“Everyman desires to live long, butno man would be old.” Johnathan Swift, 1667-1745
Theories of AgingBiological Theories• address the anatomic and physiologic changes occurring with age.Psycho-Social Theories• explain the thought processes and behaviors of aging persons.
Biological Theories of AgingGenetic Theories Nongenetic Theories• Gene • Immunologic /• Error Autoimmune• Somatic mutation • Free Radical• Programmed • Wear & Tear • Cross link or Collagen http://prolongyouth.com/theories.html
Psycho-Social Theories of Aging• Disengagement Theory• Activity Theory• Continuity Theory
Disengagement Theory• developed by Cummings and Henry in late 1950’s.• “aging is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the aging person and others in the social system he/she belongs to.”
Activity Theory• developed by Robert Havighurst in the 1960’s.• supports the maintenance of regular activities, roles, and social pursuits.• persons who achieve optimal age are those who stay active.• as roles change, the individual finds substitute activities for these roles.
Continuity Theory• proposed by Havighurst and co-workers in reaction to the disengagement theory• “basic personality, attitudes, and behaviors remain constant throughout the life span”
“ENJOY THE BALLET, LORETTA ….AND TRY TO SELL MY TICKET.”
????????????????????????? ?????What is the relevance of the biological and psychosocial theories of aging to nursing?
Developmental Task• an activity or event that arises at a certain period in the life of an individual• successful achievement leads to happiness, growth, and success with later tasks• failure leads to unhappiness, disapproval by society, and difficulty with later tasks (Havighurst, 1972)
???????????????????????? ?????? What are some important roles that older individuals fulfill?
Erickson’s Developmental Stages• Young Adulthood (20-30) - Intimacy vs. Isolation• Middle Adulthood (30-60) - Generativity vs. Stagnation• Older Adulthood (60+) - Integrity vs. DespairArea of Resolution and Behavior: Intimacy - capacity for relationships vs. Isolation - impersonal relations
Peck’s Developmental Tasks of Aging• Ego Differentiation vs. Work-Role Preoccupation• Body Transcendence vs. Body Preoccupation• Ego Transcendence vs. Ego Preoccupation (Peck, 1968)
Havighurst’s Developmental Tasks of Aging• Adjusting to decreasing physical strength and health• Adjusting to retirement and reduced income• Establishing an affilitation with one’s age group• Meeting civic and social obligations• Establishing satisfactory living arrangements• Adjusting to death of spouse
???????????????????????? ?????? What are factors which influences a person’s success at achieving developmental tasks?
Nursing InterventionsHow can nurses assist elders accomplish developmental tasks?• encourage clients to maintain and establish roles and relationships• offer maximum opportunities for decision making• build on client’s unique interests ands skills• listen to client’s concerns• promote reminiscence (Eliopoulas,1995)
Common Psychosocial Changes• Assume Grandparent Role• Adjust to Retirement• Increase Volunteer Activity• Maintain or Develop New Interests• Cope with Death of Spouse, or S.O.• Adjust to Change in Intimacy & Sexuality• Cope with Relocation• Cope with Losses
Coping with Psychosocial Changes & Developmental Crises• Support System• Community Resources• Counseling• Prayer/Religion
Spirituality and Religiosity• These concepts are frequently confused.• Studies have found that nurses tend to avoid addressing spiritual needs of patients.
Spirituality is the:• “totality of man’s inner resources,• the ultimate concerns around which all other values are focused,• the central philosophy of life that guides conduct,• and the meaning-giving center of human life which influences all individual and social behavior” (Moberg, 1979)• “trust & faith in a power greater than oneself” (levin & Taylor, 1997)
Religion is:• only one aspect of spirituality;• an organized practice of beliefs;• may or may not fill an individual’s spiritual needs eg. spiritual needs are much broader & more personal than any particular religious persuasion
Church and Synagogue Attendance is:• Lowest among those in their 30’s,• Peaks in the late 50’s - early 60’s,• Declines in late 60’s and early 70’s, however 65+ are the most likely to belong to church-affiliated groups
Research Findings:• Black women tend to be significantly more religious than black men and whites of both genders (Levin & Taylor, 1993).• Involvement in church activities tended to increase self-esteem (Krause, 1995).• Religious preference & practice were inversely related to depressive symptomatology (Kennedy, 1996).• Persons who attended religious services had lower mortality (Oman & Reed, 1998).
Nursing Interventions that enhances the spirituality of clients: • Presence and acceptance • Active Listening & Touch • Value clarification • Discuss pt’s. source of strength & instill hope • Conduct a spiritual assessment • Call/make referral to clergy • Pray, or obtain religious articles (Poncar,94; MacLennan & Tsai, 95)