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Theories of aging_fall 2013 abridged


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Theories of aging_fall 2013 abridged

  1. 1. 1Theories of AgingNURS 4100 Care of the Older AdultFall 2013Joy A. Shepard, PhD(c), MSN, RN, CNE,BC
  2. 2. 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
  3. 3. 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
  4. 4. 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
  5. 5. 5Mystery of Aging Goal ofeverlasting youth Aging as acomplex process Highlyindividualizedprocess
  6. 6. 6Lifestyle Lift infomercialGlaringexample of a youth-driven andyouth-obsessed culture
  7. 7. 7Who Has More Value?
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 11Aging: Many InterrelatingFactors, Causes No single factor,theory Heredity, nutrition,health status, lifeexperiences,environment, activity,& stress Aging is highlyindividualized
  12. 12. 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**
  13. 13. 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
  14. 14. 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
  15. 15. 15Error Theories of Aging Cross-Linking Theory Loss of flexibility,diminished functionalmotility Wear & Tear Theory Effects of stress Stress causesstructural & chemicalchanges resulting inirreversible tissuedamage
  16. 16. 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
  17. 17. 17Solar Elastosis: ChronicExposure to Solar Radiation(UV)
  18. 18. 18Lipofuscin
  19. 19. 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
  20. 20. 20Question Is the following statement true orfalse? The genetic theories of aging bestdescribe how and why a person ages
  21. 21. 21Identical Twins (Age 52)
  22. 22. 22Identical Twins (Age 61)
  23. 23. 23Aging Disease: Progeria
  24. 24. 24Psychosocial Theories ofAging Disengagementtheory Activity theory Continuity theory Developmentaltasks Erik Erikson
  25. 25. 25Sociological Theories ofAging Social & Psychological Models: Dynamic interplaybetweens gains & losses Disengagement TheoryAs individuals age, they inevitably withdraw from societySociety withdraws from themSeparation mutually agreed upon Activity TheoryContinue middle-age lifestyle; deny existence of old ageLife satisfaction: involvement in new interests, hobbies, roles,and relationshipsVolunteering: one way retirees stay connected to community
  26. 26. 26Sociological Theories ofAging Continuity Theory –Values &personalityGoals & individualcharacteristicsPsychologicalpatternsSuccessfuladaptive strategiesValues, morals, &behaviors
  27. 27. 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.
  28. 28. 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
  29. 29. 29Developmental ChallengesAssociated with Aging Certain developmentalchallenges bringopportunities for olderpeople to experiencefeelings of success, loss Social relationships, rolesRetirement Coping with lossDeath of a loved one Living arrangementsLoss of independence Financial challengesFixed income The strengths of eachindividual (including pastcoping skills) must beidentified & utilized whenplanning care
  30. 30. 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
  31. 31. 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
  32. 32. 32Opportunities for Older People toExperience Feelings of Success Older adults often assume new roles, such as grandparents, asthey mature
  33. 33. 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
  34. 34. 34
  35. 35. 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.
  36. 36. 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
  37. 37. 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.
  38. 38. 38“Blue Zones” of Longevity
  39. 39. 39