Foundations of

Gerontology
ASW426
MR NJOVU
ASSIGNMENTS

• Elaborate ways in which a Social Work Practitioner can

utilise indigenous and traditional support systems in the
welfare of Older Persons in the context of Zimbabwe.
• OR
• Come up with a concept note seeking for funding to
address the psychosocial needs of Older Persons.

• (DUE DATE: 4 OCTOBER)

ESSAY REQUIREMENTS

• New Times Roman

• Font size 12
• Full justification
• Use APA STYLE of referencing 7th ed
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• What is aging?
• Ageing or aging is the process of becoming older.
• At the biological level, ageing results from the impact of the
accumulation of a wide variety of molecular and cellular
damage over time (WHO, 2022).
• This leads to a gradual decrease in physical and mental
capacity, a growing risk of disease and ultimately death.
• These changes are neither linear nor consistent, and they
are only loosely associated with a person’s age in years.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• Aging is associated with changes in dynamic biological,

physiological, environmental, psychological, behavioural,
and social processes (National Institute of Aging, 2022).
• Some age-related changes are benign, such as graying hair.
• Others result in declines in function of the senses and
activities of daily life and increased susceptibility to and
frequency of disease, frailty, or disability.
• In fact, advancing age is the major risk factor for a number
of chronic diseases in humans.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD
• Aging is ultimately a combination of physiological changes in our bodies and
the environmental factors we are exposed to.
• While the latter is often beyond our control, some environmental factors are
modifiable and may influence the course of aging.
• Types of Aging:
• Cellular Aging
• A cell can replicate about 50 times before the genetic material is no longer
able to be copied accurately.
• This replication failure is referred to as cellular senescence during which the
cell loses its functional characteristics.
• The accumulation of senescent cells is the hallmark of cellular aging, which in
turn translates to biological aging.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• Hormonal Aging
• Hormones play a huge role in aging, especially during
childhood when they help build bones and muscles and
facilitate the development of secondary male or female
characteristics.
• Over time, the output of many hormones will begin to
diminish, leading to changes in the skin (such as wrinkles
and the loss of elasticity) and a loss of muscle tone, bone
density, and sex drive.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• Accumulative Damage
• Aging caused by accumulative damage (i.e., "wear and
tear") is about the external factors that can build up over
time. Exposure to toxins, UV radiation, unhealthy foods, and
pollution can just some of the things that can take a toll on
the body.
• Over time, these external factors can directly damage DNA
in cells (in part by exposing them to excessive or persistent
inflammation). The accumulated damage can undermine
the body's ability to repair itself, promoting rapid aging.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• Metabolic Aging
• As you go about your day, your cells are constantly turning
food into energy, which produces byproducts—some of
which can be harmful to the body. The process of
metabolization, while essential, can cause progressive
damage to cells, a phenomenon referred to as
metabolic aging.
• Some experts believe that slowing down the metabolic
process through practices such as calorie restriction may
slow aging in humans.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• The diversity seen in older age is not random.

• Beyond biological changes, ageing is often associated with other
life transitions such as retirement, relocation to more appropriate
housing and the death of friends and partners.
• Common health conditions associated with ageing:
• Common conditions in older age include hearing loss, cataracts and
refractive errors, back and neck pain and osteoarthritis, chronic
obstructive pulmonary disease, diabetes, depression and dementia.
• As people age, they are more likely to experience several
conditions at the same time.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD
• Older age is also characterized by the emergence of several complex
health states commonly called geriatric syndromes.
• They are often the consequence of multiple underlying factors and
include frailty, urinary incontinence, falls, delirium and pressure ulcers.
• Factors influencing healthy ageing:
• Evidence suggests that the proportion of life in good health has
remained broadly constant, implying that the additional years are in
poor health.
• If people can experience these extra years of life in good health and if
they live in a supportive environment, their ability to do the things
they value will be little different from that of a younger person.
INTRODUCTION TO AGING AND
OLDER ADULTHOOD

• Evidence suggests that the proportion of life in good health

has remained broadly constant, implying that the additional
years are in poor health.
• If people can experience these extra years of life in good
health and if they live in a supportive environment, their
ability to do the things they value will be little different
from that of a younger person.
• If these added years are dominated by declines in physical
and mental capacity, the implications for older people and
for society are more negative.
What is Gerontology?

• Gerontology is the study of the physical aspects of aging, as well as the mental,
social and societal implications of aging (Southern New Hampshire University,
2022).
• Gerontology can be a rewarding field, allowing you to practice a range of skills to
improve the health of older adults.
• As a gerontologist, you will apply a mix of biological and psychological practices
to the study of aging.
• There are also opportunities to research and improve the policies and
technology intended to protect and help older adults heal.
• The skills you learn as a gerontologist are going to be needed even more in the
future.
• Life expectancy has increased dramatically in recent decades, ensuring that the
need for gerontologists will increase.
What is Gerontology?

• Gerontology is the study of aging processes and individuals

across the life course.
• It includes:
• The study of physical, mental, and social changes in people
as they age;
• The investigation of changes in society resulting from our
aging population; and
• The application of this knowledge to policies and programs.
What are Geriatrics?

• Geriatrics refers to medical care for older adults, an age

group that is not easy to define precisely (Moore, 2020).
• The branch of medicine that focuses on the elderly,
specifically health and wellness through the prevention and
treatment of disability and disease.
• Geriatricians are primary care doctors who have additional
specialized training in treating older patients
Group exercise

• Get into groups of five

• Identify any legislative instrument in that focuses on Older
Persons..
• Focus on one clause or section In the instrument.
• Identify its strengths and weaknesses
Theories of aging

• These attempt to explain the phenomenon of aging as it

occurs over the lifespan

• Aging is viewed as a total process that begins at conception

• Senescence: a change in the behaviour of an organism with age
leading to a decreased power of survival and adjustment.
Theories of Aging: Types

• Biological

• Sociological

• Psychological

• Moral/Spiritual
Biologic Theories:

• Concerned with answering basic questions regarding the

physiological processes that occur in all living organisms as
they chronologically age.
Foci of Biological Theories

• Explanations of:
• 1) deleterious effects leading to decreasing function of the organism

• 2) gradually occurring age-related changes that are progressive over time

• 3) intrinsic changes that can affect all member of a species because of

chronologic age
• ALSO:
• all organs in any one organism do not age at the same rate

• any single organ does not necessarily age at the same rate in difference
individuals of the same species
Biologic Theories: Divisions

• Stochastic: Explain aging as events that occur randomly

and accumulate over time
• Nonstochastic: View aging as certain predetermined, timed
phenomena
Stochastic Theories

• Error Theory Free Radical Theory

• Cross-Linkage Theory

• Wear & Tear Theory

Error Theory

• Originally proposed in 1963

• Basis: 1)errors can occur in the transcription in any step of the
protein synthesis of DNA
• 2) error causes the reproduction of an enzyme or protein that is not an exact
copy
• 3) As transcription errors to occur, the end product would not even resemble
the original cell, thereby compromising its functional ability
• More recently the theory has not been supported by research
• not all aged cells contain altered or misspecified proteins

• nor is aging automatically or necessarily accelerated if misspecified proteins

or enzymes are introduced into a cell
Free Radical Theory

• Free radicals are byproducts of metabolism--can increase as a

result of environmental pollutants
• When they accumulate, they damage cell membrane, decreasing
its efficiency
• The body produces antioxidants that scavenge the free radicals
• In animal studies, administration of antioxidants postpones the
appearance of diseases such as cardiovascular disease and CA
• Free radicals are also implicated in the development of plaques
associated with Alzheimer’s
Cross-Linkage Theory

• Some proteins in the body become cross-linked, thereby

not allowing for normal metabolic activities
• Waste products accumulate
• Result: tissues do not function at optimal efficiency
• Some research supports a combination of exercise and
dietary restrictions in helping to inhibit the cross-linkage
process
Wear & Tear Theory

• Proposed first in 1882

• Cells simply wear out over time because of continued use--
rather like a machine
• Would seem to be refuted by the fact that exercise in OA’s
actually makes them MORE functional, not less
• Nonstochastic Theories:

• Programmed Theory

• Immunity Theory
Programmed (Hayflick Limit) Theory

• Based on lab experiments on fetal fibroblastic cells and

their reproductive capabilities in 1961
• Cells can only reproduce themselves a limited number of
times.
• Life expectancies are seen as preprogrammed within a
species-specific range
Immunity Theory

• Immunosenescence: Age-related functional diminution of the immune

system
• Lower rate of T-lymphocyte (“killer cells”) proliferation in response to a
stimulus
• & therefore a decrease in the body’s defense against foreign
pathogens
• Change include a decrease in humoral immune response, often
predisposing older adults to:
• 1)decreased resistance to a tumor cell challenge and the development of cancer
• 2) decreased ability to initiate the immune process and mobilize defenses in
aggressively attaching pathogens
• 3) increased susceptibility to auto-immune diseases
EMERGING THEORIES OF AGING

• Neuroendocrine Control (Pacemaker) Theory

• Metabolic Theory/Caloric Restriction

• DNA-Related Research
Neuroendocrine Control

• “…examines the interrelated role of the neurologic and

endocrine systems over the life-span of an individual”. (p.
24)
• there is a decline, or even cessation, in many of the
components of the neuroendocrine system over the
lifespan
• Research has shown
• 1) the female reproductive system is controlled by the
hypothalamus. What are the mechanisms that trigger changes?
• 2) adrenal glands’ DHEA hormone
• 3) melatonin (from pineal gland)--a regulator of biologic rhythms
and a powerful antioxidant. Declines sharply from just after puberty
Metobolic Theory of Aging (Caloric
Restriction)

• “…proposes that all organisms have a finite amount of

metabolic lifetime and that organisms with a higher
metabolic rate have a shorter lifespan”. (p. 24)
• Rodent-based research has demonstrated that caloric
restriction increases the lifespan and delays the onset of
age-dependent diseases
SOCIOLOGIC THEORIES OF AGING

• Disengagement Theory
• Activity/Developmental Task Theory
• Continuity Theory
• Age Stratification Theory
• Person-Environment Fit Theory
• Changing FOCUS of Sociological considerations of aging:
• 60’s focus on losses and adaptation to them
• 70’s broader global, societal, and structural factors influencing lives
of OA’s
• 80’s-90’s exploration of interrelationships between OA’s and their
physical, political, environmental & socioeconomic mileau
Disengagement Theory

• Cumming & Henry--1961

• Aging seen as a developmental task in and of itself, with its
own norms & appropriate patterns of behavior
• “appropriate” behavior patterns involved a mutual
agreement between OA’s and society on a reciprocal
withdrawal.
• No longer supported
Activity Theory (Developmental Task
Theory)

• Havighurst, Neugarten, Tobin ~1963

• “Activity is viewed by this theory as necessary to maintain a
person’s life satisfaction and a positive self-concept”. (p.27)
• Theory based on assumptions:
• 1) it’s better to be active than inactive

• 2) it is better to be happy than unhappy

• 3) an older individual is the best judge of his or her own success in

achieving the first two assumptions
Continuity Theory

• How a person has been throughout life is how that person

will continue through the remainder of life
• Old age is not a separate phase of life, but rather a
continuation and thus an integral component
Age Stratification Theory

• Riley--1985
• Society consists of groups of cohorts that age collectively
• The people & Roles in these cohorts change & influence
each other, as does society at large
• Thus, there is a high degree of interdependence between
older adults & society
Person-Environment Fit Theory

• Lawton, 1982
• Individuals have personal competencies that assist in dealing with
the environment:
• ego strength
• level of motor skills
• individual biologic health
• cognitive & sensory-perceptual capacities
• As a person ages, there may be changes in competencies & these
changes alter the ability to interrelate with the environment
• Significant implications in a society that is characterized by
constantly changing technology
PSYCHOLOGIC THEORIES OF AGING

• Maslow’s Hierarchy of Human Needs

• Jung’s Theory of Individualism

• Erikson’s Eight Stages of Life

• Peck’s Expansion of Erikson’s Theory

• Selective Optimization with Compensation
Maslow’s Hierarchy of Human Needs

• Maslow--1954
• “…each individual has an innate internal hierarchy of needs that motivates all
human behaviors”. (p. 29
• depicted as a pyramid; the ideal is to achieve self-actualization, having met all
the “lower” level needs successful,
• “Maslow’s fully developed, self-actualized person displays high levels of all of
the following characteristics: perception of reality; acceptance of self, others,
and nature; spontaneity; problem-solving ability; self-direction; detachment and
the desire for primacy; freshness of peak experiences; identification with other
human beings;
• satisfying and changing relationships with other people; a democratic character
structure; creativity; and a sense of values.
• Only about 1% of us are truly ideal self-actualized persons
Jung’s Theory of Individualism

• Carl Jung--1960
• origins are Freudian
• Self-realization is the goal of personality development
• as individual ages, each is capable of transforming into a
more spiritual being
Erikson’s Eight Stages of Life

• 1993
• Stages throughout the life course. Each represents a crisis to be
resolved.
• For OA’s:
• 40 to 65 (middle adulthood): generativity versus self-absorption or stagnation
• 65 to death (older adulthood): ego integrity versus despair
• “Self-absorbed adults will be preoccupied with their personal well-being
and material gains. Preoccupation with self leads to stagnation of life”
• “Unsuccessful resolution of the last crisis may result in a sense of
despair in which individuals view life as a series of misfortunes,
disappointments, and failures”. (p.30)
Peck’s Expansion of Erikson’s Theory

• Erikson’s last two stages are expanded to 7

• The final three of the developmental tasks for old age:
• ego differentiation versus work role preoccupation
• body transcendence versus body preoccupation
• ego transcendence versus ego preoccupation
AGING AND SENSATION

• As you age, the way your senses (hearing, vision, taste, smell, touch)
give you information about the world changes. Your senses become
less sharp, and this can make it harder for you to notice details.
• Sensory changes can affect your lifestyle. You may have problems
communicating, enjoying activities, and staying involved with people.
Sensory changes can lead to isolation.
• Your senses receive information from your environment. This
information can be in the form of sound, light, smells, tastes, and
touch. Sensory information is converted into nerve signals that are
carried to the brain. There, the signals are turned into meaningful
sensations.
AGING AND SENSATION

• A certain amount of stimulation is required before you

become aware of a sensation. This minimum level of
sensation is called the threshold. Aging raises this
threshold. You need more stimulation to be aware of the
sensation.
• Aging can affect all of the senses, but usually hearing and
vision are most affected. Devices such as glasses and
hearing aids, or lifestyle changes can improve your ability
to hear and see.
AGING AND SENSATION

• What to expect over time: As you get older, it's harder to see in
dim light. "That's because your pupils naturally shrink with age, so
they can't let in as much light,” Bednarczyk explains. In fact, by age
60, your pupils may be only one-third of the size they were when you
were 20.
• In addition, the lens in your eyes loses elasticity. This makes it harder
to focus close up — a blurriness that typically begins in your 40s.
(Hence, the need for reading glasses.)
• Several vision-robbing conditions also disproportionately affect older
adults, including cataracts; glaucoma; and diseases that damage the
retina, such as age-related macular degeneration — a leading cause
of vision loss in people over age 50.
Memory loss

• The brain is capable of producing new brain cells at any

age, so significant memory loss is not an inevitable result
of aging.
• But just as it is with muscle strength, you have to use it or
lose it. Your lifestyle, habits, and daily activities have a
huge impact on the health of your brain.
• Whatever your age, there are
many ways you can improve your cognitive skills, prevent
memory loss, and protect your grey matter.
Normal forgetfulness vs. dementia

• For most people, occasional lapses in short-term memory are a

normal part of the aging process, not a warning sign of serious
mental deterioration or the onset of Alzheimer's or another
dementia.
• The following types of memory lapses are normal among older
adults and generally are not considered warning signs of
dementia:
• Occasionally forgetting where you left things you use regularly,
such as glasses or keys.
• Forgetting names of acquaintances or blocking one memory with a
similar one, such as calling a grandson by your son's name.
Spirituality and Aging

Spirituality has many meanings.

Root-words (Hebrew, Latin and Greek): wind, breath, or air
which gives life.
• Other word associations: Inspiration,
meaning, beliefs and values, nature,
connection, transcendent, purpose,
journey, pilgrimage.
Spirituality and Aging

• “Spirituality is that which allows a person to experience

transcendent meaning in life…whatever beliefs and values
give a person a sense of meaning and purpose in life.”
Spirituality: Relationship to
Person/Patient-Centered Care

• Need to understand the person who has the disease and

not merely the disease that the person has.
• Spirituality is integral to the care of the whole person. It is
grounded in person/patient-centered care.
• Interdisciplinary team approach.
• Grounded in the biopsychosocial model of care.
Spirituality: Relationship to
Person/Patient-Centered Care
Settings of Care: Spiritual Advisors

Know who is available for spiritual support in all care settings

-- from the home to the nursing home.
Chaplains, clergy, pastoral care, or other spiritual leaders.
• Chaplains: generic term that refers to any clergy or
qualified layperson who assists patients, families and staff
in addressing spiritual/religious needs.
• Exist in hospitals, prisons, military, mental health institutes.
• May come from any religious tradition, they may be
certified.
When to Refer to Chaplains

Grief Isolation
Major Change Difficult Ethical Issues
Desire for Comfort Desire for Rituals
Decision-Making Desire for “Sacred
Stress & Distress
Community Clergy/Community Support

• Can be vital resource for home settings.

• Often have the big picture of the older adult and their practical
situation.

• Support groups may offer support -i.e. breast cancer, grief, Alcoholics
Anonymous.

• May not have a degree.

• May have congregational health ministry, faith community nurse, and

parish nurse activities.
Interventions of Spiritual Care:
Overlap with Cultural/Psychosocial Care

• Creative/expressive arts
• Story/Spiritual Reminiscence
• Music
• Presence/listening/empathy
• Humour