The Older Adult

Chapter 20

By: Jondea Orr, RN, MSN Mt. San Antonio College

Associate Degree Program

GROWTH & DEVELOPMENT

GROWTH: Physical changes and increase in size,

EXAMPLES: Ht., Wt., bone size.

DEVELOPMENT: Increase in the complexity of

functions and skill progression.

Biophysical Theory
Gesell (1880-1961) Physical Body

Psychosocial
Freud

Erikson Peck & Gould

Piaget

Three Primary Abilities

1. Assimilation
2. Accommodation 3. Adaptation or coping behavior

Phases
Sensorimotor
Preoperational Concrete Operations Formal Operations

Moral
Kohlberg Gilligan

Spiritual
Fowler Westerhoffs

Chapter 23 By : Jondea Orr, RN, MSN

Aging Population
Young-old
Old
65 to 75 years

Old-old

75 to 85 years
85 to 100 years Over 100 years

Elite old

Characteristics of Elders
Demographic
Longer life spans
Fastest growing age group

Socioeconomic
Women have longer life

is 65 years and over

Ethnicity
Number of minority elders

increasing Elder Hispanic fastest growing subpopulation

expectancy Men more likely to remarry Educational level gradually increasing Lower incomes Most live in community settings Poverty level more likely when living alone

Characteristics of Elders
Health Chronic health problems and disabilities increase 73% rate their health as good, very good, or excellent 20% report disability and most have chronic disease

Ageism
Discrimination based solely on

age Exists among some professionals Negative stereotypes based on myths and incorrect information

Gerontology and Geriatrics

Gerontology The study of aging and older adults Multidisciplinary Specialized area within various disciplines including nursing Geriatrics Associated with the medical care of the elderly

Care Settings for Older Adults

Acute care facilities
Intensive care units
Emergency department Rehabilitation

Community
Hospice
Home health care Nurse-run clinics Adult day care

Long-term care facilities

Assisted living Intermediate care Skilled care Alzheimers units Hospice Rehabilitation

Physiological Aging
Biological Theories

Biological Theories
Wear & Tear
Endocrine Theory Free Radicals Genetic Factors Cross-linking Immune Theories

Physical Changes
Integument
Skin Nails Hair

Sensory/Perceptual
Vision Hearing

Mouth Cardiovascular

Physical Changes Continue

Pulmonary/Respiratory Breast Gastrointestinal Genitourinary

Physical Changes Continue

Musculoskeletal
Neurological Endocrine Sexuality

 Retirement E-Health Economic

Psychosocial

Grandparenting Relocation Independence Death & Grief

Cognitive Ability
Perception
Cognitive Ability Memory
Short Term Long Term

Learning

Spiritually and Aging

Many take there faith and religious practices very

serious
This age group grew up in a time where religion was

viewed differently
May not be able attend their church services

Health Problems
Accidents/Injury Chronic Disabling Illness Drug Use/ Misuse/ Alcoholism

Concerns Continue
Dementia
Mistreatment Depression Suicide

Elder Abuse
Ethical & Legal Issues Residents Bill of Rights

Client Bill of Rights

Privacy
Respect Confidentiality Informed Consent Right to Refuse any and all treatment including

feeding

Health Promotion

Health Promotion
Health Test & Screening
Safety Nutrition and Exercise Elimination Social Interaction

Nursing Diagnosis for the Older Adult

Self care deficit Impaired skin integrity Immobility Impaired urinary elimination Imbalanced nutrition Impaired communication

Risk for falls Risk for injury Risk for loneliness Risk for sleep pattern alteration Risk for body image disturbance Risk for knowledge deficit