Fund. Chapter 23 Elders

65-75 years
75-85 years
85-100 years
over 100 years

* Access to quality health services.
* Cancer
* Chronic Kidney disease
* Diabetes
* Disability
* Education - Community-based programs
* Food Safety
* Health communication

* Heart disease and stroke
* Immunizations and infectious diseases
* Injury and violence prevention
* Mental health
*Nutrition and obesity
*Oral Health
*Physical activity and fitness
* Respiratory disease
*Substance abuse
*Tobacco abuse
*Vision and hearing

Deep profound prejudice in American society against older adults.

"ology" = study of aging and older adults.

"iatrics" = associated with medical care.

Acute care - 65 and older use the ER at the highest rate.

* nurses in this setting protect the health of older adult.
* goal is to have older adult return to prior level of independence.

Long-term care facilities
* assisted living - help with ADL's - - specialized units, ie. Alzheimer's

Hospice - care for dying

Rehabilitation - goal is to maintain physical independence.

* Home health care - homebound

* Nurse-run clinics - manage chronic illness, follow-up via telephone. Helps decrease hospital readmission.

* Adult daycare - focus on social activites, and health care.

* Wear and tear
* Endocrine
* Free-radical
* Genetic
* Cross-linking - (chemical rx's create stong bonds between proteins)
* Immunological

* Integumentary - nutrition, H2O, sunscreen

* Neuromuscular - sarcopenia (muscle loss) - osteopenia then osteoporosis (bone loss)
--Wt. Train, and walk!

* Neouromuscular - loss of speed and power.

*Sensory/Perception - decreases pain, touch, smell, vision, hearing, taste.

* Pulmonary - decreased ability to expel foreign matter, lung expansion, dyspnea with exercise.

* Cardiovascular - reduced cardiac output, elasticity of arteries, increased BP, othrostatic hypotension (fluid volume shift)

* Gastrointestinal - delayed swallowing, increased indigestion and constipation.

Urinary - reduced filtering, less concentrated, increased frequncy & urgency
(esp. nocturnal)

* Genitals - (M) increase prostate size, time to arousal, more flacid diggler, longer refractory period.
(W) - atrophy of all internals, changes in vaginal flora, dryness (less lube)

* Immunological - lowered resistance, poor response to immunization, decreased stress response.

* Endocrince - increased insulin resistance, decreased thyroid function.

1960's by Cumming & Henry
-- involves mutual withdrawal between older person and other's in their environment.

by Havighurst
-- best way to age is to stay active physically and mentally.

by Atchley
-- people maintain their values, habits, and behavior in old age.
"set in your ways"

* Perception - ability to interpret the environment.

* Sensory memory - momentary perception of environmental stimuli.

* Short-term memory - info for immediate use minutes to hours. aka: "recent memory"

* Long-term memory - repository of info- longer than 72 hours to many years.

by Kohlberg 1984 - moral development completed in early adult years, avoid pain & displeasure of others.

by Gilligan 1982 - challenged Kohlberg's theo does not apply to women. Her theory is based on "concept of caring".

Many elders take faith and religious practice very seriously. Grew up with religion as a central focus...just continues as they age. vs today's youth and indifference.

* Injuries - falls 87% of all fractures...driving, fires, burns.

* Chronic disabiling illness

* Drug use and Misuse

* Alcoholism - 2 types, early in life and later in life (many are widowers)

*Dementia - progressive loss of cognitive function.

Approx. 1 -2 million American over age 65 have been abused neglected, or exploited.

* Health tests and screening

* Safety

* Nutrition and exercise

* Elimination

* Social interactions