ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
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NCM 114: CARE OF THE OLDER ADULT
INSTRUCTOR: GINO PAULO A. BUIZON, R.N.
❖ Aging is a normal part of human development.
❖ Patterns of aging – what happens, how, and when – vary greatly among older people.
❖ Each person ages in his own way.
❖ People become more diverse rather than more alike, each influenced by physical, social and
environmental factors.
❖ How a person changes depends on life experiences, available support system, and previous
coping skills.
❖ Individual body systems don’t age from the same functional level at the same rate
BIOLOGICAL THEORIES
• Biologic theories of aging attempt to explain why the physical changes of aging occur.
Identification of which biologic factor have the greatest influence on longevity
THE PROGRAMMED THEORY/ BIOLOGICAL CLOCK THEORY
• The programmed theory proposes that every person has a “Biologic clock” that starts ticking at the
time of conception.
• In this theory each individual has a genetic program specifying an unknown but predetermined
number of cell divisions.
• As the program plays out, the person experiences predictable changes such as atrophy of the thymus,
menopause, skin changes and graying of the hair
• Aging has a biological timetable or internal biological clock.
THE RUN OUT OF PROGRAM THEORY
• Every person has a limited amount of genetic material that will run out over time.
• All events are specifically programmed into genome and are sequentially activated.
• After maturation genes have been activated there are no more programs to be played and as cells age
there may be chance of inactivation of genes that cannot be turned on.
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
Emboldened...On Fire: Building a Culture of Innovation and Communion
GENE THEORY
• The gene theory proposes the existence of one or more harmful genes that activate overtime,
resulting in the typical changes seen with aging and limiting the life span of the individual.
• Organism failure occurs in later life because of the presence of imperfect genes activated over lengthy
periods of time.
• Two gene types, one supports growth and vigor, and the other supports senescence and deterioration.
MOLECULAR THEORIES
The aging is controlled by genetic materials that are encoded to predetermine both growth and decline.
• The error theory
• The somatic mutation theory
1.THE ERROR THEORY
• The error theory 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.
• Error theory Aging is a result of internal or external assaults that damage cells or organs so they can no
longer function properly.
2. THE SOMATIC MUTATION THEORY
• The somatic mutation theory proposes that aging result from deoxyribonucleic acid (DNA) damage
caused by exposure to chemicals or radiation and this damage causes chromosomal abnormalities that
lead to disease or loss of function later in life.
• Exposure to x-ray radiation and or chemicals induces chromosomal abnormalities.
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
Emboldened...On Fire: Building a Culture of Innovation and Communion
CELLULAR THEORIES
• The cellular theories propose that aging is a process that occurs because of cell damage.
• When enough cells are damaged, overall functioning of the body is decreased.
• The free radical theory
• The crosslink or connective tissue theory
• Clinker theory
• The wear and tear theory
1. THE FREE RADICAL THEORY
• Denham Harman 1956.
• The term free radical describes any molecule that has a free electron, and this property makes it react
with healthy molecules in a destructive way.
• Free radical molecule creates an extra negative charge.
• This unbalanced energy makes the free radical bind itself to another balanced molecule as it tries to
steal electrons.
• Balanced molecule becomes unbalanced and thus a free radical itself.
• Diet, lifestyle, drugs (e.g. tobacco and alcohol) and radiation
2. THE CROSSLINK OR CONNECTIVE TISSUE THEORY/ GLYCOSYLATION THEORY OF AGING
• Cell molecules from DNA and connective tissue interact with free radicals to cause bonds that
decrease the ability of tissue to replace itself.
• The results in the skin changes typically attributed to aging such as dryness, wrinkles, and loss of
elasticity.
• Fibrous tendons, loosening teeth, diminished elasticity of arterial walls and decreased efficiency of
lungs and GI tract.
• It is the binding of glucose (simple sugars) to protein, (a process that occurs under the presence of
oxygen) that causes various problems.
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
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• Senile cataract and the appearance of tough, leathery and yellow skin.
3. THE CLINKER THEORY
• The clinker theory 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.
4. THE WEAR AND TEAR THEORY
• Body is similar to a machine, which loses function when its parts wear out.
• As people age, their cells, tissues and organs are damaged by internal or external stressors.
• Good health maintenance practices will reduce the rate of wear and tear, resulting in longer and
better body function.
THE NEUROENDOCRINE THEORY
• Prof Vladimir Dilman and Ward Dean
• this theory elaborates on wear and tear by focusing on the neuroendocrine system.
• This system is a complicated network of biochemicals that govern the release of hormones which are
altered by hypothalamus.
• The hypothalamus controls various chain-reactions to instruct other organs and glands to release their
hormones etc. The hypothalamus also responds to the body hormone levels as a guide to the overall
hormonal activity. Accordingly, as ages the secretion of many hormones declines and their effectiveness
is also reduced due to the receptors downgrading.
IMMUNOLOGIC THEORY
• The immunologic theory proposes that aging is a function of changes in the immune system.
• The immune system weakens over time, making an aging person more susceptible to disease, increase
in autoimmune disease and allergies
• Over time, cells involved in immune function are less selfregulatory, resulting in cells being
misidentified as foreign material and being attacked by the immune system’s own defenses.
THE MITOCHONDRIAL DECLINE THEORY
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• The power producing organelles.
• Their primary job is to create Adenosine Triphosphate (ATP) and they do so in the various energy
cycles that involve nutrients such as Acetyl-L-Carnitine, CoQ10 (Idebenone), NADH and some B vitamins
etc.
• Enhancement and protection of the mitochondria is an essential part of preventing and slowing aging.
THE MEMBRANE THEORY OF AGING
• Professor Imre Zs.
• It is the age-related changes of the cells ability to transfer chemicals, heat and electrical processes that
impair it.
• As older the cell membrane becomes less lipid (less watery and more solid). This impedes its efficiency
to conduct normal function and in particular there is a toxic accumulation.
PSYCHOSOCIAL THEORIES
• Psychosocial theories of aging attempt to explain changes in behavior, roles and relationship that
occur as individual age.
• This attempt to predict and explain the social interactions and roles that contribute to successful
adjustment to old age in older adults.
✔ The disengagement theory
✔ The activity theory
✔ The continuity theory
✔ The subculture theory
✔ DISENGAGEMENT THEORY
✔ • Cummings and Henry(1961) states that aging people withdraw from customary roles and
engage in more introspective, self-focused activities.
✔ • The disengagement theory was developed to explain why aging process separate from the
mainstream of society.
✔ • This theory proposes that older people are systematically separated, excluded, or disengaged
from society because they are not perceived to be of benefit to the society as a whole.
✔ • This theory further proposes that older adults desire to withdraw from society as they age, so
the disengagement is mutually beneficial.
THE ACTIVITY THEORY
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
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• This theory proposes that activity is necessary for successful aging.
• Active participation in physical and mental activities helps maintain functioning well into old age.
• Purposeful activities and interactions that promote self-esteem improve overall satisfaction with life,
even at the older age.
• The continuation of activities performed during middle age is necessary for successful aging (Lemon,
Bengston and Peterson, 1972).
THE CONTINUITY THEORY
• The continuity theory (Neugarten, 1964) state that personality remains the same and the behaviors
become more predictable as people ages.
• Personality and behavior pattern developed during a life time determine the degree of engagement
and activity in older adulthood.
• Personality is a critical factor in determining the relationship between role activity and life satisfaction.
THE SUBCULTURE THEORY
• Rose (1965) theorized that older adults from a unique subculture within society to defend against
society’s negative attitude toward aging and the accompanying loss of status.
• Older adults are a subculture with their own norms and beliefs. The subculture occurs as a response to
loss of status.
• In the subculture, individual status is based on health and mobility, instead of on education,
occupation and economic achievement.
DEVELOPMENTAL THEORIES
■ Developmental theories or life-course theories
■ These theories trace personality and personal adjustment throughout a person’s life.
■ Many of these theories are specific in identifying lifeoriented tasks for the aging person.
✔ Erikson’s
✔ Havighurst’s
✔ Newman’s
✔ Peck’s
✔ Jung’s theory
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
Emboldened...On Fire: Building a Culture of Innovation and Communion
ERIKSON’S THEORY
▪ Erickson’s(1963) theory identifies eight stages of developmental tasks that an individual must
comfort throughout the life span:
✔ Trust versus mistrust
✔ Autonomy versus shame and doubt
✔ Initiative versus guilt
✔ Industry versus inferiority
✔ Identity versus identity confusion
✔ Intimacy versus isolation
✔ Generativity versus stagnation
✔ Integrity versus despair
✔ The last of these stages is the domain of late adulthood, but failure to achieve success in tasks
earlier in life can cause problems later in life.
✔ • The stage pertaining to older adults is : Ego integrity versus Despair.
✔ • The task of this stage is acceptance of one’s life as meaningful and that death is part of life,
versus despair, which is failure to accept the meaningfulness of one’s life, along with fear of
death.
PECK’S THEORY
● Peck expanded Erikson’s theory and focused more on later developmental stages.
• Body transcendence versus body preoccupation is a phase concerned with enjoyment of life in the
face of physical discomforts associated with aging.
• Ego transcendence versus ego preoccupation is a phase concerned with the older adult’s ability to
focus on the welfare of the future generation rather than on one’s own inevitable death.
HAVIGHURST THEORY
• Havighurst’s(1968) theory details the process of aging and defines specific task for late life, including
adjusting to decreased physical strength and health, adjusting to retirement and decreased income,
adjusting to the loss of a spouse, establishing a relationship with one’s age group, adapting to social
roles in a flexible way, and establishing satisfactory living arrangements.
• Later maturity is Havighurst’s term for older adults.
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
Emboldened...On Fire: Building a Culture of Innovation and Communion
• The task for later maturity is disengagement. Disengagement from tasks of middle age allows
involvement in new roles such as grandparent, citizen, friend.
NEWMAN’S THEORY
• Newman’s theory identifies the task of aging as
Coping with the physical changes of aging Redirecting energy to new activities and roles including
retirement, grand-parenting and widowhood
Accepting one’s own life;
Developing a point of view about death.
JUNG’S THEORY
• Jung’s theory proposes that the development continues throughout life by a process of searching,
questioning and setting goals that are consistent with the individual’s personality.
• As individuals age, they go through a reevaluation stage at midlife, at which point they realize there
are many things they have not done.
• At this age they begin to question whether the decision and choices they have made were the right
choices for them. This is so called “midlife crisis”, which can lead to radical career or lifestyle changes or
acceptance of the self as is.
• As aging continues, Jung proposes that the individual is likely to shift from an outward focus (wit
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.
CONCEPTS OF DEVELOPMENTAL THEORIES
• The concepts based on the identification of traits and characteristics that may be developed early in
life or may change emphasis at different stages of development.
• Those who succeed at the final task also develop wisdom, which includes accepting without major
regrets the life that one has lived, as well as the inescapability of death.
• However, even older adults who achieve a high degree of integrity may feel some despair at this stage
as they contemplate their past
ST. ANTHONY COLLEGE OF ROXAS CITY, INC.
San Roque Extension, Roxas City 5800, Capiz, Philippines
Member, DC-SLMES, DC-SLMHS Philippines
Emboldened...On Fire: Building a Culture of Innovation and Communion
APPLICATION IN THE NURSING FIELD
• Physical theories of aging indicate that, although biology places some limitations on life and life
expectancy, other factors are subject to behavior and life choices. Nursing can help individuals achieve
the longest, healthiest lives possible by promoting good health maintenance practices and a healthy
environment
• Psychosocial theories help to explain the variety of behaviors seen in the aging population.
Understanding all of these theories can help nurses recognize problems and provide nursing
interventions that will helping aging individuals successfully meeting the development tasks of
aging. Cultural, spiritual, regional, socioeconomic, educational and environmental factors as well
as health status impact older adult’s perceptions and choices about their health care needs.
• Theories can predict patient outcomes hold the greatest promise for guiding nursing practice in ways
that help each individual patient age successfully.
