Care of the older adult

Care of The Older AdultH. Deepani

RN, BN, Nursing TutorSchool of Nursing

ColomboSri Lanka

OLD AGE…..generally begins at the

age of

60

People in this age group are called… …..Senior Citizens

According to the World Health Organization….

…among those 13% are over 80 years old.

….there are almost 700 million people over the age 60

living in the world today.

…it is expected that by 2050 this number will be almost

2 billion and the number of elderly will be

higher than the number of children

Gerontology study of ageing processYoung old age 55- 60Old age 60-85Very old (old-old) above 85Gerentophobia- fear of ageing

Changes in Elderly Physicalvisual and hearing problemssmell and taste lossessusceptibility to illnesses

Leading Cause of Death

heart diseases

cancer

pneumonia

Physical theories of ageingCross link theoryFree radical theoryImmunologic theoryWear and tear theory

Changes in elderlyCognitivedecline in mental processes – may experience memory lapses or disorientation.

Socialbecause of their declining health and limited mobility, most elderly have the tendency to withdraw from the society – spending most of their time looking back – reflecting on what they have made out of their lives.

Social Theories of AgingDisengagement TheoryActivity TheorySocial breakdown Reconstruction Theory

Social Theories of AgingDisengagement Theory – as older adults slow down, they gradually withdraw from the society.

Disengagement is a mutual activity in which the elderly not only disengaged in the society, but the society disengages from the older adult.

The elderly develops greater self-preoccupation and decrease emotional ties with people and reduced interest in social activities. Such social withdrawal and increased self-absorption was thought to increase life satisfaction among them.

Social Theories of AgingActivity Theory– as opposed to the disengagement theory, this theory argues that the more active and involved the elderly are, the more likely that they are satisfied with their lives.

It is therefore important to find substitute activities for them after their retirement.

Social Theories of AgingSocial Breakdown -Reconstruction Theory

This theory states that aging is promoted through negative psychological functioning brought about by the negative views of the society about elderly and inadequate provision of services for them.

Social reconstruction can occur by changing the society’s view of the elderly and by providing adequate social services for them.

Society provides inadequate support services, and funds for the elderly.

Society views elderly as

incompetent; obsolete

Society develops label for the elderly: useless; ineffective;

helpless

Elderly’s skills deteriorate

Elderly labels self as incompetent

What Elderly wants?

Society provides support systems for the elderly: family support; housing; health services; economics; nutrition and social services.

Society views elderly as

competent; important

Society develops positive label for the elderly: helpers;

self-controlled; wise; competent

Elderly’s skills improve

Elderly labels self as competent

Issues Facing the Elderly

ABUSE

“Having someone else look after aging parents is a tough decision to make, and is made even tougher by fact that one of four nursing homes has been blamed for the death or serious injury to a resident each year, according to government figures.”

Issues Facing the Elderly

ABUSE

•It can happen in the family•It can happen in nursing homes•Physical•psychological (like verbal abuse) • NEGLECT! When people who are suppose to care for them ignore their needs and concerns•Sexual•Financial•Self neglect

Issues Facing the Elderly

LONELINESS•Death of a husband or wife and many friends.

•Children are busy with work and may not even come to visit them. Grandchildren are busy with school.

•Physically weak elderly may feel that they are burden so they try to stay away even if people are around. •Loneliness leads to depression – they feel alone and unproductive.

Issues Facing the Elderly POVERTY

•They cannot earn anymore and they do not have money.

•May receive retirement pension but may not also be enough because of their increasing medical needs.

•As such many even try to continue working even after reaching the retirement age.

Issues Facing the Elderly

HEALTH

•diminished sensory and motor abilities

•tendency to acquire various illnesses such as heart disease, Alzheimer's, cancer, etc.

Issues Facing the Elderly

DISCRIMINATION

•Job discrimination – employers prefer younger applicants because

….inexperienced workers have cheaper salaries

…employers believe that the elders could only stay in work for a short time because of their declining physical condition

….elderly are thought of as slower and less capable.

Issues Facing the Elderly DISCRIMINATIO

N

•Social discrimination – maybe excluded from family or community services because they are seen as incapable.

Medical Discrimination - Some doctors treat them without much care because they think they don’t deserve such because they are already old.

Effects of ageinga) Physical1. Integumentary Less elastic and dry Loss of fat tissue-wrikling Thinning of hair Thickening of nails No new growth of skin cells

2. MusculoskeletalMuscle atrophyJoint pain and stiffnessDecrease in strengthGradual shortening of vertebraeBrittle bonesWeight lossSlow overall mobility

3. Neurologic Slow response to stimuliDecreased reflux actionsDecreased blood flow to the brain

dizziness, memory lossDecreased temperature regulationSleep disturbancesPeripheral numbness

4. Special sensesDiminished visionDiminished hearingDecreased smell &tasteDecreased cutaneous senseLoss of balance of the body

5. Cardiovascular systemDecreased cardiac outputDecreased heart rateAtherosclerosisFatigue due to less myocardial perfusionRisk of IHDPeripheral edema due to venous stasis

6. Respiratory systemIncreased respiratory rateDecreased pulmonary elasticityAccumulation of secretionChronic respiratory diseases

7. Gastro intestinal systemTooth decayDecreased appetiteDecreased secretion of gastric juice & enzymes

Decreased absorption of nutrientsDecreased peristalsis-Constipation

Dysphagia/regurgitation

8. Urinary systemDecreased UOPFluid & electrolyte imbalancesFrequencyuria due to decreased bladder

capacityIncontinenceUTI due to incomplete emptyingProstate enlargement in male

9. Reproductive systemMale

slow production of spermdecreased libidoproblems of erectionsmall & less firm sperm

Femalemenopausesagging of breastdecreased libidodecreased vaginal secretions-dysparauniauterine prolapse

b) Psychosocial changes