GERIATRIC NURSING
GERIATRIC NURSING
→ Nursing care for the older adults
→ Age: 60/65 and above (retirement age)
→ GERONTOLOGY: The study of aging process
→ AGEISM: negative views towards older adults
BIOLOGICAL THEORIES OF AGING (I wear free end
cross gene)
Immunologic
→ Proposes that the immune system becomes less
effective with age, resulting in reduced resistance to
infectious disease and viruses.
→ Decreased function of the immune system making the
older adults high risk for infection
→ WOF pneumonia (common nosocomial infection)
Wear and Tear
→ Proposes that humans, like automobiles, have vital
parts that run down with time, leading to aging and
death.
→ The human body is like a piece of equipment
→ Overtime the function of the body decreases
→ E.g., Degenerative disorders (e.g., joints)
Free Radical
→ These radicals cause biochemical changes in the
cells, and the cells cannot regenerate themselves.
→ Free radicals are waste products of the body that can
cause irreversible damage to the cells
• Free radicals is one of the suspect for cancers
→ Antioxidants are substances that can act against free
radicals
• Obtained from balanced diet, vitamins (BV)
Endocrine
→ Proposes that events occurring in the hypothalamus
and pituitary are responsible for changes in hormone
production and response that result in the organism’s
decline.
→ Hormones are chemical messengers that control the
different organs inside the human body
→ ↓hormones → ↓function of the body
• E.g., ↓estrogen → high risk for osteoporosis
(estrogen is r/t bones)
SYSTEM CHANGES
o Osteoporosis is common in female
Cross-linking
→ Proposes that the irreversible aging of proteins such
as collagen is responsible for the ultimate failure of
tissues and organs.
→ Changes to the protein → ↓elasticity → wrinkles, rigid
• Collagen and elastin (found in the lungs and skin)
Genetic
→ Proposes that the organism is genetically programmed
for a predetermined number of cell divisions, after
which the cells/organism dies.
→ The body is programmed to expire
→ Cease production of cell
• Slow wound healing
• Apoptosis: programmed cell death; r/t cancer cells
(skipped by cancer cells)
PSYCHOSOCIAL THEORIES OF AGING (ACED)
Activity theory
→ Life satisfaction in normal aging requires maintaining
social interactions
→ Increase activity
• Social interaction
Continuity Theory
→ Successful adjustment to old age requires continuing
life patterns across a lifetime.
→ Continue good habits
• E.g., Swimming, running, exercises
Ego integrity vs Despair
→ Older adults contemplate accomplishments in life.
→ Erik Erikson
→ Ego integrity: success in life, reminiscing the past
→ Despair: regrets and failure, always angry
Disengagement theory
→ Aging results in decreased interaction in the social
systems
→ The opposite of activity theory
→ Weak → high risk for infection → decrease social
interaction
→ Lung compliance: ability of the lungs to expand and return to its form (elasticity)
→ Residual volume: total amount of air that is retained in the lungs after exhalation
→ Vital capacity: total amount of air that comes in and out in the lungs
Skin Changes
→ Seborrheic Dermatitis (Scaling) d/t dryness
→ Keratosis (overgrowth) d/t abnormality with the number of keratin (keratin accumulates in a single spot)
→ Slowed nail growth → Thickening of nail (brittle)
→ Solar lentigo/Liver spots/Lentigo senilis → localized increase in melanin

Sexual Desire
→ Sexual impression will improve the quality of life of the older adult
→ Sexual desire persist
→ Slow arousal (nerve endings are hard to stimulate)
• Cannot maintain erection
• Cannot maintain orgasm
• Impotence and dryness
SPECIAL SENSES

MENTAL HEALTH CONCERNS (DIGS): • Puncture wounds

→ ❗Never part of normal aging ❗ • Sprains, dislocations, or fractures
→ Depression → Emotional
• d/t high dependence, death of loved ones • Fearful and agitated
• Pet therapy for companion • Withdrawn and loss of interest in self and social
→ Isolation activities
• Self-isolation → Neglect
• Family d/t ageism • Disheveled appearance
→ Grief • Lacking physical needs, such as glasses, hearing
• d/t death of a loved one aids, and dentures
• Ineffective coping → self-neglect or use of → Economic
substance abuse • Inability to pay bills and fearful when discussing
→ Suicide finances
• Any verbalizations of plans, ideations should be • Lacking physical needs, such as glasses, hearing
taken seriously aids, and dentures
→ Sexual
ABUSE OF OLDER ADULTS • Torn or stained underclothing
• Discomfort or bleeding in the genital area
Types of Abuse among Older Adults (PENES) • Difficulty in walking or sitting
→ Physical abuse • Unexplained genital infections or disease
• Abrasions, bruises, or lacerations → Suspect abuse when these cues are present
Factors:
→ Individual’s dependence - highest risk
• Immobility & psychiatric illness - require assistance
→ Caregiver stress
• Family or nurse
→ History of family violence

Categories:
→ Domestic
• Family member
→ Institutional
• Caregiver (nurses or physician)
→ Self-neglect

Nursing Responsibilities:
→ Assess
• Probe questions; interview
• Usually uses alibi or cover the abusers through lying
→ Treat the injury
→ Safety
• Remove from dangerous/hazardous environment
→ Report to authorities (legal case)
• Police
• Social services
• Always follow reporting policies
→ Document
• Serve as evidence