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Multidisciplinary Perspective on Aging, Exams of Nursing

Chamberlain College of NursingNursing

A comprehensive overview of the multidisciplinary perspective on aging, covering various aspects such as normal aging, population shifts, theories of aging, the impact of aging on physical, cognitive, and mental health, and the challenges faced by the elderly. It delves into topics like vision and hearing changes, mobility issues, the young-old, old-old, and oldest-old populations, social institutions and policies, rituals and rites of passage, theories like disengagement theory and activity theory, the impact of leisure time and disposable income, spirituality and religion, senescence, telomeres, compression of morbidity, immune-related diseases, malnutrition, obesity, exercise, sleep, sexuality, cognitive changes, and depression in the elderly. The document serves as a valuable resource for understanding the multifaceted nature of the aging process and the various factors that influence it.

Typology: Exams

2023/2024

Available from 08/08/2024

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HCAD 222 MULTIDISCIPLIARY PERSPECTIVE
OF AGING EXAM 1. 2024/2025 PREDICTION
QUESTIONS
"Normal Aging" -vision, hearing, mobility
Vision:
-Begin mid-life, stabilizes at 70-80
-Then further changes--> 95% >70 yrs--> cataracts or other vision problems
-To compensate: Increase illumination, reduce glare, Use large, clear visual images, Increase contrast.
Hearing:
-Begin midlife, mild to 60-70
-Reduced ability to hear low intensity and high frequency sounds. Ex. "Thats the wrong way" vs. "thats
the long way"
-To improve communication: Raising voice does not help, Lower pitch and speak slowly, Rephrase the
sentence, Avoid background noise, Face-to-face facilitates lip reading
Mobility:
-Combined functions of cardiovascular, respiratory, and musculoskeletal systems.
-Common threats: arthritis, strokes, pulmonary disease
-Interventions to come with impairments: Identify alternative or adaptive ways of accomplishing
activities of daily living (ADL's)
Cohort
Refers to people who were born at the same time and thus share similar life experiences
Senior population changes/trends
-Our generation will live longer but will have less babies
-Birth control
-Better healthcare system
-New advances in technology
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HCAD 222 MULTIDISCIPLIARY PERSPECTIVE

OF AGING EXAM 1. 2024/2025 PREDICTION

QUESTIONS

"Normal Aging" - vision, hearing, mobility Vision:

  • Begin mid-life, stabilizes at 70- 80
  • Then further changes--> 95% >70 yrs--> cataracts or other vision problems
  • To compensate: Increase illumination, reduce glare, Use large, clear visual images, Increase contrast. Hearing:
  • Begin midlife, mild to 60- 70
  • Reduced ability to hear low intensity and high frequency sounds. Ex. "Thats the wrong way" vs. "thats the long way"
  • To improve communication: Raising voice does not help, Lower pitch and speak slowly, Rephrase the sentence, Avoid background noise, Face-to-face facilitates lip reading Mobility:
  • Combined functions of cardiovascular, respiratory, and musculoskeletal systems.
  • Common threats: arthritis, strokes, pulmonary disease
  • Interventions to come with impairments: Identify alternative or adaptive ways of accomplishing activities of daily living (ADL's) Cohort Refers to people who were born at the same time and thus share similar life experiences Senior population changes/trends
  • Our generation will live longer but will have less babies
  • Birth control
  • Better healthcare system
  • New advances in technology

Population Shift

  • Lower fertility rate
  • Increased life expectancy
  • Graying of the baby boomers Young-old, Old-old, Oldest-old Young old: 65- 74 Old-old:75- 84 Oldest-old: 85+ Influences on the life course Social institutions and policies:
  • Order and predictability or dependency on the system
  • Time and the life course
  • "Successful aging" Rituals/Rites of passage Ceremonies that mark important transitional periods in a persons life. Usually involve ritual activities and teachings designed to strip individuals of their original roles and prepare them for new ones. Ex. Confirmation, Graduating, Drivers License, Job, Marriage, Children/Grandchildren Modernization Theory The view that nations can be placed on a continuum from least developed to most developed, according to such indicators as the level of industrialization or the degree of urbanization, with those exhibiting certain qualities of social structure termed modern; basic premise is that the aged were revered in the past and that modernization has caused the status of the aged to decline. Continuity Theory A more formal elaboration of activity theory; uses a life course perspective to define normal aging and to distinguish it from pathological aging. Carrying on leisure activities and religious Free radical theory View that free radicals contribute to the aging process by forming age pigment and by producing cross- links
  • Multidimensional disengagement
  • Church offers multiple roles for fulfillment
  • Positive effects on well-being
  • Religion habits remain stable, increased spirituality and faith as people search for meaning
  • Religion helps older people by: Reducing impact of stress, providing sense of order, offering social networks and strengthening psychological resources. Life Satisfaction How satisfied/happy are you with your life Those with high levels of activity (physical, spiritual, mental) commitment have higher levels of life satisfaction. Senescene vs aging Aging is the process of becoming older or more mature while senescence is the stats or process of aging, especially in humans, old age Telomeres
  • Essential part of the human cells that affect how our cells age
  • Caps at the end of each DNA strand that protect our chromosomes. Free radicals- how to combat?
  • Toxic byproducts of normal cell metabolism
  • Causes mutations, or damage to cell membranes, cross-linking ect.
  • Suspected link to many chronic diseases: Parkinson's, cancer, stroke, heart disease, arthrisis Antioxidants-Why beneficial? For what? Antioxidants neutralize the cells ex. Lemon juice on a cut apple Hayflick Limit
  • Max number of cell divisions, cells from older organisms have fewer cell divisions Compression of morbidity The theory that improvements in health care and prevention will compress the years that an individual will be disabled into the last few years of the life span Immune decline
  • Immune system protects by distinguishing between "self" and "non-self"
  • Response is why we experience sympotoms such as fever, redness, swelling, pus, pain.
  • Immune-related diseases: Autoimmune, MS, Lupis, IBD, AIDS, cancer
  • Declines immunity with age: weaker t-cells, Thymus shrinks, T helper cells:fewer, less effective, aberrant, Mucosal antibodies decrease.
  • Bad news: Higher risk of infections, disease, cancer, autoimmune disease
  • Good news: Produce less IgE---> "outgrow" allergies Longevity
  • Some "longevity assurance" genes detected
  • Longevity is like a polygenic trait
  • 10,000+ genes have been associated with specific diseases do far Epigenetics How to modify the expression of genes Malnutrition in seniors Over and under nourishment is problematic. Factors contribution to malnutrition: Swallowing, dental issues, resources, unfamiliar food, isolation, sensory changes, transportation Obesity & Seniors
  • Decrease cancer risk: lung, laryngeal, esophageal, oral, pancreatic, bladder and cervical cancers "Flight or fight" response Response of the sympathetic nervous system to a stressful event, preparing the body to fight or flee. Stress: Sympathetic N.S. Relax: Parasympathetic N.S. Healthier ways of coping with stress
  • Relaxation strategies: Diaphragmatic breathing, progressive muscle relaxation, neuromuscular exercise, visualization/imagery, massage
  • Support network
  • Eliminate stressors
  • Change cognitions/reactions
  • Take a break! Aging/Health impacts on sexuality
  • Relationships aspects of sexuality become more important
  • A second "peak" once "empty nest" Intimacy/relationships Women: menopause Men: increased time to arousal, shorter duration, erectile dysfunction Ways to compensate? Health conditions that affect sexuality Medications, surgery, traumas, illness (cancer, vascular system, neurological conditions), chronic pain, incontinence

STD's/HIV 50+

  • 50+ has the fastest growing HIV rates
  • Gender ratios
  • Cohort differences Privacy Caregivers should consider giving privacy to elders in LTC or assisted-living who are sexually active. Issues with sex in the nursing home
  • Cognitive ability
  • Autonomy resident rights
  • Physical space
  • Staff attitudes
  • Safety risks, including STD's Crystallized vs. fluid intelligence While fluid intelligence involved out current ability to reason and deal with complex information around us, crystallized intelligence involves learning, knowledge and skills that are acquired over a lifetime. "Classic aging pattern"-what changes? Age-related declined in verbal and performance intelligence among people 60 or older "Whats bad for the heart is bad for the brain" Smoking, diabetes, other things that harm physical health linked to poorer mental function Wisdom The acquisition of practical expertise in everyday life Decrement with compensation

Costs of depression

  • Direct and indirect costs: $43 billion each year
  • Depressed persons: Experience social and cognitive impairment, Have higher rates of disability, Have poorer physical health/medical conditions worsen, Takes longer to recover from medical illness and have less tolerance for______?, and Poor compliance with medical treatment
  • Depression increases the risk of death
  • Treatment is available-why not feel better? Suicide rates, opportunities, risks of txt
  • Many have visited a primary care physician near time of suicide
  • 12% of population, but 20% of suicides
  • 2 - 4 attempts per suicide vs 100-200 (younger)
  • Paradoxically increases as patient responds to treatment Symptoms: feeling, cognitive, somatic, behavioral
  • Biological, social and psychological risk factors
  • Somatic symptoms: Persistant somatic complaints, Changes in sleep patterns, Changed in appetite or unintentional weight loss/gain, Low energy/sex drive, delayed recovery from medical illness
  • Feeling symptoms: Anhedonia-inability to experience pleasure-FLAT, Lack of motivation, Anxiety/worry, General dissatisfaction or sadness, Hopelessness, helplessness, Irritability
  • Cognitive symptoms: Slow to answer questions, Forgetful, Inability to concentrate, Guilt, Negativism, Suicidal Ideation, Delusions
  • Behavioral symptoms: Crying, Stooped posture, Worried or flat expression, Signs of social isolation, Increased dependency, Refusal of medical treatment, Frequent doctor office visits, Resistance to hospital discharge, Minimization of symptoms, Expression of depressing statements. Common treatments for depression
  • Use of screening tools
  • Poor recognition by primary MD's
  • Medical Evaluation: History, Physical, Labratory, Current medications

Aphasia

  • Speech
  • Involves damage to the speech and language centers in the brain; one of the consequences of a stroke; occurs when the brain is deprived of oxygen; patients may be unable to produce meaningful speech or to understand spoken or written language
  • Very frustrating for individual Apraxia Motor tasks Agnosia inability to recognize stimulus Causes of dementia? Brain cell death, head injury, stroke, brain tumor Dementia vs. delirium
  • Delirium is an acute state of functioning conscienceless.
  • Onset and course of delirium differs from dementia
  • Frequent causes include drug therapy, dehydration, pain, and infections. Dementia vs. depression
  • Depressed individuals often complain of cognitive difficulties
  • Symptoms of depression often have a well-defined onset.
  • Pt's with depression often make little effort in formal testing
  • Level of insight(do they know that they are losing it?!)
  • Treatments:
  • Improve brain communication pathways with meds
  • Experimental treatments: insulin, BP meds
  • Non-Medical: prevention-strength training, behavioral, supportive *CNA skills to calm a dementia patients/ little while lies are not bad in cases like this. RAI/Mds-what, why, purposes Core set of clinical and functional status items. Standardizes communication RAI Resident Assessment Instrument MDS Minimum Data Set CAA Care Assessment Area RUG's Resource Utilization Group Assessment schedule, When? Upon admission, quarterly, annually, change of status, error is detected Info assessed & by who MDS coordinator, nurses & CNA's, Physicians, Residents, Family members