Perspective on Aging:

Aging is a Developmental Process

 “Is Life What You Make It”, explored this with those who face challenging circumstances
outside of their control, such as debilitating disease, chronic illness, or significant loss of a
loved one.
 “Everything in your life is a reflection of a decision you have made” may miss the mark—such
statements may not always be true or appropriate as we reflect upon loss, debilitating disease,
or chronic illness, for example. tremendous value in attempting to maintain a positive mindset,
making the most of any situation, striving to press forward.
 In addition, there are several circumstances that may occur in life that are not the result of our
own decision-making and do not feel that anyone should ever be made to feel weak or
inadequate if they feel their joy has been stolen, or a situation has gotten the best of them.

5 Basic stages of aging in Older Adults

 Independence
 Interdependence
 Dependency
 Crisis management
 End of life.

Independence
 Seniors at this stage are completely self-reliant
 They live in their own homes, apartments or retirement communities.
 They don't need support to manage the tasks of daily living household chores and errands,
bathing, dressing, medications, cooking or finances — and require little or no support from
family members to manage any chronic disease or disabilities

Interdependence
 Seniors at this stage of aging begin to need some support from their family caregivers.
 They may notice the initial stages of memory loss.
 Their changing physical needs may result in their having increased difficulty with the tasks of
daily living or with management of their own health.

Dependency
 A senior at this stage is no longer able to safely live on his or her own without daily support.
 He or she may still be able to age in place, with in-home nursing or other community-based
services like Meals on Wheels deliveries or with daily visits from a family caregiver.
 But the likelihood is that a fully dependent senior will need residential retirement care in the
very near future.

Crisis management/ Infirmity

 At this stage of aging, your loved one's survival is dependent upon close medical support.
 He or she may still be mentally aware, but worsening chronic illness or advanced age is taking its
toll.
 A senior at this stage may be in the moderate to late stages of dementia and require residential
memory care.
End of Life
 People at this stage of life are approaching the end. But that doesn't mean that they feel sad —
especially if they continue to have close emotional and spiritual support from their loved ones,
neighbors and friends.

What is natural aging process?

 Aging is a gradual, continuous process of natural change that begins in early adulthood.
 During early middle age, many bodily functions begin to gradually decline. People do not
become old or elderly at any specific age.
 Traditionally, age 65 has been designated as the beginning of old age.

What is meant by the aging process?

 Ageing or aging is the process of becoming older
 In humans, aging represents the accumulation of changes in a human being over time and can
encompass by:
 Physical change
 Psychological change
 Social change

Physical change
 is a process of gradual change over time that is most noticeable in older people. We reach our
peak physical functioning and ability in our 20's and early 30's. These are the years that our
bodies are the strongest, our senses are the keenest, and our minds are the sharpest.
 skin becomes less elastic, dry, increase sensitivity in temperature (cold)
 spots and wrinkles become noticeable around age 40 or 50 and skin becomes less elastic.
Wrinkles and sagging skin are most common in the arms, face and neck.

Psychological changes
 Most elderly people seem to be most vulnerable to psychological dysfunction when they
experience change.
 Affective function refers to the mood, emotions (such as happiness, sadness, fear, pain, anger,
and confusion).
 Cognitive function refers to memory, learning, and intelligence.
 Cognitive and affective functioning affects the person’s self-esteem.

Psychosocial problems
 Poor adjustment to role changes
 Poor adjustment to lifestyle changes
 Family relationship problems
 Grief
 Low self-esteem
 Anxiety and depression
 Aggressive behavior
 Loneliness
 Isolation
 Problems with sexuality
 Elderly abuse
 Withdrawing and having a negative attitude toward life in general
Role of the gerontological nurse to promote psychosocial adaptation
The psychosocial assessment is an essential component of the overall health assessment

Nursing intervention to enhance mental alertness

 Allow the client to do as many tasks for himself as possible.
 Encourage use of the mind in problem solving.
 Encourage use of numbers and calculations.
 Encourage creative activities (e.g., painting, storytelling).
 Encourage the discovery of new talents and abilities.

Nursing intervention when caring for a client with a short-term memory loss
 Identify yourself each time there is an interaction with the client.
 Give instructions in simple, direct terms.
 Repeat instructions several times.
 Explain everything that is happening, even if the client does not seem to understand.
 Perform only one activity at a time.
 Report any sudden confusion.

Nursing intervention when teaching an older person new information

 Assess current knowledge.
 Evaluate for any visual or hearing deficit. Make sure the hearing aid is working or glasses are
available, if indicated.
 Determine the person's ability to learn.
 Identify any language barrier.
 Determine if the information to be taught is thought to be important or relevant to the elderly
person.

Nursing role to increased self-esteem

 Develop a trusting relationship
 Treat the elderly with dignity and respect
 Allow sufficient time for the performance of daily activities of self-care
 Encourage verbalization
 Practice active listening
 Give positive reinforcement for progress.
 Use reminiscence therapy (encourage the elderly to recall or remember past events).
 Be alert for opportunities to include the patient in decision making.
 Use verbal and nonverbal communication
 Encourage socialization.

Nursing intervention that fosters positive personality traits in elderly

 Accept the elderly.
 Identify the positive characteristic of each elderly.
 Encourage verbalization.
 Reward positive behavior.
 Avoid a judgmental attitude.
Adjusting to retirement
 It is easier if activities that will become prominent after retirement are begun during the
working years.
 Therefore, adjustments to retirement are influenced by pre-retirement plan and engaging in
other activities before withdrawing completely from their work.

Find a new role

 Such as a grandparent role. The grandparent role is generally one that brings great satisfaction
and contentment.

Facilitating maximum independence

 Make sure that the person has access to all necessary assistive devices and personal accessories.
 Allow enough time for the person to perform tasks at her or his own place
 Make sure that the environment has been adapted as much as possible to compensate for
sensory losses and other functional impairments.

Facilitating maximum independence

 Make sure that the person has access to all necessary assistive devices and personal accessories.
 Allow enough time for the person to perform tasks at her or his own place
 Make sure that the environment has been adapted as much as possible to compensate for
sensory losses and other functional impairments.

Intervention that promotes social support

 Use interventions to deal with hearing impairments and other communication barriers.
 Encourage participation in group activities.

Intervention that promotes social support

 For people in wheelchairs, especially those who cannot move independently, position the chairs
in a way that promotes social interaction.
 For nursing home residents, plan tables and room arrangements in such a way that social
relationships are fostered

Social Changes
 The social changes that come with life are change in life style, loss of other family members,
neighbors and friends.
 The main social problems, which confront elderly persons, are:
- social isolation
- finance
- loneliness
- rejection and loss of purpose in life.
- deterioration in housing standard and poor nutritional level.

Retirement
 A change in work role comes with retirement.
 It changes the way time is managed and daily activities are carried out.
 Retirement alters identity, status, financial problem, lack of self-satisfaction and self-esteem and
sometimes friendships
Widowhood
 A common event that alters family life for the aged is the death of a spouse.
 The spousal role composed of many sub roles, such as companion, sexual partner, confidante,
cook, house-keeping, and care provider.
 Loss of spouse is a highly stressful experience. Death of a spouse affects more women than men
because most older men will marry again .

Loneliness
 Loneliness is the feeling of emotional isolation, being locked inside oneself and unable to obtain
the warmth and comfort from others.

 Any loss that creates a deficit in intimacy and inner personal relationships can lead to loneliness.

Role change (role reversal)

 Numerous role changes occur with the aging process, but the transitions expected by most
elders are related to the work role and the role of spouse or partner.

Multiple losses
 Aging is associated with major physical, psychological and sociologic losses as well as a reduced
ability to adapt and compensate for stressors.
Examples of some losses
 Loss of job (retirement)
 Loss of status
 Change role
 Loss related to normal age-related changes
 Decreased income
 Increase expenditure on medical services
 loss of significant person
 Loss of housing
 Decreased the ability to adapt and compensate for stressors
 Limitations impose as a result of multiple chronic diseases

Awareness of Mortality
 Widowhood, death of friends, and the recognition of declining functions make older person
more aware of the reality of their own death.
 Attitudes about death vary with aging.
 The elderly tends to think and talk about death, but they find the prospect of death less
frightening.