Gerontological Nursing

Patricia Tabloski
Life Expectancy
All nations are facing an aging population
In 1997, approximately 10% world population was older than age
60
This figure is projected to increase 15% by 2025
Women comprise 55% of the worlds older population
The majority reside in developing countries
Men have shorter life expectancies
Because of greater exposure to risk factors, both occupational and
vocational
Women will close this gender gap if they increase their risk exposures
Life expectancy is also impacted by nationality, race, and
socioeconomic status (SES).
FIGURE 1-1 U.S. population age
structure, 2000 and 2030 (projected).
Source: Center for Disease Control, 2004.
FIGURE 1-2 Percentage of females for older age groups, 2000. Source: U.S. Census
Bureau, 2000.
FIGURE 1-3 Life expectancy at birth for selected countries, 19001998. Source:
U.S. Census Bureau, 2000.
FIGURE 1-4 U.S. population percent change by age between 1990 and 2000.
Source: U.S. Census Bureau. Census 2000 Summary File 1: 1990 Census of Population.
General Population Characteristics, United States (1990 C.P.1.13)
Life after 65
Chronic conditions develop over time.
Nurses can intervene using three levels of prevention
Primary
Secondary
Tertiary
In 1990, two of the leading causes of death among
elders, heart disease and stroke, declined by 1/3
Seventy percent of physical decline is a result of
modifiable risk factors
Tobacco
Poor nutrition
Inactivity
Lack of preventive care

FIGURE 1-5 Selected chronic conditions affecting U.S. adults age 70 or older.
Source: Centers for Disease Control. National Center for Health Statistics. Supplement
on Aging Study and Second Supplement on Aging Study. 1995.
Myths of Aging
Myths of Aging
You cant teach an old dog new tricks
Dirty old man
Disease and disability are an inevitable part of aging
Health promotion is wasted on older people
The elderly do not pull their own weight
Myths of aging lead to:
Ageism
Reduced healthcare services
Segregation of elders from mainstream society
Nurse recruitment difficulties
Chronic Conditions
Seventy percent of physical decline is
modifiable through
Smoking cessation
Improved nutrition
Physical activity
Prevention of injuries from falls
Improved use of Medicare-covered preventive
services

Chronic Disease
Leading chronic diseases are treatable
but not curable.
Chronic disease
Reduces quality of life
Limits activity
Requires assistance
Increases healthcare costs
Increases hospitalizations
Impacts emotional health
Healthy People 2010 Goals
Increase quality and quantity of healthy life
Eliminate health disparities

Nurses can have significant impact on
peoples lives.


The Aging Process
The aging process is multifactorial and
includes
Benign changes, such as graying hair
Nonbenign changes, such as senescence
Individualized aging progression
Modifiable changes related to lifestyle
Normal or universal aging processes


FIGURE 1-7 Normal changes of aging.
Normal aging includes
Loss of organ reserves resulting in decreased
response to physiological stress
Variations among individuals
Chronologic and physiologic aging, which are
not synonymous
Organ system changes
The Aging Process
Biological Aging Theories
Programmed Theories
Endocrine Theory
Immunological Theory
Error Theory
Wear and Tear Theory
Cross-Link Theory
Free Radical Theory
Somatic DNA Damage Theory

Psychological Aging Theories
Jungs Theory of Individualism
Eriksons Developmental Theory
Sociological Aging Theories
Disengagement Theory
Activity Theory
Continuity Theory

Evolution of the Study of Aging
1950s and 1960s disease based
Today, holistic and health promotion
focused