1. Older Adulthood:
    • n Traditionally begins at retirement ~ 65.
    • n Estimated 20% of population will be over 65 by 2030- ~71.5 million older Americans
    • n Most elders are:
    • q Functional
    • q Active
    • q In the community
    • n Will benefit from wellness activities!
  2. The older adult population:
    • n Average Life expectancy
    • q Women- 80.5
    • q Men- 75.4
    • n Young Old - 60-74
    • n Middle Old- 75-84
    • n The over 85 group: old-old
    • q Fastest growing segment
    • n Elite old
    • q Over 100!
  3. An Adaptive Population:
    • n Lived through the most change
    • n Experienced losses-house, people, independence
    • n Unique perspective
    • q Can look back over entire lives
    • q Have no “next phase” to look forward to
    • q Functional health-extremely important
    • n How well can they function, remain independent-major nursing focus
  4. Ageism:
    • q Form of prejudice
    • q Deep seated uneasiness on the part of the young and middle aged adults; general dislike
    • q Personal revulsion or distaste
  5. Consequences of Ageism:
    • n People distance themselves from elders
    • n Don’t see elders as “like them”
    • n Elder is viewed as being less than human
    • n Elder not seen as someone with
    • q Feelings
    • q Motivations
    • q Human emotions
  6. Nurses’ Attitudes:
    • n Important to explore own attitudes
    • n These attitudes will influence care
    • n Negative attitudes may result in damage to client’s sense of security and well-being
    • n Nurse must foster positive attitudes; model these behaviors
    • q Promoting independence and self-esteem
  7. Examples of Negative Attitudes
    • n Raising the voice when speaking to an elder
    • n Providing no or less privacy during care
    • n Referring to elders as cute
    • n Talking about elder in their presence
  8. Myths
    • q Most elders are in nursing homes
    • q Being elderly means being “senile”
    • q Older adults do not care how they look
    • q Most elderly have bladder problems
  9. Realities
    • q Most in community
    • q Many elderly retain mental capabilities
    • q Older adults are concerned about their looks and want to be attractive to others
    • q Incontinence is not a normal part of aging
  10. Realities:
    • q Most in community
    • q Many elderly retain mental capabilities
    • q Older adults are concerned about their looks and want to be attractive to others
    • q Incontinence is not a normal part of aging
  11. Common Aging Changes-Physiologic Aging:
    • n General status
    • n Integumentary
    • n Musculoskeletal
    • n Neurologic
    • n Sensory
    • n Cardiopulmonary
    • n GI/ oral
    • n GU
  12. General Status:
    • n Less efficiency of physiologic processes
    • n Fragile balance of homeostasis
    • n More vulnerable to stressors
    • n Decreased reserves
  13. Integumentary:
    • n Wrinkles- decreased elasticity
    • n Dryness
    • n Balding
    • n Skin pigmentation-moles
    • n Thickened nails
  14. Neurologic:
    • n CNS responds more slowly to multiple stimuli (driving)
    • q Cognitive/behavioral response is delayed
    • n Temp perception and pain regulation become less efficient
    • n Sense of balance declines, fine movements become more difficult
    • n Sleep at night shortens, naps more common
  15. Special Senses:
    • n Diminished visual acuity
    • q Presbyopia
    • q Increased sensitivity to glare
    • q Cataracts-opacity of the lens of the eye
    • n Diminished hearing acuity-isolates person, hearing aids are easy to lose and hard to keep track of.
    • q Presbycusis
    • q Poor pitch discrimination with environmental noises
    • n Taste and smell decreased
  16. Musculoskeletal:
    • n Muscle mass, strength decrease
    • n Bone demineralization-osteopnenia, osteoporosis, older adult female polulation, pathological fractures then the fall.
    • n Stiff joints
    • n Overall mobility slows. "Keep moving" Height decreases
    • n Decrease in subcutaneous tissue and weight
  17. Cardiopulmonary
    • n Blood vessels-
    • q Less elastic, rigid
    • q Fatty plaque deposits
    • q Lower extremity edema and cooling
    • n Body less able to increase HR and cardiac output with activity
    • n Pulmonary elasticity and ciliary action decrease
  18. Gastrointestinal:
    • n Digestive juices diminish
    • n Nutrient absorption decrease
    • n Anemia
    • n Decreased peristalsis
    • q Constipation
    • q Indigestion
  19. Genitourinary:
    • n Blood flow to kidneys decrease with diminished cardiac output
    • n Waste products filtered more slowly
    • n Bladder capacity decreased
    • n Men
    • q Hypertrophy of the prostate -Flow Max
    • ...about this time glasses!
  20. Cognitive Changes:
    • n Cognitive-thinking, judgment, understanding, learning
    • q Pertaining to cerebral functioning
    • n Ability to understand
    • q Older adults retain ability to
    • n Learn
    • n Understand
    • n Problem solve-cellphne and remote
    • q Personality remains consistant

    • n Mild short term memory loss is common
    • n Serious mental impairment not common
    • q Not all older adults
  21. Adjusting to Changes: Look in text
    • n Retirement-what will I do? Diversify
    • n Isolation-
    • n Sexuality-many older people cohabit
    • n Living arrangements-change of living conditions, what to do with the junk
    • n Facing death
    • q Loved ones
    • q Self-facing your own death
  22. Older Adult Health: What do they fear? Look in text
    • n Chronic illness
    • n Accidents and injuries
    • n Dementia, Depression
    • n Elder Abuse
  23. Chronic Illness
    • n Living with illness
    • q Diabetes
    • q Arthritis- Otheo not rheumatoid
    • q Heart disease
    • q Respiratory disease
    • n Limitations
  24. Accidental Injuries:
    • n Falls
    • n Accidents
    • n Isolation
    • n P. 676 Taylor
  25. Elder Abuse:
    • n Neglect
    • n Abuse
    • q Physical
    • q Emotional
    • q Financial-moved to nursing home, check will quit coming.
    • Table 20-4, p.461
  26. Dementia-does not get better
    • n Various organic disorders that effect cognition,progressive disease, medication can help alleviate symptoms
    • n Alzheimer’s disease
    • q Most common
    • q Affects brain cells
    • q Progressive
  27. Gerontologic Nursing
    • n Gerontologic nursing-
    • q Specialty of nursing concerned with assessment of health and functional status of older adults and planning, implementing health care and services to meet needs as well as evaluating the effectiveness of care
    • n Gerontology
    • q Scientific and behavioral study of all aspects of aging and its consequences
  28. Meeting Healthcare Needs
    • n Major goals:
    • q Promote health
    • q Prevent illness/injury
    • n Table 20-5 Taylor p 462- Promoting Health
    • q Areas of concern
    • q Nursing actions
  29. Care Settings
    • n Retirement communities
    • q Continuing care retirement communities
    • n CCRC
    • n Acute care
    • n Home care
    • n Assisted living
    • n Adult day care
    • n Respite care
    • n Long-term care
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