NCM 114 – Care for Older Adults Myth: The elderly do not pull their own weight.

MODULE 1  Fact: Older adults contribute greatly to society

Cross Cultural Caring ; Principles & Theories in the by supporting the arts, doing volunteer work,
Care of Older Adult and helping with grandchildren
 Fact: Paid employment is not the only measure
DEFINITION OF TERMS of value and productivity and older adults
 Geriatrics – a term associated with the medical continue to work into advanced old age.
care of older adults
o Gerontology – is a multidisciplinary & Myth: “It’s too late now to change my bad habits.
specialized area within various disciplines The horse is out of the barn.”
such as nursing, psychology and social  Fact: The risk of heart disease begins to fall as
work. soon as the elderly quit smoking
o Geriatric nursing - focuses on the care of  Fact: Exercise dramatically increases physical
the sick elderly fitness, muscle size, and strength in older adults.
o Gerontologic Nursing – includes not only
the care of a sick elderly but also health Myth: Older adults have no interest in sex
maintenance, prevention of illness and the  Fact: Although sexual activity does decrease in
promotion of quality life to assist the person some older adults, there are tremendous
to grow to an ideal state of life and well- differences. Most often, the human need
being. affection, physical contact continues throughout
life
Ageism is a stereotyping and discriminating against
individual or groups on the basis of aging. CARE OF THE OLDER PERSON
Categories of Aging:
Coined by Robert Neil Butler to describe discrimination  60 to 74 – Young old age
against older person.  75 to 84 – Old age
 85 - 100 – Old-old age
MYTHS OF AGING:
 Over 100 – Centenarians
Myth: Being Old, being Sick
 Fact: Only 5 % of older adults are frail enough
to require long-term care facilities
 Fact:: Most elder adults have chronic diseases
but function quite well.

Myth: Older Adults are set on their ways and can’t

learn new things
 Fact: Older Adults learn new things and should
be challenged to stay mentally active.
 Fact: Older adults who engage in challenging  Based on the statics female outlive males older
activities to keep their minds active are less adults.
likely to get set in their ways and are even less  In the Philippines, the # of older people is
likely to develop Alzheimer’s disease. increasing rapidly, faster than the growth of the
total population.
Myth: Health Promotion is wasted on Older Adults  The World Population Prospect 2019 - projects
 Fact: It is never too late to begin good lifestyle that in 2050, older people will make up around
habits such as eating a healthy diet and engaging 16.5% of the total population.
in exercise  The growing number of persons older than 65
 Fact: Although it may not be possible to reverse years of age impacts the health & social service
all the damage, it is never too late to stop bad agencies and health care providers.
habits such as smoking cigarettes or drinking too  Impact of baby boomers (people born between
much alcohol and enjoy better health outcomes. 1946 and 1964) - these people are well-
informed consumers of health care & will desire
a highly active role in their care
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  It will also have an impact on the government,  It’s also customary in Korea to have a big
the source of payment for many of the services celebration to mark an individual’s 60th and
older adults need. 70th birthdays. The hwan-gap, or 60th birthday,
 The older population has higher rates of is a joyous time when children celebrate their
hospitalization, surgery, and physician visits. parents’ passage into old age.

IMPLICATIONS OF AN AGING POPULATION In China

 The aging population demand for health  Chinese families traditionally view filial piety
services. and respect for one’s elders as the highest virtue,
 The aging family..... deriving from the Confucian tradition.
 Older parents are expected to have limited  “Placing your parents in retirement homes will
input into the lives of their older children. see you labelled as uncaring or a bad son,”
 Many grandparents care for their  “To abandon one’s family is considered deeply
grandchildren while parents are at work. dishonourable.”
 Older adults may enjoy independence &  However, this tradition is beginning to break
freedom from responsibilities that nuclear down in China, due to the country’s one-child
family life offers. policy, rising life expectancy and an aging
 Children are not required to meet the needs population.
of the aging parents for financial support,  Nursing homes are beginning to become a more
health services or housing. socially acceptable option for elderly care.

ETHINICITY – Regard for Elders In Western In Japan

cultures  The elderly are generally treated with the utmost
 The elderly are commonly removed from the respect.
community and relegated to hospitals and  Many Japanese families have several
nursing homes — aging can become a shameful generations living under one roof – one of the
experience. reasons for longevity
 Physical signs of human aging tend to be  There are more elderly citizens than young
regarded with distaste, and aging is often people in Japan
depicted in a negative light in popular culture if  Many Japanese live to be well over 100 years
it is even depicted at all. old.
 Some reasons attributed to the longevity include:
U.K. and U.S. o Strong community bonds
 elderly citizens live "lonely lives separated from o Plenty of exercises
their children and lifelong friends." o Healthy, low-fat diet
 As their health deteriorates, the elderly in these o Low-stress way of life
cultures often move to retirement communities,
assisted living facilities, and nursing homes. ( In ancient Rome
Anthropologist Jared Diamond)  Elders were a precious resource.
 Though the average life expectancy in ancient
In Greek and Greek-American culture Rome was around 25, some individuals did live
 Old age is honoured and celebrated, and respect into their 70s, and they were generally respected
for elders is central to the family. for their wisdom and experience.
 In many tribal communities, elders are respected  Older individuals had to earn that high status of
for their wisdom and life experiences. respect by living a virtuous life.
 Within Native American families, it’s common  The old were expected to act with moderation
for the elders to be expected to pass down their and dignity, at all times. The old had to be an
learnings to younger members of the family. example to the young, as it was thought the
young learned by example. This was ingrained
In Korea in Roman society.
 Younger members of the family have a duty to
care for the aging members of the family.
 Outside the family unit, Koreans are socialized
to respect and show deference to older
individuals as well as authority figures
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In India THEORIES of AGING
 Many Indians live in joint family units, with the 1. Biological /Physiological Aging Theory
elders acting as the head of the household. 2. Wear And Tear Theory
 The elders are supported by the younger 3. Somatic Theory
members of the family and they, in turn, play a 4. The Law Of Entropy Theory
key role in raising their grandchildren. 5. Nutrient-Deprivation Theroy
 Advice is always sought from them on a range 6. Cross-linking Theory
of issues, from investment of family money to 7. Rate of Living theory
traditional wedding rituals and intra-family 8. Free Radical Theory
conflicts. 9. Accumulative Waste Theory
 Their word is final in settling disputes. 10. Autoimmune Theory
 The elderly are often the most religious and 11. Error Theory
charitable members of the family.”
 Disrespecting the elders of the family or sending BIOLOGICAL /PHYSIOLOGICAL AGING
them to an old-age home has a social stigma in THEORY
India  deterioration theory
 body systems as used overtime “wear out "thus
In the Philippines they can no longer function correctly.
 Filipinos treat elders with the utmost respect.  CAUSES:
 The reason why there are only 13 nursing homes  Exposure to radiation, toxins, UV light.
in the 7,107 islands of the country is that we  The effect of body functioning
want them to age in their own homes.  Free radical produced by body metabolism
 There are programs that attend to the social,  Irreparable cellular system. Ex. Effects of
emotional, mental, physical, occupational, and radiation
recreational needs of the elder.
WEAR & TEAR THEORY
IMPLICATIONS OF CROSS-CULTURAL  Proposes that the human body wears out due to
CARING FOR GERONTOLOGICAL NURSING & use and time.
HEALTHY AGEING  Parts of the body such as cell and tissue
 An overview of culture & aging, as well as eventually wear out due from repeated use
strategies that Gerontological nurse can use to  Strategies to adapt to WEAR & TEAR
best respond to the changing face of aging, THEORY:
thereby promoting healthy ageing thus reducing  Be aware of stressors & emotional &
inequities physical reaction:
o Understand more about stress itself
LEARN Model – a tool of cultural assessment in o Determine how the body respond to
which the Gerontological nurse works with Elderly stress & find solution

SOMATIC THEORY
L – Listen carefully to what the elder is saying. And to  From the time of conception, body cells in our
the non verbal communication.
genes continue to reproduce. As cells divide,
there is a chance that some genes will be copied
E – Explain your perception of the situation & the incorrectly (mutation) à causes problems in the
problem. body’s functioning related to aging.

A – Acknowledge & discuss similarities and differences THE LAW OF ENTROPY THEORY
between your perception and goal’s and those with the  Entropy is the measure of disorder or
elders. randomness in a system such as the human body.
 The Law on Entropy
R- Recommend a plan that takes perspectives into  A system involving spontaneous process left to
account. itself, it inevitably deteriorates with time until its
state of disorder reaches a maximum (death)
 Entropy increases as the # of cells and the total
N – Negotiate a plan that is mutually acceptable. energy with in the body increased. (Kittle 1969).

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THE RELATIONSHIP OF ENTROPY TO THE RATE OF LIVING THEORY
CHARACTERISTICS OF A SPONTANEOUS Proposes that
PHYSICAL SYSTEM  Organisms with higher metabolic rate may
 Decay – a system will decay faster if insufficient actually live longer than a person with lower
work from the outside world is applied to the metabolic rate (SOHAL 1986),
system  Two Distinct Factors believed to govern
 Deteriorates – a soft system deteriorates length of life:
(worsen) faster than a hard one 1. A genetically determined metabolic
 Particles – addition of more particles increase potential.
entropy of the system. 2. Rate of metabolism.
 Complexity – increasing the complexity of a  Ways to Boost Metabolism:
system results in larger entropy.  Drink a lot of water
 Time – passage of time causes system entropy to  Do physical activities such as lifting and
increase automatically unless adequate standing activity.
reventropy is supplied  Get enough sleep.
 Random Activities – entropy increases, the
degree of random activities within the system FREE RADICAL THEORY
 System Entropy – if the system entropy  this theory proposes that accumulation of
increases the energy becomes less available for oxidative damage causes functional deterioration
useful work.  Invoke molecular damage caused by free
oxygen- derived free radicals: Reactive Oxygen
species (ROS) and reactive nitrogen species
WAYS TO REDUCE BODY DECAY (RNS).
 Physical – developing routine of aerobic and  Original Free Radical Theory ROS (Reactive
muscle building exercises . Oxygen Species) are irrelevant in a certain
 Mental – brain needs to be stimulated & stressed situations. Oxidative damage by ROS represents
on a regular basis. only a subtotal of damage.
 Nutritional – minimize food intake & to select  When it gives rise to accumulation, it gives rise
food of low caloric value. to accumulation of waste product (Accumulative
Waste Theory).
 Relaxation – allow to remove the entropy
 Modified Free Radical Theory- explains that
created during a normal day’s activities
there are hermetic effects for free radical theory:
 Mild radical effects
NUTRIENT - DEPRIVATION THEORY
 vascular changes in aging deprives cells of  reversible molecular stress
nutrients and oxygen  increase longevity.
 Severe radical effects
CROSS – LINKING THEORY  irreversible molecular damage
 Accumulation of crossed-linked proteins  decrease longevity
damages cells &tissues , slowing down bodily  Ways to slow Down the damage:
processes resulting in aging in which certain  Eating more antioxidant foods.
proteins in human cells interact randomly and  Cutting Calorie intake
produce molecules that get linked in such a way
as to make the body stiffer. ACCUMULATIVE WASTE THEORY
 These binding of glucose to protein cause  The by products and damaged mitochondria,
replicative damage or related decline in protein resulting from molecule oxidation accumulate in
turnover linked to loss of functioning proteins the non-dividing cells causing dysfunction,
further promoting age associated pathologies toxicity, aging and cell death.
 Examples:  Mechanism of Waste accumulation that
 Cataract- stiffening of eye senses affects cell:
 Wrinkles cross linking of protein collagen  Changes in the structural organization of the
 Researchers believe that if the concentration of cells causing delay In cellular functions and
sugar is high, then cross linking occurs. metabolic functions.
 What to do?  Accumulation of waste materials within the
 Keep the sugar level from spiking cell worsen the damage due to toxicity.

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 Non-dividing cells are more susceptible than 6. Adaptation theory - adaptation involves
the dividing cells’ careful tuning of functions at every level for
 Mechanisms for Damage repair: bodily integration ---à absence of the
1. Autophagy –cellular & proteins within the required adaptive genomic information à
cells undergo breakdown are recycled for aging
making a new protein and organelles 7. PSYCHOSOCIAL AGING THEORY
 How to Increase Autophagy: 8. Disengagement theory
 Intermittent fasting 9. Activity theory
 Acknowledge- know your trigger 10. Continuity theory
 Exercise 11. PSYCHOSOCIAL AGING THEORY
 Certain drugs & supplements 12. Disengagement theory
13. Activity theory
AUTOIMMUNE THEORY 14. Continuity theory
 proposes that decrease in immune function may
enhance immune response
 causing the body to produce antibodies that
attacks itself.
 As immune system age it becomes harder to
distinguish themselves from foreign cells.
 In conclusion infectious diseases are prevalent in
elderly when compared to its counterparts.
 The elderly are frequently present with
respiratory and urinary infections and usually
with poor prognosis. (Cunha et al, 2020)
 Coping Strategies:
 Eat healthy diet Practice stress
management
 Exercise regularly
 Sleep – practice sleep hygiene

ERROR THEORY
 the cellular cant function normally causing
cellular breakdowns, deterioration, and
eventually death in the host.
 The structure of DNA is altered as people age.
 Due to alteration DNA cannot read correctly
resulting to translation and transcription
malfunction aging / illness/ cancer directly or
indirectly.
 Genetic Therapy Technique:
1. Killing of specific cells – the aim is to insert
DNA into the diseased cell causing the
selected cell to die.
2. Gene augmentation Therapy – stops the
cell from producing functioning products.
3. Gene Inhibition Therapy = introduction of
gene that inhibits expression of another gene
as in infectious disease and cancer.
4. PHYSIOLOGICAL AGING THEORY
5. Stress theory –effects of environmental
stressors (generation of free radicals à
disrupts DNA & CHON function à aging