Gerontology

GERONTOLOGY Jan Leynard Camposagrado, RN

Imagine yourself 50 years from now Will you look like…

Demographics of Aging ,[object Object],-> Average number of years that a person can be expected to live. In 1900, the average life expectancy was 47.3 years . By 1998, the figure had increased to 76.7 years .

Epidemiological Transition ,[object Object],[object Object],[object Object],[object Object]

Gerontology vs. Geriatrics Gerontology - the comprehensive study of aging and its effects. Geriatrics - deals with the problems and diseases of old age and aging people. (illnesses)

Common Biologic Theories of Aging

Wear-and-Tear Theories ,[object Object],[object Object],[object Object]

Endocrine Theory ,[object Object]

Free-radical Theory ,[object Object],These chemicals cause biochemical changes in the cells. Cells cannot regenerate themselves

Genetic Theories ¹ ,[object Object]

Cross-linking Theories ,[object Object],Therefore reduce sugar

Immune Theories ¹ ,[object Object],viruses that have incubated the body become ABLE damage to body organs

[object Object],Immune Theories ² increase in autoimmune responses body produces antibodies that attack itself

Cardiovascular System ,[object Object],[object Object],-> both results to…

[object Object],-> CO ~ 5-5.6 L/min (1.25L/min) ↓ Cardiac Output ↓ cerebral perfusion ↓ renal perfusion

Take note: hypertension Shown to be a serious risk factor at all ages for cardiovascular disease and stroke. Only confirmed by TWO SUBSEQUENT READINGS Classified as: 1. Isolated systolic hypertension 2. Primary hypertension 3. Secondary hypertension

heart failure ,[object Object],Major cause of morbidity & mortality manifestations: Younger persons Older patients ∆ exertional dyspnea ∆ orthopnea ∆ peripheral edema ∆ men are more prone Φ fatigue Φ nausea Φ abdominal discomforts Φ greater number of women develop it

‡ overview: congestive heart failure ‡ Left & Right sided heart failure ‡ goals: ‡ current standard of therapy for HF ,[object Object],[object Object],[object Object]

Cardiovascular health promotion: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object]

Respiratory System ,[object Object],[object Object],} Result in… ,[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Health Promotion Activities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Integumentary System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Strategies to Promote Healthy Skin ,[object Object],[object Object],[object Object],[object Object]

Reproductive System ,[object Object],a. Thinning of the vaginal wall b. Narrowing in vaginal size & elasticity c. Decreased vaginal secretions d. Atrophy of the uterus & ovaries e. Decreased pubococcygeal muscle tone -> these changes contribute to…

[object Object],a. Penis & testes decrease in size b. Levels of androgen decrease c. Erectile dysfunction  sexual desire & activity decline but do not disappear.  use of water-based lubricants can help prevent painful intercourse.

For erectile dysfunction: ,[object Object]

2. Placement of vasostimulating drugs ,[object Object],-> alprostadil (muse) -> pellet, the size of a grain of rice -> placed 1 inch into the urine channel 3. Use of Sildenafil citrate (viagra) 4. For both, daily physical exercise promotes enhanced sexual performance

Genitourinary System 1. Changes in kidney function -> Decreased filtration rate -> Diminished tubular function 2. Older women suffer from stress & urge incontinence 3. Common finding in men is BPH

benign prostatic hyperplasia/hypertrophy

Healthy habits ,[object Object],[object Object],[object Object],[object Object],[object Object],-> Makes use of pubococcygeal muscle -> pelvic muscle is first tightened, then relaxed -> done for 30-80 repetitions each day

Prevalence of UTI (common in older women) ,[object Object],↓ water consumption ↓ poor bathroom hygiene 2 nd to impaired mobility

Gastrointestinal System ,[object Object],[object Object],[object Object],[object Object],☼ More serious complications include fecal impaction & obstruction

Predisposing factors for constipation: ,[object Object],b. Use of some medications c. Inactivity d. Decrease fluid intake e. Ignoring urge to defecate

Health Promotion Practices (GIT) ,[object Object],2. Eating small frequent meals 3. High fiber, low fat diet 4. Adequate amount of fluids 5. Establishing regular bowel habits

Musculoskeletal System ,[object Object],Osteoporosis -> Usually associated with: a. Inactivity b. Inadequate calcium intake c. Loss of estrogen d. Cigarette smoking 2. Muscle diminishes in size & loses strength, flexibility and endurance.

Recommendations for Skeletal Health ,[object Object],2. Low phosphorous diet Dairy products & dark green vegetables Calcium supplements Avoid 3. Weigh-bearing exercises 4. Reduction of caffeine & alcohol

[object Object],6. Selective estrogen receptor modulator 7. Biphosphate drugs 8. Regular exercise

[object Object],[object Object],[object Object],[object Object],What condition is this?

Prevention 1. Moderate physical & mental exercise 2. Reading 3. Doing crossword puzzles

Sensory System ,[object Object],-> pupil dilates slowly & less completely -> due to… -> as a result… Recommend: -> sunglasses & hats -> yearly check-ups -> optical aids

[object Object],[object Object],[object Object],[object Object],[object Object],3. TASTE & SMELL ,[object Object],[object Object],[object Object]

Stress & coping in the older adult ,[object Object],Develops a positive image even until old age Common stressors of old age ,[object Object],[object Object],[object Object],[object Object],☼ older adult rely strongly on their spiritual beliefs for comfort during stressful times.

Developmental Theories of Aging ,[object Object],Ego integrity ♠ accepting one’s lifestyle ♠ believing that one’s choices were best ♠ being in control of one’s life Despair ♣ feels dissatisfied ♣ disappointed with life ♣ would live differently if given another chance ♠ using past experiences to assist others

Cognitive aspects of Aging Ф intelligence- progressive decline beginning midlife ,[object Object],(+) effects on intelligence score Cardiovascular health Stimulating environment High levels of education Occupational status routine/non-routine Income

strategies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pharmacologic Aspects of Aging Medications capable of altering nutritional status a. antacids b. cathartics c. Antibiotics & phenytoin d. Phenothiazines, estrogen & corticosteroids

Altered pharmacokinetics Age-related changes and their effects 1. absorption ,[object Object],[object Object],2. distribution ,[object Object],-> e.g. warfarin, OHA, calcium channel blockers, NSAIDs ,[object Object],[object Object],[object Object],-> e.g. barbiturates, diazepam, morphine

3. metabolism ,[object Object],4. excretion ,[object Object],[object Object],Nursing implications ,[object Object],[object Object],[object Object],[object Object]

Steps to improve compliance a. Explain the action, side effects, & dosage b. Write out medication schedule & review periodically c. Destroy old, unused medications d. Discourage OTC medications & herbal agents Medication dispenser

Herbal Alternatives Most individuals buy herbal medicines in stores without the consultation of a health care professional Herbal medicines can be in the form of Tablets, Capsules, Teas, Elixirs ,[object Object],[object Object],[object Object]

Physical Health Problems in Older Population 1. Impaired mobility -> Caused by: Parkinson’s disease, osteoarthritis, osteoporosis -> encourage to stay active as possible -> when bed rest cannot be avoided, do aROM -> frequent turning

2. Increased susceptibility to infection -> possibly due to -> influenza vaccines -> vitamin and dietary supplements

3. Altered pain & febrile response -> response to pain is lessened -> pain may be absent in older patients experiencing MI & appendicitis -> baseline body temperature = 1°F lower Be alert for other subtle signs: ,[object Object],[object Object],[object Object],[object Object]

Depression in the Elderly ,[object Object],What are risk factors for depression in the elderly? 1. Being a female 2. Being unmarried 3. Lack of supportive social network 4. Stressful life events

Additional risk factors: 1. Certain medicines or combination of medicines 2. Damage to body image (from amputation, cancer surgery, or heart attack) 3. Family history of major depressive disorder 4. Living alone, social isolation 5. Recent bereavement

Depression self-help for seniors 1. Getting out in to the world 2. Connecting to others 3. Participating in activities you enjoy 4. Taking care of a pet 5. Exercising 6. Make sure all medications are taken as instructed

Gerontology

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Gerontology