The elderly

Question 1

Categories of aging

Answer 1

Young-old: 65-74 yrs
Old: 75-84
Old-old: 85-99
Elite-old: over 100
each category has distinct set of interests and HC needs

Question 2

65 years and over population

Answer 2

grown twice as fast, US census in 2000 found that of 35 million 1/8 were >65, by 2030 in a population of 70 million 1/4 will be >65,

Question 3

85 years and older population

Answer 3

most rapidly increasing age group, projected to reach 9.6 million in 2030, in 2002 the population was 6 million

Question 4

Baby-boomers

Answer 4

turning 65 placing greater demands on health care, born within 1946-1964

Question 5

Four basic characteristics of aging process

Answer 5

Universal, progressive, intrinsic in nature, and affected by extrinsic factors

Question 6

Senescence

Answer 6

the process of growing old

Question 7

Biological

Answer 7

progressive loss of function, multifactor process, quality of life while increasing life span, slow or reverse age related changes, and researched to reverse effects of aging

Question 8

Two categories of biological aging theories:

Answer 8

Stochastic (aging is due to chance) and nonstochastic theory (age related molecular and cellular events)

Question 9

Stochastic theories

Answer 9

Genetic, Free radical, cross-link theories

Question 10

Genetic theory

Answer 10

determines life expectancy, internal mechanism determines senescence, faulty synthesis of DNA, thought to be primary cause, somatic/intrinsic/transcription

Question 11

Free Radical theory

Answer 11

unstable free radicals, causes biochemical changes (cells cannot regenerate), byproducts of cellular processes and environment (atherosclerosis, cataracts, and cancer)

Question 12

Cross-link theory

Answer 12

chemical reactions as cells age, loss of elasticity, stiffness, loss of function and rigid, fragile tissue

Question 13

Nonstochastic theory

Answer 13

Neuroendocrine, immunity theory, programmed theory, telomere-telomerase hypothesis, and stress theory

Question 14

Neuroendocrine

Answer 14

efficiency of signals between mechanisms is lost or altered, changes in hypothalamic-pituitary system

Question 15

Immunity theory

Answer 15

reduced resistance to infectious diseases and viruses-possibly related to genetics, environment, or endocrine factors

Question 16

Programmed theory

Answer 16

biological clock triggers specific cell behaviors @ specific times, specific # of cell divisions and specific life span, impairment in ability of cell to continue dividing

Question 17

Telomere-telomerase hypothesis

Answer 17

limits number of times cell can divide, strong relationship between aging and cancer

Question 18

Stress theory “wear and tear”

Answer 18

cells wear due to internal and external stressors (trauma, chemicals, metabolic waste products, nutrient deprivation) Leads to organ malfunction, and body wears out like an automobile with time leading to aging and death

Question 19

Psychosocial theories

Answer 19

supports the concept that lifestyle, personality, and environmental factors influence aging

Question 20

Personality theory

Answer 20

each individual is unique, persons characteristics, habits, behavior, and other qualities

Question 21

Adult development

Answer 21

definable, predictable, sequential patterns, physical and psychosocial growth undergo reorganization, normative activities in each stage,

Question 22

Disengagement theory

Answer 22

process of elders withdraw from roles and responsibilities. Four main concepts.

Question 23

Four main concepts of disengagement theory:

Answer 23

1: aging person and society mutually withdraw
2: withdrawal process is systematic and inevitable
3: necessary for successful aging by providing time for reflection and coming to terms with unfulfilled expectations
4: beneficial for society- an orderly transfer of power from old to young

Question 24

Activity theory

Answer 24

belief that the way to age successfully is to stay active,

Question 25

continuity or developmental theory

Answer 25

predict how person will adjust to aging, personality traits remain the same as aging occurs

Question 26

Aging

Answer 26

normal physical and behavioral changes that occur under normal environmental conditions as people mature and advance in age

Question 27

Geriatrics

Answer 27

branch of medicine that deals with problems and diseases of old age/aging

Question 28

Gerontology

Answer 28

study of all aspects of the aging process and its consequences

Question 29

Safety issues

Answer 29

care of the patient (apply non-skid shoes/socks), accidents(fallophobia, presbyopia, reduced sense of touch, decreased reaction time), protective device usage ( restraints), alternative restraints (close obs., assess pain/comfort, educate/med. review, family conference, bed alarm, and decrease stimulation)

Question 30

Therapeutic communication

Answer 30

nurse (respect the older adults uniqueness, special considerations: sensory deficits, listen, touch, orientation, reminiscence), sensory deficits (sensory losses change mentation, isolate, create comm. barrier), sensory deprivation (sensory deficit from sight/hearing loss), listening ( very important), reminiscence (recall past to assign new meanings to experience), reality orientation (person, place, time, and circumstance), barriers to communication (uncomfortable, med. effect, psychosocial function, contact with reality, culture/lang. differ., prejudices/stereotypes), environment (lighting, face to face, private)

Question 31

Guidelines for reality orientation

Answer 31

realism (don't reinforce delusions), independence (promote independence), individualized (allow them to have familiar objects), reinforcement (positive), repetition (repeat info), and clarity/consistency (clear short directions)

Question 32

Skin care for the elderly

Answer 32

integumentary changes (increased dryness, pallor, fragility, loss of elasticity, wrinkling, sagging, alopecia, thick- britle nails), positioning (turn q2 hrs), bathing (great time to assess), hydration risk (encourage fluids unless contraindicated), prevent trauma (falls, fires, MVAs most common cause of accidental death), mental health (assess for all basic needs), incontinence (keep dry and clean)

Question 33

Driving safety

Answer 33

MVA most common cause of injury related death in young old population

Question 34

sundown syndrome

Answer 34

agitation, confusion occurs late in day/when sun goes down

Question 35

depression

Answer 35

mood disorder, use geriatric depression scale

Question 36

dementia

Answer 36

slow insidious loss of cognitive function (chronic state)

Question 37

delirium

Answer 37

usually transient condition disorganized thinking, loss of concentration (acute state)

Question 38

Eriksons stages of development

Answer 38

each stage has a specific developmental task based on successful attainment of previous developmental tasks (ego integrity vs despair, >65 yrs)

Question 39

Sense of wholeness

Answer 39

can accept death as a part of life, sense of unique life, sense of self

Question 40

Behaviors reflecting problems

Answer 40

fear for future and dying

Question 41

Causes of older adult malnutrition

Answer 41

lack of transportation, inappropriate foods, inability to carry bags, loneliness, diminished sense of taste and smell, and tooth loss/ill fitting dentures

Question 42

How to improve eating habits

Answer 42

educate, allow time for meals, check dentures, make food look attractive, favorite foods, smaller more frequent meals, time meals around favorite TV shows

Question 43

Teaching older adults

Answer 43

peer educators, simplicity repetition, support belief that change is helpful and worth the effort of increased learning (Ex: meds., nutrition, hygiene, mobility, support services, when/how to seek help)