BRENT COLLEGE OF NURSING

CARE
FOR THE
ELDERLY
NCM 114
JOY CONCEPCION GARCIA,MN
INSTRUCTOR
INTRODUCTION
 Course Description:   
            
 This course explains the role of the

nurse in meeting the physiologic,

psychosocial, and spiritual needs of the
elderly.  Course content includes the
normal aging process, effects of aging
on the body, physiologic, psychosocial,
and spiritual needs of the elderly, effects
of medications in the elderly and
leadership and management skills of the
nurse.  The concepts from Basic Nursing
are integrated into this course. 
INTRODUCTION
THE LEARNING OUTCOMES:
 Apply critical thinking and problem

solving skills across disciplines.

 Apply life skills in areas such as

teamwork, interpersonal relationships,

ethics, and study habits.
 Communicate clearly in written or oral

formats.
 Use technology appropriate for learning.

 Discuss issues of a diverse global society.

 Demonstrate math and/or statistical skills.

INTRODUCTION
COURSE OUTCOMES:    
 Utilize the nursing process and critical thinking

skills to develop a plan of care for common

physiologic, psychosocial, and spiritual problems of
the older adult, (measured by written plan of care
from critical thinking activity).
 Identify therapeutic communication techniques when

working with older adults (measured by critical

thinking activity).
 Describe principles of safety when working with the

older adult including falls, restraints, environmental

issues, and dementia (measured by critical thinking
activity).
 Explain the effects of an individual’s culture on

physiologic, psychosocial, and spiritual needs of the

older adult (measured by critical thinking activity).
INTRODUCTION
COURSE OUTCOMES:    
 Discuss caring behaviors of the nurse when caring
for the older adults (measured by critical thinking
activity).
 Recognize the normal physiologic, psychosocial,
and spiritual changes of the older adult due to aging
(measured by critical thinking activity).
 Describe ethical and legal aspects involved in
providing care to the older adult (measured by
critical thinking activity).
 Prioritize physiologic, psychosocial, and spiritual
needs when caring for the older adult (measured by
critical thinking activity).
 List leadership skills for a charge nurse in a nursing
home or long term care facility (measured by critical
thinking activity).
INTRODUCTION
COURSE OUTCOMES:    
 State principles of medication

administration in the older adult to safely

administer medication and monitor
patients for adverse reactions (measured
by critical thinking activity).
 Identify importance of incorporating

evidence-based practice to provide

effective patient care (measured by topic-
of-the-week assignment and discussion).
ONLINE MANAGEMENT:

 ATTENDANCE:  EXAMS:
STUDENTS MUST BE STUDENTS MUST TAKE
PRESENT AT ALL QUIZZES/EXAMS ON
TIMES AND TIME. LATE
VIRTUALLY PRESENT SUBMISSION MEANS
WITH THEIR SCHOOL DEDUCTION OF POINTS.
UNIFORM with SEAL.
PERMIT MUST BE
SUBMITTED PRIOR THE
CAMERA WILL BE OPEN SUMMATIVE/TERM
RANDOMLY! EXAMS
ONLINE MANAGEMENT:

 SCHEDULE:  GRADING:
CLUSTER A:AUG 16- 50% -
OCT 16 QUIZZES.ACTIVITY
OUTPUT, OTHERS
SECTIONS E-F-G-H
50%- TERM
MIDTERM-SEPT. 16-18 EXAMINATIONS
FINAL TERM- OCT. 14-
16
  BRIEFLY DISCUSS THE
TO BE DEVELOPMENTAL
SUBMITTED TASK OF THE ELDERLY.
on AUGUST 20,  IDENTIFY ATLEAST 3
2021 via
COMMON TRENDS AND
GCLASS
ISSUES AMONG
ELDERS
 WHAT ARE THE AGING
THEORIES?EXPLAIN
BRIEFLY.
ASSIGNMENT
OVERVIEW of AGING
MODULE 1
SENIOR; PINOY VERSION

 What is the Senior Citizen

Age?
The senior citizen age in the
Philippines is 60 years old
and above. This is based on
the country's senior citizen
act, which is Republic Act
9994 also commonly known
as the Expanded Senior
Citizens Act of 2010.
SENIOR; PINOY VERSION

 REPUBLIC ACT
NO. 7432 . AN ACT TO
MAXIMIZE THE
CONTRIBUTION OF
SENIOR CITIZENS TO
NATION BUILDING,
GRANT BENEFITS AND
SPECIAL PRIVILEGES
AND FOR OTHER
PURPOSES.
 SENIOR; PINOY VERSION
 CITY Ordinance No. 539,
otherwise known as Giving
Benefits to Octogenarian and
Nonagenarian Residents in
Zamboanga City, the latest Octogenarian:
benefit package for senior 10,000.00
citizens unveiled during the Nonagenarian:
administration of Mayor 10,000.00
Maria Isabelle Climaco-
Salazar and authored by Hon.
Pinpin Pareja; City Counselor
for District 1 and other
members of the Counsel
Pioneer who revolutionized
pressure sore management
and geriatric nursing to
international acclaim
TRENDS & ISSUES IN ELDERLY IN THE PHILIPPINES

The elderly population in the

Philippines is steadily increasing in
the past decade. As of the latest
figures, the elderly dependent
population (aged 65 and older)
comprises 3.83 percent of the
population; by 2025 it is expected
that the elderly will be 10.25
percent of the population.
The framework of active aging identifies the following determinants of active aging:
economic, health and social services, social determinants, physical environment,
behavioural and personal factors. Gender and culture were also identified as cross
cutting determinants for understanding the six previously mentioned determinants
(see diagram above). Cultural meanings associated with aging which in turn influences
social norms and the role of the elderly in their families and in society in general, are
important variables in describing the their quality of life; gender on the other hand
has a great influence in shaping people's position and access to resources and
opportunities in their societies.
 Issues
Household The household, rather than the family, was taken as the
Relations reference point for the elderly primary relationship in
recognition of the various living arrangements of people
Health status
The elderly are conscious to keep themselves healthy.
However, due to some reasons not all seek for professional
care.
Community
Community participation is a right of all peoples regardless
Life/Participation of age. In the context of older people, it is also a venue for
socialization which strengthens their social capital and self-
Financial Security esteem, and invariably their physical and mental well-
being.
Financial security is another critical issue for senior citizens
Access to programs
& Benefits
Republic Act 9994 also commonly known as
the Expanded Senior Citizens Act of 2010
CHECK UP TIME!!!!
 Lives independently, with only 5%
lives in nursing home
 Tend to be sick, frail, and lives in
nursing homes
 Becomes more difficult and rigid in
thinking
 Typically remain engaged &
productive, often working or
volunteering in social networks
 Remains sexually active but frequency
may decrease

FACT OR MYTH!!!!!
LET’S DEFINE THE MEANING
 GERIATRICS  GERONTOLOGY
 Greek word “GERAS” =  Greek word “GERO”=
OLD AGE related to OLD AGE
 “IATRO”= MEDICAL  “OLOGY” = STUDY OF
TREATMENT = the study of all aspects of
= medical specialty that aging process (clinical,
deals with the diagnosis & physiological,
treatment of dse. Affecting economic,and sociologic
older adults(abnormal problems and its
conditions & treatment)
consequences.
LET’S DEFINE THE MEANING
 GERONTICS/GERON
TIC NURSING
 Was coined by Gunter &
Estes in 1979 to define the
nursing care& the service
provided to older adults;
encompasses holistic view
of aging with the goal
increasing health, providing
comfort and caring for older
adult needs.
 MYTHS FACTS
 Diverse age group
 Pretty much more alike  Typically remain engaged &
 In general are lonely & productive, often working or
alone volunteering in social networks
 Lives independently, with only 5%
 Tend to be sick, frail, lives in nursing home
and lives in nursing  May experience some cognitive
homes decline but usually not severe
 Are often cognitively enough to cause problems
 Remains sexually active but
impaired frequency may decrease
 Suffer from depression  Lower rate of depression compared to
more than younger young adults though the
adults consequences may be severe
 Maintain consistent personality
 Becomes more difficult  Adjust well to the challenges of aging
and rigid in thinking
DEMOGRAPHICS
 Importance:
 Information's are used by the
 The statistical study of government as basis
human populations 1. for granting aid to cities and
which deals with a states.
population’s size, 2. cities to project their budget
needs for schools,
distribution and vital 3. Hospital to determine the
statistics( includes birth, number of beds needed
death, age at death, 4. Public health agencies to
determine the immunization
marriages, race, and needs of community
many variables) 5. Markets to sell products
  The LE tends to be low
 LIFE EXPECTANCY- because of environmental
one of the important hazards, wars, accidents,
piece which determines food & water scarcity,
the number of years an inadequate sanitation and
average person can contagious disease.
expect to live. (Projected
from the time of birth to
the ages of all people
who die in a given year)
 Is defined as the failure to provide for the
SELF NEGLECT self because of a lack of ability or lack of
awareness
 Indicators:
1. The inability to maintain 4. Changes in mental function
(confusion, disorientation,
ADL’s incoherence)
2. The inability to obtain 5. The inability to manage personal
adequate food and fluid as finances as indicated by the failure
indicated by malnutrition or to pay bills or hording, squandering
dehydration or giving away money
inappropriately
3. Poor hygiene practices as
6. Failure to keep important business or
indicated by body odor, medical appointments
lesions, rashes or inadequate 7. life-threatening or suicidal acts, such
or soiled clothing. as wandering, isolation or substance
abuse.
ABUSE OR NEGLECT BY THE FAMILY
 PHYSICAL ABUSE
Is an act that causes
physical pain or injury
which may involve a
physical attack upon a
frail older adult who is
unable to defend himself
or herself from younger,
stronger family members.
ABUSE OR NEGLECT BY THE FAMILY
 NEGLECT  EMOTIONAL ABUSE
is a passive form of Is the most subtle &
abuse in which care difficult to recognize type
providers fail to provide of abuse and often
for the needs of older includes behavior such as
person which includes isolating, ignoring, or
situations of poor depersonalizing older
hygiene or safety needs. adults. (Verbal/Non-
(Intentional/unitentional) verbal)
ABUSE OR NEGLECT BY THE FAMILY
 FINANCIAL ABUSE  Actions to protect their financial
assets:
Exist when the resources 1. Direct deposit of SSS pension &
of an older adult are other benefit checks
stolen or misused by a 2. appointed of SPA or advising a
person whom the older will.
3. securing pin numbers of ATM
adult trusts. and online banking
4. written agreements
5. keeping valuables on secure
locations
6. remembering that workers are
not friends.
ABUSE OR NEGLECT BY THE FAMILY
 ABANDONMENT  RESPONSES TO
occurs when dependent ABUSE
older are deserted by the
person responsible for
their custody (physically,
emotionally and
fear!
financially)
ABUSE OR NEGLECT BY THE FAMILY
 SIGNS:
1. Excessive agreement
2. Poor hygiene
3. Dehydration/malnutrition
4. Burns/ pressure injuries
5. Bruises that are clustered in
trunks/upper arms
6. Bruises in various stages of
healing (repeated injury)
ABUSE OR NEGLECT BY THE FAMILY
 SIGNS:
7. Inadequate clothing/footwear
8. Inadequate medical attention
9. Lack of food, medication and care
1 0 . Ve r b a l i z a t i o n o f b e i n g l e f t
alone/isolated
1 1 . Ve r b a l i z a t i o n o f l a c k o f c o n t r o l
in personal activities or finances
ABUSE OR NEGLECT BY THE FAMILY
 ABUSIVE BEHAVIORS in HE. CARE SETTING
1. Use of sedatives or hypnotic drug unnecessarily

2. Use of restraints when not indicated

3. Use of derogatory language or verbal languages or ethnic slurs.

4. Withholding of privileges

5. Excessive roughness during transfer or handling of patients

6. Delay on management such as cleaning or bathing

7. Consumption of residents food

8. Theft of money or other belongings

9. Physical striking or assaultive behavior

10. Violation of a resident’s rights to make decisions

11. Failure to provide privacy

ABUSE OR NEGLECT BY THE FAMILY
* WAY S TO H E L P D E C R E A S E L I K E L I H O O D
OF ABUSE:
1 . Create a positive team environment with full staffing levels; convey
respect & appreciation of work
2. Encourage staff to take a break on time & to rest & re-energize (break
relief)
3. Rotate any difficult assignments to avoid overwhelming any team
members
4. Improve staff training
5. Initiate stress-reduction program
6. Recognize the value of every members
7. Develop positive reward system
8. Institute “get to know the resident” program
9. Develop a comprehensive and proactive feed backing mechanisms.
B l a d d e r b re a k ! ! ! !
15 minutes
 THEORIES OF AGING
 Discuss how a theory is different from a fact.
 Describe the most common biologic theories of aging..
WHAT IS A THEORY OF AGING?

Theories of aging can be divided into two categories: those that

answer the question
•“Why do we age?” and those that address the question
•“How do we age?”

Only a few broad, overarching theories attempt to explain why we

and nearly all living organisms age. These theories compete with
each other, making it unlikely that more than one of them could be
true. Over time, some theories have fallen out of favor as others
have become more widely accepted.
There are many theories about the mechanisms of age
related changes.  No one theory is sufficiently able to
explain the process of aging, and they often contradict
one another.  All valid theories of aging must meet
three broad criteria:

•The aging changes that the theory addresses must

occur commonly in all members of a humans.

•The process must be progressive with time.  That is,

the changes that result from the proposed process
must become more obvious as the person grows older.

•The process must produce changes that cause organ

THEORIES
 BIOLOGIC  PSYCHOSOCIAL
THEORIES THEORIES
Attempts to explain the Attempts to explain why
physical changes of aging older adults have different
as this have greatest responses to the aging
influence on longevity. process.

Each theory attempts to

describe the processes of
aging by examining
various changes in cell
structures or function.
 BIOLOGIC THEORIES; Genetic Perspective

 Programmed Theory  Run-out-program Theory

-proposes that everyone has a -proposes that every person

certain biologic time line to has limited amount of genetic
follow; each individual has a material that will run out
genetic “program” specifying eventually.
an unknown but
predetermined number of cell
divisions.

-Example; menopause
skin changes
graying of hair
 BIOLOGIC THEORIES; Genetic Perspective

 Rate Of Living Theory  Gene Theory

-proposes that individuals -Proposes the existence of one
have a finite number of breaths or more harmful genes that
or heartbeats that are used up activate over time, resulting in
over time. the typical changes seen with
aging and limiting the life span
of the individual.
 BIOLOGIC THEORIES; Molecular Theory

 Error Theory  Somatic Mutation

-Proposes that aging is caused -Proposes the aging results

by environmental damage that from DNA damage caused by
accumulates over time exposure to chemicals or
radiation and that this results
-Example: ERROR in RNA in chromosomal abnormalities
synthesis causes progressive that lead to disease or loss of
decline in biologic function () functions later in life.
 BIOLOGIC THEORIES; Cellular Theory

 Free Radical Theory  Crosslinkor Connective

-Provides explanation for cell Tissue Theory
damage; as they are unstable
molecules produced by the -Proposes that cell molecules
body during normal processes from DNA & connective
of respiration and metabolism tissues interact with free
or following exposure to radicals to cause bonds
radiation & pollution. (crosslink) that decrease the
-These free radicals are ability of tissue to replace itself,
suspected to cause damage to causing cell damage.
the cells, DNA and immune
-Examples: dryness, wrinkles, & loss
system
-Examples; Arthritis, diabetes, circulatory
of elasticity
diseases, atherosclerosis
 BIOLOGIC THEORIES; Cellular Theory

 Clinker Theory  Wear-Tear-Theory

-Combines the Somatic

-Presumes that the body is
Mutation & Free Radicals &
Crosslink theory; suggests that similar to a machine which
chemicals produced by loses function when its parts
metabolism accumulate in wear out. It proposes that good
normal cells & caused damage health maintenance practices
to body organs (muscles, heart, will reduce the rate of wear
nerves and brain) and tear, resulting in longer &
better body function.
 BIOLOGIC THEORIES; Cellular Theory

 Reliability Theory  Neuroendocrine Theory

-Focuses on the complicated

-is a complex mathematical
chemical interactions set off by
model of system failures first
the hypothalamus of the brain.
used to describe failure of
Simulation or inhibition of
complex electronic equipment.
various endocrine glands by
It is a model to describe
the hypothalamus initiates the
degradation(disease) and
release of hormones from the
failure(death) of human body
pituitary & other glands which
system.
in return regulated body
functions.
-Examples: decreased muscle mass,
increased body fats, changes in
reproductive functions
 BIOLOGIC THEORIES; Immunologic Theory

proposes that aging is a function of changes in immune

system.
Immune system is important defence mechanism of the
body- weakens over time, making an aging person more
susceptible to disease.
Proposes that the increase in autoimmune diseases &
allergies seen with aging is caused by changes in immune
system.
PSYCHOSOCIAL THEORIES

 Disengagement Theory  Activty Theory

-proposes that older people are -Proposes that activity is

systematically separated, necessary for successful aging;
excluded, or disengaged from active participation in physical
society because they are and mental activities helps
perceived to be of benefit to the maintain functioning wee into
society; older people desire to old age. (Purposeful activities &
withdraw from society as they interaction)
age and this mutually
beneficial.
PSYCHOSOCIAL THEORIES
 Life course Theory
-Perhaps the theories are best known to
nursing because it traces personality &
personal adjustments throughout life.

 1. Eric Erikson’s Theory

- Identifies 8 stages of
developmental tasks that an
individual must confront
throughout the life span.
PSYCHOSOCIAL THEORIES
 2. Robert J. Havighurst’s Theory
-the main assertion of Havighurst Theory is that
development is continuous throughout a person’s entire
lifespan, occurring in stages; when people successfully
accomplish the D.T. at a stage, they feel pride and satisfaction
thus, they also earn the approval of their community or
society.
-6 major age periods:
- 1. Infancy & early childhood (0-5 y.o)
- 2. middle childhood(6-12 y.o)
- 3. adolescence(12-18 y.o)
- 4. early adulthood (19-29 y.o)
- 5. middle adulthood(30-60 y.o)
- 6. later maturity (above 60 y.o))
PSYCHOSOCIAL THEORIES
 2.Margaret Newman’s Theory
-the basic concepts of Newman’s Theory of health
are consciousness, movement, space & time;
postulated that these are interrelated.
PSYCHOSOCIAL THEORIES
 2. Margaret Newman’s Theory
Developing Tasks:
Coping with the physical changes of
aging
Redirecting energy new activities &
roles including retirement, grand
parenting and widowhood
Accepting one’s own life
Developing a point of view about
PSYCHOSOCIAL THEORIES
 3. Carl Jung’s Theory
-proposes that development continues
throughout life by a process of searching,
questioning and setting goals that are consistent
with the individual’s personality. Thus, life
becomes an ongoing search for “TRUE SELF”

-he proposes that the individual is likely to shift

from an outward focus (EXTROVERT) to a
more inward focus (INTROVERT)
PSYCHOSOCIAL THEORIES
 3. Carl Jung’s Theory
Jung’s Four Functions of Personality
For Carl Jung, there were four functions that, when combined with
one of his two attitudes, formed the eight different personality types.
The first function — feeling — is the method by which a person
understands the value of conscious activity.
Another function — thinking — allows a person to understand
the meanings of things. This process relies on logic and careful
mental activity.
The final two functions — sensation and intuition — may seem
very similar, but there is an important distinction. Sensation
refers to the means by which a person knows something exists
and intuition is knowing about something without conscious
understanding of where that knowledge comes from.
SUMMARY; THEORIES OF AGING
The programmed theory:
•Aging by Program, where biological clocks act
through hormones to control the pace of aging. 

•Gene Theory, which considers aging to be the result

of a sequential switching on and off of certain genes,
with senescence being defined as the time when age-
associated deficits are manifested. 

•Autoimmune Theory, which states that the immune

system is programmed to decline over time, leading
to an increased vulnerability to infectious disease
and thus ageing and death.
The damage or error theory:
•Wear and tear theory, where vital parts in our cells
and tissues wear out resulting in ageing. 
•Rate of living theory, that supports the theory that the
greater an organism’s rate of oxygen basal, metabolism,
the shorter its life span 
•Cross-linkage theory, according to which an
accumulation of cross-linked proteins damages cells
and tissues, slowing down bodily processes and thus
result in ageing.
•Free radicals theory, which proposes that superoxide
and other free radicals cause damage to the
macromolecular components of the cell, giving rise to
GLUTATHIONE is the  ANTIOXIDANT THERAPY
most powerful and
important among the
 Proposed as a method of neutralizing free
antioxidants our body radicals which may contribute to aging &
produces. It's a disease process.
combination of three  Includes a number of vitamins & minerals,
amino acids; it tackles such as Vit. A,B6, B12, C & E; beta carotine,
ageing through the folic acid and selenium
intestines and circulatory
system. It has strong
 Generally safe when consumed as fruits &
anti-ageing properties, it vegetables as part of the overall diet.
protects cells, tissues  High doses may cause more harm than
and organs of the body benefits
and it keeps them young  Must be consulted with care providers
before starting the therapy
 Has not been proven to be effective.

COMPLEMENTARY THERAPIES TO SLOW OR REVERSE AGING

DHEA: an important  HORMONE THERAPY
precursor hormone, and is
the most abundant  Proposed to replace a reduction in
circulating steroid present in hormones, which naturally decrease
the human body. It has little
biological effect on its own with aging.
but has powerful effects  Includes hormones such as
when converted into other
hormones such as sex
dehydroepiandrosterone(DHEA),
steroids. estrogen, testosterone, melatonin, &
human growth hormone (HGH)
 Requires prescription, may cause
more harm than benefits
 Little evidence to support claims

COMPLEMENTARY THERAPIES TO SLOW OR REVERSE AGING

A dietary supplement is a
manufactured product
 SUPPLEMENTS
intended to supplement  Proposed to replace or enhance
one's diet by taking a pill, nutritional status (natural remedies)
capsule, tablet, powder,
or liquid. A supplement
 Includes substance such as ginseng,
can provide nutrients coral calcium and other herbal
either extracted from preparations
food sources or that are  With high risk for interaction with
synthetic in order to
increase the quantity of
prescription medications
their consumption  Not regulated
 No proof of effectiveness (NO
THERAPEUTIC CLAIMS)

COMPLEMENTARY THERAPIES TO SLOW OR REVERSE AGING

Calorie restriction  CALORIE-RESTRICTED
means reducing
average daily caloric
DIET
intake below what is  Proposed that significant calorie
typical or habitual, reduction can extend life(proven in
without malnutrition animals but not in human)
or deprivation of  Severe calorie restriction can cause in
essential nutrients. inadequate consumption of necessary
nutrients
 Dietary changes must be discussed
with care providers to ensure
adequate nutrition is maintained.
(nutritionist)

COMPLEMENTARY THERAPIES TO SLOW OR REVERSE AGING

 I See Them Aged
ACTIVITY 1 A report on how my loved one aged
PROFILE:

Name: _______________ Age: ______ Civil Status: _______

Current/Previous Occupation: ____________ No. of Years in Service: ____
Number of Children: ______ Address: ___________

MILESTONE: (Discussed normal/usual tasks based on the different developmental

tasks presented and indicate author)

COMPARATIVE ADL’s
ADL’s before the aged of 60 ADL’s above 60 years old
Feeding:
Self Care:
Exercise:
Sleeping Pattern:
Mobility:

Attached photo of your loved one with you.

 To c a r e f o r
those who
once cared
for us is one
of the
highest
honors.

Thank You Future Nurses!

  Structural changes
 Impacts of normal changes on self-images and lifestyle

 Commonly observed functional changes

 Most common diseases related to aging
 Impact of age-related changes on nursing care.

MODULE 2: PHYSIOLOGICAL
CHANGES