LEARNING OUTCOMES - © 2014 by Pearson Education, Inc. Chapter 1: P...

Tabloski, Instructor's Resource Manual, Gerontological Nursing 3rd Edition © 2014 by Pearson Education, Inc.

Chapter 1: Principles of Gerontology

Concepts for Lecture

LEARNING OUTCOMES

• Interpret demographic data according to race, gender, and age.
• Relate leading causes of morbidity and mortality among older adults.
• Identify common myths of aging and their contribution to ageism.
• Describe the effects of chronic disease.
• Contrast several major theories of aging.
• Evaluate the natural history of disease using principles of epidemiology.

I INTRODUCTION

The aging of America will trigger a huge demand for increased healthcare services.This book addresses the key issues involved in caring for the older person, with an emphasis on health problems encountered by nurses caring for older persons in clinical settings.Gerontology is the holistic study of the aging processes and individuals as they mature throughout the adult life span, including the study of the physical, mental, and social changes of aging.As a result of the multidisciplinary focus of gerontology, professionals from diverse fields, including nurses, call themselves "gerontologists."

Geriatrics is defined as:

• the study of health and disease in later life; • comprehensive health care of older persons and the well-being of their caregivers.Older people receive nursing care in skilled nursing facilities, retirement communities, adult day care, residential care facilities, transitional care units, rehabilitation hospitals, community-based home care, and a variety of other settings.Attitudes and myths about older people can be considered to be ageist or reflect negative stereotypes of aging.Gerontological nurses can promote the causes of the aging adult by educating others when they hear negative attitudes about aging.In recent years, the study of gerontology has moved beyond the disease focus to the improvement of health holistically, including physical, mental, emotional, and spiritual well-being.(Gerontological Nursing 3e Patricia Tablosk) (Instructor Manual) 1 / 4

Tabloski 3e Ch 1 Concepts for Lecture Tabloski, Instructor's Resource Manual, Gerontological Nursing 3rd Edition © 2014 by Pearson Education, Inc.2 Health promotion and “Tips for Healthy Aging” are a key component of the practice of gerontological nursing.The reality of aging reflects our understanding that there has been a dramatic reduction in the prevalence of the precursors to chronic disease, including hypertension, high cholesterol, and smoking.Refer to Box 1-2.The goal for nurses who provide health care to older people is not only to improve the length of life, but also to improve the quality of life.

II DEMOGRAPHICS AND AGING

Countries all over the world are facing demographic aging.In the United States, we often speak of “the graying of America,” but all nations are or will be faced with important issues regarding the provision of health care to older persons.The proportion of persons over the age of 60 is projected to double worldwide over the next 50 years.The United States is projected to experience rapid growth in its older population.Aging trends occurring now and into the future will affect each of the three subgroups of older people in different

ways, including:

• The “Young Old” (65–74) Over the next 20 years, 74 million Boomers will retire. Medicare and Social Security will add 10,000 new retirees per day.• The Middle Old (75–84) Over the next decade, increased life expectancy will add to the numbers of aging Boomers and increase the total numbers in this category.• The Old-Old (85+) The old-old are the fastest growing segment of the population, growing at twice the rate of those 65 and over and four times faster than the total U.S. population. This group will triple by 2050.Refer to Figure 1-2.

III LONGEVITY AND THE SEX DIFFERENTIAL

Prior to 1950, the male population outnumbered the female population. In 1950, this trend reversed.Women now comprise the majority of the older population in all nations.In the United States, women outnumber men and the ratio of men to women over the age of 65 is 49 men to every 100 women.Older women are more likely to be widowed, to live alone, to be less educated, and to have fewer years of labor experience, thus making them more likely to live in poverty. 2 / 4

Tabloski 3e Ch 1 Concepts for Lecture Tabloski, Instructor's Resource Manual, Gerontological Nursing 3rd Edition © 2014 by Pearson Education, Inc.3 As the healthcare systems of developing countries improve, the differences between countries have narrowed over time.The gender differences in life expectancy may be explained by the interaction between biological, social, and behavioral factors.Gerontological nurses will find greater demand for their services in home, community-based, and institutional settings.

IV LIFE AFTER 65

This increase in life expectancy has been attributed to improved health care, increased use of preventive services, and healthier lifestyles.Nurses should be aggressive in health promotion efforts and rehabilitation after surgery or illness.Chronic conditions usually develop over long periods and thus offer ample opportunity for nurses and other healthcare professionals to screen, detect, educate, and intervene.The actions that older persons, families, and healthcare professionals take can alter and change the course of a chronic illness.Nurses have the opportunity to intervene using the three levels of prevention designated as primary, secondary, and tertiary.In recent years, Medicare has expanded coverage of preventive services to encourage older people to stay healthy.As nurses and other healthcare professionals continue to work on closing the gap between life span and healthy life span, the older adult should be urged to assume more responsibility for healthy aging.

V LIVING LONGER OR LIVING BETTER?

From 2009 to 2010, the death rates for older persons declined significantly for 7 of the 10 leading causes of death (heart disease, malignant neoplasms, lower respiratory diseases, stroke, accidents, influenza, and pneumonia).The death rate increased significantly from 2009 to 2010 for Alzheimer’s disease, nephritis, nephrotic syndrome and nephrosis.Refer to Figure 1-5.Heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes cause more than two-thirds of all deaths each year.Costs of caring for chronic illness are staggering both to older persons and their family members and society.Refer to Box 1-4.

VI HEALTHY PEOPLE 2020

Healthy People 2020 is the prevention agenda for the United States.

The four basic goals are:

• Attain high-quality; longer lives 3 / 4

Tabloski 3e Ch 1 Concepts for Lecture Tabloski, Instructor's Resource Manual, Gerontological Nursing 3rd Edition © 2014 by Pearson Education, Inc.4

• Achieve health equity
• Create social and physical environments that promote good health
• Promote quality of life.

Emerging issues for improving the health of older adults:

• Coordinate care; helping older adults manage their own health care needs.
• Establish quality measures; identifying minimum levels of training for people who care

for older adults.

• Support research and analysis in order to provide appropriate training for health care providers.
• Gather more data relating to the healthcare needs of aging

lesbian, gay, bisexual, and transgender population.

VII THEORIES OF AGING

The study of aging continues to grow and evolve.Multiple processes can affect how humans age.Senescence is the progressive deterioration of body systems.Generally, each body system is affected by aging.Modifiable changes can be slowed by exercise, good nutrition, and other elements of a healthy lifestyle.Understanding the normal changes can help distinguish chronological age (number of years from birth) from physiological age (degree of senescence experienced by each body system).Refer to FIGURE 1-8.Normal aging includes but is not limited to changes in the heart, arteries, lungs, brain, kidneys, bladder, body fat, muscles, bones, sight, hearing, and personality.

VIII THEORIES OF AGING

• Biological aging theories • Psychological aging theories • Sociological aging theories

IX PATIENT AND FAMILY TEACHING

Gerontological nurses require skills and knowledge related to teaching patients and families about the key concepts of gerontology and the role of gerontological nurses.Educating patients and families is critical so they can assume a large role in health promotion.

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