CONCEPTS,

PRINCIPLES, AND
THEORIES IN THE
CARE OF OLDER
ADULT
CONCEPTS, PRINCIPLES, AND THEORIES IN THE CARE OF
OLDER ADULT

I. Perspective of Aging
A. Definition
B. Geriatric health Care Team
C. Demography of Aging and Implications for Health
and Nursing Care
D. Impacts of Aging in the Family

II. Theories of Aging and Its Nursing Implications

A. Biologic Theories
B. Psychosocial Theories

III. Physiologic Changes in Aging Affecting Various Systems

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I
Perspective of
Aging
A. Definition of Terms
⦁ Senescence
Young old 65 and 74 years
Middle old 75 and 84
Old old 85 and above
⦁ Aging
⦁ Agism
⦁ Gerontology

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B. Geriatric Health Care Team
1. Gerontologist / Geriatrician
2. Nurse Gerontologist
3. Occupational Therapist
4. Physical Therapist
5. Speech Therapist
6. Case Manager
7. Nursing and Interdisciplinary
Care Conference Team
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C. Demography of Aging
Global Aging
⦁ There were 703 million persons aged 65
years or over in the world in 2019.
⦁ The number of older persons is
projected to double to 1.5 billion in 2050.
⦁ *That proportion is projected to rise
further to 16 per cent by 2050, (one in six
people in the world will be aged 65 years
or over.

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C. Demography of Aging
Aging in the Philippines
⦁ As of 2019, 3.83 percent of the
population
⦁ By 2025 it is expected that the
elderly will be 10.25 percent of the
population.
⦁ By 2032, the elderlywould
comprise at least 7% of the total
population. 7
D. Impacts of Aging in the Family

⦁ Emotional Effects
⦁ Financial Effects
⦁ Structural Effects
⦁ Physical Effects
⦁ Positive Effects
.

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II
Theories of Aging
and Its Nursing
Implications
A. Biologic Theories
1. The Programmed Theory
2. Endocrine Theory
3. Immunological Theory
4. The Membrane Theory
5. The Damage or Error Theories:
a. Wear and Tear Theory
b. Rate of Living Theory
c. Cross-Linking Theory
d. Free Radicals Theory
e. Radiation Theory
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B. Psychosocial Theories
1. Disengagement Theory
2. Social Exchange Theory
3. Activity Theory

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III
Physiologic
Changes in Aging
Affecting Various
Systems
A. Integumentary
Changes
1. Skin: wrinkles, saggy, dry, age spots
2. Hair: graying, falling and thinning
Management
⦁ Daily bath is not necessary
⦁ Use mild soap, super fatter soap much
preferable
⦁ Use bath oils, lanolin or body lotion
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B. Musculo-skeletal
Changes
1. Decrease in bone and muscle mass
2. Bones shrink in size and density
Management
⦁ Get adequate amounts of calcium
⦁ Get adequate amounts of vitamin D
⦁ Include physical activity
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C. Respiratory
Changes
1. May show impaired gas exchange
2. Decrease in vital capacity
3. Slower expiratory flow rates

Management
⦁ Exercise

15
D. Cardiovascular
Changes
1. Loss of elasticity
2. Fibrotic changes in the valves
3. Decrease of elasticity of the arterial
vessels
Management
⦁ Proper diet, exercise, adequate sleep

16
E. Digestive
Change
1. Structural changes in the large intestine
can result in more constipation

Management
⦁ Increase in fiber and fluid
⦁ Include physical activity in daily routine
⦁ Don't ignore the urge to have a bowel
movement
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F. Urinary
Change
1. Bladder may become less elastic resulting in
the need to urinate more often

Management
⦁ Urinate regularly
⦁ Increase fluid intake
⦁ Avoid bladder irritants
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G. Endocrine
Changes
1. May affect function in
glucose maintenance
2. Reproductive
functioning
3. Calcium metabolism

19
H. Neurologic
Change
1. May have minor effects on memory
or thinking skills

Management
⦁ Stay mentally active
⦁ Be social

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I. Reproductive
Change
1. Hormonal changes may affect sexual
desire and performance

Management
⦁ Talk to the partners related to sexual
concerns

21
J. Vision
Changes
1. Decline in accommodation (presbyopia)
2. Glare tolerance
3. Low-contrast
4. Attentional visual fields
5. Color discrimination
Management
⦁ Keep eyeglasses clean and available
⦁ Keep night lights on
⦁ Be careful when driving
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K. Hearing
Changes
1. Conductive and sensory hearing losses
2. Presbycusis
3. Loss is primarily high tones

Management
⦁ Daily bath is not necessary
⦁ Use mild soap, super fatter soap much preferable
⦁ Use bath oils, lanolin or body lotion

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L. Smell
Changes
1. Olfactory function declines
2. Hyposmia

Management
⦁ Avoid strong scents

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M. Taste
Change
1. Taste acuity does not
diminish but salt
detection declines
Management
⦁ Careful when preparing food

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END OF PRESENTATION

26
NURSING CARE OF OLDER
ADULTS IN WELLNESS
AND WITH CHRONIC
ILLNESS
 CONTENTS

I. Assessment
II. Planning for Health Promotion, Health maintenance
and Home Health Considerations
III. Implementation
IV. Nursing Care of Older Adults with Chronic Illness

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I. ASSESSMENT
 I. ASSESSMENT
A. Subjective Data
1. Health Nursing History
a. Personal Data
• Date of Admission • Age
• Name • Marital Status
• Gender • Religion
• Date of Birth • Address
b. Chief Complaint
c. Present Medical History (current health status)
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 I. ASSESSMENT
A. Subjective Data
1. Health Nursing History
d. Past Medical History
• History or illness • Allergies
• Surgery • Emotional Status
• Hospitalization
• Injuries/Accidents
• Disabilities/Impairment
• Immunization History
• Medications (Prescriptions, OTC, Herbal,
Complementary Therapies)
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 I. ASSESSMENT
A. Subjective Data
1. Health Nursing History
e. Family Health History
• Genetic Disorders
• Family Member with Illness
• Family History of diseases (heart disease,
hypertension, TB, diabetes, asthma, thyroid,
kidney, STDs,)

32
 I. ASSESSMENT
A. Subjective Data
1. Health Nursing History
f. History
• Home Conditions
• Environment
• Occupation
• Habits Religious Practices
• Sexual Practices
• Other Health Practices

33
 I. ASSESSMENT
A. Subjective Data
2. Functional Health Patterns
a. Perception and Health Management Pattern
b. Nutrition and Metabolism Pattern
c. Pattern
d. Activity and Exercise Pattern
e. Cognition and Perception Pattern
f. Sleep and Rest Pattern
g. Perception and Self-Concept Pattern
h. Roles and Relationships Pattern
i. Sexuality and Reproduction Pattern
j. Coping and Stress Tolerance Pattern
k. Values and Belief Pattern 34
B. Objective Data I. ASSESSMENT
1. Psychosocial Assessment
a. The major components of a psychosocial
interview include:
• • Cultural assessment
Identifying the patient
• • Financial assessment
Chief complaint
•
• History of presenting illness Coping skills
• • Violence risk
Psychiatric history
• Medical or surgical history assessment
• Medication list
• Alcohol and drug use

35
B. Objective Data I. ASSESSMENT
1. Psychosocial Assessment
b. Questions to ask to assess violence risk
• Have you had thoughts of hurting yourself?
• Has there been a previous suicide attempt? When?
• Do you have a plan to commit suicide?
• Is there a means to carry out the plan?
• Is there intent to carry out the plan?
• How lethal is the plan?
• Do you have thoughts of harming others? If yes, who is the target?
• Can these thoughts of harm be managed?
• Do you have the means to carry out a plan to harm others?
• Is there intent to carry out the plan?
• What is the lethality of the plan?
• Do you have any high-risk behaviors such as self-cutting, anorexia,
bulimia, headbanging, or other self-injurious behaviors?
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 I. ASSESSMENT
B. Objective Data
2. Physical Assessment
a. General Survey
• Height and Weight
• Vital Signs (Temperature, Pulse,.
Respiration, Blood Pressure)
• General Appearance and Behavior o Hygiene and Grooming
o Sex and Race
o Dress
o Signs of Distress
o Body Odor
o Body Type
o Mood and Affect/
o Posture
Facial Expression
o Gait
o Speech
o Body Movements
o Level of Consciousness
o Age 37
 I. ASSESSMENT
B. Objective Data
2. Physical Assessment
b. Head to Toe Assessment
• Head • Heart
• Eye • Breasts
• Ears • Abdomen
• Nose • Upper
• Mouth extremities
• Neck • Lower
• Thorax and Lungs (Anterior Extremities
and Posterior)
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 I. ASSESSMENT
B. Objective Data
2. Physical Assessment
c. Neurologic Assessment
• Mental and Emotional Status
• Sensory Function
• Cerebellar Function
• Motor Function
• Reflexes
• Cranial Nerves

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I I . PLANNI NG FOR HEALTH
PROMOTI ON, HEALTH
MAI NTENANCE AND HOME
HEALTH CONSI DERATI ONS
 I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S

A. Planning for Successful Aging

1. Adopt and maintain healthy habits and positive
lifestyles.
2. Maintain intellectual stimulation and socialization.
3. Be wise in financial planning.
4. Work to maintain dignity and good health in old
age.

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A. Planning for Successful Aging
5. The twelve keys to reach centenarians.
• Attitude is everything
• Eat a healthy diet
• Physical activity and exercise
• Engage your brain
• Be social
• Stay in tune to the times
• Practice being safe
I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S
• Manage your numbers
• Manage your stress
• Keep finances in order
• Sleep
• Take time for yourself
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 I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S

B. Home Care and Hospice

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 I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S

C. Community-Based Services
1. Home health care, such as:
• Skilled nursing care
• Therapies: Occupational, speech, and physical
• Dietary management by registered dietician
• Pharmacy
• Durable medical equipment
• Case management
• Personal care
• Caregiver and client training
• Health promotion and disease prevention
• Hospice care (comfort care for patients likely to die from their
medical conditions) 44
 I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S

C. Community-Based Services
2. Human Services support daily living:
• Senior centers
• Adult daycares
• Congregate meal sites
• Home-delivered meal programs
• Personal care (dressing, bathing, toileting, eating, transferring to or
from a bed or chair, etc.)
• Transportation and access
• Home repairs and modifications
• Home safety assessments
• Homemaker and chore services
• Information and referral services
• Financial services
• Legal services, such as help preparing a will
• Telephone reassurance
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 I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S

D. Assisted Living
• 24-hour supervision
• 3 meals a day in a group dining room
• Personal care services (help with bathing, dressing, toileting,
etc.)
• Medication management, or assistance with self-
administration of medicine
• Social services
• Supervision and assistance for persons with Alzheimer’s or
other dementias and disabilities
• Recreational and spiritual activities
• Exercise and wellness programs
• Laundry and linen service
• Housekeeping and maintenance
• Arrangements for transportation
• Each resident receives individualized services
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 I I . F O R H E A LT H P R O M O T I O N ,
H E A LT H M A I N T E N A N C E
A N D H O M E H E A LT H
C O N S I D E R AT I O N S

E. Special Care Units

• Memory/cognitive care (Alzheimer’s disease
dementia)
• Neurological care f(Parkinson’s, Huntington’s
disease)
• Orthopedic rehabilitation
• Cardiac/pulmonary care
• Approaching the end of life

F. Geriatric Unit

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III. IMPLEMENTATION
 III. IMPLEMENTATION

A. Physical Care of Older Adults

1. Aging Skin Mucus Membranes
2. Elimination
3. Activity and Exercise
4. Sleep and Rest

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 III. IMPLEMENTATION

B. Psychosocial Care of Older Adults

1. Cognition and Perception
2. Coping and Stress
3. Emotional Needs
4. Values and Beliefs
5. Respect values and beliefs
6. Sexuality and Aging

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IV. NURSING CARE OF
OLDER ADULTS WITH
CHRONIC ILLNESS
 I V. N U R S I N G C A R E O F
O L D E R A D U LT S W I T H
CHRONIC ILLNESS
A. Disturbance in Sensory Perception
• Identify time, place, and stimuli surrounding the
appearance of symptoms
• Assist client to develop strategies for dealing with
sensory and thought disturbances
• Provide care for a client experiencing visual, auditory or
cognitive distortions (e.g., hallucinations)
• Provide care in a nonthreatening and nonjudgmental
manner
• Provide reality-based diversions

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 I V. N U R S I N G C A R E O F
O L D E R A D U LT S W I T H
CHRONIC ILLNESS
B. Chronic Confusion
• Keep patient free from harm
• Promote functions at a maximal cognitive level
• Encourage to participates in activities of daily living
at the maximum of functional ability
• Involves family members

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 I V. N U R S I N G C A R E O F
O L D E R A D U LT S W I T H
CHRONIC ILLNESS
C. Impaired Verbal Communication
• Demonstrate respect by remembering names and
calling the person by names
• Face the person when speaking
• Do not shout
• Provide written instruction repetition of instruction

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 END OF
PRESENTATION