Theories of aging_fall 2013 abridgedPresentation Transcript
1Theories of AgingNURS 4100 Care of the Older AdultFall 2013Joy A. Shepard, PhD(c), MSN, RN, CNE,BC
2Objectives Discuss the change in focus regardinglearning about factors influencing aging List the major biological theories of aging Describe the major psychosocial theories ofaging Identify factors that promote a healthyaging process Describe implications of theories of aging
3Definitions Aging – Process of growing older that begins atbirth Compression of morbidity – Healthy old age,followed by rapid decline & death (“Health Span”) Homeostasis - The regulation of bodily functionswithin precise limits in order to maintain idealbodily function Homeostenosis - The decline of the bodys abilityto maintain homeostasis as a result of decreasedorgan function in old age
4Definitions Life expectancy –Expected years of lifefrom birth Maximum life span –Maximum possiblelength of life Senescence (old age) –Point in time when age-associated functionaldeficits are manifested
5Mystery of Aging Goal ofeverlasting youth Aging as acomplex process Highlyindividualizedprocess
6Lifestyle Lift infomercialGlaringexample of a youth-driven andyouth-obsessed culture
7Who Has More Value?
8Focus of Research on Aging Better understandingof aging process: Healthier lifestyles Postponement ofnegative consequences Healthy & active Understanding factorsthat influence healthand well-being “Successful aging” Avoiding disease &disability Maintaining mental &physical function Continuingengagement with life
9The Aging Process The aging process ismultifactorial, includes: Benign changes, such asgraying hair Nonbenign changes, suchas senescence Individualized agingprogression Modifiable changes relatedto lifestyle Normal or universal agingprocesses
10The Aging Process Senescence:progressivedeterioration of bodysystems Characterized by failureto maintain homeostasisunder conditions ofphysiological stress(homeostenosis) Decreased viability,increased vulnerabilityof individual Normal aging includes Loss of organ reservesresulting in decreasedresponse tophysiological stress Variations amongindividuals Chronologic &biological aging, whichare not synonymous Organ system changes
11Aging: Many InterrelatingFactors, Causes No single factor,theory Heredity, nutrition,health status, lifeexperiences,environment, activity,& stress Aging is highlyindividualized
12Theories of aging includebiological, psychological,sociological, and spiritual aging**Important: No single known factor causes orprevents aging; no one theory can explain thecomplexities of aging**
13Biological Theories of Aging “FATE” – Internal (Nonstochastic) Program theories of aging (Genetic) Genetically programmed events cause cellulardamage that accelerates aging of the organism “CHANCE” – External (Stochastic) Error Theories (Environmental) Random events cause cellular damage thataccumulates as organism ages
14Programmed Theories Programmed Longevity Genetic clock (Hayflick limit) Human genome Neuroendocrine & Neurochemical Theories Immunological/ Autoimmune Theory Changes in immune function with aging Diminishing of thymus, impaired immunologicfunction
15Error Theories of Aging Cross-Linking Theory Loss of flexibility,diminished functionalmotility Wear & Tear Theory Effects of stress Stress causesstructural & chemicalchanges resulting inirreversible tissuedamage
16Error Theories of Aging Free Radical Theory Oxygen radicals, antioxidants Lipofuscin Nutrition theory Somatic Mutation (DNA Damage) Theory Radiation Theories Decreased function & efficiency of cells & organs Solar elastosis – “old age” type of skin wrinkling
17Solar Elastosis: ChronicExposure to Solar Radiation(UV)
19Question Which of the following statements bestdescribes the autoimmune theory ofaging? A. Genetic programs determine life expectancy B. Cells undergo change and the body identifiesthem as foreign C. Organs decline as a result of cellular mutations D. Failure of the production of a growth substancecauses aging cells to die
20Question Is the following statement true orfalse? The genetic theories of aging bestdescribe how and why a person ages
25Sociological Theories ofAging Social & Psychological Models: Dynamic interplaybetweens gains & losses Disengagement TheoryAs individuals age, they inevitably withdraw from societySociety withdraws from themSeparation mutually agreed upon Activity TheoryContinue middle-age lifestyle; deny existence of old ageLife satisfaction: involvement in new interests, hobbies, roles,and relationshipsVolunteering: one way retirees stay connected to community
27Question Is the following statement true orfalse? The continuity theory of aging statesthat personality and basic patterns ofbehavior are said to remainunchanged as the individual ages.
28Developmental: Erickson FinalStage - Integrity vs. Despair Development – Process of natural growth,differentiation, or change Old Age (after age 65) - Reflecting back on life Successful in accomplishments – Feel sense of integrity Few regrets, satisfaction Attain wisdom, even when confronting death “Only when we are so old, only, we are aware of thebeauty of life.” Alice Herz Sommer, age 106 Unsuccessful - Feel life was wasted, many regrets Bitterness, despair, depression, anger
29Developmental ChallengesAssociated with Aging Certain developmentalchallenges bringopportunities for olderpeople to experiencefeelings of success, loss Social relationships, rolesRetirement Coping with lossDeath of a loved one Living arrangementsLoss of independence Financial challengesFixed income The strengths of eachindividual (including pastcoping skills) must beidentified & utilized whenplanning care
30Opportunities for Older People toExperience Feelings of Success Gaining insight or wisdom, self-understanding, self-acceptance Deepening gratitude & appreciation Gaining new knowledge & experiences Developing better social skills, copingability Enhancing creativity & confidence Developing new skills, hobbies, & interests
31Opportunities for Older People toExperience Feelings of Success Civic & community positions of responsibility Seeing children transform into responsible,successful adults Becoming a grandparent Renewing & deepening one’s relationship withone’s spouse, significant others, or friends Accepting & adjusting to physical changesassociated with aging Pursuing spiritual interests
32Opportunities for Older People toExperience Feelings of Success Older adults often assume new roles, such as grandparents, asthey mature
33More ChallengingDevelopmental Tasks Death of a spouse Major declines in health or physical ability Physiologic changes may result in losses, causingimpairments in communication, vision & learning,mobility, cognition, or psychosocial skills Loss of social role, prestige, occupation,income Loss of independent living Accepting a fixed income
35Erikson Question Which of the following best reflects Erikson’sdescription of the old age task of reconciling egointegrity with despair? A. 75-year-old woman who is insecure and has developed ageneral attitude of mistrust concerning the world. B. 77-year-old man who fears death as he struggles to findpurpose in his life, reflecting upon his experiences and failures. C. 78-year-old woman who has unresolved feelings ofinadequacy and inferiority, which shows in her relationshipswith friends and acquaintances. D. 80-year-old man who has not been successful in findingdeep intimacy and satisfying relationships and now feelsisolated.
36Implications of Theories ofAging No single theory can adequately explainaging process Knowledge of all theories: guide nursinginterventions to promote health andlongevity Sensitivity to the impact of attitudes towardaging on patients themselves
37Interesting Quotation… Do YouAgree? “Aging is a self-fulfilling prophecy. If we dreadgrowing old, thinking of it as a time offorgetfulness and physical deterioration, then it solikely to be just that. On the other hand, if weexpect it to be full of energy and anticipate thatour lives will be rich with new adventures andinsight, then that is the likely reality. We prescribewho we are. We prescribe what we are tobecome” (Bortz, 1990, p. 55). Bortz, W. (1990). Use it or lose it. Runner’s World, 25, 55-58.