NCM 114-LESSON 1 AND 2.pptx

HENCM 114- CARE OF THE OLDER PERSON
Presented by: CRISTIL ANN V. DESCALSOTA, RN, MN, LPT

LESSON 1
THE AGING
EXPERIENCE
A. The Aging Population
1. Views of Older Adults
Through History
2. Characteristics of The
Older Adult Population
3. Health Insurance
4. Implications of An Aging
Population
2

VIEWS OF OLDER ADULTS THROUGH
HISTORY
Historically, societies have viewed their elder members in a variety of ways. In the time of
Confucius, there was a direct correlation between a person’s age and the degree of respect to
which he or she was entitled.
The early Egyptians dreaded growing old and experimented with a variety of potions and
schemes to maintain their youth. Opinions were divided among the early Greeks. Plato
promoted older adults as society’s best leaders, whereas Aristotle denied older people any role
in governmental matters. In the nations conquered by the Roman Empire, the sick and aged
were customarily the first to be killed. And, woven throughout the Bible is God’s concern for
the well-being of the family and desire for people to respect elders (Honor your father and
your mother … Exodus 20:12). Yet, the honor bestowed on older adults was not sustained.
3

Medieval times gave rise to strong feelings regarding
the superiority of youth; these feelings were expressed
in uprisings of sons against fathers. Although England
developed Poor Laws in the early 17th century that
provided care for the destitute and enabled older
persons without family resources to have some
modest safety net, many of the gains were lost during
the Industrial Revolution. No labor laws protected
persons of advanced age; those unable to meet the
demands of industrial work settings were placed at the
mercy of their offspring or forced to beg on the streets
for sustenance.
20XX 4

CHARACTERISTICS OF THE OLDER ADULT
POPULATION
Older adults are generally defined as individuals aged 65 years and older. At one time, all persons over 65 years
of age were grouped together under the category of “old.” Now it is recognized that much diversity exists among
different age groups in late life, and older individuals can be further categorized as follows:
-young-old: 65 to 74 years
-old: 75 to 84 years
-oldest-old 85+
In addition to chronological age, or the years a person has lived since birth, functional age is a term used
by gerontologists to describe physical, psychological, and social function; this is relevant in that how older
adults feel, and function may be more indicative of their needs than their chronological age. Perceived age is
another term that is used to describe how people estimate a person’s age based on appearance. Studies have
shown a correlation between perceived age and health, in addition to how others treated older adults based on
perceived age and the resultant health of those older adults.
20XX 5

How people feel or perceive their own age is described as
age identity. Some older adults will view peers of similar
age as being older than themselves and be reluctant to join
senior groups and other activities because they see the
group members as “old people” and different from
themselves.
Any stereotypes held about older people must be discarded;
if anything, greater diversity rather than homogeneity will
be evident. Further, generalizations based on age need to be
eliminated as behavior, function, and self-image can reveal
more about priorities and needs than chronological age
alone.
20XX 6

POPULATION GROWTH AND INCREASING LIFE EXPECTANCY
There was a significant growth in the number of older people for most of the 20th century.
Except for the 1990s, the older population grew at a rate faster than that of the total population
under age 65. The U.S. Census Bureau projects that a substantial increase in the number of
individuals over age 65 will occur between 2010 and 2030 due to the impact of the baby
boomers, who began to enter this group in 2011. In 2030, it is projected that this group will
represent nearly 20% of the total U.S. population. Currently, persons older than 65 years
represent more than 13% of the population in the United States. This growth of the older adult
population is due in part to increasing life expectancy. Advancements in disease control and
health technology, lower infant and child mortality rates, improved sanitation, and better living
conditions have increased life expectancy for most Americans. More people are surviving to their
senior years than ever before. In 1930, slightly more than 6 million persons were aged 65 years
or older, and the average life expectancy was 59.7 years. The life expectancy in 1965 was 70.2
years, and the number of older adults exceeded 20 million. Life expectancy has now reached
78.2 years, with over 34 million persons exceeding age 65 years. Not only are more people
reaching old age, but they are living longer once they do; the number of people in their 70s and
80s has been steadily increasing and is expected to continue to increase. The population over age
85 years is projected to double by the year 2036 and triple by 2049. The life span currently is
122 years for humans. 20XX 7

• The current life expectancy for Philippines in 2023 is 71.66 years, a 0.18%
increase from 2022.
• The life expectancy for Philippines in 2022 was 71.53 years, a 0.18%
increase from 2021.
increase from 2020.
increase from 2019
20XX 8

Although life expectancy has increased, it still differs by race and gender, as Table 1-1 shows. From
the late 1980s to the present, the gap in life expectancy between white people and black people has
widened because the life expectancy of the black population has declined. The U.S. Department of
Health and Human Services attributes the declining life expectancy of black people to heart disease,
cancer, homicide, diabetes, and perinatal conditions. This reality underscores the need for nurses to
be concerned with health and social issues of persons of all ages because these impact a population’s
aging process. Whereas the gap in life expectancy has widened among the races, the gap is
narrowing between the sexes. Throughout the 20th century, the ratio of men to women had steadily
declined to the point where there were fewer than 7 older men for every 10 older women. The ratio
declined with each advanced decade. However, in the 21st century, this trend is changing, and the
ratio of men to women is increasing.
Although living longer is desirable, of significant importance is the quality of those years. More
years to life means little if those additional years consist of discomfort, disability, and a poor quality
of life. This has led to a hypothesis advanced by James Fries, a professor of medicine at Stanford
University, called the compression of morbidity (Fries, 1980; Swartz, 2008). This hypothesis
suggests that if the onset of serious illness and decline would be delayed, or compressed, into a few
years prior to death, people could live a long life and enjoy a healthy, functional state for most of
their lives
20XX 10

MARITAL STATUS AND LIVING ARRANGEMENTS
The higher survival rates of women, along with the practice of
women marrying men older than themselves, make it no surprise
that more than half of women older than 65 years are widowed, and
most of their male contemporaries are married. Married people have
a lower mortality rate than do unmarried people at all ages, with
men having a larger advantage.
Most older adults live in a household with a spouse or other family
member, although more than twice the number of women than men
live alone in later life. The likelihood of living alone increases with
age for both sexes. Most older people have contact with their families
and are not forgotten or neglected. 20XX 11

INCOME AND EMPLOYMENT
The percentage of older people living below the poverty level has
been declining, with about 10% now falling into this category.
However, older adults still do face financial problems. Most older
people depend on Social Security for more than half of their income.
Women and minority groups have considerably less income than do
white men. Although the median net worth of older households is
nearly twice the national average because of the high prevalence of
home ownership by elders, many older adults are “asset rich and
cash poor.” The recent decline in housing prices, however, has made
that asset a less valuable one for many older adults.
20XX 12

HEALTH INSURANCE
This decade has shaken the health care reimbursement systems in the United States, and changes will be
unfolding as the need to assure that every American will have access to health care is balanced against
unsustainable costs to support that care. Passed in 1965 as Title 18 of the Social Security Act, Medicare is the
health insurance program for older adults who are eligible for Social Security benefits. This federally funded
program primarily covers hospital and physician services with very limited skilled home health and nursing home
services under Part A. Preventive services and nonskilled care (e.g., personal care assistance) are not covered. To
supplement the basic coverage, a person can purchase Medicare Part B, which includes physician and nursing
services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal
dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ
transplant recipients, chemotherapy, hormonal treatments, and other outpatient medical treatments
administered in a doctor’s office. Part B also assists with the payment of durable medical equipment, including
canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as
artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract
surgery, and oxygen for home use are also covered. Medicare Part C or Medicare Advantage Plans give people the
option of purchasing coverage through private insurance plans to cover benefits not provided by Medicare Parts A
and B plus additional services. Although regulated and funded by the federal government, these plans are
managed by private insurance companies. Some of these plans also include prescription drug benefits, known as a
Medicare Advantage Prescription Drug Plan or Medicare Part D.
20XX 13

HEALTH STATUS
The older population experiences fewer acute illnesses than younger
age groups and a lower death rate from these problems. However,
older people who do develop acute illnesses usually require longer
periods of recovery and have more complications from these
conditions. Chronic illness is a major problem for the older
population. Most older adults have at least one chronic disease, and
typically, they have multiple chronic conditions, termed
comorbidity, that requires them to manage the care of several
conditions simultaneously. Chronic conditions result in some
limitations in activities of daily living and instrumental activities of
daily living for many individuals. The older the person is, the greater
the likelihood of difficulty with self-care activities and independent
living.
20XX 14

TEN LEADING CHRONIC CONDITIONS AFFECTING
POPULATION AGED 65 YEARS AND OLDER
1. Arthritis
2. High blood pressure
3. Hearing impairments
4. Heart conditions
5. Visual impairments (including cataracts)
6. Deformities or orthopedic impairments
7. Diabetes mellitus
8. Chronic sinusitis
9. Hay fever and allergic rhinitis (without asthma)
10. Varicose veins
15

LEADING CAUSES OF DEATH FOR PERSONS 65 YEARS
OF AGE AND OLDER
20XX 16

Despite the advances in the health status of the older population, disparities
exist. Studies have found that older minorities have lower levels of health and
function. The number of older Hispanics, blacks, and Asians admitted to nursing
homes has been increasing, whereas the number of older white nursing home
residents has been declining (Feng, Fennell, Tyler, Clark, & Mor, 2011).
20XX 17

IMPLICATIONS OF AN AGING POPULATION
The growing number of persons older than 65 years impacts
health and social service agencies and health care
providers—including gerontological nurses—that serve this
group. As the older adult population grows, these agencies
and providers must anticipate future needs of services and
payment for these services.
20XX 18

IMPACT OF THE BABY BOOMERS
In anticipating needs and services for future generations of older adults, gerontological nurses must consider the
realities of the baby boomers—those born between 1946 and 1964—who will be the next wave of senior citizens.
Their impact on the growth of the older population is such that it has been referred to as a demographic tidal
wave. Baby boomers began entering their senior years in 2011 and will continue to do so until 2030. Although
they are a highly diverse group, representing people as different as Bill Clinton, Bill Gates, and Cher, they do
have some clearly defined characteristics that set them apart from other groups:
-Most have children, but this generation’s low birth rate means that they will have fewer biologic children
available to assist them in old age.
-They are better educated than preceding generations with slightly more than half having attended or graduated
from college.
-Their household incomes tend to be higher than other groups, partly due to two incomes (three out of four baby
boomer women are in the labor force), and most own their own homes
-They favor a more casual dress code than do previous generations of older adults.
-They are enamored with “high-tech” products, are likely to own a computer, and spend several hours online
daily.
-Their leisure time is scarcer than other adults, and they are more likely to report feeling stressed at the end of
the day.
-As inventors of the fitness movement, they exercise more frequently than do other adults. 20XX 19

BIOLOGICAL
THEORIES OF
AGING
The process of biological aging differs not only
from species to species but also from one human
being to another. Some general statements can be
made concerning anticipated organ changes;
however, no two individuals age identically.
Varying degrees of physiologic changes,
capacities, and limitations will be found among
peers of a given age group. Further, the rate of
aging among different body systems within one
individual may vary, with one system showing
marked decline while another demonstrates no
significant change.
22
Aging is a highly individualized process, demonstrated by the
differences between persons of similar ages.

Stochastic theories view
the effects of aging as
resulting from random
assaults from both the
internal and external
environment.
Nonstochastic theories
see aging changes resulting
from a complex,
predetermined process.
23

STOCHASTIC THEORIES
 Cross-Linking
Theory
The cross-linking theory proposes that cellular division is threatened
as a result of radiation or a chemical reaction in which a cross-
linking agent attaches itself to a DNA strand and prevents normal
parting of the strands during mitosis. Over time, as these cross-
linking agents accumulate, they form dense aggregates that impede
intracellular transport; ultimately, the body’s organs and systems
fail. An effect of cross-linking on collagen (an important connective
tissue in the lungs, heart, blood vessels, and muscle) is the reduction
in tissue elasticity associated with many age-related changes.
20XX 24

FREE RADICALS AND LIPOFUSCIN
THEORIES
The free radical theory suggests that aging is due to oxidative metabolism and
the effects of free radicals. Free radicals are highly unstable, reactive molecules
containing an extra electrical charge that are generated from oxygen
metabolism. They can result from normal metabolism, reactions with other free
radicals, or oxidation of ozone, pesticides, and other pollutants. These molecules
can damage proteins, enzymes, and DNA by replacing molecules that contain
useful biological information with faulty molecules that create genetic disorder.
It is believed that these free radicals are self-perpetuating; that is, they generate
other free radicals. Physical decline of the body occurs as the damage from these
molecules accumulates over time. However, the body has natural antioxidants
that can counteract the effects of free radicals to an extent. Also, beta-carotene
and vitamins C and E are antioxidants that can offer protection against free
radicals.
20XX 25

 Hormone therapy includes hormones such as dehydroepiandrosterone
(DHEA), estrogen, testosterone, melatonin, and human growth hormone
(HGH). Hormone therapy may actually cause more harm than benefits in
improving the chance of a long life according to current theories of aging.
SAMPLE FOOTER TEXT 20XX 26

WEAR AND TEAR THEORIES
The comparison of the body’s wearing down to machines that lost their ability to
function over time arose during the Industrial Revolution. Wear and tear
theories attribute aging to the repeated use and injury of the body over time as it
performs its highly specialized functions. Like any complicated machine, the
body will function less efficiently with prolonged use and numerous insults (e.g.,
smoking, poor diet, and substance abuse).
In recent years, the effects of stress on physical and psychological health have
been widely discussed. Stresses to the body can have adverse effects and lead to
conditions such as gastric ulcers, heart attacks, thyroiditis, and inflammatory
dermatoses. However, because individuals react differently to life’s stresses—one
person may be overwhelmed by a moderately busy schedule, whereas another
may become frustrated when faced with a slow, dull pace—the role of stress in
aging is inconclusive.
20XX 27

EVOLUTIONARY THEORIES
Evolutionary theories of aging are related to genetics and hypothesize that the
differences in the aging process and longevity of various species occur due to
interplay between the processes of mutation and natural selection. Attributing
aging to the process of natural selection links these theories to those that
support evolution. There are several general groups of theories that relate aging
to evolution. The mutation accumulation theory suggests that aging
occurs due to a declining force of natural selection with age. In other words,
genetic mutations that affect children will eventually be eliminated because the
victims will not have lived long enough to reproduce and pass this to future
generations. Genetic mutations that appear late in life, however, will accumulate
because the older individuals they affect will have already passed these
mutations to their offspring.
20XX 28

The antagonistic pleiotropy theory suggests that accumulated
mutant genes that have negative effects in late life may have had
beneficial effects in early life. This is assumed to occur either because
the effects of the mutant genes occur in opposite ways in late life as
compared with their effects in early life or because a particular gene
can have multiple effects—some positive and some negative.
29

The disposable soma theory differs from other evolutionary theories by
proposing that aging is related to the use of the body’s energy rather than to
genetics. It claims that the body must use energy for metabolism, reproduction,
maintenance of functions, and repair, and with a finite supply of energy from
food to perform these functions, some compromise occurs. Through evolution,
organisms have learned to give priority of energy expenditure to reproductive
functions over those functions that could maintain the body indefinitely; thus,
decline and death ultimately occur.

BIOGERONTOLOGY
The study of the connection between aging and disease processes has been
termed biogerontology. Bacteria, fungi, viruses, and other organisms are
thought to be responsible for certain physiologic changes during the aging
process. In some cases, these pathogens may be present in the body for decades
before they begin to affect body systems. Although no conclusive evidence exists
to link these pathogens with the body’s decline, interest in this theory has been
stimulated by the fact that human beings and animals have enjoyed longer life
expectancies with the control or elimination of certain pathogens through
immunization and the use of antimicrobial drugs.
20XX 31

NONSTOCHASTIC THEORIES
Apoptosis
Apoptosis is the process of programmed cell death that continuously occurs
throughout life due to biochemical events. In this process, the cell shrinks and
there is nuclear and DNA fragmentation, although the membrane maintains its
integrity. It differs from cell death that occurs from injury in which there is
swelling of the cell and loss of membrane integrity. According to this theory, this
programmed cell death is part of the normal developmental process that
continues throughout life.
20XX 32

GENETIC THEORIES
Among the earliest genetic theories, the programmed theory of aging proposes
that animals and humans are born with a genetic program or biological clock that
predetermines the life span . Various studies support this idea of a predetermined
genetic program for life span. For example, studies have shown a positive relationship
between parental age and filial life span. Additionally, studies of in vitro cell
proliferation have demonstrated that various species have a finite number of cell
divisions. Fibroblasts from embryonic tissue experience a greater number of cell
divisions than those derived from adult tissue, and among various species, the longer
the life span, the greater the number of cell divisions. These studies support the theory
that senescence—the process of becoming old—is under genetic control and occurs at
the cellular level. The error theory also proposes a genetic determination for
aging. This theory holds that genetic mutations are responsible for aging by causing
organ decline as a result of self-perpetuating cellular mutations
20XX 33

Other theorists think that aging results when a growth substance
fails to be produced, leading to the cessation of cell growth and
reproduction. Others hypothesize that an aging factor responsible for
development and cellular maturity throughout life is excessively
produced, thereby hastening aging. Some hypothesize that the cell’s
ability to function and divide is impaired. Although minimal
research has been done to support the theory, aging may be the
result of a decreased ability of RNA to synthesize and translate
messages.
20XX 34

 The rate of living theory proposes that individuals have a finite
number of breaths or heartbeats that are used up over time.

NUTRITION THEORIES
The importance of good nutrition throughout life is a theme hard to escape in
our nutrition-conscious society. It is no mystery that diet impacts health and
aging. Obesity is shown to increase the risk of many diseases and shorten life.
The quality of diet is as important as the quantity. Deficiencies of vitamins and
other nutrients and excesses of nutrients such as cholesterol may cause various
disease processes. Recently, increased attention has been given to the influence
of nutritional supplements on the aging process; vitamin E, bee pollen, ginseng,
gotu kola, peppermint, and kelp are among the nutrients believed to promote a
healthy, long life. Although the complete relationship between diet and aging is
not well understood, enough is known to suggest that a good diet may minimize
or eliminate some of the ill effects of the aging process.
20XX 36

ENVIRONMENTAL THEORIES
Several environmental factors are known to threaten health
and are thought to be associated with the aging process. The
ingestion of mercury, lead, arsenic, radioactive isotopes,
certain pesticides, and other substances can produce
pathologic changes in human beings. Smoking and
breathing tobacco smoke and other air pollutants also have
adverse effects. Finally, crowded living conditions, high
noise levels, and other factors are thought to influence how
we age.
20XX 37

PSYCHOLOGICAL THEORIES OF AGING
Developmental Tasks
Psychological theories of aging explore the mental processes, behavior, and feelings of
persons throughout the life span, along with some of the mechanisms people use to
meet the challenges they face in old age. Among these theories are those that describe
the process of healthy psychological aging as the result of the successful fulfillment of
developmental tasks. Developmental tasks are the challenges that must be met and
adjustments that must be made in response to life experiences that are part of an adult’s
continued growth through the life span.
Erik Erikson (1963) described eight stages through which human beings progress from
infancy to old age and the challenges, or tasks, that confront individuals during each of
these stages (Table 2-1). The challenge of old age is to accept and find meaning in the
life the person has lived; this gives the individual ego integrity that aids in adjusting and
coping with the reality of aging and mortality. Feelings of anger, bitterness, depression,
and inadequacy can result in inadequate ego integrity (e.g., despair).
20XX 38

Refining Erikson’s description of old age tasks in the eighth stage of development, Robert Peck
(1968) detailed three specific challenges facing the older adults that influence the outcome of ego
integrity or despair:
-Ego differentiation versus role preoccupation: to develop satisfactions from oneself as a person
rather than through parental or occupational roles
-Body transcendence versus body preoccupation: to find psychological pleasures rather than
become absorbed with health problems or physical limitations imposed by aging
-Ego transcendence versus ego preoccupation: to achieve satisfaction through reflection on
one’s past life and accomplishments rather than be preoccupied with the finite number of years
left to live
 Robert Butler and Myrna Lewis (1982) outlined additional developmental tasks of later life:
-Adjusting to one’s infirmities
-Developing a sense of satisfaction with the life that has been lived
-Preparing for death
20XX 40

 Carl Jung's theory of development proposes that an
individual progresses through life searching and setting goals for
him or herself in an ongoing search for one's "true self." The "mid-
life crisis" is the time in which the individual reevaluates his or her
life and progresses toward his or her true self.

GEROTRANSCENDENCE
Gerotranscendence is a recent theory that suggests aging entails a
transition from a rational, materialistic metaperspective to a cosmic
and transcendent vision. As people age, they are less concerned with
their physical bodies, material possessions, meaningless
relationships, and self-interests and instead desire a life of more
significance and a greater connection with others. There is a desire to
shed roles and invest time in discovering hidden facets of oneself.
20XX 42

NURSING THEORIES OF AGING
Although there are many classic theories that describe biological,
social, and psychological aging, none integrate all of these various
dimensions of aging into a holistic theory. Because nurses address all
aspects of the person, theories that offer the holistic perspective
would be valuable in guiding nursing care. In an effort to address
this need, several nurses have recently developed theories of aging.
20XX 44

FUNCTIONAL CONSEQUENCES
THEORY
The Functional Consequences Theory for Promoting Wellness in Older Adults
integrates theories from aging and holistic nursing. It holds that nurses can
promote wellness by addressing individuals holistically, recognizing the
interconnection of body, mind, and spirit. The consequences of age-related
changes and risk factors can result in either positive or negative functional
consequences (i.e., wellness outcomes) for older adults. Through interventions
that promote wellness and alleviate or reduce the impact of negative factors,
nurses can promote positive functional consequences.
20XX 45

THEORY OF SUCCESSFUL AGING
By integrating Roy’s adaptation model with the theory of gerotranscendence and other aging
literature, Flood (2005) attempt to develop a nursing theory to guide the care of older adults.
The Adaptation Model of Nursing, developed by Sister Callista Roy, saw the individual as a
biopsychosocial being that continuously interacts with and adapts to the changing internal and
external environment (Roy & Andrews, 2008). Roy viewed health on a continuum and involves
the person becoming an integrated, whole individual. The Theory of Successful Aging not only
considers successful aging in terms of the older adult’s physical, mental, and spiritual well-being
but also includes the individual’s self-appraisal. Flood hypothesizes that people with high levels
of personal control and a positive affect will experience higher levels of wellness in aging due to
their ability to participate in health-promoting activities. Higher levels of physical health, in
turn, contribute to deeper spirituality. These factors contribute to greater life satisfaction and
the aging individual’s positive perception of his or her status. By aiding older adults in achieving
high levels of health and personal control over their lives, nurses can help aging individuals to
have a positive view of their lives, which in turn can promote their ability to cope and achieve
greater life satisfaction with age.
20XX 46

FACTORS CONTRIBUTING TO A LONG AND HEALTHY
LIFE
Diet. A positive health state that can contribute to longevity is supported by reducing saturated
fats in the diet, limiting daily fat consumption to less than 30% of caloric intake, avoiding
obesity, decreasing the amount of animal foods eaten, substituting natural complex
carbohydrates for refined sugars, and increasing the consumption of whole grains, vegetables,
and fruits.
Activity. Exercise is an important ingredient to good health. It increases strength and
endurance, promotes cardiopulmonary function, and has other beneficial effects that can affect a
healthy aging process.
Play and laughter. Laughter causes a release of endorphins, stimulates the immune system,
and reduces stress. Finding humor in daily routines and experiencing joy despite problems
contribute to good health. It has been suggested since the time of Solomon that “a cheerful heart
is good medicine, but a crushed spirit dries up the bones” (Proverbs 17:22).
20XX 47

Faith. A strong faith, church attendance, and prayer are directly
related to lower rates of physical and mental illness. Religion and
spirituality can have a positive effect on the length and quality of life.
Empowerment. Losing control over one’s life can threaten self-
confidence and diminish self-care independence. Maximum control
and decision making can have a positive effect on morbidity and
mortality.
Stress management. It is the rare individual who is unaware of
the negative consequences of stress. The unique stresses that may
accompany aging, such as the onset of chronic conditions,
retirement, deaths of significant others, and change in body
appearance, can have significantly detrimental effects. Minimizing
stress when possible and using effective stress management
techniques are useful interventions.
20XX 48

ASSISTING INDIVIDUALS IN MEETING THE PSYCHOSOCIAL
CHALLENGES OF AGING
 OVERVIEW
As individuals progress through their life span, they face challenges and adjustments in response
to life experiences called developmental tasks. These developmental tasks can be described as:
-Coping with losses and changes
Establishing meaningful roles
-Exercising independence and control
-Finding purpose and meaning in life
-Satisfaction with oneself and the life one has lived is gained by successfully meeting these tasks;
unhappiness, bitterness, and fear of one’s future can result from not adjusting to and rejecting
the realities of aging.
 GOAL
-Aging persons will express a sense of ego integrity and psychosocial well-being.
20XX 49

 ACTIONS
Learn about patients’ life stories; ask about family backgrounds, faith, work histories, hobbies,
achievements, and life experiences. Encourage patients to discuss these topics, and listen with sincere
interest.
Build on lifelong interests and offer opportunities for patients to experience new pleasures and interests.
Accept patients’ discussions of their regrets and dissatisfactions. Help them to put these in perspective of
their total lives and accomplishments.
-Encourage reminiscence activities between patients and their families. Help families and staff to
understand the therapeutic value of reminiscence.
-Respect patients’ faith and assist them in the fulfillment of spiritual needs (e.g., help them locate a church
of their religious affiliation, request visits from clergy, pray with or for them, and obtain a Bible or other
religious book).
-Use humor therapeutically.
-If patients reside in an institutional setting, personalize the environment to the maximum degree possible.
-Recognize the unique assets and characteristics of each patient.
20XX 50

CRITICAL THINKING EXERCISES
1. What disease processes are caused by or related to factors believed to influence aging?
2. You are asked to speak to a community group regarding environmental issues. What recommendations
could you make for promoting a healthy environment?
3. Think about everyday life in your community. What examples do you see of opportunities to engage and
disengage older adults?
4. What specific methods could you use to assist an older adult in achieving ego integrity?
20XX 51

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