nicely described about ageing

2. The Aging
Paramita Bhunia
Msc. Nursing final year student

3. • Aging is psychosocially and
biologically defined as being
older. An aged or geriatric
patient is defined as a person
whose biological age is
advanced.
• Aging can be characterized as a
deterioration of the physiological
functions essential for survival
and fertility that is time-related.

4. DEFINITION OF AGEING:
Ageing is the process of becoming
older. Aging is associated with
changes in dynamic biological,
physiological, environmental,
psychological, behavioral and Social
processes.
• The process of ageing is a complex
one that can be described
chronologically, physiologically and
functionally.

5. • Chronological age refers to the number of
years a person has lived.
• It is easy to identify and measure.
Chronological age serves as criteria in the
society for certain activities such as driving,
employment, and the collection of retirement
benefits.
• Physiological age refers to the determination
of age by body function. Although age-
related changes affect everyone, it’s
impossible to pinpoint exactly when these
changes occur. That’s why physiological age
isn’t useful in determining a person’s age.

6. • Functional age refers to a person’s
ability to contribute to society and
benefit others and himself. It’s based
on the fact that not all individual of
the same chronologic age function at
the same level.
• Many people may be chronologically
older but remain physically fit,
mentally active, and productive
measure of society. Others may be
chronologically young, but physically
or functionally old.

7. Chronological
categories
 Young- old (ages 65 to
74)
 Middle- old (ages 75 to
84)
 Old- old (ages 85 and
older)

8. AGEING: THE INDIAN SCENARIO
• According to Population Census 2011 there are nearly 104
million elderly persons (aged 60 years or above) in India; 53
million females and 51 million males.
• A report released by the United Nations Population Fund and
HelpAge India suggests that the number of elderly persons is
expected to grow to 173 million by 2026

9. •According to the Report of the Technical Group
on Population Projections for India and States
2011-2036, there are nearly 138 million elderly
persons in India in 2021 (67 million males and
71 million females) and is further expected to
increase by around 56 million elderly persons in
2031.

10. Cont..
•
• As regards rural and urban areas, as per 2011 census, 71% of
elderly population resides in rural areas while 29 % is in urban
areas.
• •In the last few years, medical science has identified a new
group within the senior citizen category, namely that of super-
agers. The term refers to people in their 70s and 80s who have
the mental or physical capability of their decades-younger
counterparts. With the world ageing at a rapid rate, it is
estimated that by 2030 there will be 34 nations with over 20%
population above 65 years.

11. Some terms related to ageing
study..
• Gerontology:Gerontology is the study of aging and older adults.
• Geriatrics: The term geriatrics originates from the Greek ‘geron’
meaning "old man", a branch of medicine that deals with the problems
and diseases of old age and the medical care and treatment of aging
people. Geriatrics, or geriatric medicine, is a medical specialty focused
on providing care for the unique health needs of the elderly.

12. • Geropsychiatry is the branch of clinical medicine specializing
in psychopathology of the elderly population

14. Theories are grouped into two
broad categories:
Biological and
Psychosocial.

15. BIOLOGICAL THEORIES
Biological theories attempt to explain the
physical process of aging, including
molecular and cellular changes in the
major organ systems . They also attempt
to explain why people age differently and
what factors affect longevity and the
body's ability to resist disease.
Biological theories contain 5 major
theories they are….

18. Wear and tear theory
Proponents of this theory believe that the body wears out on a scheduled
basis. Free radicals are molecules with unpaired electrons that exist
normally in the body; they also are produced by ionizing radiation, ozone,
and chemical toxins. According to this theory, these free radicals cause
DNA damage, cross-linkage of collagen, and the accumulation of age
pigments.

19. Environmental Theory
According to this theory, factors in the environment (e.g.,
industrial carcinogens, sunlight, trauma, and infection) bring
about changes in the aging process. Although these factors are
known to accelerate aging, the impact of the environment is a
secondary rather than a primary factor in aging.

20. Immunity Theory
The immunity theory describes an age-related decline in the
immune system. As people age, their ability to defend against
foreign organisms decreases, resulting in susceptibility to
diseases such as cancer and infection.

21. Neuroendocrine Theory
This theory proposes that aging occurs because of a
slowing of the secretion of certain hormones that have an
impact on reactions regulated by the nervous system. This
is most clearly demonstrated in the pituitary gland,
thyroid, adrenals, and the glands of reproduction.

22. PSYCHOSOCIAL THEORIES
Psychosocial theories focus on social and
psychological changes that accompany
advancing age, as opposed to the
biological implications of anatomic
deterioration. Several theories have
attempted to describe how attitudes and
behaviour in the early phases of life
affect people's reactions during the late
phase. This work is called the process of
"successful aging."

24. Personality theory
• Personality theories address aspects of psychological growth
without delineating specific tasks or expectations of older
adults. Evidence supports the general hypothesis that
personality characteristics in old age are highly correlated
with early life characteristics. In extreme old age, however,
people show greater similarity in certain characteristics,
probably because of similar declines in biological functioning
and societal opportunities.

25. 1. Mature men are considered well-balanced persons who maintain close personal
relationships. They accept both the strengths and weaknesses of their age, finding
little to regret about retirement and approaching most problems in a relaxed or
convivial manner without continually having to assess blame.
2. "Rocking chair" personalities are found in passive dependent individuals who
are content to lean on others for support, to disengage, and to let most of life's
activities pass them by.
3. Armored men have well-integrated defense mechanisms, which serve as
adequate protection. Rigid and stable, they present a strong silent front and often
rely on activity as an expression of their continuing independence.

26. 4. Angry men are bitter about life, themselves, and other people.
Aggressiveness is common, as is suspicion of others, especially of
minorities or women. With little tolerance for ambiguity or frustration,
they have always shown some instability in work and their personal lives,
and now feel extremely threatened by old age.
5. Self-haters are similar to angry men, except that most of their animosity
is turned inward on themselves. Seeing themselves as dismal failures,
being old only depresses them all the more.

27. Developmental Task Theory
Developmental tasks are the activities and challenges that one must
accomplish at specific stages in life to achieve successful aging.
Erikson (1963) described the primary task of old age as being able to see
one's life as having been lived with integrity. In the absence of achieving
that sense of having lived well, the older adult is at risk for becoming
preoccupied with feelings of regret or despair

28. Disengagement theory
 Disengagement theory describes the process of withdrawal by older adults from societal
roles and responsibilities.
 According to the theory, this withdrawal process is predictable, systematic, inevitable,
and necessary for the proper functioning of a growing society.
 Older adults were said to be happy when social contacts diminished and responsibilities
were assumed by a younger generation.
 The benefit to the older adult is thought to be in providing time for reflecting on life's
accomplishments and for coming to terms with unfulfilled expectations.
 The benefit to society is thought to be an orderly transfer of power from old to young.
There have been many critics of this theory, and the postulates have been challenged. For
many healthy and productive older individuals, the prospect of a slower pace and fewer
responsibilities is undesirable.

29. Activity theory
 In direct opposition to the disengagement theory is the activity theory of
aging, which holds that the way to age successfully is to stay active.
 Multiple studies have validated the positive relationship between maintaining
meaningful interaction with others and physical and mental well-being.
 Social integration is the prime factor in determining psychosocial adaptation
in later life.
 Social integration refers to how the aging individual is included and takes part
in the life and activities of his or her society.
 This theory holds that the maintenance of activities is important to most
people as a basis for deriving and sustaining satisfaction, self-esteem, and
health.

30. Continuity Theory
 This theory, also known as the developmental theory, is a
follow-up to the disengagement and activity theories.
 It emphasizes the individual's previously established
coping abilities and personal character traits as a basis for
predicting how the person will adjust to the changes of
aging. Basic lifestyle characteristics are likely to remain
stable in old age, barring physical or other types of
complications that necessitate change.

31. ETILOGY OF AGEING
Primary or Intrinsic Factors of
Aging
• Include biologic and physiologic
changes that are influenced by
one’s gender, culture, ethnicity
and race, intelligence and
personality, familial longevity
patterns, and genetic disease.

32. Secondary or Extrinsic Factors
 Employment
 Economic level
 Education
 Health practices and related diseases
 Societal attitude
 Income, economic level, and educational level partially determine how one
lives..
 Poor diet, experience poor living conditions, have a substance-abuse problem,
or ignore or minimize health problems also are at risk for a shortened lifespan.

34. BIOLOGICAL CHANGES ASSOCIATED WITH AGEING
• Cellular Level
• Immune System
• Musculoskeletal
• Integument
• Genitourinary and Reproductive
• Special Senses
• Neuropsychiatric
• Memory
• Neurotransmitters
• Brain
• Gastrointestinal (GI) System
• Respiratory

41. Adaptation to the Tasks of Aging
•Loss and Grief
•Attachment to Others
•Attachment to Others
•Maintenance of Self-Identity
•Dealing with Death

42. Psychiatric Disorders in Later life
• Neurocognitive disorders
• Delirium
• Depression
• Schizophrenia
• Anxiety disorders
• Personality disorders
• Sleep disorders

43. Other Disorders of Old age
•Vertigo
•Syncope
•Elderly abuse

44. Sociocultural Aspects of Aging
• Elderly people in virtually all cultures share some basic
needs and interests:
• They choose to live the most satisfying life possible
until their demise.
• They want protection from hazards and release from the
weariness of everyday tasks.

45. • They want to be treated with the respect and dignity that is deserving
of individuals who have reached this pinnacle in life.
• They want to die with the same respect and dignity.

46. Sexual aspect of ageing

50. • These cultural stereotypes undoubtedly play a large part in
the misperception many people hold regarding sexuality of
the aged, and they may be reinforced by common tendency of
the young to deny the inevitability of aging.

51. Long-Term Care
•Long-term care facilities are defined by the level of care they provide.
• They may be skilled nursing facilities, intermediate care facilities, or a
combination of the two.
 Some institutions provide convalescent care for individuals recovering
from acute illness or injury,
 some provide long-term care for individuals with chronic illness or
disabilities, and still others provide both types of assistance.

52.  Most elderly individuals prefer to remain in their own homes or in the
homes of family members for as long as this can meet their needs
without deterioration of family or social patterns.
 Many elderly individuals are placed in institutions as a last resort only
after heroic efforts have been made to keep them in their own or a
relative's home.
 The increasing emphasis on home health care has extended the period of
independence for aging individuals.

53. Murray and Zentner (2001) list four developmental
tasks related to successful adaptation in retirement:
 Remaining actively involved and having a sense of belonging unrelated to
work
 Re-evaluating life satisfaction related to family and social relations and
spiritual life rather than to work
 Re-evaluating the world's outlook, keeping a view of the world that is
coherent and meaningful and a view that one's own world is meaningful
 Maintaining a sense of health, integrating mind and body to avoid
complaints or illness when work is no longer the focus.

54. Economical Implications
 Because retirement is generally associated with 20 to
40 percent reduction in personal income, the standard
of living after retirement may be adversely affected.
 Most older adults derive post-retirement income from
a combination of Social Security benefits, public and
private pensions, and income from savings or
investments.

56. The following risk factors are taken into
consideration to predict potential need for services
and to estimate future costs.
• Age
• Health
• Mental health Status
• Socioeconomic and Demographic Factors
• Marital Status, Living Arrangement, and the Informal
Support Network

57. Cont..
• Several considerations are unique to assessment of the elderly.
Assessment of the older person's thought processes is a primary
responsibility.
• Knowledge about the presence and extent of disorientation or
confusion will influence the way in which the nurse approaches
elder care.
• Information about sensory capabilities is also extremely
important. Because hearing loss is common, the nurse should
lower the pitch and loudness of his or her voice when addressing
the older person.
• Looking directly into the face of the older person when talking
facilitates communication.

58. Cont..
• Questions that require a declarative sentence in
response should be asked; in this way, the nurse is able
to assess the client's ability to use words correctly.
• Visual acuity can be determined by assessing
adaptation to the dark, color matching, and the
perception of color contrast.
• Knowledge about these aspects of sensory functioning
is essential in the development of an effective care
plan. The nurse should be familiar with the normal
physical changes associated with the aging process.

59. Diagnosis related to physiologically
• Risk for trauma related to confusion, disorientation. muscular
weakness, spontaneous fractures, falls .
• Hypothermia related to loss of adipose tissue under the skin,
evidenced by increased sensitivity to cold and body temperature below
98.6°F .
• Decreased cardiac output related to decreased myocardial efficiency
secondary to age-related changes, evidenced by decreased tolerance
for activity and decline in energy reserve..
• Ineffective breathing pattern related to increase in fibrous tissue and
loss of elasticity in lung tissue, evidenced by dyspnea and activity
intolerance

60. Application of the Nursing Process
•Assessment of the elderly individual may follow
the same framework used for all adults but with
consideration of the possible biological,
psychological, sociocultural, and sexual changes
that occur in the normal aging process described
previously.

61. • Risk for aspiration related to diminished cough and laryngeal
reflexes Impaired physical mobility related to muscular wasting and
weakness, evidenced by need for assistance in ambulation
• Imbalanced nutrition, less than body requirement related to
inefficient absorption from gastrointestinal tract, difficulty chewing
and swallowing, anorexia difficulty in feeding self, evidenced by
wasting drome, anemia, weight loss
• Constipation related to decreased motility; in quate diet; insufficient
activity or exercise danced by decreased bowel sounds; hard, for
stools; or straining at stool .
• Stress urinary incontinence related to degenerative changes in pelvic
muscles and structural s associated with increased evidence

62. Cont…
• Imbalanced nutrition less than body requirements
• Constipation
• Stress urinary incontinence
• Urinary retention.
• Disturbed sensory perception
• Insomnia
• Chronic pain Self-care deficit Risk for impaired skin integrity

63. Diagnosis related to Psychologically
Psychosocially related nursing diagnoses may include
• Disturbed thought processes.
• Complicated grieving risk for suicide Powerlessness
• Low self-esteem
• Fear disturbed body image
• Ineffective sexuality pattern

64. Therapy most effective in Aging
• Crisis intervention .
• Group therapy .
• Orientation therapy.
• Reminiscence therapy encourages clients to think about and reflect on
the past.
• Reminiscence therapy helps older adults to work through their losses
and maintain self-esteem.

65. Geriatric care
• This is related to the disease process of old age a aims at keeping old
age and it aims at keeping old persons at a state of self-dependence as
far as possible and t provide facilities to improve their quality of life.
• Gerontology Nurse
• A nurse who has specialization in geriatrics or in the care of old people
is called geriatric nurse or gerontological nurse.

66. Functions of Gerontological nurse:
• G (guiding): Giving guidance to people of all ages regarding ageing process.
 E (elimination): eliminating ageism, or considering old age as disease.
 R (respecting): respecting the rights of older people.
 (observing): observing the facilities provided to old people & improving them.
 N (noticing): noticing health hazards that may happen in old age & try to reduce them.
 T (teaching): teaching how to take care of old people, for those who are caring for them.
 O (opening channels): opening the channels of development activities for the care of the
aged.

67.  L (listening): listening attentively to the problems of old people & giving
due importance to them.
 O (offering): offering positivism- presenting different possibilities of life.
 G (generating): generating energy for participation in the care of aged &
researches for new supporting techniques.
 I (implementing): implementing activities for rehabilitation & re-
adjustment.
 C (co-coordinating): coordinating different services related to the care of
the aged.

68.  A (assessing): Assessing the needs & health of the old people.
 L (linking): linking, contacting services according to need.
 N (nurturing): prepare 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 & religious aspects of old age & giving
them recognition.
 S (supporting): supporting the old people in accepting realities & preparing them
mentally for impending death.
 E (education & encouraging): educating & encouraging old people for self-care.

69. Responsibilities of Nurse in Aging
• The nurse has to fulfil the following roles in gerontology nursing.
Caregiver
Health educator
Co-ordinator of health services
 Counsellor and guardian (those people who protect the old person or take responsibilities as his
guardian’s spokesman or responsible person)

70. The nurse may have to perform different functions in relations to the above roles:
• Health assessment
• Arranging/promoting good nutrition
• Promoting activity and exercise
• Providing psychological support

71. Preventive care of elderly
• In case of the elderly, their physical and mental safety is very important. Gerontological
NURSE and care givers should pay special attention to the following safety measures
 Protection from unhealthy environment
 Protection from mental tensions
 Special care of personal health.
 Protection from physical and mental injuries, threats and fatigue
 Providing rehabilitation services.