Childhood, youth, adulthood and old age are different
stages of life. With increasing age we become old. Birth,
development, decline and death are the laws of life. Whether
we want it or not, we have to pass through these stages. Old
age is also one part of this cycle.
What is ageing?
Old age or ageing expresses the continuous pressure
and effect of time on our body, senses and skin. Due to
continuous functioning, the cells, tissues and organs of our
body degenerate. In the later part of life, we have to face many
physical and mental problems. Hence old age is the result of
physical and psychological fatigue caused by continuous
functioning. Just like problems or defects occur in machines
due to continuous functioning, or workload, with increasing
age, problems also arise in human body. www.drjayeshpatidar.blogspot.i
Ageing and Demography
Large number of aged people in the population is the
result of demographic change.
The number of people above 60 years is assessed to
be over 49 crores in world. By 2040, their number
will be 140 crores. (According to the prediction of
As compared to old men, there are more old women.
Because of the increasing number of old people,
many socio-economic problems are arising. The main
problems are of housing, their livelihood and medical
French doctor Jean Martan Carcot was the first
person who had studied about old age diseases, in the
year 1881. www.drjayeshpatidar.blogspot.i
National Policy for Older Persons
The Government of India in January-1999
announced the National Policy for older persons. The
principle areas of intervention and action strategies
suggested in the policy sector include the following:
Financial security for older persons working in the
formal sector as well as those working in the informal
Health care and nutrition to enable older persons to cope
with the health, associated with ageing, with particular
emphasis on prevention.
Shelter/housing keeping in view the life style of older
Emphasis upon education, training and information needs
for older persons.
Priority attention to vulnerable groups such as the
destitute, widows and disabled older persons.www.drjayeshpatidar.blogspot.i
Establishment of welfare fund for older persons.
Protection of life and property of older persons.
Concessions, rebates and discounts to older persons.
Participation of NGOs in the care of aged.
Strengthening the family and reinforcing inter-
generational relationship between children and older
Formation of self-support group of older persons.
Development of the manpower for the caring of
Creative use of media in the sector for care of old
Establishment of a separate bureau for older persons
in the ministry
This is a science dealing with ageing
This is related to the disease process of
old age and it aims at keeping old persons at a
state of self-dependence as far as possible and to
provide facilities to improve their quality of life.
A nurse who has specialization in geriatrics
or in the care of old people is called geriatric
nurse or gerontoiogical nurse.
Functions of Gerontoiogical Nurse-
G (Guiding): Giving guidance to people of all ages
regarding ageing process.
E (Eliminating): Eliminating ageism or considering old
age as disease.
R (Respecting): Respecting the rights of old people.
O (Observing): Observing the facilities provided to old
people and improving them.
N (Noticing): Noticing health hazards that may happen
in old age and try to reduce them.
T (Teaching): Teaching how to take care of old people,
for those who are caring for them (family members,
friends, community health worker, voluntary
O (Opening Channels): Opening the channels of
developmental activities for the care of the aged.
L (Listening): Listening attentively to the problems of old people and
giving due importance to them.
0 (Offering): Offering positivism – Presenting different possibilities
G (Generating): Generating energy for the participation in the care of
aged and researches for new supporting techniques.
I (Implementing): Implementing activities for rehabilitation and re-
C (Co-coordinating): Co-coordinating different services related to the
care of the aged.
A (Assessing): Assessing the needs and health of the old people.
L (Linking): Linking, contacting services according to need.
N (Nurturing): Preparing 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 and religious aspects of old age
and giving them recognition.
S (Supporting): Supporting the old people in accepting realities and
preparing them mentally for impending death.
E (Education and Encouraging): Educating and encouraging old people
for self care.
Factors Affecting Ageing
Hereditary diseases, the capacity for longevity
and physical capacities influence the ageing process.
Three types of environmental factors affect ageing:
a) Abiotic Factors
Factors affecting ageing process like climate, radiation, chemical and
physical elements of pollution, etc. are included in this.
b) Biotic Factors
In this, living organisms present in the environment like pathogens,
parasites, the availability and quality of food etc. are included. They
all influence the ageing of the person.
C) Socio-economic Factors
Several socio-economic factors responsible for creating adverse living
or working conditions increase "the wear and tear" of life. Such
tensions make people grow old early.
Common Ageing Changes
Changes, which may occur in different systems, are as follows:
1. Integumentary System
Decrease in elasticity of skin and dryness appears
Age spots appear
Hair of head, axilla or pubic region become scanty grey/white
Hair growth on women's face
Thickening of nasal hair and hair on ears
2. Cardiovascular System
Less blood circulation in heart
Increased blood pressure
Flexibility of heart valve diminishes
Blood vessels of head, neck, hands and legs become prominent.
3. Respiratory System
The capacity of lungs becomes less.
Ineffective gas exchange
The chances of cough increases
More chances of respiratory infections
4. Genito-Urinary System
The kidney function may be impaired
Fluid and electrolyte imbalance
Capacity of urinary bladder decreases
Enlargement of prostate in males
Atrophy of reproductive organs in females
Vaginal secretion decreases
5. Gastro-intestinal System
Falling of teeth
Less secretion of saliva and gastric juice
Complaints of constipation
Digestion becomes weak
6. Musculo-Skeletal System
Height reduces (In most of persons above 70 years height decreases
unto two inches)
Kyphosis, swelling in joints
Bones become weak
Mobility decreases, if proper exercise is not donewww.drjayeshpatidar.blogspot.i
7. Endocrine System
Thyroid gland becomes less active
More susceptible to cold
Secretion of testosterone, oestrogen, progesterone decreases.
Less secretion of insulin by pancreas
8. Neurological System
Sensitivity becomes less/reaction is delayed
Change in sleeping habits
9. Sensory System
Eyes become weak
Hearing capacity decreases
Complaint of presbyopia
Ability to smell is reduced
Ability to taste is reduced
Tactile sensations are affected
10. Immune System
Ability to prevent diseases or resistance power decreases
Probability of infections increases www.drjayeshpatidar.blogspot.i
2. Psychosocial Changes
The psychosocial changes occurring in old age cannot be
separated from physical changes. Because of decreased
activity of sensory organs, person is not able to work with full
efficiency in his environment. Due to this, psychosocial state
is affected. Person feels the sense of 'uselessness'. Social and
psychological changes of old age are as follows
Because of the experiences and happenings of life, person's
personality is affected. But in old age, no remarkable changes
occur in the basic personality structure. Changes may occur in
the personality due to death of life partner, decreased or end of
self-dependence, loss of source of income, incapacity, etc.
Memory power may decrease with increasing age.
Recalling of less frequently used information is difficult. In
some old people, the tendency to repeat facts and information
increases. Confused memory also may be found.
Some Forms of Old Age Abuse
Old people may have to undergo a lot of neglect. Some main
forms of neglect or abuse are following:
Beating and physical punishment
Restraining or locking them in the house
Teasing them for physical conditions or diseases
Giving mental torture
Calling by names (disrespectful words like old man etc.), making
fun of them, threaten them.
Treat them as children
Snatching their property illegally
Misuse or wasting their property for personal pleasureswww.drjayeshpatidar.blogspot.i
Not providing food purposely or giving less food
Neglecting their likes and dislikes
Spoiling or removing their dentures, glasses, hearing aid
Forbid them to play with grand children
Encouraging grand children to insult grand parents
Become lazy or neglecting the care of old people.
Neglect may be due to ignorance also.
Neglecting their advice
Overlooking their experiences
Not providing them proper place or
honour on social occasions. www.drjayeshpatidar.blogspot.i
Adjustment in Ageing
a. Family Changes :
Family is such a unit through which maximum satisfaction
may be obtained. But in old age the person's family status is
changed. A father, who was the chief of the family till now,
may have to become dependent on his children. A mother
may have to subject herself to the rule of daughters-in-law. If
one of the partners is dead, the other has to face loneliness.
The decision making process in the family changes and the
control is transferred.
In Indian context, retirement is a symbol of old age. In the
retirement process, the person may pass through the following
1. Remote Phase
Even when retirement is near or approaching, person does not
get ready for it.
2. Near Phase
When retirement is very near, making imaginary plan for it
3. Honeymoon Phase
Just after retirement person wants to do all those
things, which he could not do so far or was always
desirous of doing. But health and financial resources may
cause problems (not in all people) in fulfilling his dreams
4. Disenchantment Phase
The problems/realities of retired life may dispirit the
person. His excessive dream regarding retired life may
result in more disappointments. At this stage, person may
begin to come out of false imaginations.
5. Stability Phase
Person understands the realities of retired life. He
makes adjustments to his new roles.
6. Termination Phase
This happens either by taking up some work again or
due to illness or incapacity. www.drjayeshpatidar.blogspot.i
Responsibilities of Nurse in Ageing
Coordinator of health services
Counselor and guardian (Those people who
protect the old person or take responsibilities
as his guardian, spokesman or responsible
Daily activities of living (bathing, excretion,
clothing, urinary control, ability to eat etc.).
Activities related to use of equipment (Telephone,
bank account, food preparation, etc., his ability in
Health Screening: Ability to see and hear, dental
problems, blood pressure, examination of breasts and
uterus, cancer testing, examination of skin, etc.
should be done.
In laboratory tests; blood examination, urine
analysis, cholesterol, blood sugar, thyroid, etc. tests
should be conducted www.drjayeshpatidar.blogspot.i
2.Arranging / Promoting Good Nutrition
3.Promoting Activity and Exercise
4.Preventive Care of Elderly
5.Providing Psychological Support
Ageing: New Nursing Challenges
Gerontological psychiatric nurse specialist in old age
home and nursing homes.
Care manager and family counselor of chronic old
patients in the community.
Pre admission assessor of nursing homes hospitals.
Nurse Director of old age care giving training centre,
old age day care centre.
Counselor of old patients in surgical wards.
Pre-retirement counselor / educator.
Theories of Aging:
Intrinsic Factors: Several theories assume that individuals inherit a
genetic program that determines their specific life expectancy. In fact,
various studies have shown a positive relationship between parental
age and filial life span. Genetic mutations are also thought to be
responsible for aging, a pattern depicted below, laboratory experiments
which have accelerated mutation rates have not produced proportionate
increases in the rate of aging, thus reducing support of this theory.
Some theorists believe that a growth substance fails to be produced
causing the cessation of cell growth and reproduction.
Extrinsic Factors: Disease producing organisms are often associated
with biological aging. Bacteria, fungi, viruses, and other organisms are
thought to be responsible for certain physiological changes during the
aging process. Although no conclusive evidence presently exists to link
these pathogens with the aging process, interest in this theory has been
stimulated by the fact that humans and animals have been shown to
live longer with the control or elimination of certain pathogens via
immunization and the use of antimicrobial drugs.
Psychological and social changes during the aging
process are closely united, and they have a significant impact
on each other. It is difficult to explain mental processes,
behavior and feelings without the perspective of social roles,
positions and norms. A theory of aging that is purely social or
psychological would be most unusual, and it is more
appropriate to approach these aging factors as psychosocial
theories. Probably the most controversial and widely
discussed is the disengagement theory, developed by Elaine
cumming and William Henry. This theory views aging as a
process whereby society and individual gradually withdraw or
disengage, from each other, to the mutal satisfaction and
benefit for both. The benefit to individual is that they can
reflect and be centered on themselves, having been freed from
societal roles. The value of disengagement for society is that
some orderly means is established for the transfer of power
from old to young, making it possible to society to continue
functioning after its individual members have died.www.drjayeshpatidar.blogspot.i
Springhouse, mastering geriatric care, USA.1997.1-
Charlotte Eliopoulos, Geriatric nursing, UK.1-335.
Park.k, Preventive and social medicine, 19th edition,
India (Jabalpur).2007; 475.
Gulani k, Community health nursing principles and
practices. Delhi; 469-472.