Module 1

Concepts, Principles and Theories in the care of older adults.

A. Perspectives on aging
1. Aging is a developmental process
B, Demography of Aging and Implications for health and nursing
care.
2. Global Aging
3. Aging in the Philippines
   C.Impact of Aging Members in the family
D. Theories of Aging and Its Nursing Implications
1. Biologic Theories
2. Pyschosocial Theories
D. Changes in Aging Affecting various systems
1. Integumentary
2. Musculo-skeletal
3. Respiratory
4. Cardio-vascular
5. Hematopoeitic & Lymphatic
Aging is a development process

 aging is, in fact, a natural developmental process for human beings

(Meilaender, 2011). According to Meilaender (2011), aging is a normal stage
of life in which our bodies begin to function less effectively, making us more
vulnerable to disease.

 Ageing or aging (see spelling differences) is the process of becoming older.

 for example, reaction may slow with age, while knowledge of world events
and wisdom may expand.
 Ageing or aging (see spelling differences) is the process of becoming older.
The term refers especially to humans, many other animals, and fungi,
whereas for example bacteria, perennial plants and some simple animals are
potentially biologically immortal. (Wikipedia)
 5 stages of aging
 Independence.
 Interdependence.
 Dependency.
 Crisis management.
 End of life.
Independence (AKA, They Really Don’t Need Help)

The vast majority of older adults choose to stay in their own home during this stage of the normal aging process because, quite
simply, they can. 
 Thisincludes transportation, finances,
health care needs, and more. No common
activity of daily living should be too taxing.
Mental and physical activity may
experience a minor decline, but not enough
to impact their lives.
 Basically, age-related changes are minimal.
They’re likely in good health. They’re self-
sufficient and able to handle their own errands.
And their quality of life is typically quite high.

 Ifyou looked at the aging process by decade,

independence would include mostly people up to
their 60s and 70s. With a smaller number of lucky
seniors in their 80s — or even older!
 While those in this group may not need help, this
is a good time to sit down with them to talk.
Evaluate their living situation. Plan for the future.
And make any changes that seem necessary.

 Take note of any existing medical issues that may be a risk

factor and get worse with age, such as cardiovascular
disease, heart disease, obesity, and high blood pressure.
 The earlier you make plans for healthy aging at home, the
better.
Life expectancy
 Interdependence
(AKA, They Won’t Think They Need Help)

 They  will likely start to find it more difficult to handle certain everyday tasks
during this stage as age-related changes speed up. Even if they don’t want to
admit it. 

 Physical activity will be more straining. Mental tasks may be more taxing. You
might notice them forgetting things more frequently.
 An interdependent senior may need a caregiver to handle a specific activity
of daily living (or several), such as driving, mowing the lawn, or paying bills.
Or they might be able to do everything just fine… but slower. Seniors in this
situation may benefit from a few hours of help each week to maintain their
lifestyle.

 This is a complicated period in the normal aging process. Both because older
people tend to be resistant to the notion of needing help… and because
professional caregiver agencies tend to have minimum hour requirements that
the senior may not need yet.
 Those in this stage are typically between 70 and 80 years of age.
 Another thing to really watch for in this stage: dementia, Alzheimer’s
disease, memory loss, and other types of cognitive decline. Often, a senior
won’t realize they have dementia, Alzheimer’s, or changes in their cognition.
Or they may not want to admit it. They may even appear normal and fully
functional for the vast majority of the time. 
Dependency (AKA, They Need a Moderate-to-High
Amount of Help)

 By this stage of old age, you’ll likely find that your aging
loved ones have trouble handling quite a few everyday
tasks by themselves as age-related changes kick into
overdrive. 
 Worse, many start to struggle more with both mental and
physical activity. And it may be hard (or even dangerous!)
for them to drive or travel to places alone, making healthy
aging at home harder but still very possible.
 This is the stage when most people start to need more significant assistance
and their quality of life dips dramatically. Dependent seniors often require
moderate help from a healthcare provider. This can include managing
medication, regularly monitoring their physical condition, or having someone
to prepare meals to help them maintain a healthy weight.
Support needed at this stage

 Emergency medical alert and health monitoring systems

 Medication management solutions
 Caregivers and companion care
 Nutrition and meal planning
 Housekeeping and laundry
 Transportation
Crisis Management and End of Life (AKA, Medical
Help Is Necessary)

 By the time the vast majority of people reach these last two stages of the
normal aging process — crisis management and end of life  —  they need more
or less round-the-clock care. And possibly quick access to more robust health
care facilities. Because of this, they tend to be in assisted living facilities,
nursing homes, or even hospice care.

 Just like the dependency stage, many seniors reach these

last two starting in their late 70s. However, some may
find themselves here earlier. While others might not enter
it until much later in their life span.
Difference between Dementia &
Alzheimer’s
 Dementia is a syndrome, not a disease. A syndrome is a group of symptoms
that doesn’t have a definitive diagnosis. Dementia is a group of symptoms
 that affects mental cognitive tasks such as memory and reasoning. Dementia
is an umbrella term that Alzheimer’s disease can fall under. It can occur due
to a variety of conditions, the most common of which is Alzheimer’s disease.
Signs & Symptoms of Dementia

 difficulty remembering and impairments in

 language
 communication
 focus
 reasoning
Subtle short-term memory changes

 Trouble with memory can be an early symptom of dementia. The changes are
often subtle and tend to involve short-term memory. An older person may be
able to remember events that took place years ago but not what they had for
breakfast.
 Other symptoms of changes in short-term memory include forgetting where
they left an item, struggling to remember why they entered a particular
room, or forgetting what they were supposed to do on any given day.
Difficulty finding the right words

 Another early symptom of dementia is struggling to communicate thoughts. A

person with dementia may have difficulty explaining something or finding the
right words to express themselves. Having a conversation with a person who
has dementia can be difficult, and it may take longer than usual to conclude.
Changes in mood

A change in mood is also common with dementia. If you have dementia, it isn’t always easy to recognize this in yourself, but
you may notice this change in someone else. Depression, for instance, is typical of early dementia.
 Along with mood changes, you might also
see a shift in personality. One typical type
of personality change seen with dementia is
a shift from being shy to outgoing. This is
because the condition often affects
judgment.
Apathy

 Apathy, or listlessness, commonly occurs in early dementia. A person with

symptoms could lose interest in hobbies or activities. They may not want to
go out anymore or do anything fun. They may lose interest in spending time
with friends and family, and they may seem emotionally flat.
5. Difficulty completing normal tasks

 A subtle shift in the ability to complete normal tasks may indicate that
someone has early dementia. This usually starts with difficulty doing more
complex tasks like balancing a checkbook or playing games that have a lot of
rules.
 Along with the struggle to complete familiar tasks, they may struggle to learn
how to do new things or follow new routines.
. Confusion

 Someone in the early stages of dementia may often become confused. When
memory, thinking, or judgment lapses, confusion may arise as they can no
longer remember faces, find the right words, or interact with people
normally.
 Confusion can occur for a number of reasons and apply to different situations.
For example, they may misplace their car keys, forget what comes next in the
day, or have difficulty remembering someone they’ve met before.
Difficulty following storylines

 Difficulty following storylines may occur due to early dementia. This is a

classic early symptom.
 Just as finding and using the right words becomes difficult, people with
dementia sometimes forget the meanings of words they hear or struggle to
follow along with conversations or TV programs.
A failing sense of direction

 The sense of direction and spatial orientation commonly starts to deteriorate

with the onset of dementia. This can mean not recognizing once-familiar
landmarks and forgetting regularly used directions. It also becomes more
difficult to follow a series of directions and step-by-step instructions.
Being repetitive

 Repetition is common in dementia because of memory loss and general

behavioral changes. The person may repeat daily tasks, such as shaving, or
they may collect items obsessively.
 They also may repeat the same questions in a conversation after they’ve been
answered
Struggling to adapt to change

 For someone in the early stages of dementia, the experience can cause fear.
Suddenly, they can’t remember people they know or follow what others are
saying. They can’t remember why they went to the store, and they get lost on
the way home.
 Because of this, they might crave routine and be afraid to try new
experiences. Difficulty adapting to change is also a typical symptom of early
dementia.
 Can you prevent dementia?
 You can take steps to improve cognitive health and reduce your or your loved
one’s risk. This includes keeping the mind active with word puzzles, memory
games, and reading. Being physically active, getting at least 150 minutes of 
exercise per week, and making other healthy lifestyle changes can also lower
your risk. Examples of lifestyle changes include stopping smoking if you smoke
and eating a diet rich in:
 omega-3 fatty acids
 fruits
 vegetables
 whole grains
 You can also reduce your risk by increasing your intake of vitamin D.
According to the Mayo Clinic, some researchers suggest that “people with low
levels of vitamin D in their blood are more likely to develop Alzheimer’s
disease and other forms of dementia.”
 Alzheimer's disease is thought to be caused by
the abnormal build-up of proteins in and around
brain cells. One of the proteins involved is called
amyloid, deposits of which form plaques around
brain cells. The other protein is called tau,
deposits of which form tangles within brain cells.
The Peanut butter test for Alzheimer’s

 The researchers discovered that those who had an impaired sense of smell in
the left nostril had early-stage Alzheimer's. They noted that the participants
needed to be an average of 10 centimeters closer to the peanut
butter container in order to smell it from their left nostril compared to their
right nostril.
TO BE CONTINUED

 Thank you for listening.