GERONTOLOGY
Aging and Senescence are frequently used interchangeably, and
Is the study of the processes of aging and challenges of older both are considered fundamental and intrinsic properties of most
people. living organisms.
Is considered a young science.
Is an applied science AGING – the sum of all the changes that normally occur in an
Seeks to understand the processes and effects of normal aging. organism with the passage of time.
GERIATRICS – IS THE STUDY AND PRACTICE OF THE MEDICAL - is a complex and variable phenomenon.
PROBLEMS AND CARE OF OLDER PEOPLE WITH DISEASE. - is a highly individualized process that affects each
GERONTOLOGICAL NURSING – is the practice and study of person in unique ways.
adapting and applying generic nursing methods to the older adult - is the result of the interaction among genetic
patient, using specialized knowledge about aging, including endowment, environmental influences, lifestyles, and the effects of
information derived from gerontology and geriatrics. disease processes.
AGING AND THE LIFE SPAN SENESCENCE – is the progressive deterioration of the body and
LIFE SPAN – as the average maximum length of time an its processes.
organism can be expected to survive or last .
- in human beings, the life span is thought to be CHARACTERISTICS OF AGING PROCESS
about 110 to 115 years. Increased mortality rate with age after maturation.
LIFE EXPECTANCY – as the average observed years of life from Changes in biochemical composition in tissue with age.
birth or any stated age, and depends on both biological and Progressive decrease in physiological capacity with age.
environmental influences. Reduced ability to respond adaptively to environmental stimuli
- the present life expectancy is 74.7 in with age.
men and 79.9 in women. Increased susceptibility and vulnerability to disease.
THE HUMAN LIFE SPAN THEORIES OF AGING
The Embryonic development – occurs from conception to birth. 1. EVOLUTIONARY THEORIES – also known as developmental
Growth and Maturity – occurs from birth to adulthood. theory, explores the human life span as affected by the forces of
Senescence – occurs at the last stages of adulthood through natural selection. Natural selection encourages reproduction of the
death. species; as a result, genes that encourages healthy life until
successful reproduction are selected and the population is
increased. This selection in turn affects aging either directly or - genes may be selected because they positively influence early life
through mechanism that are helpful early in life, yet affect the through reproduction, but just happen to have negative affects on
aging process later. health in later life.
- Genes beneficial at younger age become deleterious at
EVOLUTIONARY THEORY older age.
A. MUTATION ACCUMULATION THEORY
- suggest that genes that have negative effect in later life 2. CELLULAR THEORIES
gradually increase in the population, because they are not weeded Explores factors that affect cell division and cumulative damage
out by natural selection. to cells that results in cell senescence. All of the cells can divide
initially but with age many stop dividing, although they continue to
B. DISPOSABLE SOMA function well.
- proposes that once the organism has produced, it is Explores mechanisms that result in cell damage. When this
disposable. As a result, humans are not programmed to continue damage reaches a certain level cell death can result.
maintenance and repair of the body after reproduction, and
become more susceptible to disease with age. CELLULAR THEORY
A. CELLULAR SENESCENCE – TELOMERE THEORY
EVOLUTIONARY THEORY - Phenotype of aging are caused by an increase in frequency of
A. MUTATION ACCUMULATION THEORY senescent cells. Senescence may result from telomere loss or cell
- suggest that genes that have negative effect in later life stress.
gradually increase in the population, because they are not weeded B. WEAR AND TEAR THEORY
out by natural selection. - aging is a physiological process determined by the amount of
stress and damage to which one has been exposed.
B. DISPOSABLE SOMA - cells wear out from normal use, ultimately resulting
- proposes that once the organism has produced, it is disposable. in cell death.
As a result, humans are not programmed to continue maintenance 3. SYSTEM THEORY
and repair of the body after reproduction, and become more Explores the impact of the body’s regulatory system on aging,
susceptible to disease with age. including the neurological-endocrine systems and immune system.
These system help the body respond and adapt to internal and
C. ANTAGONISTIC PLEIOTROPY THEORY external stimuli by their impact on other body system.
GERONTOLOGICAL NURSING:(Gunter and Estes 1079)
A health service that incorporates generic nursing methods and
SYSTEM THEORY specialized knowledge about the aged to establish conditions
A. NEUROENDOCRINE – alteration in neuroendocrine control of within the (patient) and within the environment that will do the
homeostasis result in aging –related physiological changes. following:
1. Increase health-promoting behaviors in the aged.
B. IMMUNOLOGICAL – decline of immune function with aging 2. Minimize and compensate for health related losses and
results in decreased resistance to infectious diseases and increased impairments related to aging.
incidence of autoimmunity. 3. Provide comfort and sustenance through the distressing and
debilitating events of aging, including dying and death.
C. RATE OF LIVING – assumes a fixed rate of metabolic potential 4. Facilitate the diagnosis, palliation, and treatment of disease in
for every living organism. the aged.
FACTORS AFFECTING THE PRACTICE OF
HIGH PREVALENCE OF CHRONIC DISEASE GERONTOLOGICAL NURSING:
1. Hypertension – 50% Characteristics of the recipients of gerontological nursing.
2. Heart Disease – 32% The environment in which health care is delivered.
3. Arthritic Symptoms – 30% Essential knowledge and competencies of gerontological
4. Cancer – 21% nurses.
5. Diabetes – 16% Roles and standard for care.
6. Stroke – 10% Application of the nursing process to care of the older adult:
7. Asthma – 9% Assessment, nursing diagnosis , nursing interventions , and
8. Chronic Bronchitis – 7% nursing sensitive outcomes.
9. Emphysema – 6%
( percentage of people age 65 and over who reported GERONTOLOGICAL NURSING TIME LINE:
having selected chronic condition) 1904 - American journal of nursing publishes an
article on care of the aged.
1920s – Many older individuals live on “poor farms”.
1940s – Older adults are cared for in hospitals; no focused plans certification. A key focus of her career was identifying and
are made for discharging older adult home. meeting the educational needs of nurses on care of the older
1950s – First geriatric nursing text by Newton is published. adult.
1961 – ANA recommends the formation of a special interest group MARY OPAL WOLANIN (1920-1997) – examined the benefits of
for geriatrics. rehabilitation, which later formed the subjects of her writings. She
1966 – ANA Conference Group on Geriatrics Nursing Practice is became an expert on long term care nursing and administration.
recognized. DORIS SCHWARTZ (1917-1999) – started one of the 1st geriatric
1970 – ANA developed standards of geriatric nursing practice; First nurse practitioner programs at Cornell Medical College and
publication of standards for geriatric nursing practice. published some of the 1st gerontological nursing research. First
1973 – NANDA publishes the first list of nursing diagnoses; ANA nurse to receive funding from the National Institutes of Health.
certification in geriatric practice is offered. IRENE BURNSIDE (1924-2003) – pioneered therapeutic group
1975 - The JOURNAL OF GERONTOLOGICAL NURSING becomes work recognizing the value of reminiscence and life review for
the first professional nursing journal for gerontological nurses. older adult.
1981 – ANA publishes a statement on the scope of gerontological
nursing practice; National Conference of Gerontological THE PRACTICE OF GERONTOLOGICAL NURSING
Practitioners founded.
1984 – The Council of Gerontological Nursing is formed; The POTENTIAL ROLES FOR GERONTOLOGICAL NUIRSE
NGNA is formed.
1989 – ANA certification is established for gerontological nurse 1. Direct care provider
2. Independent practitioner
specialist.
3. Health educator
1993 – Approximately 12000 nurses are certified in gerontological
4. Researcher
nurse specialties.
5. Nursing faculty
2001- ANA publishes an updated Scope and Standards of
6. Consultant to community agencies
Gerontological Nursing
7. Provider of direct care and interventions
2004 – Terry Fulmer becomes the 1st nursing president of the 8. Clinical research coordinator
Gerontological Society of America. 9. Continuing education provider
10. Care manager/ case manager
PIONEERS IN GERONTOLOGICAL NURSING 11. Health planner
VIRGINIA STONE (1912-1993) – helped lead the ANA to develop 12. Administrator
standards of practice in gerontological nursing , as well as specialty
13. Counselor v Pathophsiology, epidemiology, treatment of chronic diseases,
14. Leader and the impact of disease processes and therapeutic regimens.
v Sign and symptoms of atypical manifestation of disease in older
individuals, as well as common geriatric syndromes.
ESSENTIAL FOUNDATION FOR THE PRACTICE OF
v Altered pharmacology of drugs in the older adult
GERONTOLOGICAL NURSING
v Approaches to health promotion, disease prevention, and risk
reduction in later life.
1. ASSUMPTIONS TO GUIDE GERONTOLOGICAL NURSING
v Current theory, research, and evidence for nursing intervention,
PRACTICE
and standards of care for the older adult.
Older individuals and their families can be viewed as open
3. SKILLS AND COMPETENCIES FOR GERONTOLOGICAL NURSING
system, capable of change, growth, and mutual interaction.
Older individuals are affected in unique ways by the
Interact effectively with individuals who have sensory and
combined effects of the aging process, disease processes, lifestyle,
cognitive loss.
and environment.
Perform comprehensive assessment of the older person
Older people are capable of making independent decisions,
using standardized tools and individualized approaches based on
unless some well-documented pathological process interferes with
level of nursing practice.
this ability.
Serve as a collaborative partner in interdisciplinary
Older adult are interested in learning more about health
teamwork.
and aging, with primary motivation of maintaining their
Implement rehabilitative and restorative nursing
independence.
techniques.
Older people have the potential to benefit from a wide
Help patient integrate past needs and meet developmental
variety of health services, if appropriately targeted. Nurses are not
needs
and should not be the sole providers of care but should function
Develop caring, collaborative relationships with the older
within an interdisciplinary team context.
person and family members in developing goals for nursing care,
even if the individual has significant communication or cognitive
impairment.
2. KNOWLEDGE BASE FOR GERONTOLOGICAL NURSING
Modify the environment to maximize the older person’s
v Physical, psychological, and social aspect of aging throughout
ability to function independently.
the life span; the resulting impact on the individual and family.
Provide excellent palliative, supportive, and spiritual care for
those who are dying.
Counsel the grieving.
Participate in professional quality improvements activities
designed to improve health care for older adults.
Teach professional care givers, and older adults about the
aging process, disease management, and health promotion.
Provide leadership by modeling appropriate care for older
patient.
Engage in life long learning activities to maintain up to date
knowledge.
4. POTENTIAL CONSEQUENCES OF NEGATIVE ATTITUDES
TOWARD AND STEREOTYPES OF AGING
q The needs of older adults are invisible
q Older people are presumed to be the opposite of lively and fun.
q People involved in facilitating elderly individuals are regarded as
being at the low end of the career pecking order.
q There is relatively little interest in understanding the strengths
and advantages of later years.
