OLDER CLIENTS AS AGGREGATE

Theories of Aging

Stochastic theories

Genetic theories

Psychological theories

Sociological theories

Stochastic Theories Somatic mutation theory: Prolonged

exposure to background radiation of several types results in cell mutations that eventually lead to death.

Error theory: Environmental changes interfere with cell function and protein synthesis, thus causing errors in reproduced cells.

Genetic Theories - 1 Neuroendocrine theory: Aging results from

functional decrements in neurons and their hormones that are genetically programmed.

Intrinsic mutagenesis theory: A genetic constitution regulates the replication of genetic materials. Over time, regulatory activity diminishes, creating mutations in cells that result in the effects of aging.

Genetic Theories - 2

Immunologic theory: Aging is an autoimmune process in which the body perceives aging cells as foreign bodies and destroys them.

Free radical theory: Free radicals, metabolic by-products, accumulate over time to cause cell damage.

Psychological Theories - 1

Psychoanalytic theory: Aging is a time of developing self-awareness through reflective activity.

Interpersonal theory: The loss of interpersonal relationships over time results in a loss of interpersonal security and the consequent psychological aspects of aging.

Psychological Theories - 2 Human needs theory: Physical aging and

environmental changes contribute to difficulty in meeting basic human needs, which leads to the psychological effects of aging.

Theory of psychosocial development: The degree of success in accomplishing prior developmental tasks influences the accomplishment of the tasks of the older adult.

Sociological Theories - 1

Disengagement theory: Older people begin a process of withdrawal from society that prevents social disruption when death occurs.

Activity theory: Older people continue their engagement with society and assume new roles and responsibilities.

Sociological Theories - 2

Continuity theory: One’s behavior

becomes more predictable with age.

Myths of Aging - 1

Aging is a time of tranquility. Senility is a universal experience of

aging. People become less productive with age. Older people resist change. Aging is a uniform process.

Realities of Aging Aging may cause more problems with fewer

resources to deal with them. Many older people retain mental acuity. Older people continue to be productive, but

avenues of productivity change. Older people are no more resistant to change than

younger people. Aging is a variable process.

Assessing Older ClientsGeneral Principles - 1

Distinguish normal effects of aging from pathology.

Illnesses may have atypical presentations in the elderly.

Dysfunction in one system may cause problems in other systems.

Assessing Older ClientsGeneral Principles - 2

Older people have strengths as well as problems.

Older people may have experienced a variety of losses.

Communication difficulties may influence assessment.

Biophysical Considerations Maturation and aging

Retirement Preparation for death

Physiologic function Existing conditions Functional ability Immunity

Psychological Considerations

Cognitive assessment

Response to stress

Affective assessment

Suicide potential

Physical Environmental Considerations

Safety hazards in the home

Community safety hazards

Effects of weather, pollution, etc.

Sociocultural Considerations

Social support Family roles and responsibilities Employment and occupation Economic factors Potential for abuse

Behavioral Considerations

Diet (amount, type, preparation, etc.)

Physical activity and rest

Personal habits

Sexuality

Health System Considerations

Access to health care

Preventive services

Source of care

Financing of health care

Goals of Primary Prevention for Older Clients Promoting healthy aging through

Selection of important aspects of life Optimization in use of available

resources Compensation for lost abilities

Promoting self-care

Primary Prevention Nutrition Hygiene Safety Immunization Rest and exercise Maintaining independence Life resolution and preparation for death

Secondary Prevention - 1 Skin breakdown Constipation Urinary incontinence Sensory loss Mobility limitation Pain Confusion Depression

Secondary Prevention - 2 Social isolation Abuse and neglect Alcohol abuse Inadequate financial resources Chronic illness Communicable diseases Advocacy

Tertiary Prevention

Preventing complications of existing

problems

Preventing recurrence of problems

Providing end-of-life care to clients

and families

Health Education for Older Clients Circumvent sensory losses Repeat material frequently Proceed at a slower pace Set realistic, attainable goals Limit the length of teaching sessions Break learning into discrete tasks

Evaluation Considerations Some problems may be the result of aging and

not amenable to complete resolution. The prognosis for one problem may be

influenced by the occurrence or status of other problems.

Some problems may diminish while others increase.

Deterioration may result in additional problems.