Geriatric Nursing Week3

8/6/2019 Geriatric Nursing Week3

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Medical University of South Carolina/SC-Geriatric Education Center

Care of the Chronically Ill

and the Older PersonsELECTIVE 2

BSN 14B

June 22, 2011

Madeline N. Gerzon

Level IV Clinical Instructor

Davao Doctors College


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Recap..

Myths of aging

Theories of Aging

Psychosocial

Sociological

Biological


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One aspect that is

common to all forms ofaging is Change.


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Socio-economic Aspect of

Aging

Industrialization

UrbanizationLack of facilities for older pop


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Aging

Industrialization

Speed of productionEarly unemployment

Longer pension years (critical economic

problem)


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Aging

Urbanization

Shrinking to two-generation familiesMoving to cities

Living arrangement issues

Personality differences


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Aging

Lack of facilities for older pop

More facilities for the younger agegroup

Few opportunities for health facilities,

learning and practice activities.

Less facilities to retrain for new jobs


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The Aging Family


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Post-Parental Period

The post-parental - the middle years ofadulthood, after the departure of children,but before retirement

The empty nest and the launching stage

For married parents this is characterized bya return to a two-person, married-couplehousehold


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Marital Status in the

Middle YearsA majority of 45 to 64 years old are

married with a spouse present.

The percentages of people who arenever married, divorced, and widowedare low relative to other categories.

The post-parental period lasts longerthan any other in the marital life

course.


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Co-Residence in the

Middle Years

Co-Residence refers to adult children

living in the same household as their

parents.


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Co-Residence in the

Middle Years

These factors contribute to earlier

home-leaving:

Family instability

Crowding

Non-traditional family structure


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Co-Residence in the

Middle Years 4/5 of adults leave home by age twenty-

three, but nearly half return home.

Boomerang kids leave home and thenreturn, due to:

Divorce

Unwed motherhood

Job loss

Economic hardship


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Grandparent Status

Increased life

expectancy has made

grandparenthood a near

universal experience in

the U.S.


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Grandparent Status

Grandparenthood has become a

transition of the middle years because:

Families are smaller;

Children are spaced more closely; and

Women are having their last child atyounger ages.


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Grandparent Status

Role expectations are not always clear.

Roles vary by social class and gender.

Grandmothers are likely to provide regularcare.

Grandfather roles tend to be moreaffectionate than functional.


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Grandparent Status

Step-grandparent is a new role created

by the frequency of divorce and

remarriage in the U.S.

It is a role-less role since there are few

role expectations associated with it.


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Grandparent Status

Grandparent visitation rights are a

new phenomenon.

Every state allows grandparents to

petition for visitation.


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Growth of the

Elderly Population Early marriage and longer life have

increased:

The length of marriageThe number of living generations

The size of the kin network

The number of older persons has risen as

average life expectancy has increased.


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Marital Status in

the Later Years As persons age, the percentage of widows

and widowers increases.

More women are widowed than men. For the elderly, marital and family

relationships are primary sources of:

Social involvement;

Companionship;

Fulfillment; and

Happiness.


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Intergenerational

Relationships

The sandwich generation are persons

in the middle years who manage the

demands of caring for their own

children and aging parents

Intergenerational family relations areimportant, strong and resilient in the

U.S.


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Common Problems of

Older Persons

Health and care

Childrens problems

Income and standard of living

Abuse and neglect


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Health and Health Care

Older people prefer care by familymembers

Informal care by family members is themost common type


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Health and Health Care

Daughters are more likely than sons to

provide:Personal care

Assistance with mobility and daily living

Emotional support

Companionship


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Childrens Problems

The elderly are affected by their

childrens:Marital problems

Mental problems

Physical problems

Stress-related problems


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Income and

Standard of Living The percentage of elderly persons below

the poverty line is 1/3 what it was in 1970.

The economic status of the elderly hasimproved greatly, particularly whencompared to children.

Government programs and services for theelderly have expanded dramatically.


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Socialization in

Later LifeThe re-socialization needs of the

elderly are often ignored.

The family system fulfills many of theneeds and services of elder members.

The effectiveness of the family inmeeting cultural goals depends on thestructural opportunities available.


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Retirement

Retirement involves re-socializingpersons for new roles and lifestyles.

Decreases are common in:Health;

Income;

Status; and

Feelings of self-worth.

Being married acts as a buffer to these

problems.


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Dying and Death

For adult children, the death of aparent adversely affects:

Marital relationships

Physical health

Psychological well-being


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Dying and Death

The family and kin network are majorsources of decision making and social

support during the dying process.

Hospice offers an alternative tohospital care for dying people.


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Widows and Widowers

Widowhood is:

Disproportionately represented

among people over 65.

Associated with loneliness and social

isolation.


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Widows and Widowers

Losing a partner is more

psychologically detrimental formen.

Finances are the biggest challenge

for women.


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Widows and

Widowers

Adjustment to Widowhood is

Facilitated by:

Personal Autonomy

Close Friendships

A

Realistic Philosophy of LifeEconomic Security

Meaningful Personal Interests


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OLDER PERSONS AND

IMPLICATION TO CARETHE GRAYING POP


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Graying Pop

Growing numbers ofAmericans are

interested in wellness programs to

stay youthful, active, and healthy

More than one-third of all surgicalpatients are over 65 years of age


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Graying Pop

The prevalence of mental health

problems increases with age

Chronic diseases occur at a rate

four times greater in old age than

at other ages


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Graying Pop

Approx 40% of all elders will spend

some time in a nursing home during

their lives

Most beds in acute medical hospitals

are filled by elderly patientsOlder adults are the most significant

users of home health services.


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PHYSICALPHYSIOLOGICAL


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Normal Aging Changes

Integumentary

Thinner

Wrinkles

Drier

NervousSlowed reactions

Impaired senses


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Sensory

Vision (Night-blindness)

Hearing

Touch

Duller

Pain threshhold higher

Taste

Smell


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Respiratory

Decreased activity tolerance

More vulnerable to infection

Reproductive

Decreased hormone production


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Musculoskeletal

Osteoporosis

Pathologic fractures

Decreased muscle strength

CardiovascularArteries loss elasticity

Decreased response to stress


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GI

Decreased motility

Constipation

Urinary

Decreased nephron activityMore frequent voiding

Retention


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Endocrine

Hormones changesImmune

Decreased function

More susceptible to infection &

disease

Atypical S&S of infection


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Mental Health Disorders

Depression

Most common

Can be a reaction

Aggressive behavior

Abnormal anger, rage, or hostility

Causes

Rehabilitation


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