Growth & Development in Older Persons: Anatomy & Physiology Study Notes

Older Persons: Demographics and Classification

Defining Older Adulthood

Older adulthood is commonly defined as beginning at age 65, a threshold used in demographics and social policy. This population is further subdivided to better understand health and social needs.

• Youngest old: 65–74 years

• Old: 75–84 years

• Oldest old: 85 years and older

The number of older persons is increasing both in absolute terms and as a proportion of the total population.

Variability Among Older Persons

Individual Differences in Aging

Older adults exhibit significant variation in physiological, cognitive, and psychosocial health. These differences influence their functional abilities and independence.

• Functional ability: The capacity to perform activities of daily living (ADLs) varies widely.

• Dependence vs. independence: Some older adults require assistance, while others remain highly independent.

• Strengths and abilities: Many older persons retain significant skills and resilience.

Myths, Stereotypes, and Ageism

Common Misconceptions

Society often holds inaccurate beliefs about older adults, which can negatively affect their care and well-being.

• That older persons are ill and disabled

• Not interested in sex or sexual activities

• Unable to use computers

• Forgetful, confused, rigid, boring, or unfriendly

• Unable to learn and understand new information

• Unattractive and worthless to society

Ageism refers to discrimination or prejudice against individuals based on their age, often resulting in unfair treatment.

Nurses’ Attitudes Toward Older Persons

Promoting Dignity and Advocacy

Nurses play a critical role in challenging ageism and supporting older adults.

• Questioning negative attitudes and stereotypes

• Advocating for older persons’ rights and needs

• Treating older persons as independent, dignified individuals

Developmental Tasks for Older Persons

Life Adjustments in Later Adulthood

Older adults face unique developmental tasks as they adapt to changes in health, relationships, and lifestyle.

• Adjusting to decreasing health and physical strength

• Adjusting to retirement and reduced or fixed income

• Adjusting to the death of a spouse

• Accepting oneself as an aging person

• Maintaining satisfactory living arrangements

• Redefining relationships with adult children

• Finding ways to maintain quality of life

Aging Well and Quality of Life

Active Aging and Goal Setting

"Aging well" refers to maintaining physical, mental, and social well-being in older adulthood. Nurses collaborate with older persons to set objectives that enhance quality of life.

• Active aging: Engaging in activities that promote health and independence

• Quality of life: A subjective measure encompassing physical health, psychological state, level of independence, social relationships, and personal beliefs

Community-Based and Institutional Health Care Services

Care Settings for Older Adults

Older persons may receive care in a variety of settings, depending on their needs and preferences.

• Private homes and apartments

• Adult day care centres

• Home care services

• Personal care homes

• Assisted-living facilities

• Long-term care facilities

• Hospice care

Nurses assist older adults in making informed decisions about appropriate health care services.

Assessing the Needs of Older Persons

Comprehensive Nursing Assessment

Assessment of older adults requires consideration of both physical and psychosocial factors.

• Interrelationship between physical and psychosocial aspects of aging

• Effects of disease and disability on functional status

• Decreased efficiency of homeostatic mechanisms

• Lack of standardized health and illness norms

• Altered manifestations and responses to specific diseases

Key principles:

• Timely detection of cardinal signs of illness

• Focus on identifying underlying causes to initiate treatment

Physiological Changes with Aging

Normal and Pathological Changes

Physiological changes occur in all body systems as part of the aging process. Not all changes are pathological; many are normal adaptations.

• Integumentary system: Thinning skin, wrinkles, decreased elasticity

• Cardiovascular system: Reduced cardiac output, increased blood pressure

• Respiratory system: Decreased lung capacity, reduced gas exchange

• Gastrointestinal system: Slower digestion, decreased absorption

• Musculoskeletal system: Loss of bone density, decreased muscle mass

• Neurological system: Slower nerve conduction, mild memory changes

• Sensory system: Decline in vision, hearing, taste, and smell

• Genitourinary system: Reduced kidney function, urinary incontinence

• Reproductive system: Hormonal changes, decreased sexual function

• Endocrine system: Altered hormone levels

• Immune system: Decreased immune response

General survey: Initial inspection may reveal common aging changes such as facial wrinkles, grey hair, loss of body mass in extremities, and increased body mass in the trunk.

Functional Changes

Impact on Daily Living

Declines in physical, psychological, cognitive, and social function are often linked to illness or chronic disease. The ability to perform ADLs is a sensitive indicator of health status in older adults.

• Physical function: Mobility, strength, endurance

• Psychological function: Emotional well-being, coping skills

• Cognitive function: Memory, attention, problem-solving

• Social function: Engagement in relationships and community

Cognitive Changes

Normal vs. Pathological Cognitive Aging

While some structural and physiological changes in the brain are normal with aging, significant cognitive impairments are not typical.

• Normal aging: Mild memory lapses, slower information processing

• Abnormal changes: Disorientation, loss of language skills, inability to calculate, poor judgement

Conditions Affecting Cognition

Condition	Description
Delirium	Acute state of confusion; sudden onset
Dementia	Generalized impairment of intellectual functioning; gradual deterioration
Depression	Mood disturbance characterized by sadness and despair

Psychosocial Changes

Social and Emotional Adjustments

Older adults may experience significant psychosocial changes that affect their well-being.

• Retirement: Loss of work-related identity and income

• Social isolation: Reduced social contacts

• Abuse: Vulnerability to neglect or mistreatment

• Sexuality: Changes in sexual health and relationships

• Housing and environment: Need for age-friendly communities

• Death: Coping with loss of loved ones

Health Concerns and Promotion

Common Causes of Death and Prevention

The two most common causes of death in older adults are cancer and heart disease. Other significant causes include respiratory disease, stroke, accidents, falls, diabetes, kidney disease, and liver disease.

• Preventive measures: Health promotion strategies can reduce or delay the onset of these conditions.

Physiological Health Concerns

• Cancer

• Arthritis

• Heart disease

• Falls

• Smoking

• Substance abuse

• Nutrition

• Pain

• Oral health

• Exercise

• Medication use and polypharmacy

Psychosocial Health Concerns

• Therapeutic communication

• Touch

• Cognitive stimulation

• Reminiscence

• Body-image interventions

Older Persons in Acute Care Settings

Risks and Considerations

Hospitalization poses specific risks for older adults, including adverse events such as:

• Delirium

• Dehydration

• Malnutrition

• Nosocomial infections

• Urinary incontinence

• Skin breakdown

• Falls

It is important to identify the pre-hospitalization level of functioning to guide care planning.

Restorative and Palliative Care

Ongoing and End-of-Life Care

Restorative care aims to help older adults regain or improve independence and ADLs after acute illness or surgery, and to manage chronic conditions.

• Continues recovery from acute illness or surgery

• Addresses chronic conditions affecting daily functioning

Palliative care focuses on improving quality of life for persons with life-limiting illness and their families through symptom management, interprofessional collaboration, and supporting patient and family goals.

Summary Table: Key Topics in Older Adult Care

Topic	Key Points
Physiological changes	Normal and pathological changes in body systems
Functional changes	Impact on ADLs and independence
Cognitive changes	Normal aging vs. delirium, dementia, depression
Psychosocial changes	Retirement, isolation, abuse, sexuality, environment
Health concerns	Cancer, heart disease, falls, polypharmacy
Health promotion	Prevention, exercise, nutrition, communication
Acute care	Risks: delirium, dehydration, falls, infections
Restorative care	Regain/improve independence, manage chronic illness
Palliative care	Symptom management, quality of life, family support

Additional info: These notes expand on the original slides by providing definitions, examples, and context for each topic, ensuring a comprehensive understanding suitable for Anatomy & Physiology students.