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Theories of Aging
NURS 4100 Care of the Older Adult Spring 2014Joy A. Shepard, PhD(c), MSN, RN, CNE, BC
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Objectives Discuss the change in focus regarding
learning about factors influencing aging List the major biological theories of aging Describe the major psychosocial theories
of aging Identify factors that promote a healthy
aging process Describe implications of theories of aging
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Definitions Aging – Process of growing older that begins at
birth Compression of morbidity – Healthy old age,
followed by rapid decline & death (“Health Span”)
Homeostasis - The regulation of bodily functions within precise limits in order to maintain ideal bodily function
Homeostenosis - The decline of the body's ability to maintain homeostasis as a result of decreased organ function in old age
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Definitions Life expectancy –
Expected years of life from birth
Maximum life span – Maximum possible length of life
Senescence (old age) – Point in time when age-associated functional deficits are manifested
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Mystery of Aging Goal of
everlasting youth
Aging as a complex process
Highly individualized process
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Lifestyle Lift infomercialGlaring example of a youth-driven and youth-obsessed culture
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Who Has More Value?
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Focus of Research on Aging
Better understanding of aging process: Healthier lifestyles Postponement of
negative consequences
Healthy & active Understanding
factors that influence health and well-being
“Successful aging” Avoiding disease &
disability Maintaining mental
& physical function Continuing
engagement with life
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The Aging Process The aging process is
multifactorial, includes: Benign changes, such as
graying hair Nonbenign changes,
such as senescence Individualized aging
progression Modifiable changes
related to lifestyle Normal or universal
aging processes
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The Aging Process Senescence:
progressive deterioration of body systems
Characterized by failure to maintain homeostasis under conditions of physiological stress (homeostenosis)
Decreased viability, increased vulnerability of individual
Normal aging includes Loss of organ reserves
resulting in decreased response to physiological stress
Variations among individuals
Chronologic & biological aging, which are not synonymous
Organ system changes
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Aging: Many Interrelating Factors, Causes
No single factor, theory
Heredity, nutrition, health status, life experiences, environment, activity, & stress
Aging is highly individualized
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Theories of aging include biological, psychological, sociological, and spiritual aging
**Important: No single known factor causes or prevents aging; no one theory can explain the complexities of aging**
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Biological Theories of Aging
“FATE” – Internal (Nonstochastic) Program theories of aging (Genetic)
Genetically programmed events cause cellular damage that accelerates aging of the organism
“CHANCE” – External (Stochastic) Error Theories (Environmental)
Random events cause cellular damage that accumulates as organism ages
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Programmed Theories Programmed Longevity
Genetic clock (Hayflick limit) Human genome
Neuroendocrine & Neurochemical Theories
Immunological/ Autoimmune Theory Changes in immune function with aging Diminishing of thymus, impaired
immunologic function
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Error Theories of Aging Cross-Linking Theory
Loss of flexibility, diminished functional motility
Wear & Tear Theory Effects of stress Stress causes
structural & chemical changes resulting in irreversible tissue damage
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Error Theories of Aging Free Radical Theory
Oxygen radicals, antioxidants Lipofuscin Nutrition theory
Somatic Mutation (DNA Damage) Theory Radiation Theories
Decreased function & efficiency of cells & organs
Solar elastosis – “old age” type of skin wrinkling
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Solar Elastosis: Chronic Exposure to Solar Radiation (UV)
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Lipofuscin
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Question Which of the following statements
best describes the autoimmune theory of aging? A. Genetic programs determine life expectancy B. Cells undergo change and the body identifies
them as foreign C. Organs decline as a result of cellular
mutations D. Failure of the production of a growth
substance causes aging cells to die
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Question Is the following statement true or
false?
The genetic theories of aging best describe how and why a person ages
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Identical Twins (Age 52)
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Identical Twins (Age 61)
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Aging Disease: Progeria
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Psychosocial Theories of Aging
Disengagement theory
Activity theory Continuity
theory Developmental
tasks Erik Erikson
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Sociological Theories of Aging
Social & Psychological Models: Dynamic interplay betweens gains & losses Disengagement Theory
As individuals age, they inevitably withdraw from society Society withdraws from them Separation mutually agreed upon
Activity Theory Continue middle-age lifestyle; deny existence of old age Life satisfaction: involvement in new interests, hobbies,
roles, and relationships Volunteering: one way retirees stay connected to
community
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Sociological Theories of Aging
Continuity Theory – Values &
personality Goals & individual
characteristics Psychological
patterns Successful
adaptive strategies Values, morals, &
behaviors
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Question Is the following statement true or
false?
The continuity theory of aging states that personality and basic patterns of behavior are said to remain unchanged as the individual ages.
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Developmental: Erickson Final Stage - Integrity vs. Despair
Development – Process of natural growth, differentiation, or change
Old Age (after age 65) - Reflecting back on life Successful in accomplishments – Feel sense of
integrity Few regrets, satisfaction Attain wisdom, even when confronting death “Only when we are so old, only, we are aware of
the beauty of life.” Alice Herz Sommer, age 106 Unsuccessful - Feel life was wasted, many regrets
Bitterness, despair, depression, anger
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Developmental Challenges Associated with Aging
Certain developmental challenges bring opportunities for older people to experience feelings of success, loss
Social relationships, roles Retirement
Coping with loss Death of a loved one
Living arrangements Loss of independence
Financial challenges Fixed income
The strengths of each individual (including past coping skills) must be identified & utilized when planning care
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Opportunities for Older People to Experience Feelings of Success
Gaining insight or wisdom, self-understanding, self-acceptance
Deepening gratitude & appreciation Gaining new knowledge & experiences Developing better social skills, coping
ability Enhancing creativity & confidence Developing new skills, hobbies, &
interests
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Opportunities for Older People to Experience Feelings of Success
Civic & community positions of responsibility Seeing children transform into responsible,
successful adults Becoming a grandparent Renewing & deepening one’s relationship
with one’s spouse, significant others, or friends
Accepting & adjusting to physical changes associated with aging
Pursuing spiritual interests
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Opportunities for Older People to Experience Feelings of Success
Older adults often assume new roles, such as grandparents, as they mature
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More Challenging Developmental Tasks
Death of a spouse Major declines in health or physical ability
Physiologic changes may result in losses, causing impairments in communication, vision & learning, mobility, cognition, or psychosocial skills
Loss of social role, prestige, occupation, income
Loss of independent living Accepting a fixed income
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Erikson Question Which of the following best reflects Erikson’s
description of the old age task of reconciling ego integrity with despair?
A. 75-year-old woman who is insecure and has developed a general attitude of mistrust concerning the world.
B. 77-year-old man who fears death as he struggles to find purpose in his life, reflecting upon his experiences and failures.
C. 78-year-old woman who has unresolved feelings of inadequacy and inferiority, which shows in her relationships with friends and acquaintances.
D. 80-year-old man who has not been successful in finding deep intimacy and satisfying relationships and now feels isolated.
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Implications of Theories of Aging
No single theory can adequately explain aging process
Knowledge of all theories: guide nursing interventions to promote health and longevity
Sensitivity to the impact of attitudes toward aging on patients themselves
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Interesting Quotation… Do You Agree?
“Aging is a self-fulfilling prophecy. If we dread growing old, thinking of it as a time of forgetfulness and physical deterioration, then it so likely to be just that. On the other hand, if we expect it to be full of energy and anticipate that our lives will be rich with new adventures and insight, then that is the likely reality. We prescribe who we are. We prescribe what we are to become” (Bortz, 1990, p. 55).
Bortz, W. (1990). Use it or lose it. Runner’s World, 25, 55-58.
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“Blue Zones” of Longevity
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