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Care of the Chronically Ill and the
Older Persons
ELECTIVE
BSN 14B
June 15, 011
Madeline N. Gerzon
Clinical Instructor
Davao Doctors College
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0011 0010 1010 1101 0001 0100 1011Listen to the agedFor they will tell you about living
and dying.For they will enlighten you aboutproblem-solving, sexuality, grief,
sensory deprivation, and survival.For they will teach you how to becourageous, loving and generous.
~
Irene Burnside, 1975~
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CORE VALUES & PRINCIPLES OF
GERIATRICS and GERONTOLOGICALNURSING
Health promotion Health protection
Disease prevention
Treatment of diseases
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Nurses help via three levels of
preventionPrimary Health
Promotion
Education, nutritionalassessment and guidance,
exercise prescriptions,
avoidance of tobacco,
moderation of alcohol andlimiting exposure or
avoiding known carcinogens
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Nurses help via three levels of
prevention
Secondary- Early Diagnosis & Prompt
Treatment
Screening questions and health assessment,referral for examination and testing & disease
cure and aggressive treatment to limit
disability and disease progression.
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Nurses help via three levels of
prevention
Tertiary- Restoration and Rehabilitation
Multidisciplinary rehabilitation (Physical,
occupational, speech and recreationaltherapy), short term placement in rehabilitation
facilities or aggressive in-home rehabilitation,
appropriate services and aids to increase
independence ( walkers, cane)
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THEORIES OF AGING
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Purpose Of Nursing Theory
Leads to prediction
Provides process and understanding
Must be holistic and take intoaccount all that impacts on a personthroughout a lifetime of aging
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Myths of Aging
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0011 0010 1010 1101 0001 0100 1011AgingThe Pros In some societies, old
age is revered for thewisdom and knowledge
But, most people wouldprefer somehow to
keep the option of notexperiencing all theeffects of growing old.
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AgingThe Cons
Characterized by loss ofteeth, taste and of thepleasures of eating and
drinking.
Visiting the dentist, anactivity not looked forwardto by most
Greater physical andemotional challenge forthe elderly.
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Myths of Aging
Being old means being sick
Older people are set in their waysand cannot learn new things
You cant teach an old dog new
tricks
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Myths of Aging
Health promotion is wasted on
older people
Elderly do not pull their own weight
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Myths of Aging
Dirty old man
Disease and disability are aninevitable part of aging
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Myths of aging lead to:
Ageism is the disliking of
aging and older people basedon the belief that aging makes
people unattractive,
unintelligent andunproductive.
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Myths of aging lead to:
Reduced healthcare services
Segregation of elders frommainstream society
Nurse recruitment difficulties
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Theories of Aging
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Aging Theories
Cultural, spiritual, regional,socioeconomic, educational,
environmental factors, and healthstatus impact the older adultsperceptions and choices about their
health care needs
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Types of Theories
Psychosocial
Sociological
Biological
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Types of Theories
Encompass psychological andsociological theories
Psychological: How mental processes,emotions, attitudes, motivation, andpersonality influence adaptation tophysical and social demands
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Types of Theories
Erik EriksonGenerativity vs. stagnation
Busy with creative and meaningful work
"be in charge fear of inactivity
meaninglessness
Mid-life crisis
self-absorbed and stagnate
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Types of Theories
Erik Erikson
Integrity vs. despair Happiness and content Fulfilled with a deep sense that life
has meaning
Made a contribution to life perceived failure - despair
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Maslows Hierarchy of Human
Needs Theory
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Maslows theory
Although Maslow doesntspecifically address old age, it is
clear that physical, economic,social, and environmentalconstraints can impede needfulfillment of older adults.
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Types of Theories
Sociological theories How changing roles, relationships,
and status within a culture orsociety impact the older adultsability to adaptVgotsky
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Types of Theories
Sociological theories Activity theory central theme that
remaining active in old age isdesirable
Disengagement theory
characterized by gradualwithdrawal from society andrelationships (reciprocalwithdrawal)
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Types of Theories
Sociological theories Continuity Theory
Successful aging involves
maintaining or continuingprevious values, habits,preferences, family ties, and allother linkages that formed basic
underlying structure of adult life.
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Types of Theories
Biological theories Explain the physiologic processes
that change with aging
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Types of Theories
Biological theoriesSenescence progressive
deterioration of body systems thatcan increase risk of mortality
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Types of Theories
Biological theories Senescence
process by which the capacity forcell division, growth and function islost over time, ultimately leading toan incompatibility with life
process of senescence terminatesin death.
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Types of Theories
Biological theories
Free Radical Theory aging caused
by effects of free radicals
Wear and Tear Theory cumulative
changes occurring in cells age anddamage cellular metabolism
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0011 0010 1010 1101 0001 0100 1011Free Radical Theory
Oxygen metabolism free radicals
Damages cell membranes
Lipofuscin
What are antioxidants?
Vitamins C and E
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DNA Theories
Human Genome Project
Telomeres
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Immunity Theory
Immune response
Immune self-regulatory
Body defenses
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Types of Theories
Biological theories
Programmed theories
Genetic codes containing
instructions for the regulation of
cellular reproduction and death
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0011 0010 1010 1101 0001 0100 1011Hayflick Limit Theory
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Nursing Theories
Need to take human aging into
consideration
Need to develop a more situation-specific theory of aging to guide practice
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Functional Consequences Theory
A guiding framework that would address
older adults with physical impairment
and disability
Nursings role is to minimize age-
associated disability in order to enhance
safety and quality of living
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Theory of Thriving
Based on the concept of failure to
thrive and application of thriving to
the experience of well-being amongfrail elders living in nursing homes
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Theory of Thriving
Nurses identify and modify factors that
contribute to disharmony among a
person and his or her physicalenvironment and personal relationships
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