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Chapter 20 The Aging Adult

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Theories of Aging
Geneticgenes control genetic clocks Immunityfocuses on the functions of the immune system

Cross-linkagechemical reaction produces damage to the DNA and cell death


Free radicalmolecules with separated high-energy electrons have adverse effects on adjacent molecules

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Which one of the following theories of aging focuses primarily on cell metabolism and function? A. Genetic theory

B. Immunity theory
C. Cross-linkage theory D. Free radical theory

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
Answer: D. Free radical theory Rationale: The focus of the free radical theory is the free radicals formed during cellular metabolism that have adverse effects on adjacent molecules. The genetic theory focuses on genetic inheritance. The immunity theory of aging focuses on the functions of the immune system. The focus of the cross-linkage theory is a chemical reaction damaging the DNA and causing cell death.
Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Development of the Middle Adult


Physiologicgradual internal and external physiologic changes occur Cognitivelittle change from young adulthood

Psychosocialtime of increased personal freedom, economic stability, and social relationships

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
Answer: A. Continue an established lifestyle or reorganize ones life in a period of transition Rationale:

According to Levinson, middle adults may continue or reorganize their lifestyle.


It is the role of the older adult to adapt to, and face, already completed tasks. Choosing a vocation and developing an ethical system as a guide to behavior are developmental tasks for adolescents and young adults.
Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Developmental Tasks of Middle Adulthood


Establish and guide the next generation. Accept middle-age changes. Adjust to the needs of aging parents. Re-evaluate ones goals and accomplishments.

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Middle Adult Years Characterized by Expanded Family Roles

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Leading Causes of Death in Middle Adulthood


Malignant neoplasms Cardiovascular disease Unintentional injury including poisoning, motor vehicle accidents, and falls Diabetes mellitus Cerebrovascular causes (CDC, 2009)

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Tell whether the following statement is true or false. Both acute and chronic illnesses are more likely to occur in middle adulthood, and recovery takes longer.

A. True
B. False

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
Answer: A. True Both acute and chronic illnesses are more likely to occur in middle adulthood, and recovery takes longer.

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Major Health Problems


Cardiovascular and pulmonary disease Cancer Rheumatoid arthritis Diabetes mellitus Obesity Alcoholism Depression

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Role of the Nurse in Promoting Health


Teach the dangers of substance abuse, smoking, and alcohol consumption. Teach adults to eat a diet low in fat and cholesterol.

Teach the importance of regular exercise.

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Life Changes of the Middle Years


Employment Relationship with a spouse Relationships with adult children Relationships with aging parents Midlife transition

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Development of the Older Adult


Physiologicall organ systems undergo some degree of decline, body less efficient Cognitivedoes not change appreciably, may take longer to respond and react Psychosocialself-concept is relatively stable throughout adult life Disengagement theory

Eriksonego integrity versus despair and disgust; life review


Havighurstmajor tasks are maintenance of social contacts and relationships
Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Tell whether the following statement is true or false. Fundamental to ageism is the view that older people are the same as younger people; therefore, they experience the same desires, needs, and concerns as other age groups. A. True B. False

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
Answer: B. False Fundamental to ageism is the view that older people are different than younger people; therefore, they do not experience the same desires, needs, and concerns as other age groups.

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Common Myths of the Older Adults (Ageism)


Old age begins at 65 years. Most older adults are in nursing homes. Older adults are sick, and mental deterioration occurs. Older adults are not interested in sex. Older adults do not care how they look and are lonely. Bladder problems are a problem of aging. Older adults do not deserve aggressive treatment for illnesses.
Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Changes of Older Adulthood


Physical strength and health Retirement and reduced income Health of spouse Relating to ones age group Social roles Living arrangements Family and role reversal

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Moral and Spiritual Development of Older Adults


Kohlbergolder adults have completed their moral development and most are at a conventional level Spiritually, an adult may be at earlier level, often at individuative-reflective level Many adults demonstrate conjunctive faith and trust in a greater power Self-transcendence is characteristic of later life

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Basis for Teaching Plan for Older Adults


Chronic illness limits activities in almost half of older adults. Meeting expenses of healthcare is often difficult.

Medication costs, hospitalization costs, and costs of special equipment and supplies
Family members must learn to cope with needs of the ill person. Family members must adapt to psychological stressors.

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Causes of Accidental Injuries in Older Adults


Changes in vision and hearing Loss of mass and strength of muscles Slower reflexes and reaction time Decreased sensory ability Combined effects of chronic illness and medications Economic factors

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Mental Impairment in Older Adults


Dementia Alzheimers disease Sundowning syndrome Cascade iatrogenesis

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question
Tell whether the following statement is true or false. Sundowning syndrome is a temporary state of confusion that can last from hours to weeks, and resolves with treatment. A. True B. False

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Answer
Answer: B. False Delirium is a temporary state of confusion that can last from hours to weeks and resolves with treatment.

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Goal of Nursing Care


Promote independent function. Support individual strengths. Prevent complications of illness. Secure a safe and comfortable environment. Promote return to health.

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Nursing Interventions for Hospitalized Older Adults Prevent Complications

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Housing Options for Older Adults


Home modifications Homesharing Accessory apartments

Elderly cottage housing opportunities


Senior retirement communities Continuing care retirement communities

Assisted living
Board and care homes Nursing homes
Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins