.
-financial
◼ Concerns:
Role of the Nurse in Promoting Health: Teaching
◼ Issues of diminished earning
✓ Nutrition capacity and of increasing risks of
✓ Exercise having health problems.
✓ Immunizations
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 ◼ Changing roles in society, such as
grandparents assuming parental
roles in the lives of their
grandchildren.

◼ The economic and social implications derive from the

requirements of older people that must be addressed
by any society. When there is an increase in the
numbers and proportions of older people in the
society, there is an increase demand for services by a
sector that for the most part is no longer economically
active.

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