Geriatric Nursing

- Darshana Dhungana

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Geriatric Nursing – 6 marks

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Contents
Part 1
 Terminologies
 Activities of daily living
 Theories of Ageing

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Terminologies

1) Senior Citizens/ Older adults

a. WHO defines, 60 years and above.
b. The Senior Citizens Acts 2063, Nepal 60
years and above.
c. International Older people day 1st
October

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Terminologies
2) Ageing Categorization
a. Young old = 60 – 74 years
b.Middle old = 75 – 84 years
c. Old old = 85 – 100 years
d.Elite old = over 100 years

3) Gerontology
 Study of all aspects of the aging process, including the
clinical, psychological, economic and social issues
encountered by older persons within their environment.

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Probable Question
Q no. 1
The term geriatrics comes from the Greek word
‘geron’ which means;
a) Old man
b) Healer
c) Adult
d) Ageing

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a) Old man

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Terminologies
3) Geriatrics
 Focuses on the health care of ageing people.
 Geriatrics comes from, Greek word ‘geron’ means,
“old man” and ‘iatros’ means, “healer”

4) Geriatric Nursing
 Field of nursing specializes in the care of the elderly.
 Florence Nightingale First Geriatric
Nurse

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Father of
Geriatrics Father of Gerontology

Ignatz Leo Nascher V. Korenchevsky

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Terminologies
5) Ageing
 Process of growing older, regardless of chronological
age.
 Normal physiological and developmental process
causing progressive changes in functional capabilities,
begins at conception and ends at death.

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Probable Questions
Q . no. 2
What is the retirement age for general
civil citizen in Nepal ?
a) 60 years
b) 52 years
c) 65 years
d) 58 years

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d) 58 years

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Best to learn !!
 Retirement age for military: 45 to 48 years
 Retirement age for school teachers: 63 years
 Retirement age for chief justice, member of supreme
court, constitutional bodies: 65 years

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Probable Question
Q no. 3
The term denotes physical and mental deterioration
often associated with old age is;
a) Senescence
b) Senility
c) Ageism
d) Ageing

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b) Senility

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Terminologies
6) Senescence
 Cessation of cell division and growth.
 Mental and physical function decline.

7) Senility
 Conditions of being senile – weakness or disease.
 The correct term would be related to a specific disease
such as Senile Dementia.

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Terminologies
8) Ageism
 Bias to older people based on their chronological age,
without consideration of their functional status.
 Stereotyping and discrimination.

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Successful Ageing
  Explained by Rowe and Kahn’s (in 1997).
 Three components;

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 Healthy Ageing
 “Process of developing and maintaining the functional
ability that enables wellbeing in older age” (WHO)
 Disease or infirmity – not included.

Functional ability
 Ability to meet their basic needs;
 to learn, grow and make decisions;
 to be mobile;
 to build and maintain relationships;
 to contribute to society

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Probable Question

Q no. 4
To improve the lives of older people, the United Nation
along with WHO proclaimed the decade of healthy
ageing in,
a) 2021 – 2030
b) 2011 – 2020
c) 2031 – 2040
d) 2041 – 2050

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a) 2021 – 2030

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Active Ageing
 Adapted in working place
 Longer activity
 Social engagement

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Activities of daily living (ADLS)

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Basic Activities of daily living

 Are those basic self care activities that the individual

must accomplish each day to meet his own needs and
the demands of daily life which include personal
hygiene, bathing, dressing, grooming, feeding,
toileting, mobility, communication and walking.

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Probable Questions

Q no. 5
The older adult needs help in moving from bed to chair
and also needs help for complete transfer. This is an
example of;
a) Compromised Basic ADLS
b) Compromised Instrumental ADLS
c) Compromised Advanced ADLS
d) Disability

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a) Compromised Basic ADLS

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Instrumental Activities of Daily Living

 Are those activities needed to support independent

living.
 These include functional ability of housekeeping, food
preparation, use of telephone, doing laundry, using
public transportation, taking medicine, handling
finances, shopping and home maintenance.

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Probable Questions
Q no. 6
Responsibility for own medications is a component
of;
a) Basic activity of daily living
b) Instrumental activity of daily living
c) Advanced activity of daily living
d) Functional Ability

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b) Instrumental Activity of daily living

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Probable Questions

Q .no. 7
A health care professional while assessing the older
patient for IADLs, will assess the following history;
a) Cooking
b) Dressing
c) Bathing
d) Toileting

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a) Cooking

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Advanced Activities of daily living

 Complex activities of daily living.

 Skills to maintain working ,planning trips,
participation in community groups or religious
activities, driving, planning events, or playing games.

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Important stats and dates
 Almost, 8.1 % (2011) and 9% (2019) of country’s
total population.
 Total life expectancy of Nepal is ___________ ?
o70.88 years; 2020
o70.60 years; 2019
o68.03 years; 2011

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Theories of Ageing

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Theories of Ageing

Broadly classified as;

A. Biological Theory of Ageing
B. Psycho- Social Theory of Ageing

Others;
C. Developmental Theory
D. Evolutionary Theory

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A. Biological Theory of Ageing

First Classifications
a) Molecular Theory
b) Biological Clock Theory
c) Autointoxication Theory
d) Physiologic Theory

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a) Molecular Ageing Theory

 Ageing as a result of inappropriate and inadequate

information required for normal cell function.
 Caused by changes in the base pairs or DNA, increases
error in RNA, deterioration in arrangement of basic
control elements in chromosomes.

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b) Biological Clock Ageing Theory

 Hay flick
 Also called, Cellular ageing theory
 Clock of aging, a genetically predetermined program.

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c) Autointoxication Ageing theory

 Basic metabolic process of the cells produce waste

product ‘lipofucin’ or “age pigment” or “ wear &
tear pigments” which accumulates and destroys
cells.

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d) Physiologic Ageing Theory

 Changes occur outside the molecules and cells i. e.

in the tissues and organs.
 Involves changes associated with ageing in
immunological and endocrine system.

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Probable questions

Q no. 8
Which of the following is also called autointoxication
theory?
a) Wear and Tear theory
b) Physiological theory
c) Disengagement theory
d) Molecular theory

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a) Wear and Tear theory

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 A. Biological Theory of Ageing
Second Classification;

1) Stochastic Theory 2) Non stochastic Theory

• Free Radical Theory • Programmed theory

• Orgel/ Error Theory • Gene/biological clock
• Wear and Tear Theory theory
• Connective tissue/ Cross • Neuroendocrine theory
link theory • Immunological theory

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Theory Description
1) Stochastic Ageing, as the result of small inevitable
theory random events/ errors that accumulates over
time.

a) Free radical Membranes, nucleic acid proteins which are

theory. damaged by free radicals causes cell to stop
functioning and causes ageing.

b) Orgel/ Error Error in DNA and RNA synthesis occur with

theory ageing.
c) Wear and Tear Cells wear out and cannot function with
theory ageing.
d) Connective Accumulation of cross – linked proteins
tissue/ Cross link damages cells and tissues, slowing down
theory bodily processes resulting in ageing
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2) Non Stochastic Ageing as a result of genetically pre
theory determined, programmed or neuro
endocrine or immunological system events.
a) Programmed Cells divide until they are no longer able to,
theory and this trigger apoptosis and cell death.
b) Gene/ Biological Cells have genetically programmed aging
Clock theory code; biological clock.
c) Neuroendocrine Hypothalamic- pituitary axis (HPA)
theory controls homeostasis which decline with
ageing; increased insulin growth factor
accelerates ageing.
d) Immunological The immune system decline over time,
theory leading to disease, thus ageing.

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