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Promoting Health in Older Adults Reynel Dan L. Galicinao
AGING normal process of time-related change, begins with birth and continues throughout life ,[object Object]
Subjectively: how a person feels
Functionally: changes in physical or mental capabilities,[object Object]
Categorizing the Aging Population
Care Settings for Elders
1. Acute Care Facilities Protect the health of the older adult and return to his/her previous level of independence ,[object Object]
ED
CCU,[object Object]
Intermediate care
Skilled care units
Alzheimer’s units,[object Object],[object Object]
Nurse-run clinics
Adult day care,[object Object]
1. Wear-and-Tear Theories Vital parts run down with time  -> aging  -> death The faster you live, the quicker you die ,[object Object],[object Object]
3. Free-radical Theory
4. Genetic Theories Organism is genetically programmed for a predetermined number of cell divisions, then organism dies
5. Cross-Linking Theories Irreversible aging of proteins (collagen)  -> failure of tissues & organs
6. Immunological Theories Immune system becomes less effective with age, resulting in reduced resistance to infection & diseases
PHYSIOLOGICAL AGING
A. Integumentary ↑skin dryness, pallor, fragility Progressive wrinkling & sagging of skin Brown “age spots” (lentigo senilis) ↓perspiration
Thinning & graying of scalp, pubic, axillary hair Slower nail growth; ↑ thickening & brittle Loss of SQ fat
Health Promotion Strategies Optimal nutrition Adequate hydration Lotion after bath
Avoid products with alcohol/perfume Assess frequency of bathing Sun screen lotions with SPF ≥ 15 Observe for skin changes & seek medical consultation
Wide-brimmed hat, sun visor, sunglasses No strong detergent to launder clothes
Avoid rough-textured clothing & highly starched linens ,[object Object],[object Object]
Health Promotion Strategies Pace teaching Encourage visitors with hospitalization
Enhance sensory stimulation With sudden confusion, look for cause
C. Musculoskeletal ↓ speed & power of muscle contractions Joint stiffness
Loss of ht (stature) -> kyphosis
Loss of bone mass -> osteoporosis -> pathologic fractures Impaired balance
Health Promotion Strategies Slow rising from a resting position Regular exercise
High-calcium diet Limit phosphorus intake Calcium & vitamin D supplements as prescribed
D. Sensory/Perceptual Loss of visual acuity ↑ sensitivity to glare; ↓ ability to adjust to darkness Arcus senilis Lens opacity (cataract)
Presbyopia Presbycusis ↓ sense of taste (sweet) ↓ sense of smell ,[object Object],[object Object]
Adequate indoor lighting with area lights and nightlights Large-print books Magnifier for reading
Avoid night driving Contrasting colors Avoid glare of shiny surfaces and direct sunlight Hearing examination Reduce background noise
Face person; enunciate clearly Speak with a low-pitched voice Use nonverbal cues Encourage use of lemon, spices, herbs
E. Pulmonary ↓ ability to expel foreign/accumulated matter ↓ lung expansion less effective exhalation ↓ vital capacity
↑ residual volume Difficult, short, heavy, rapid breathing (dyspnea) after intense exercise
Health Promotion Strategies Regular Exercise No smoking Adequate fluids to liquefy secretions
Yearly influenza immunizations Avoid exposure to URTI
F. Cardiovascular ↓ cardiac output & stroke volume (during ↑ activity) -> SOB on exertion & pooling of blood in extremities
↓ elasticity, ↑ rigidity of arteries ↑ diastolic & systolic BP Orthostatic hypotension
Health Promotion Strategies Regular exercise Pace activities ,[object Object]
Low-fat, low-salt diet ,[object Object]
G. Gastrointestinal ↓ salivation Delayed swallowing time ↑ tendency for  	indigestion & 	constipation
Health Promotion Strategies Small, frequent meals Ice chips, mouthwash Brush, floss,  	massage gums  	daily
Regular dental care Sit up and avoid heavy activity pc Limit antacids
High-fiber, low-fat diet Limit laxatives Toilet regularly Adequate fluids
H. Urinary ↓ filtering ability of the kidney; impaired renal function
Less effective concentration of urine Nocturnal frequency Retention of residual urine
Health Promotion Strategies Adequate fluid intake (8-10 glasses of non-caffeinated liquid) Avoid bladder-irritant foods (sugar, caffeine, alcohol, chocolate, artificial sweeteners, spicy & acidic food) Pelvic muscle exercise
I. Genitals
Health Promotion Strategies ,[object Object]
Provide privacy to promote intimacy,[object Object]
J. Immunological ↓ immune response; ↓ resistance to infections Poor response to immunization ↓ stress response
Health Promotion Strategies Avoid exposure to infection Up to date influenza, pneumonia immunizations
K. Endocrine ↑ insulin resistance ↓ thyroid function
Health Promotion Strategies Balance diet Regular exercise Ideal body wt Blood sugar test
Psychosocial Theories of Aging
1. Disengagement Theory Mutual withdrawal Reduces society’s pressure Reduces # of people whom elderly interacts
2. Activity Theory Best way to age:  ,[object Object],[object Object]
Psychosocial Aging
Erikson’s Psychosocial Stage Ego integrity vs. Despair
Peck’s Developmental Task of Aging
Retirement Can be a time when projects or recreational activities can be pursued Can be a difficult time of adjustment
Economic Change Adequate financial resources enable the older person to remain independent
Grandparenting Provide sense of continuity family heritage, rituals, folklore, support
Relocation Older client has many living options depending on income, health status, activity level, level of independence, family or other support systems
Maintaining Independence & Self-Esteem It is important for them to look after themselves even if they have to struggle to do so Encourage them to do as much as possible for themselves & maintain safety
“I’m getting so old that my friends in heaven will think I didn’t make it.”
Facing Death & Grieving Loss is an inevitable part of life; the longer a client lives, the more losses will be experienced.
The setting sun is as beautiful  as the rising sun. —Japanese proverb
Thank you! ☺

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Promoting health in older adults