Chapter 2 Theories Of Aging: Basic Geriatric Nursing

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EACH THEORY:

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ATTEMPTS TO DESCRIBE THE PROESSES OF AGING BY EXAMINING VARIOUS CHANGES IN CELL STRUCTURES OR FUNCTION

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the programmed theory

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proposes that every person has a "biologic clock" that starts ticking at the time of conception. Each person has a genetic "program" specifying an unknown but predetermined number of cell divisions. The person experiences predictable changes such as atrophy of the thymus, menopause, skin changes, graying of hair

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run out of program theory

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which proposes that every person has a limited amount of genetic material that will run out over time

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gene theory

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proposes the existence of one or more harmful genes that activate over time, resulting in the typical changes seen with aging and limiting the life span of the individual

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molecular theories

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propose that aging is controlled by genetic materials that are encoded to predetermine both growth and decline

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error theory

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proposes that errors in RIBONUCLEIC ACID protein synthesis cause errors to occur in cells in the body, resulting in a progressive decline in biologic function

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somatic mutation theory

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proposes that aging results from DNA damage causes chromosomal abnormalities that lead to disease or loss of function later in life

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cellular theories

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propose that aging is a process that occurs because of cell damage. when enough cells are damaged, overall functioning of the body is decreased

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free radical theory

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provides one explanation for cell damage. Free radicals are unstable molecules produced by the body during the normal processes of respiration and metabolism or following exposure to radiation and pollution. Free radicals are suspected to cause damage to the cells, DNA and immune system, cause arthritis, circulatory diseases, diabetes, atherosclerosis.

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one free radical called

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lipofuscin, has been identified to cause a buildup of fatty pigment granules that cause age spots in older adults

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individuals who support the FREE RADICAL THEORY

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propose that the number of free radicals can be reduced by the use of antioxidants such as vitamins, carotenoids, selenium, and phytochemicals

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a variation of the free radical theory is the CROSSLINK or CONNECTIVE TISSUE THEORY

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proposes that cell molecules from DNA and connective tissue interact with free radicals to cause bonds that decrease the ability of tissue to replace itself, this results in skin changes from aging, such as dryness, wrinkles, loss of elasticity

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CLINKER THEORY

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combines the somatic mutation, free radical, and cross link theories to suggest that chemicals produced by metabolism accumulate in normal cells and cause damage to body organs such as the muscles, heart, nerves, and brain

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wear and tear theory

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presumes that the body is similiar to a machine, which loses function when its parts wear out. cells are damaged by internal or external stressors. Good health practices will reduce the rate of wear and tear, results in longer and better body function

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neuroendocrine theory

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focuses on the complicated chemical interactions set off by the hypothalamus of the brain. with age the hypothalamus appears to be less precise in function, decreased muscle mass, increased body fat, changes in reproductive function. Hormone supplements may be designed to delay or control age related changes

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immunologic theory

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proposes that aging is a function of changes in the immune system, it weakens over time, making aging more susceptible to disease, also increase in autoimmune diseases and allergies seen with aging is caused by changes in the immune system

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aging to caloric intake

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animal research has shown that a point of metabolic efficiency can be achieved by consuming a high nutrient but low calorie diet, it is hypothesized that this diet, when combined with regular exercise, may extend optimal health and life span

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psychosocial theories of aging

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do not explain why the physical changes of aging occur, rather they attempt to explain why older adults have different responses to the aging process.

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most prominent psychosocial theories of aging are?

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disengagement theory
activity theory
life course
developmental theories
variety of other personality theories

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disengagement theory
(highly controversial)
explains why the aging person separates from the mainstream of society, older people are separated, excluded or disengaged because...

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they dont benefit the society as a whole, they withdraw as they age, so it is mutally beneficial. Critics believe that it attempts to justify ageism, oversimplifies the psychosocial adjustment to aging, fails to address the diversity and complexity of older adults

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activity theory

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proposes that activity is needed for sucessful aging, physical and mental activities helps maintain function as we age. Will promote self esteem improve satisfaction with life, "busy work" and casual interaction WERE NOT SHOWN to improve self esteem of older adults

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life course theories

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theories best known to NURSING. they trace personality and personal adjustment throughout a person's life. Many of these theories are specific in identifying life oriented tasks for the aging person

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most common life course theories

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Eriksons
Havighursts
Newmans
Jungs

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Eriksons theory

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has 8 stages of developmental tasks that an individual must confront throughout the lifespan
1. trust vs mistrust 2. autonomy vs shame & doubt
3. initiative vs guilt 4. industry vs inferiority
5. identity vs identify confusion 6. intimacy vs isolation
7. generativity vs stagnation 8. integrity vs despair

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the last of Erikson's theories are the domain of late adulthood

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failure to achieve success in tasks earlier in life can cause problems later in life. late adulthood is when people review their lives and determine whether they have been negative or positive overall, most positive outcomes of this life review are wisdom, understanding and acceptance, NEGATIVE are doubt, gloom and despair

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Havighurst's theory--
details the process of aging and defines specific tasks for late life, including>>>

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1. adjusting to decreased physical strength & health 2. adjusting to retirement & less income 3. adjusting to loss of spouse 4. establishing a relationship with one's age group 5. adapting to social roles in a flexible way 6. establishing satisfactory living arrangements

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Newmans theory
identifies the tasks of aging as

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1. coping with the physical changes of aging 2. redirecting energy to new activities and roles 3. accepting one's own life 4. developing a point of view about death

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Jung's theory

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continues throughout life by a process of searching, questioning, and setting goals. Ongoing search for the "TRUE SELF" they go through a reevaluation stage at midlife, "MIDLIFE CRISIS" which can lead to a radical career or lifestyle change likely to shift from an OUTWARD focus with concerns about success and social position to a more INWARD focus, successful aging includes acceptance and valuing of the self without regard to the view of others

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nursing can

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help individuals achieve the longest, healthiest lives possible by promoting good health maintenance practices and a healthy environment

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psychosocial theories help explain the variety of behaviors seen in the aging population

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understanding all of these theories can help nurses recognize problems and provide nursing interventions that will help aging individuals successfully meet the developmental tasks of aging

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alternative and complementary therapies

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to slow or reverse aging

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antioxidant therapy

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1. proposed as a method of neutralizing free radicals, which may contribute to aging and disease processes

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antioxidant therapy

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1. includes a number of vitamins and minerals, including A, B6, B12, C, E, beta carotene, folic acid, selenium

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antioxidant therapy

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1. generally safe when consumed as fruits and vegetables as part of the overall diet 2. high doses of some antioxidants may cause more harm than benefits

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antioxidant therapy

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1. no proof that antioxidants are effective
2. discuss with physician before starting use

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hormone therapy

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1. proposed to replace a reduction in hormones, which naturally decrease with aging
2. includes hormones such as DHEA, estrogen, testosterone, melatonin, human growth hormone

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horomone therapy

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1. little evidence to support clains made by advocates
2. may actually cause more harm than benefits
3. usually requires prescription or supervised medical administration

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supplements

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1. proposed to replace or enhance nutritional status; often marketed as "Natural" remedies
2. include substances such as ginseng, coral calcium, echinacea, and other herbal preparations

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supplements

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1. no proof of effectiveness
2. not regulated by FDA, so there is no control regarding amount of active ingredients
3. high risk for interaction with RX meds, doctor must be notified if these products are used

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calorie-restricted diet

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1. proposes that calorie reduction can extend life; based on studies in rats, mice, fish, and worms; not proven in humans

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calorie restricted diet1. severe calorie restriction can result in inadequate consumption of necessary nutrients
2. studies show that severely underweight persons have a higher risk for some diseases and even death

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1. severe calorie restriction can result in inadequate consumption of necessary nutrients
2. studies show that severely underweight persons have a higher risk for some diseases and even death

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calorie-restricted diet

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dietary changes should be discussed with a doctor or nutritionist to ensure that adequate nutrition is maintained

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many biologic, environmental, and psychosocial theories have been

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proposed to explain why we age

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these theories remain theories

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because the exact processes that cause the changes seen with aging are not completely understood

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to determine which theory or combination of theories is most accurate

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further research and studies are needed

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to date, hormone replacement therapy

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appears to have more risks than benefits

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the quest for the "fountain of youth"

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have motivated explorers such as "PONCE DE LEON"

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maxium life expectancy for human

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110 years