The document discusses quality nursing care for the elderly. It begins with definitions of elderly, geriatrics, and geriatric nursing. It then covers concepts and theories of aging including biological, psychosocial, and developmental theories. Finally, it discusses needs assessment of the elderly which includes functional assessment, physical examination, nutrition assessment, and health history review to identify problems and needs. The goal is to integrate theoretical knowledge of geriatrics with best assessment skills to provide quality care for older adults.

1. Advanced
Nursing Practice I
(NRS 505)
Leda Lyn S. Apostol, RN
Oral presentation

2. QUALITY NURSING
CARE FOR THE
ELDERLY

3. AGENDA
Needs
Assessment
05
Introduction
Concepts
and
Principles
Theories
of Aging
Health
Needs of
the
Elderly
01 02 03 04

4. Introduction
• The dictionary defines old as “having lived or existed for
a long time.” The meaning of old is highly subjective; to
a great degree, it depends on how old we ourselves are.
Few people like to consider themselves old. A recent
study reveals that people younger than 30 years view
those older than 63 as “getting older.” People 65 years of
age and older do not think people are “getting older”
until they are 75.
• Young old (60-74 yrs.), middle old (75-84yrs.), and old-old
(above 85 years).

5. Elderly- an individual over 65
years old who have a functional
impairment.
Elderly Care- the fulfillment of
the special needs and requirements that
are unique to senior citizens.

6. ger·i·at·ric
/ˌjerēˈatrik/
The term geriatric comes from the Greek words
“geras,” meaning old age, and “iatro,” meaning
relating to medical treatment. Thus, geriatrics is the
medical specialty that deals with the physiology of
aging and with the diagnosis and treatment of
diseases affecting older adults.
ger·on·tol·o·gy
/ˌjerənˈtäləjē/
noun
1.the scientific study of old age, the process of
aging, and the particular problems of old people.

7. Geriatric Nursing
is the specialty that concerns itself with the
provision of nursing services to geriatric or
aged individuals.
Geriatric staff nurses focus on caring
for older adults and are educated to
understand and treat their often complex
physical and mental health needs.

8. Aging- the time-related
deterioration of the physiological
functions necessary for survival and
fertility.
Aging process- is the process of
growing old or developing the
appearance and characteristics of old
age.

9. Objectively- aging is a universal process
that begins at birth and is specified by the
chronological age criterion.
Subjectively- aging is marked by changes
in behavior and self perception and
reaction to biologic changes.
Functionally- aging refers to the
capabilities of the individual to function in
society.
Classification of Aging

10. Concepts of Aging
Refers to the actual
amount of time a
person has been
alive.
Chronologic Aging

11. Concepts of Aging
Refers to the actual
amount of time a
person has been
alive.
• Senescence or biological aging is
the gradual deterioration of
function characteristics.
• Refers to the physical changes
that “slows us down” as human
gets into middle and older years.
• Also known as the PHYSIOLOGIC
AGING
Biologic Aging

12. Concepts of Aging
.
Refers to the psychological changes,
including those involving mental
functioning and personality that
occurs as human age.
Psychologic Aging

13. Concepts of Aging
Refers to changes in person’s roles
and relationships, both within their
networks of relatives and friends and
in formal organizations such as the
workplace and houses of worship
Social Aging

14. Concepts of Aging
Is the decline in cognitive processing
that occurs as people get older.
Cognitive Aging

15. Biologic
Theories
Theories of Aging

16. Psychosocial
Theories
Theories of Aging

17. Developmental
Theories
Theories of Aging

18. Biologic Theory of aging

19. Programmed Theory
• proposes that everyone has a “biologic clock” that starts ticking at
conception.
Run-out-of-program Theory
• which proposes that every person has a limited amount of genetic
material that will run out eventually.

20. Rate of Living Theory
• which proposes that individuals have a finite number of breaths or
heartbeats that are used up over time.
Gene Theory
• proposes the existence of one or more harmful genes that activate
over time, resulting in the typical changes seen with aging and
limiting the life span of the individual.

21. The error theory
• proposes that errors in ribonucleic acid protein synthesis cause
errors to occur in cells in the body, resulting in a progressive decline
in biologic function
The Somatic Mutation Theory
• is similar but proposes that aging results from deoxyribonucleic acid (DNA)
damage caused by exposure to chemicals or radiation and that this damage
causes chromosomal abnormalities that lead to disease or loss of function later
in life.

22. Free radical Theory
• provides one explanation for cell damage. Free radicals are unstable molecules
produced by the body during the normal processes of respiration and
metabolism or following exposure to radiation and pollution.
• which proposes that cell molecules from DNA and connective tissue
interact with free radicals to cause bonds that decrease the ability of
tissue to replace itself.
Crosslink or connective tissue theory

23. The wear-and-tear Theory
• presumes that the body is similar to a machine, which loses
function when its parts wear out.
Clinker Theory
• combines the somatic mutation, free radical, and crosslink theories to suggest
that chemicals produced by metabolism accumulate in normal cells and cause
damage to body organs, such as the muscles, heart, nerves, and brain.

24. Neuroendocrine Theory
• focuses on the complicated chemical interactions set off by the hypothalamus of the brain.
• It is proposed that hormone supplements may be designed to delay or control age-related
changes
Reliability Theory of aging and
longevity
• is a complex mathematical model of system failures first used to describe
failure of complex electronic equipment. It is used as a model to describe
degradation (disease) and failure (death) of human body systems.

25. Caloric restriction Theory
• Animal research has shown that a point of metabolic efficiency can be achieved by consuming
a high-nutrient but low-calorie diet.
• It is hypothesized that this diet, when combined with regular exercise, may extend optimal
health and life span.
Immunologic Theory
• proposes that aging is a function of changes in the immune system. According to this theory,
the immune system— an important defense mechanism of the body— weakens over time,
making an aging person more susceptible to disease. The immunologic theory also proposes
that the increase in autoimmune diseases and allergies seen with aging is caused by changes
in the immune system.

26. Psychosocial Theories aging
Disengagement Theory
• This theory proposes that older people are systematically separated, excluded, or
disengaged from society because they are not perceived to be of benefit to the
society.
Activity Theory
• proposes that activity is necessary for successful aging.
Continuity Theory
• States that personality remains the same and the behaviors become more
predictable as people ages (Neugarten, 1964).

27. Developmental theories
• LIFE-COURSE THEORIES
• These theories trace personality and personal adjustment
throughout a person’s life.
• Many of these theories are specific in identifying life-
oriented tasks for the aging person.
• Four of the most common theories—Erikson’s, Havighurst’s,
Newman’s, and Jung’s—are worth exploring.

28. Erikson’s
theory
• identifies eight stages of developmental
tasks that an individual must confront
throughout the life span
• The last of these stages is the domain of
late adulthood, but failure to achieve
success in tasks earlier in life can cause
problems later in life. Late adulthood is
the time when people normally review
their lives and determine whether they
have been negative or positive overall. The
most positive outcomes of this life review
are wisdom, understanding, and
acceptance; the most negative outcomes
are doubt, gloom, and despair

29. It details the process of aging and defines specific tasks
for late life, including:
(1) adjusting to decreased physical strength and health;
(2) adjusting to retirement and decreased income;
(3) adjusting to the loss of a spouse;
(4) establishing a relationship with one’s age group;
(5) adapting to social roles in a flexible way; and
(6) establishing satisfactory living arrangements.

30. Newman’s theory
identifies the tasks of aging as:
(1)coping with the physical changes of aging;
(2) redirecting energy to new activities and roles,
including retirement, grandparenting, and
widowhood;
(3) accepting one’s own life;

31. proposes that development continues
throughout life by a process of searching,
questioning, and setting goals that are
consistent with the individual’s personality.
Thus, life becomes an ongoing search for the
“true self.”
Jung proposes that the individual is likely to
shift from an outward focus (with concerns
about success and social position) to a more
inward focus. Successful aging, according to
Jung, includes acceptance and valuing of the
self without regard to the view of others.
Jung’s Personality Theory

33. Needs Assessment of the Elderly
.
Careful assessment is the
foundation of care for all
patients, regardless of age. To
identify the problems and
needs of older adults, nurse
must integrate a sound
theoretical knowledge of the
geriatric population with best
assessment skills.

34. Needs Assessment of the Elderly
Functional
Assessment
It is the measurement of
patient’s ability to complete
functional tasks and are
used to evaluate the older
adults overall well-being and
self-care abilities.

36. Needs Assessment of the Elderly
.
Physical Examination
 Obtaining Health
History
 Current health status
 Medical History
 Review of body
systems

37. Needs Assessment of the Elderly
.
Nutrition Assessment
It includes evaluation of
medical diagnosis,
measurements of
anthropometric
parameters and
biochemical indices and
review of medications.

38. References
Basic Geriatric Nursing, 6th Edition, Williams, P.
https://slideplayer.com/slide/8911969/
https://www.slideshare.net/NehaNupur8/nursing-care-of-the-
elderly-patients?from_search=3
https://www.slideshare.net/PrincyFrancisM/concepts-and-theories-
of-aging