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45 Cards in this Set
- Front
- Back
Gerontology
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- Study of aging/the aged
- Several subfields e.g. financial, social, geropsych, geropharm, etc. |
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Geriatrics
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- Generic term relating to the aged but specifically refers to medical care of the aged
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Gerontological Nursing
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Refers to the application of skills to promote health, wellness; foster independence
- Involves nurses advocating for the health of older persons at all levels of prevention |
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Defining Gero Nursing Practice
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- Foster independence of older adults across continuum of care
- Interdisciplinary and holistic - Roles: Provider of care, manager, teacher, advocate, research consumer - Scope and standards of practice (use E-B practice) - Responsibility to educate the older adult about wats to decrease risk of certain disorders such as heart disease, CA, and CVA - Promote best interests and strengthen autonomy and decision making |
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Where do you see stereotypes of the aged?
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- TV, media, newspapers, film, commercials, magazines, greeting/birthday cards
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Ageism
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- Stereotyping/discriminating against people because they are old
- Prejudice against or in favor of an age group |
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Age-bias in Health Care
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Older adults:
- Get less aggressive treatments - Not seen as "candidates" for health promotion programs - Often excluded from health studies - Reduced care/inadequate treatment due to assumption that an ailment occurs as a natural process of aging |
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Therapeutic Nihilism
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Belief that many "cures" do more harm than good; idea that body will heal itself by doing nothing
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Stereotypes are Health Hazards
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- Results in poorer physiological/functional performance
- Negative self-perceptions associated with mortality |
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Characteristics of the Baby Boomers
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- Born 1946-1964
- Entering senior years between 2008-2030 - Diverse group - Becoming less alike/less homogeneity - Better educated - Higher incomes - More tech savvy - More physically fit - Informed consumers, independent |
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Race/ethnicity Aging Trends
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- Older population in the U.S. is growing more racially and ethnically diverse
- Minority will make up 22% of the population in the next 20 years - Losses are often encountered in aging, coupled with low socioeconomic status and lifetime racial discriminations -- high risk for poor outcomes |
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Chronic Disease (Co-morbidity)
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- Prevalence of chronic diseases increases with age
- Women: HTN, asthma, chronic bronchitis, arthritis Men: HD, CA, DM, emphysema |
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Sensory Impairments
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- More frequent with aging
- Early detection can prevent/postpone physical, social and emotional effects that these changes have - About 48% of men and 35% of women have visual impairments |
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What is successful aging?
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- #1 goal is remaining independent
- Active engagement with life/high functional development |
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Secrets of Aging: Protective Factors
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- No smoking/drinking
- Exercise - Moderate weight - Education - Low BP - Stable marriage - Mature defenses (as perspectives change, maturity increases defenses against stress |
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Sociological Theories
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- Study of society and people
- Changing roles, relationship status and generational cohort - Impacts older adult's ability to adapt |
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Sociological Theory: Subculture
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- Elderly prefer to segregate from society in an aging subculture sharing loss of status and societal negativity to the aged
- Health and mobility are key determinants |
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Sociological Theory: Continuity
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- Personality influences roles and life satisfaction and remains consistent through life. Past coping patterns recur as older adults adjust to physical, financial, and social decline.
- Identifying with one's age group, finding a residence compatible with limitations and learning new roles post-retirement are major tasks |
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Sociological Theory: Person-Environment Fit
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- Function is affected by ego, strength, mobility, health, cognition, sensory perception, and the environment.
- Competency changes ones ability to adapt to environmental demands |
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Sociological Theory: Age Stratification
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- Society is stratified by age groups that are the basis for acquiring resources, roles, status and deference from others
- Age cohorts are influenced by similar experiences, beliefs, attitudes and expectations of life course transitions |
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Gerotranscendance
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Proposes that aging individuals undergo a cognitive transformation from a materialistic, rational perspective toward oneness with the universe
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Psychological Theories
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- Characterized by life transitions and stages
- Explains aging by mental processes, emotions, attitudes, motivation and personality development |
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Psychological Theory: Life Course
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- Stages are predictable and structured by roles relationships, values and goals
- Persons adapt to changing roles and relationships - Age group norms/characteristics are an important part of Life Course |
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Psychological Theory: Developmental
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- Personality develops in 8 stages with corresponding life tasks
- Last phase, 'integrity vs. despair' is characterized by evaluating life accomplishments and includes letting go, accepting care, detachment, and physical/mental decline (Erikson) |
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Psychological Theory: Basic Human Needs
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- Motivates human behavior in a lifelong process toward need-fulfillment (Maslow)
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Biological Theories: Stochastic Theories
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- "Error Theory"
- Random events cause cellular damage that accumulates as organism ages |
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Stochastic Theory: Wear and Tear
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- Cells wear out and cannot function with aging
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Stochastic Theory: Free Radical Theory
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- Membranes, nucleic acids, and proteins are damaged by free radicals which causes cellular injury and aging
- H2SO4 - Aging due to oxidative metabolism and effects of free radicals |
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Stochastic Theory: Genotoxic Stress
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- Cells accumulate genetic damage to the mitochondria and due to free radicals and the loss of self-replication
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Biologic Theories: Nonstochastic Theories
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- "Apoptosis!"
- Programmed death perspective - Based on genetically programmed events caused by cellular damage that accelerates aging of the organism |
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Nonstochastic Theories: Gene Theory
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- Cells have a genetic programmed aging code
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Nonstochastic Theories: Programmed Longevity
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- Cells divide until they are no longer able to; this triggers apoptosis/cell death
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Nonstochastic Theories: Neuroendocrine
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- Problems with the Hippocampus-Pituitary-Endocrine Gland Feedback System causes disease; increased insulin and GF increase aging
- Decline in the immune system overtime |
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Nonstochastic Theories: Immune
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- Programmed decline in immune system leads to increased vulnerability to infection, disease, aging and eventually death
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Hayflick's Theory/Limit
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- Set # of times that a cell can replicated
- Ex. One liver cell can ONLY create X-# of liver cells |
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Telomeres and Cell Senescence
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- Telomeres = end caps of chromosomes
- Cell knows when to stop dividing and undergo apoptosis - Basically, telomere shortens with each cell division until you are left with free ends - Free ends allows chromosomes to fuse together/translocate - Ex. P53 (dysfunction) leads to cancer |
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Immunological Senescence
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- Stem cels are within out immune system; different regeneration properties
- Reduced B-cells and T-cells; but normal macrophages and granulocytes |
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Nursing Theories of Aging: Functional consequences theory
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- Environmental and biopsychosocial consequences impact functioning
- Nursing's role is to minimize age-associated disability in order to enhance safety and quality of living |
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Nursing Theories of Aging: Theory of thriving
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- Failure to thrive results from a discord between the individual and his or her environment or relationships
- Nurses identify and modify factors that contribute to disharmony among these elements - Change/maximize the environment; minimize age-associated problems |
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Functional Assessment
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- ADLs
- IADLs - AADLs - Physical performance measures |
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Functional Assessment: Grip Strength
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- Poor grip strength is associated with a higher rate of mortality
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Percent of Medicare beneficiaries reporting difficulty with IADLs or ADLs
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- Number of people reporting ADL deficiencies pretty much peaks in the 75s
- Decreases with aging |
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Social Assessment
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- Critical to holistic development
- Social support (e.g. family, friends, neighbors) - Living arrangements - Resources - Insurance - Medicare vs. medicaid as well as insurance status - Finances - Independence vs. need for assistance - Potential for isolation |
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Spiritual Assessment
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- Myth: You becomre more spiritual with age
- Spirituality, religion, worship practices, religious artifacts, spiritual leader/advisor - Check for signs of spiritual distress - See that patient's needs are met! - Make adequate referrals! |
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Cognitive Assessment
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- Foundation for early disease detection!
- Identify specific pathological conditions - Determine patient's ability to follow directions, retain instructions, express self clearly, and make decisions |