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Healthy Aging


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refers to diseases associated with aging
By 2019, what percentage of the provincial population will be 65+?
What percentage of undergraduate student nurses indentify working with older adults as their first choice?
Older adults are becoming healthier & less likely to die from infection and disease. True or False
Chronic diseases are increasing. True or False
What percentage of seniors volunteer through group organizations?
What is a nurse specialist?
-education must be at the masters or doctoral level

All people can have good health and wellbeing even as they cope with impairments and health issues. True or False
6 Principles of Healthy Aging
1. Dignity (respect)
2. Self-fulfillment (opportunities)
3. Social Inclusion (accepted)
4. Independence
5. Safety & Security
6. Fairness (considered equal)

What are the 12 determinants of health?
1. Social Support Networks
2. Education
3. Biology & Genetic Endowment
4. Health Services
5. Employment & Working Conditions
6. Income & Social Status
7. Personal Health Practices & Coping Skills
8. Physical Environment
9. Social Envirnoment
10. Healthy Child development
11. Gender
12. Culture

What is Stochastic and what are the 3 theories associated with it?
Stochastic - suggest that aging events occur RANDOMLY and ACCUMULATE with time
1. Error Theory
2. Free Radical
3. Wear & Tear

What is the error theory?
aging as a result of accumulation of errors in DNA & RNA that eventually lead to cell failure
What is Free Radical Theory?
unpaired ions that exist momentarily and are highly reactive to molecules that can damage protein membranes, enzymes, and DNA which can attach to other molecules and damage them
What is the 'wear and tear' theory?
accumulation of repeated and random injury and overuse of cells, tissues, organs, or systems
What is Nonstochastic and what are the 3 theories associated with it?
Nonstochastic - consider aging to be predetermined
1. Programmed
2. Immunological
3. Neuroendocrine

What is the Programmed Theory?
aging as a result of inner biological clock
- each cell is "born" with a limited number of replications
What is the Immunological Theory?
over time there is an alteration of B & T cells that lead to the loss of cellular regulation. These "foreign" cells are attacked by antibodies causing them to die
What is the Neuroendocrine Control Theory?
aging as part of the life span program regulated by neuro-hormonal signals that begin at the time of fertilization until death
- common neurons in high brain centers act as pacemakers that regulate the biological clock during development and aging
What are 3 things that often get neglected with nursing care?
1. Mouth Care
2. Foot Care
3. Hair Care

What percentage of people 70+ have degenerative joint disease?
What are analgesics?
remedies that relieve pain
Smoking causes bladder cancer, especially in older men. True or False
Most problems with children are not age related issues from parents. True or False
True. (However, Down's Syndrome is an age-related problem)
What are psychosocial theories of aging and what are the associated 3 subtheories?
Psychosocial Theories - behaviouristic theroies of aging and determine how older adults most successfully experience later life
1. Disengagement Theory
2. Activity Theory
3. Continuity Theory

What is the Disengagement Theory?
-person "naturally" withdraws from society
- decreased interaction with others
- amount of disengagement is measured in terms of work

What is the Activity Theory?
- Old Age is an extension of middle age
- remaining as active as possible in middle age will lead to a more satisfactory old age
What is the Continuity Theory?
- focuses on the relationship between life satisfaction and role activity
- personality influences role activity
- personality influences life satisfaction

What are the major stress hormones?
Epinephrine & Norepinephrine
What are 3 major factors in sociological aging?
1. Environmental influences

2. Life Transitions
3. Social Support

What percentage of the older population are sedentary?
Almost 75%
What is a chronic illness?
the irresversible presence, accumulation, or latency of disease states or impairments
What are some examples of chronic illnesses?

affects persons ability to communicate
- usually occurs after a stroke
Alzheimer's disease is a type of dementia. True or False.
Effective listening:
- be still and quiet
- passively wait for the message to come to you
- listen with only the ears
- listen for only the words

the medical science dealing with disease, disabilities, and care of ethnic older adults
Cultural Sensitivity
be aware of your own values, beliefs, attitudes and predjudices
- keep an open mind
- do not judge
- listen
- respect differences

What are the 3 cultural belief systems?
1. Western or Biomedical
2. Personalistic or Magicoreligious
3. Naturalistic or Holistic

What is the Western/Biomedical System?
disease is believed to be the result of abnormalities in the structure and function of the body & systems often caused by germs
- assessment & diagnosis are directed at identifying the pathogen or problem causing the disease
- treatment is based on removing or destroying the invading organism or repairing or removing the afflicted body part

What is the Personalisitic/Magicoreligious System?
- illness is caused by the actions of the supernatural
- illness might be a punishment for wrongdoing
- treatment may consist of or include religious practices such as praying, meditating, fasting, wearing amulets, burning candles, or establishing alters

What is the Naturalistic/Holistic Health System?
- based on the concept of balance and stems from ancient civilizations of China, India, and Greece
- disturbance of this balance results in disharmony and subsequent illness
- diagnosis requires a determination of the type of imbalance
- herbs are often used in treatment

Falls are the leading cause of mobidity and mortality in people over the age of 65. True or False
Nearly half of all injuries among seniors take place at home. True or False
Instrumental Activities of Daily Living (IADL's)
- more complex and higher level functions include activites such as using the phone, transportation, paying bills, planning meals, and managing meds
Normal core body temperature
36-37 degrees C
First signs of hypothermia
Confusion & Disorientation
Risk factors of hyperthermia in the older adult
extremes in temp

What foods contain fiber?
whole grains
***helps decrease Coronary Artery Disease (CAD)

Which vitamins are especially important?
Vitamins A, B6, C, E
(intake is often inadequate)
Which mineral may be linked to dementia?
Folic Acid
What factors affect nutritional intake?
- lifelong eating habits
- socialization
- income
- housing
- transportation
- decrease in senses
- dental/oral health

What interventions can be implemented to enhance nutritional intake?
- eat with family/friends
- join group meal programs
- ask doctor if meds are causing appetite changes. If so, ask about changing meds
- add spices and herbs
- soft foods
- delivery of food from stores
- use coupons
- buy foods on sale or store brands
- get food stamps

The combination of lack of physical exercise and poor diet is the 2nd highest underlying cause of death in Canada. True or False
What is Keratosis?
Dry skin
What are the 6 subscales of the Braden Scale for assessing risks for pressure ulcers?
1. sensory perception
2. skin moisture
3. activity
4. mobility
5. friction & shearing
6. Nutritional status

Should foot care be done on dry or wet feet?
interaction between the drug and the body
the prescription, use, or administration of more medications than is clinically indicated
- mainly associated with lack of knowledge, forgetfulness, & multiple care providers
What is the "brown bag approach"?
- ask client to bring in ALL meds
- do not write down what is on the container. Ask the client how they take their meds
- ask about side effects
- where the meds are stored
- who manages the meds
- individuals knowledge about the meds

Nonpharmacological Interventions for promoting sleep
- regular bedtime and wake time
- avoid naps or keep them under 30 mins
- exercise at least 3 hours before bedtime
- limit caffiene, nicotine, and diuretics late in the day
- do not use alcohol to sleep
- wind down and relax
- do not watch the clock
- use the bed only for sleep and sexual activity

Pain is not a normal part of aging. True or False
What are Nonopioid Analgesics?
-Acetaminophen (Tylenol)-mild to moderate
-NSAIDS (Ibuprofen, Motrin)-pain for arthritis
What are Opioid Analgesics?
used for acute pain or cancer
- generally the 1st dose should be half the usual dose given to younger person and increase increments by 25%
- side effects: constipation, nausea, dizziness, sedation, falls, rash
- stool softeners are almost always used with opioids (start them early)

Impotence is not a normal part of aging. True or False
What are some approaches to inappropriate sexual behaviour?
- place resident in a setting away from male/female resident
- tell resident ahead of time what is expected
- involve family members
- council resident regarding natural sexual feelings and privacy
-avoid situations or activites that promote sexual activity
- communicate with staff interventions that have worked in the past

What are the phases of retirement?
- Remote phase

What are the 3 phases of retirement?
1. Pre-Retirement
- Remote Phase
- Near Phase
2. Retirement
- Honeymoon Phase
- Disenchantment Phase
3. Post-retirement
- Re-Orientation Phase
- Stability Phase
- Termination Phase

What is the remote phase of retirement?
rarely thinks about retiring but is aware that it is in the future
(pre-retirement phase)
What is the near phase of retirement?
individual plans and prepares for life after work
- may have fantasies of doing all the things they have never been able to do
(pre-retirement phase)

What is the honeymoon phase of retirement?
- feeling of euphoria & freedom
- generally high energy level
(retirement phase)

What is the disenchantment phase of retirement?
- experienced by most retirees
- cannot do all the things they previously planned
- may not adjust to freedom from work or lower income
- realization of losses associated with job

What is the re-orientation phase of retirement?
- a more realistic routine
- generally satisfactory and comfortable lifestyle
(post-retirement phase)

What is the stability phase of retirement?
- most of one's retirement is spent in this phase
- investment is made into meaningful, satisfying decision making and activities
(post-retirement phase)

What is the termination phase?
- sometimes the retiree returns to work
What are 5 key factors that affect the impact of loss?
1. Significance of the loss
2. Person's Coping Response
3. Impact of the Loss
4. Availability of Supports
5. Personal Values

What are common losses experienced by older adults?
1. Physical losses

What are some common losses experienced by older adults?
1. Physical Losses
- self-image
- lowered resistance to disease
- diminished control of bodily functions
2. Psychological Losses
- self-esteem
- victim of ageism
- relocation
- loss of feeling of contribution
3. Personal Network Losses
- spouse
- siblings or children
- friends
- pets
- work associates
4. Financial or Economic Losses
- diminished purchasing power such as:
- food
- meds
- clothing
- rent
- car/gas
- telephone

What is the suicide rate for people 65+?
12.4/100,000 people
What are the 5 Stages of Kubler-Ross Grief and Death Reactions?
1. Denial and Isolation
2. Anger
3. Bargaining
4. Depression
5. Acceptance


What are some strategies to help individuals who are grieving?
- allow time to grieve
- help the person express their feelings
- encourage reminiscence
- secure religious support if desired
- give direction and support
- be alert for suicide ideation
- encourage family involvement

Nursing interventions for individuals who are lonely.
- explore the nature of the lonliness
- guide the client in reviewing life experiences related to loneliness to gain insight
- spend time with the person (frequent breif periods)
- let them know you are available
- suggest the person get a pet
- assist the person in keeping in contact with people important to him/her

illness caused by medical examination or treatment
- falls
- dehydration
- medication reactions
- incontinence
- pressure ulcers

What is an informal caregiver?
- an unpaid, unprofessional caregiver
- most informal care comes from family members
- usually women, ~57 years old, married

What are 4 types of elder abuse?
1. Physical Abuse
2. Emotional Abuse
3. Material Abuse
4. Sexual Abuse

What are 4 theories relative to abuse and neglect?
1. Social Learning Theory
2. Personality Disorders of Caregiver
3. Stressed Caregiver
4. Isolation of the Older Adult

What does palliative care focus on?
What are the 6 C's approach to maximizing quality of life for an individual who is dying?
1. Care
2. Control
3. Composure
4. Communication
5. Continuity
6. Closure

How to care for family members of a loved one who is dying.
- keep them informed
- ask how they are doing
- put an arm around them
- bring them food
- know their name
- cry with them
- tell them to hold the client's hand while they are dying
- get the chaplain
- let them take care of their loved one

When is a person considered incompetent?
when the courts have declared them incompetent AND the person is unable to understand the consequences of his or her actions
What is legal competence based upon?
a physician's or other health care professional's assessment
Powers of Attorney
legal document where the older adult appoints another individual to act on their own behalf
- appointed by the court
- individual, agency, or corporation that has control of an incompetent person
Do-Not-Resuscitate (DNR)
- specific order of a person's wishes to not receive CPR
- written by physician which gives direction not to perform CPR

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