Health in Gerontology exam 1

the scientific study of the effects of time on human development, specifically the study of older persons

ignatz nascher in 1900

100-109

90-99

110+

65-74

85-90

75-84

centenarians (100-109)

75.4

70 years

76.9 years

35.1 million

72 million

69.3%

36%

36%

hispanic

100+

12.4% or 35 million

80.7 years

1) unintentional weight loss (>10lbs/yr)
2) general feeling of exhuastion
3) weakness (measure by grip strength)
4) slow walking speed
5) low levels of physica activity

three of the 5 qualifying signs/symptoms

total number of years that a human is likely to live or has lived

around 115-130

16.3 more years

19.2 more years

5.6 more years

6.7 years

18%

70%

discrimination based on person's age

30%

10.2%

negatively

stochastic (error) and nonstochastic (programmed)

1) somatic mutation theory
2) error-catastrophe theory of aging
3) wear and tear theory
4) cross-linkage theory
5)freeradical theory

1)programmed aging theory
2) gene theory
3)immunity theory

attributes aging to the wear and tear on body over time as it performs its highly specialized functions

cellular division threatened as a result of chemical reaction

DNA strand

normal parting of the strands of DNA during mitosis because of the attachment of cross linking agents

the accumulation of cross-linking agents

aging is a result of free radical accumulation

when the cell is exposed to environmental pollutants such as tobacco smoke, radiation, smog and ozone

antioxidants such as B-carotene and vitamins E and C

changes of aging are attributed to process that is programmed and thought to be predetermined

originally called biological clock theories

cells of immune system lose some of their self-regulatory ability

age realted changes in immune system lead to decreased efficiency

examination on neuroendocrine functioning over time, especially DHEA and melatonin

DHEA and melatonin

reduction in coloric intake have multiple positive effects

1) role theory
2) activity theory
3) disengagement theory
4) continuity theory
5) age-stratification theory
6) social exchange theory
7) modernization theory

ability of individual to chainging roles over life course

predictor of adjustment to personal aging

views aging as process in which society and individual gradually withdraw, or disengage from eachother, to mutual satisfaction and benefit to both

an older person should continue a middle-aged lifestyle, denying existence of old age as long as possible

personality and basic patterns of behavior remain unchanged as individual ages

elders exist in cohorts or other who have shared similar historical periods in their lives

status and value of elders are lost when their labors are no longer useful

-culture in which they live no longer revere them

1) jung's theory
2) developmental theories
erikson
peck
3) maslow's hierarchy

assumes one is either extroverted or introverted
-as one ages they move from extroverted to introverted (forcus on outward achievement to one of acceptance of self)

challenges that must be met and adjustments that must be made in response to life experiences that are part of an adult's continued growth through life span

ego integrity vs. despair

challenge of old age is to accept and find meaning in life the person has lived; this gives the individual ego integrity that aids in adjusting and coping with reality of aging and mortality

1) ego differentiation vs. role preoccupation
2) body transcendence vs body preoccupation
3) ego transcendence vs ego preocupation

the elderly no longer define themselves by life work role, but in individual personhood

body and changes accepted as part of life

person sees oneself as a part of a greater whole

Maslows heirarchy of human needs

As more basic-level needs are met, the satisfaction of higher-level needs is possible, with ever-deepening richness to life, regardless of one's age.

1) increase quality and years of healthy life
2) eliminate health disparities

oriented toward maximizing potential of which individual is capable within the environment in which the person is functiong

self - actualization

suggests that every person has an optimum level of functioning for each position on the wellness continuum to acheive a good and satisfactory existence

86%

95%

1) healthy lifestyle behaviors
2) injury prevention
3) delivery of culturally appropriate clinical preventive services
4) immunization and preventive screenings
5) self-management techniques for those with chronic illnesses

1) self-responsibility
2) nutritional awareness
3) physical fitness
4) stress management
5) sensitivity to environment

pathological

1) loss or decrease in compensatory reserve
2) progressive loss in efficiency of body to repair damaged tissue
3) decreased immune response

decreases

chronic fungal infection

lessen in arms, totally lost in abdomen, maintained in knee

increase

left ventricle

systolic murmer, grade 1+ or 2+

decreases

descreases

reduced cardiac reserve

systolic b/c there is increased peripheral resistance in vessels

loss of elastic recoil, rigid rib cage

4th decade

decreases

declines

tone, elasticity, holding capacity

decreased sensitivity to insulin, increased need for insulin in obesity

motility and volume

it is lost

lower nutrient absorption

decrease

decreased near vision (4th decade)

eyelids lose elasticity and droop

gray ring at the edge of the limbus (eye)

high frequency hearing loss (sensorineural)

becomes thicker, drier, and more difficult to remove, causing hearing loss

breasts become smaller and less firm
labias become less prominent, vagina loses elasticity and pH goes from 4-6 to 6-8 after menopause

testes atrophy, fertility decreased, decreased sexual function

reducity immunity at the cellular level

Fluids
Aeration
Nutrition
Communication
Activity
Pain
Elimination
Socialization/social skills

lists essential functions and scores patients on whether they can perform them independently, with assistance or are dependent on others

bathing
dressing
toileting
transferring
continence
feeding

adaptation
partnership
growth
affection
resolution

access
treatment
disease outcomes
elderly and minorities "double jeopardy"

belonging to or deriving from the cultural, racial, religious, or linguistic traditions of a people or country

the belief in inherent superiority of ones' group and culture accompanied by devaulation of other groups or cultures

the medical science dealing with disease, disabilities, and care of ethnic elders

50% more likely to have a stroke
50% more likely to die of stroke
20% more likely to die of heart disease

scientific or western medicine

objective term used by caregivers

subjective term describing symptoms of discomfort or sickness

illness and disease cuased by actions of higher power. health is a blessing or reward, illness is punishment

based on concept of balance

consistent with western medicine...prevention important because of its effect on future health

problem now and treatment needed but treatment may not be needed in future....preventative actions not consistent

view helath of present dependent on actions of past, either from past life, earlier life, or events or circumstances of one's ancestors

white americans...highly value autonomy and individualtiy , identify bound first to oneself

family more important than individual; most groups other than eupropean american
HIPAA rules are in direct conflict with this

High context
inqure about nurse's health and family and nurse is supposed to inquire about patients family well being.
body language is more important than spoken words
quality of relationship between nurse and person more important than the needs of the person

culture of western medicine and nursing
task oriented encounters
individual identity not iportent
nonverbal communication infrequent, verblal communication used only when necessary