Course Title: CARE OF THE CHRONICALLY ILL - Stereotypes are characteristics ascribed to groups of

AND THE OLDER PERSON people involving gender, race, national origin and
other factors.
◼ Course Description : It deals with the concepts, - Stereotyping is a form of prejudice that can form
principles and techniques of nursing care damaging images of people because of a particular
management of those with chronic illness and the characteristic without having any knowledge of the
older persons. person.
CARE OF THE CHRONICALLY ILL &
THE OLDER PERSON - What are some stereotypic characteristics of the
elderly that you have heard? Or believe?
A. Introduction to Aging
Dependent ?
• Definition of Terms: Frail ?
Poor ?
◼ Gerontology: Study of all aspects of aging and its
consequences. Lonely ?
Unreliable d/t memory loss ?
◼ Gerontologic Nursing: specialized nursing with Rigid; narrow-minded ?
knowledge of illness and health of the aging. Unable to learn ?
◼ Geragogy: practices & processes used in educational ◼ GERONTOPHOBIA
settings for older learners.
Unreasonable fear and/or irrational hatred of older
◼ Gerontology is the study of the aging process and people.
individuals as they grow from middle age through
later life. It includes: Ageism and Gerontophobia are outcomes of
modernization. It is likely that the increased emphasis
◼ The study of physical, mental, social on the negative and debilitative aspects of old age
changes in older people as they age. corresponds to a change in perception of the
usefulness of older people brought about by
◼ The investigation of the changes in society
urbanization & industrialization.
resulting from our aging population.
◼ 1-Chronic Illness
◼ The application of this knowledge to
policies and programs. ✓ Illnesses not caused by infectious agents but instead
are strongly related to lifestyles.
◼ Geriatrics is… The study of health and disease in later ✓ Long –lasting effects accompanied by irreversible
life. The comprehensive health care of older persons pathology.
and the well-being of their informal caregiver. ✓ It does not go away.
◼ Older Adult
◼ Chronic illnesses are those that are prolonged, do not
• Young Old 65-74 resolve spontaneously, and are rarely cured
• Middle Old 75-84 completely. Most chronic conditions may be viewed
• Old 85 & older as a trajectory with overlapping phases, in which an
• Presently: 12.8% of population individual move from a level of optimum functioning,
• 2030: will increase to 20% of population with the illness in good control, to a period of
instability in which they may need assistance.
◼ Aging is a developmental process that begins at
◼ Chronic diseases can limit a person's ability to
conception and ends at death. Is a multidisciplinary
perform daily activities, cause them to lose their
field.
independence, and result in the need for institutional
◼ This means that the study of aging combines or care, in-home caregivers, or other long-term services
integrates information from several separate areas of and supports.
study.
◼ The quality of life in chronic illnesses can vary with
o Biology age, especially for senior adults. Chronic conditions
o Sociology affect seniors' mobility and consequently their
o Psychology physical and functional status, emotional balance,
and self-esteem decline because of their dependence
◼ AGEISM on others.
Discrimination against persons of a certain age group. Characteristics of Chronic Illness as They Impact the
A tendency to regard older persons as debilitated, Social Work Role
unworthy of attention, or unsuitable for employment.
◼ Three important characteristics of chronic illnesses
◼ Accdg. To Robert Butler(1968) AGEISM – among older adults need to be considered as they
prejudices and stereotypes that are applied to older affect the social work role and function.
people on the basis of their age.
1. The trajectory for many serious illnesses has changed
◼ Ageism: when older adults are stereotyped. from an acute terminal course to a much longer chronic
period, with episodes of exacerbations and remissions
interspersed with extended periods of good functioning.
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 2. The trajectory of advanced chronic and terminal Cancer cells differ from normal cells in size, structure,
illnesses has changed from a relatively brief period to a function, and growth rate. These malignant cells lack the
longer period in which both curative and palliative normal controls of growth seen in healthy cells, and grow
treatments are combined. Research suggests that a long, uncontrollably. This uncontrolled growth allows the cancer
advanced chronic illness can be highly stressful for both cells to invade adjacent structures and then destroy surrounding
patients and their families. tissues and organs.

3. The increase in the total number of older people with DEMENTIA

advanced chronic and terminal illnesses will require more
curative and palliative care being provided in the home, Dementia is a symptom of a variety of specific
with greater reliance on provision by family members. structural brain diseases as well as several system
degenerations. Alzheimer's disease presently is the
Key Problem Areas Experienced By Patients With Chronic commonest cause in the developed world, causing a cortical-
Illness subcortical degeneration of ascending cholinergic neurons and
large pyramidal cells in the cerebral cortex.
What are some effects of a chronic illness?
STROKE
Chronic illnesses have disease-specific symptoms, but
may also bring invisible symptoms like pain, fatigue and Ischemic stroke is caused by deficient blood and
mood disorders. Pain and fatigue may become a frequent part oxygen supply to the brain due to a narrowed or blocked vein.;
of your daily life. hemorrhagic stroke is caused by bleeding or leaky blood
vessels. Ischemic occlusions contribute to around 85% of
What impact does chronic illness have on an individual and casualties in stroke patients, with the remainder due to
their families? intracerebral bleeding.
Most chronic diseases have similar effects on family Specific assessment focus and management of the above
members including psychological and emotional functioning, conditions
disruption of leisure activities, effect on interpersonal
relationships, and financial resources. Assessment for hypertension

◼ Review of the Pathophysiology of selected chronic The evaluation of hypertension involves

conditions: Heart Disease, Hypertension, Chronic accurately measuring the patient's blood pressure,
Obstructive Pulmonary Disease Diabetes, Cancer, performing a focused medical history and physical
Dementia, Stroke examination, and obtaining results of routine laboratory studies.
A 12-lead electrocardiogram should also be obtained.
HEART DISEASE
Management for hypertensive patients
Coronary artery disease is the most common form of
heart disease and the most common cause of heart failure. The First-line medications used in the treatment of
disease results from the buildup hypertension include diuretics, angiotensin-converting
enzyme (ACE) inhibitors or angiotensin receptor blockers
of fatty deposits in the arteries, which reduces blood flow and (ARBs), beta-blockers, and calcium channel blockers (CCBs).
can lead to heart attack. A heart attack occurs suddenly when a Some patients will require 2 or more antihypertensive
coronary artery becomes completely blocked. medications to achieve their BP target.
HYPERTENSION Assessments performed for a patient with COPD
The pathophysiology of hypertension involves the Tests may include:
impairment of renal pressure natriuresis, the feedback
system in which high blood pressure induces an increase in • Lung (pulmonary) function tests. These tests measure
sodium and water excretion by the kidney that leads to a the amount of air you can inhale and exhale, and
reduction of the blood pressure. whether your lungs deliver enough oxygen to your
blood.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE • Chest X-ray. A chest X-ray can show emphysema,
one of the main causes of COPD
The cardinal pathophysiologic feature of COPD
• CT scan.
is airflow limitation caused by airway narrowing and/or
• Arterial blood gas analysis.
obstruction, loss of elastic recoil, or both. • Laboratory tests.
For people with COPD, this starts with damage to the
airways and tiny air sacs in the lungs. Symptoms progress from How is COPD managed?
a a cough with mucus to difficulty breathing. The damage done ◼ Treatments include: stopping smoking – if you have
by COPD can't be undone. COPD and you smoke, this is the most important thing
DIABETES you can do.

The pathophysiology of diabetes is related to the ◼ inhalers and tablets – to help make breathing easier.
levels of insulin within the body, and the body's ability to ◼ pulmonary rehabilitation – a specialized program of
utilize insulin. There is a total lack of insulin in type 1 diabetes, exercise and education.
while in type 2 diabetes, the peripheral tissues resist the effects
of insulin. What should be the main focus of the management and
treatment of COPD?
CANCER

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 The goal of COPD management is to improve a ◼ National Institutes of Health Stroke Scale (NIHSS)
patient's functional status and quality of life by preserving
optimal lung function, improving symptoms, and preventing ◼ Cincinnati Prehospital Stroke Scale (CPSS)
the recurrence of exacerbations. ◼ Face Arm Speech Test (FAST)
Assessment for diabetes ◼ Los Angeles Prehospital Stroke Screen (LAPSS), and.
A diabetes-focused examination includes vital signs, Management of stroke
funduscopic examination, limited vascular and neurologic
examinations, and a foot assessment. Other organ systems ◼ An IV injection of recombinant tissue plasminogen
should be examined as indicated by the patient's clinical activator (tPA) — also called alteplase
situation (Activase) — is the gold standard treatment for
ischemic stroke. An injection of tPA is usually given
Diagnosis and diagnostic criteria through a vein in the arm with the first three hours.
1. If patient is symptomatic, check a random glucose. If greater Sometimes, tPA can be given up to 4.5 hours after
than 11.1 mmol/litre, a diagnosis of diabetes is confirmed. stroke symptoms started.

What is diabetes and its management? Health Education in Chronic Illness

Diabetes can affect almost every part of your body. Why is health education important for patients?
Therefore, you will need to manage your blood glucose levels, ◼ better understanding of treatment options, side effects
also called blood sugar. Managing your blood glucose, as well and toxicities.
as your blood pressure and cholesterol, can help prevent the
health problems that can occur when you have diabetes. ◼ improved self-advocacy and greater empowerment to
make decisions related to their care.
How do you assess a cancer patient?
◼ increased compliance with treatment regimens.
Imaging tests used in diagnosing cancer may include
a computerized tomography (CT) scan, bone scan, magnetic ◼ decreased treatment related complications.
resonance imaging (MRI), positron emission tomography
What is the first step in patient education?
(PET) scan, ultrasound and X-ray, among others.
✓ The FIRST STEP in patient education is the review
Biopsy. During a biopsy, your doctor collects a sample of cells
of the Admission Assessment for learning needs.
for testing in the laboratory.
Then meet with the patient to determine what are
What are the different management of cancer? specific needs for that patient.
✓ Individualized Teaching: Is based on the patient
The most common treatments are surgery, assessment, readiness to learn, and patient and family
chemotherapy, and radiation. Other options include targeted needs.
therapy, immunotherapy, laser, hormonal therapy, and others. ✓ Behavioral Management in Chronic Illness
✓ Coping interventions for powerlessness,
Surgery is a common treatment for many types of cancer. hopelessness, sensory deprivation, sleeplessness, etc.
✓ DAY 4 PRESENTATION BY AOBALAGAPO
The following procedures used to assess/ diagnose dementia: ✓ Social Support System and Family in Chronic Illness
✓ PHYSICAL AND STRUCTURAL
• Cognitive and neurological tests. These tests are used ENVIRONMENT FOR HOLISTIC CARE OF
to assess thinking and physical functioning. OLDER PERSON EDUQUE
• Brain scans. These tests can identify strokes, tumors, ✓ COMUNICATING WITH OLDER ADULTS BY
and other problems that can cause dementia MANAHAN
• Psychiatric evaluation
• Genetic tests ◼ Causes of Population Aging
• Blood test
1. Demographic Transition- the growth of populations
What is the management of dementia? over a long period of time is characterized by 3 stages:

◼ Medications. The following are used to temporarily 1. Pre-transition-main distinguishing feature is high birth
improve dementia symptoms. Cholinesterase and high death rates. High death rates mean people on average
inhibitors. These medications — including donepezil live shorter lives.
(Aricept), rivastigmine (Exelon) and galantamine
(Razadyne) — work by boosting levels of a chemical 2. Transition stage-decline in births and decline in deaths
messenger involved in memory and judgment.1 but not at an equal pace.

Management of dementia involves care for the - Deaths decline much faster than births, resulting in
cognitive changes, behavioral changes, functional changes, and explosive growth of the population.
emotional issues. It also involves the management of other 3. The Post-transition stage where there is again very low
illnesses in light of the dementia, consideration of the needs and growth in population numbers because both birth and death
well-being of the caregiver, and particular attention to advanced rates are equally low.
care planning.
Stage 1 & 2 characterize young population, Stage 3 describes
There are multiple scales that are commonly used worldwide in an old or aging population.
the assessment of stroke victims, including the four listed
below: Causes of Population Aging

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 ◼ 15-24 years: 19.1% (male 10,107,717/female
9,753,268)
Mortality Decline. While births have been decreasing,
improvements in the human condition have also resulted in ◼ 25-54 years: 36.6% (male 19,065,843/female
declining deaths. 18,941,091)

Advances in food production, in public health & in medical ◼ 55-64 years: 5.6% (male 2,663,592/female
sciences all combine to significantly decrease the risk of death 3,102,247)
especially among the young.
◼ 65 years and over: 4.3% (male 1,948,152/female
A. Factors that affect normal functioning of the older 2,564,841) (2012 est.)
persons
The age structure of a population affects a nation's key
Demographics of Aging socioeconomic issues.

◼ Projections in the year 2030 estimate that people aged - Countries with young populations (high percentage
65 years and older will represent about 20% of the under age 15) need to invest more in schools, while
population. countries with older populations (high percentage ages
65 and over) need to invest more in the health sector.
◼ Another recent demographic phenomenon that affects
health care is the disproportionate increase in the - The age structure can also be used to help predict
number of ”oldest old” in the US and in many potential political issues. For example, the rapid
industrialized societies. growth of a young adult population unable to find
Between 2015 and 2050 the proportion of the world’s employment can lead to unrest.
population over 60 years will nearly double 12 to 22%. The Types of Aging Changes
standards and scope of gerontological nursing practice is to
provide a specialist or generalist offering comprehensive ◼ Benign and superficial
nursing care to elderly people by combining the basic needs and
providing of nursing process systematically such as assessment, ✓ Graying hair
✓ Wrinkles
diagnosis, planning implementation and evaluation.
◼ Senescence
◼ Although the proportion of old to young people in the
- Progressive body system deterioration that can
US is partially influenced by diminishing birthrates,
increase the risk for mortality
the principal reasons for the recent surge in growth of
older population are a rising life expectancy and a ◼ Plastic
declining mortality rate.
- Modifiable changes that can be slowed by exercise,
◼ Drastic increases in the number of older adults in the good nutrition, and other elements of a healthy
United States will increase the need for health care. lifestyle.
◼ The scope of gerontology includes the study of the Types of Aging Changes
diseases associated with aging, and holistic health
management principles for the aged. -Reduced organ reserve

◼ The number of persons over age 60 is projected to -Homeostenosis

double worldwide in the next 50 years.
◼ Inability of body to restore homeostasis after
◼ Thirteen percent of the population of the United environmental changes.
States is aged 60 or over.
Types of Aging Changes
◼ Fertility trends are credited for having the greatest
Normal aging consists of those universal changes that
influence on the age structure in the 20th century.
occur in all older people.
◼ Since 1950, the majority of the older adult population
◼ Aging is associated with a loss of organ reserve or the
worldwide is female.
ability of an organ to react quickly and efficiently to
◼ The term feminization of later life refers to the physiological stress.
predominance of women in the older adult age groups.
◼ The organ systems of the body synthesize
◼ The increased likelihood of men to be exposed to risk efforts to maintain equilibrium. Homeostasis
factors such as tobacco, alcohol, and occupational refers to the maintenance of equilibrium of
hazards may negatively impact male life expectancy. temperature, acid–base balance, body
chemicals, and other vital life components.
◼ If women begin to incur similar exposures to the same Loss of organ reserve is known as
risk factors as their male counterparts, the gender gap homeostenosis.
may be reduced.

◼ In the Philippines,
Theories of Aging
Age structure:
◼ Theories of aging will support the framework of
◼ 0-14 years: 34.3% (male 18,175,763/female treatment and management of elderly people with
17,452,488) different disease and with different symptoms.
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Theories of aging fall into several groups, including: Somatic Mutation Theory- DNA changes result in physical
decline.
✓ Biological
✓ Psychological Stress Theory-causes structural & chemical changes thru the
✓ Developmental lifespan.
✓ Sociological
✓ Nursing theories Psychosocial Theories of Aging

◼ Most experts believe that a combination of genetic and Sociological aging theories
stochastic (random) events are responsible for aging. ◼ Focus on roles and relationships that occur later in
◼ Any single limited theory is insufficient. life

Biologic Theories ✓ Disengagement Theory

✓ Activity Theory
◼ Decades of ages the body system also becoming ✓ Continuity Theory
defective and can no longer recognize and attack
foreign invaders. There is totally change in the body Disengagement Theory- withdrawn, introspective, self-
system because degenerative of tissue and cell make focused – Older theory; not widely accepted.
slow down the immune system so it is easy to tear and Continuity theory -characteristics, values remain constant thru
break down the body. life… repeat behaviors that brought success in the past.
Biological ◼ The latter part of life is just a “continuation” of
Programmed theories/Genetic Theories the earlier life.
◼ Programmed Aging theory- genetics and heredity ◼ As we age we try to maintain or continue previous
responsible for how an individual ages habits, commitments, values, beliefs, preferences.
◼ Hypothesize that the body’s genetic codes contain
instructions for regulation of cellular reproduction and Activity /Developmental Task Theory- satisfaction depends
death. on involvement in new interests/activities or maintenance of
✓ Programmed Longevity high levels of functioning.
✓ Endocrine Theory
✓ Immunological Theory ✓ It is better to be active than inactive.
✓ It is better to be happy than unhappy.
Biological ✓ An older person is the best judge of his or her own
success.
◼ Error theories - This is physical and intellectual. Even with illness we
◼ Hypothesize that environmental assaults and the can remain active.
body’s constant need to make energy and fuel
metabolic activities cause toxic by- products
• Coping or adaptive strategies must occur for a person
✓ Wear and Tear Theory
to age successfully.
✓ Cross-Link Theory
✓ C. Jung’s Theory of Individualism
✓ Free Radical Theory
✓ E. Erickson’s Developmental Theory
✓ Somatic DNA Damage Theory
✓ R. Havighurst Activity Theory
✓ Emerging Biological Theories
Jung’s Theory of Individualism
Biological Theories of Aging
- A key focus of Jung’s theory is the impact of an
✓ Wear and Tear Theory
inability to accept past accomplishments and failures
- Suggests that organisms have fixed amounts of energy
to promote successful aging.
available, and that they will wear out on a scheduled
basis. Erickson’s theory of aging suggests that ineffective meeting
of the tasks of each stage of life will result in maladjustment.
✓ Cross-Linkage Theory- deterioration of organs/cells
causing decreased mobility ◼ Generativity versus Stagnation
- New collagen fibers become enmeshed with old fibers Erikson’s Theory (Tasks of Middle Adulthood)
creating a dense field that decreases the cells capacity
to transport nutrients. ✓ Establish and guide the next generation
✓ Accept middle-age changes (Adjust to the needs of
✓ Free Radical Theory aging parents)
✓ Reevaluate one’s goals and accomplishments
◼ Oxygen metabolism “free radicals”

◼ Damages cell membranes Ego Integrity versus Despair

◼ Lipofuscin- is a lipid and protein enriched pigmented ◼ INTEGRITY
material that has been found to accumulate in older
adults tissues, and is commonly called “age spots” ◼ DESPAIR

What are antioxidants? Havighurst - Activity theory

Vitamins C and E

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 - The process of aging is greatly facilitated when ◼ confusing after dark
older people pursue hobbies and relationships, and
generally lead a more active lifestyle. ✓ The 3 Ds:

◼ maintenance of social contacts & relationships… 1. Dementia - Severe cognitive loss & memory loss

◼ Successful aging = ability to be flexible adapt to the 2. Depression

changes associated with aging. 3. Delirium
◼ staying mentally and physically active will increase Theories about Sundowning
happiness among older adults.
Possible Causes for increasing confusion:
◼ Risk factors for chronic illness
✓ Person can’t see well in dimming light
◼ Risk factors such as smoking, high blood pressure, ✓ Hormone imbalances r/t biological clock
cholesterol, obesity, nutrition, overweight and ✓ Person tired at end of day; decreased coping
obesity, physical inactivity and diabetes are ✓ Restlessness because daytime activities are decreasing
common to many of these chronic diseases. Primary ✓ Caregivers communicate their own fatigue & stress to
prevention of even a few of these factors could result clients
in an increase in disability-free years and ultimately, a
reduction in health care costs. General Physiological Changes

Development Theories ✓ All systems decline in overall functioning

✓ Decreased physiological reserves
- In this theory, it indicates that the elderly people find
difficulty in adjusting or adapting to new social roles. ◼ illness…stress…risk for complex
Erikson and Havighurst, it is possible to identify the reactions…increased chance of
following developmental tasks for older adults: complications.
- Maintenance of self worth
✓ Modified pace & more frequent
- Conflict resolution
- rest periods
- Adjustment to the loss of dominant roles.
- Adjustment to the deaths of significant others. Integumentary Changes
- Environmental adaptation
- Maintenance of optimal levels of wellness ✓ Decreased skin elasticity-wrinkling
✓ Increased dryness
Sociologic Theories ✓ Thickened nails
✓ Thinning of hair (baldness)
◼ Sociologic theories of aging will help to predict and
✓ Decreased SQ fat
explain the social interaction and their role into the
society. The theory emphasizes the importance of Musculoskeletal Changes
environmental psychological factors in the
development and current functioning of the patient. ✓ Stiff joints & less flexibility
✓ Mobility slows & posture stoops
Nursing Theories ✓ Muscle mass, tone & strength decrease
✓ Bone demineralization- osteoporosis
◼ Miller has suggests that the nurse has to provide the
care which depend upon to the age wise and their Neurological Changes
problem. The nurse should understand the problematic
condition so the nurses are ready to alter the outcomes ✓ CNS responds slower
for patient through nursing interventions. Appropriate ✓ Rate of reflex response decreases
nursing innervations that have a positive impact on ✓ Sense of balance declines
patient outcomes for the elderly ✓ Night sleep shortens
✓ Temp. regulation & pain perception less efficient
◼ Myths and Realities of Aging
Special Senses Changes
◼ ASPECTS of Aging
✓ Diminished vision
Changes in the Older Person “Senior Moments” ✓ Night blindness
✓ Diminished hearing
✓ Cognitive Changes
✓ Decreased taste & smell
✓ Ability to perceive and understand one’s world
✓ Mild short term memory loss Cardiopulmonary Changes
✓ Long term memory remains intact
✓ Slower responses and reactions ✓ Blood vessels less elastic
✓ Fatty plaque deposits occur
Cognitive Changes – Abnormal Aging ✓ Cardiac reserve decreases
✓ Confusion ◼ body is less able to increase cardiac output
and heart rate with activity.
✓ Alzheimer’s disease
◼ Pulmonary elasticity & ciliary's action
◼ patchy area’s of the brain degenerate
decrease
✓ Sundowning syndrome
✓ Less efficient lung clearing
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 ✓ Increased resp. rate, diminished depth ✓ Annual Physicals
✓ Medications
Gastrointestinal Changes
Nursing Dx
✓ Digestive juices & nutrient absorption decrease
✓ Malnutrition & anemia common Nursing care of geriatric pt. Based on nursing dx:
✓ Decreased peristalsis resulting in constipation &
indigestion ✓ Risk for loneliness
✓ Decreased insulin and thyroid production ✓ Altered dentition
✓ Risk for falls
Dentition Changes ✓ Knowledge deficit
✓ Confusion
✓ Tooth decay continues ✓ Sexual dysfunction
✓ Missing teeth or ill fitting dentures effect eating habits ✓ Wandering
Genitourinary Summary
✓ Renal blood flow decreases ◼ Nurses have to provide care to an increasing geriatric
✓ Waste products excreted more slowly population.
✓ Fluid/Electrolyte balance is fragile
✓ Bladder capacity decreases 50% ◼ Geriatric patients have specific needs due to
✓ Hypertrophy of prostate gland physiological and cognitive changes.
✓ Atrophy, decreased secretions & thinning of female
genital tract ◼ Nursing care needs to be tailored to the those needs.
✓ Decreased estrogen and testosterone levels Listen to the aged………
Normal changes of aging For they will tell you about living and dying.
✓ Adjusting to Changes of Aging For they will enlighten you about problem-solving, sexuality,
✓ Rest more grief, sensory deprivation, and survival.
✓ Curtail driving
✓ Cane/walker for mobility For they will teach you how to be courageous, loving and
✓ Diet/nutritional changes generous.
✓ Ageism-prejudice vs the elderly
◼ What does it mean to “grow old gracefully”
Adjusting–Older Adult is making many psychosocial
What makes an individual grow old gracefully? It is the quality
adjustments
of coping with the struggles & crises. One comes out more on
✓ Retirement the gain side from having learned profitably from the trials &
✓ Reduced income challenges experienced. Struggles in life can either make us
✓ Spouse’s health grow gracefully or deter us from doing further in our growth &
✓ Social roles-need to feel valued needed and usefulness development.
continues . Can be difficult ..no longer employed…
“Grow old along with me! The best is yet to be. The last of
social isolation can be a problem.
life, for which the first was made”. - Browning
✓ Living arrangements-may need to move to a smaller
home, assisted living in with family. “Even the oldest tree some fruit may bear:
✓ Role reversal-family and friends may take on And as the evening twilight fades away, the sky is filled with
responsibilities once belonging to the aged. stars, invisible by day”. - Henry Wadsworth Longfellow
Common health problems

✓ Heart disease, cancer, stroke ECONOMIC & SOCIOCULTURAL IMPLICATIONS

✓ Poly-Pharmacy OF POPULATION AGING
✓ Accidents, falls
✓ Arthritis ◼ Objectives:
✓ Chronic illness
◼ Describe the economic implications of an
✓ Elder Abuse
aging population
Elder Abuse
◼ Describe the socio-cultural implications of an
✓ Any deliberate action or negligence that harms elderly aging population.
individuals:
- When can a person be considered old?
-physical
-sexual ◼ Culture may define one to be old, but the
-psychological concerns of older people are the same across
-emotional cultures.
-financial
◼ Concerns:
Role of the Nurse in Promoting Health: Teaching
◼ Issues of diminished earning
✓ Nutrition capacity and of increasing risks of
✓ Exercise having health problems.
✓ Immunizations
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 ◼ Changing roles in society, such as
grandparents assuming parental
roles in the lives of their
grandchildren.

◼ The economic and social implications derive from the

requirements of older people that must be addressed
by any society. When there is an increase in the
numbers and proportions of older people in the
society, there is an increase demand for services by a
sector that for the most part is no longer economically
active.

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