Ageing ppt Final.ppt for nursing ,Happy ageing

nicely described about ageing

1. The Aging Paramita Bhunia Msc . Nursing final year student

2. Aging is psychosocially and biologically defined as being older. An aged or geriatric patient is defined as a person whose biological age is advanced. Aging can be characterized as a deterioration of the physiological functions essential for survival and fertility that is time-related.

3. DEFINITION OF AGEING: Ageing is the process of becoming older. Aging is associated with changes in dynamic biological, physiological, environmental, psychological, behavioral and Social processes. The process of ageing is a complex one that can be described chronologically, physiologically and functionally.

4. Chronological age refers to the number of years a person has lived. It is easy to identify and measure. Chronological age serves as criteria in the society for certain activities such as driving, employment, and the collection of retirement benefits. Physiological age refers to the determination of age by body function. Although age-related changes affect everyone, it’s impossible to pinpoint exactly when these changes occur. That’s why physiological age isn’t useful in determining a person’s age.

5. Functional age refers to a person’s ability to contribute to society and benefit others and himself. It’s based on the fact that not all individual of the same chronologic age function at the same level. Many people may be chronologically older but remain physically fit, mentally active, and productive measure of society. Others may be chronologically young, but physically or functionally old.

6. Chronological categories Young- old (ages 65 to 74) Middle- old (ages 75 to 84) Old- old (ages 85 and older)

7. AGEING: THE INDIAN SCENARIO According to Population Census 2011 there are nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males. A report released by the United Nations Population Fund and HelpAge India suggests that the number of elderly persons is expected to grow to 173 million by 2026

8. According to the Report of the Technical Group on Population Projections for India and States 2011-2036 , there are nearly 138 million elderly persons in India in 2021 (67 million males and 71 million females) and is further expected to increase by around 56 million elderly persons in 2031.

9. Cont.. As regards rural and urban areas, as per 2011 census, 71% of elderly population resides in rural areas while 29 % is in urban areas.  •In the last few years, medical science has identified a new group within the senior citizen category, namely that of super-agers. The term refers to people in their 70s and 80s who have the mental or physical capability of their decades-younger counterparts. With the world ageing at a rapid rate, it is estimated that by 2030 there will be 34 nations with over 20% population above 65 years.

10. Some terms related to ageing study.. Ge rontology: Gerontology is  the study of aging and older adults . Geriatrics: The term geriatrics originates from the Greek ‘ geron ’ meaning "old man",   a branch of medicine that deals with the problems and diseases of old age and the medical care and treatment of aging people . Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly.

11. Geropsychiatry is the branch of clinical medicine specializing in psychopathology of the elderly population

12. Theories are grouped into two broad categories: B iological and Psychosocial.

13. BIOLOGICAL THEORIES Biological theories attempt to explain the physical process of aging, including molecular and cellular changes in the major organ systems . They also attempt to explain why people age differently and what factors affect longevity and the body's ability to resist disease. Biological theories contain 5 major theories they are….

14. Wear and tear theory Proponents of this theory believe that the body wears out on a scheduled basis. Free radicals are molecules with unpaired electrons that exist normally in the body; they also are produced by ionizing radiation, ozone, and chemical toxins. According to this theory, these free radicals cause DNA damage, cross-linkage of collagen, and the accumulation of age pigments.

15. Environmental Theory According to this theory, factors in the environment (e.g., industrial carcinogens, sunlight, trauma, and infection) bring about changes in the aging process. Although these factors are known to accelerate aging, the impact of the environment is a secondary rather than a primary factor in aging.

16. Immunity Theory The immunity theory describes an age-related decline in the immune system. As people age, their ability to defend against foreign organisms decreases, resulting in susceptibility to diseases such as cancer and infection .

17. Neuroendocrine Theory This theory proposes that aging occurs because of a slowing of the secretion of certain hormones that have an impact on reactions regulated by the nervous system. This is most clearly demonstrated in the pituitary gland, thyroid, adrenals, and the glands of reproduction.

18. PSYCHOSOCIAL THEORIES Psychosocial theories focus on social and psychological changes that accompany advancing age, as opposed to the biological implications of anatomic deterioration. Several theories have attempted to describe how attitudes and behaviour in the early phases of life affect people's reactions during the late phase. This work is called the process of "successful aging."

19. Personality theory Personality theories address aspects of psychological growth without delineating specific tasks or expectations of older adults. Evidence supports the general hypothesis that personality characteristics in old age are highly correlated with early life characteristics. In extreme old age, however, people show greater similarity in certain characteristics, probably because of similar declines in biological functioning and societal opportunities.

20. 1. Mature men are considered well-balanced persons who maintain close personal relationships. They accept both the strengths and weaknesses of their age, finding little to regret about retirement and approaching most problems in a relaxed or convivial manner without continually having to assess blame. 2. "Rocking chair" personalities are found in passive dependent individuals who are content to lean on others for support, to disengage, and to let most of life's activities pass them by. 3. Armored men have well-integrated defense mechanisms, which serve as adequate protection. Rigid and stable, they present a strong silent front and often rely on activity as an expression of their continuing independence.

21. 4. Angry men are bitter about life, themselves, and other people. Aggressiveness is common, as is suspicion of others, especially of minorities or women. With little tolerance for ambiguity or frustration, they have always shown some instability in work and their personal lives, and now feel extremely threatened by old age. 5. Self-haters are similar to angry men, except that most of their animosity is turned inward on themselves. Seeing themselves as dismal failures, being old only depresses them all the more.

22. Developmental Task Theory Developmental tasks are the activities and challenges that one must accomplish at specific stages in life to achieve successful aging. Erikson (1963) described the primary task of old age as being able to see one's life as having been lived with integrity. In the absence of achieving that sense of having lived well, the older adult is at risk for becoming preoccupied with feelings of regret or despair

23. Disengagement theory Disengagement theory describes the process of withdrawal by older adults from societal roles and responsibilities. According to the theory, this withdrawal process is predictable, systematic, inevitable, and necessary for the proper functioning of a growing society. Older adults were said to be happy when social contacts diminished and responsibilities were assumed by a younger generation. The benefit to the older adult is thought to be in providing time for reflecting on life's accomplishments and for coming to terms with unfulfilled expectations. The benefit to society is thought to be an orderly transfer of power from old to young. There have been many critics of this theory, and the postulates have been challenged. For many healthy and productive older individuals, the prospect of a slower pace and fewer responsibilities is undesirable.

24. Activity theory In direct opposition to the disengagement theory is the activity theory of aging, which holds that the way to age successfully is to stay active. Multiple studies have validated the positive relationship between maintaining meaningful interaction with others and physical and mental well-being. Social integration is the prime factor in determining psychosocial adaptation in later life. Social integration refers to how the aging individual is included and takes part in the life and activities of his or her society. This theory holds that the maintenance of activities is important to most people as a basis for deriving and sustaining satisfaction, self-esteem, and health.

25. Continuity Theory This theory, also known as the developmental theory, is a follow-up to the disengagement and activity theories. It emphasizes the individual's previously established coping abilities and personal character traits as a basis for predicting how the person will adjust to the changes of aging. Basic lifestyle characteristics are likely to remain stable in old age, barring physical or other types of complications that necessitate change.

26. ETILOGY OF AGEING Primary or Intrinsic Factors of Aging I nclude biologic and physiologic changes that are influenced by one’s gender, culture, ethnicity and race, intelligence and personality, familial longevity patterns, and genetic disease.

27. Secondary or Extrinsic Factors Employment Economic level Education Health practices and related diseases Societal attitude Income, economic level, and educational level partially determine how one lives.. P oor diet, experience poor living conditions, have a substance-abuse problem, or ignore or minimize health problems also are at risk for a shortened lifespan.

28. BIOLOGICAL CHANGES ASSOCIATED WITH AGEING Cellular Level Immune System Musculoskeletal Integument Genitourinary and Reproductive Special Senses Neuropsychiatric Memory Neurotransmitters Brain Gastrointestinal (GI) System Respiratory

29. Adaptation to the Tasks of Aging Loss and Grief Attachment to Others Attachment to Others Maintenance of Self-Identity Dealing with Death

30. Psychiatric Disorders in Later life Neurocognitive disorders Delirium Depression Schizophrenia Anxiety disorders Personality disorders Sleep disorders

31. Other Disorders of Old age Vertigo Syncope Elderly abuse

32. Sociocultural Aspects of Aging Elderly people in virtually all cultures share some basic needs and interests: They choose to live the most satisfying life possible until their demise. They want protection from hazards and release from the weariness of everyday tasks.

33. They want to be treated with the respect and dignity that is deserving of individuals who have reached this pinnacle in life. They want to die with the same respect and dignity.

34. Sexual aspect of ageing

35. These cultural stereotypes undoubtedly play a large part in the misperception many people hold regarding sexuality of the aged, and they may be reinforced by common tendency of the young to deny the inevitability of aging.

36. Long-Term Care Long-term care facilities are defined by the level of care they provide. They may be skilled nursing facilities, intermediate care facilities, or a combination of the two. Some institutions provide convalescent care for individuals recovering from acute illness or injury, some provide long-term care for individuals with chronic illness or disabilities, and still others provide both types of assistance.

37. Most elderly individuals prefer to remain in their own homes or in the homes of family members for as long as this can meet their needs without deterioration of family or social patterns. Many elderly individuals are placed in institutions as a last resort only after heroic efforts have been made to keep them in their own or a relative's home. The increasing emphasis on home health care has extended the period of independence for aging individuals.

38. Murray and Zentner (2001) list four developmental tasks related to successful adaptation in retirement: Remaining actively involved and having a sense of belonging unrelated to work Re-evaluating life satisfaction related to family and social relations and spiritual life rather than to work Re-evaluating the world's outlook, keeping a view of the world that is coherent and meaningful and a view that one's own world is meaningful Maintaining a sense of health, integrating mind and body to avoid complaints or illness when work is no longer the focus.

39. Economical Implications Because retirement is generally associated with 20 to 40 percent reduction in personal income, the standard of living after retirement may be adversely affected. Most older adults derive post-retirement income from a combination of Social Security benefits, public and private pensions, and income from savings or investments.

40. The following risk factors are taken into consideration to predict potential need for services and to estimate future costs . Age Health Mental health Status Socioeconomic and Demographic Factors Marital Status, Living Arrangement, and the Informal Support Network

41. Cont.. Several considerations are unique to assessment of the elderly. Assessment of the older person's thought processes is a primary responsibility. Knowledge about the presence and extent of disorientation or confusion will influence the way in which the nurse approaches elder care. Information about sensory capabilities is also extremely important. Because hearing loss is common, the nurse should lower the pitch and loudness of his or her voice when addressing the older person. Looking directly into the face of the older person when talking facilitates communication.

42. Cont.. Questions that require a declarative sentence in response should be asked; in this way, the nurse is able to assess the client's ability to use words correctly. Visual acuity can be determined by assessing adaptation to the dark, color matching, and the perception of color contrast. Knowledge about these aspects of sensory functioning is essential in the development of an effective care plan. The nurse should be familiar with the normal physical changes associated with the aging process.

43. Diagnosis related to physiologically Risk for trauma related to confusion, disorientation. muscular weakness, spontaneous fractures, falls . Hypothermia related to loss of adipose tissue under the skin, evidenced by increased sensitivity to cold and body temperature below 98.6°F . Decreased cardiac output related to decreased myocardial efficiency secondary to age-related changes, evidenced by decreased tolerance for activity and decline in energy reserve.. Ineffective breathing pattern related to increase in fibrous tissue and loss of elasticity in lung tissue, evidenced by dyspnea and activity intolerance

44. Application of the Nursing Process Assessment of the elderly individual may follow the same framework used for all adults but with consideration of the possible biological, psychological, sociocultural, and sexual changes that occur in the normal aging process described previously.

45. Risk for aspiration related to diminished cough and laryngeal reflexes Impaired physical mobility related to muscular wasting and weakness, evidenced by need for assistance in ambulation Imbalanced nutrition, less than body requirement related to inefficient absorption from gastrointestinal tract, difficulty chewing and swallowing, anorexia difficulty in feeding self, evidenced by wasting drome, anemia, weight loss Constipation related to decreased motility; in quate diet; insufficient activity or exercise danced by decreased bowel sounds; hard, for stools; or straining at stool . Stress urinary incontinence related to degenerative changes in pelvic muscles and structural s associated with increased evidence

46. C ont … Imbalanced nutrition less than body requirements Constipation Stress urinary incontinence Urinary retention. Disturbed sensory perception Insomnia Chronic pain Self-care deficit Risk for impaired skin integrity

47. Diagnosis related to Psychologically Psychosocially related nursing diagnoses may include Disturbed thought processes. Complicated grieving risk for suicide Powerlessness Low self-esteem Fear disturbed body image Ineffective sexuality pattern

48. Therapy most effective in Aging Crisis intervention . Group therapy . Orientation therapy. Reminiscence therapy encourages clients to think about and reflect on the past. Reminiscence therapy helps older adults to work through their losses and maintain self-esteem.

49. Geriatric care This is related to the disease process of old age a aims at keeping old age and it aims at keeping old persons at a state of self-dependence as far as possible and t provide facilities to improve their quality of life. Gerontology Nurse A nurse who has specialization in geriatrics or in the care of old people is called geriatric nurse or gerontological nurse.

50. Functions of Gerontological nurse: G (guiding): Giving guidance to people of all ages regarding ageing process. E (elimination): eliminating ageism, or considering old age as disease. R (respecting): respecting the rights of older people. (observing): observing the facilities provided to old people & improving them. N (noticing): noticing health hazards that may happen in old age & try to reduce them. T (teaching): teaching how to take care of old people, for those who are caring for them. O (opening channels): opening the channels of development activities for the care of the aged.

51. L (listening): listening attentively to the problems of old people & giving due importance to them. O (offering): offering positivism- presenting different possibilities of life. G (generating): generating energy for participation in the care of aged & researches for new supporting techniques. I (implementing): implementing activities for rehabilitation & re-adjustment. C (co-coordinating): coordinating different services related to the care of the aged.

52. A (assessing): Assessing the needs & health of the old people. L (linking): linking, contacting services according to need. N (nurturing): prepare future nurses for the care of the aged. U (understanding): understanding every old person as an invaluable asset of the society. R (recognizing): recognizing the moral & religious aspects of old age & giving them recognition. S (supporting): supporting the old people in accepting realities & preparing them mentally for impending death. E (education & encouraging): educating & encouraging old people for self-care.

53. Responsibilities of Nurse in Aging The nurse has to fulfil the following roles in gerontology nursing. Caregiver Health educator Co-ordinator of health services Counsellor and guardian (those people who protect the old person or take responsibilities as his guardian’s spokesman or responsible person)

54. The nurse may have to perform different functions in relations to the above roles: Health assessment Arranging/promoting good nutrition Promoting activity and exercise Providing psychological support

55. Preventive care of elderly In case of the elderly, their physical and mental safety is very important. Gerontological NURSE and care givers should pay special attention to the following safety measures Protection from unhealthy environment Protection from mental tensions Special care of personal health. Protection from physical and mental injuries, threats and fatigue Providing rehabilitation services.