Theories Elderly

• STOCHASTIC THEORIES suggests that aging

  events occur randomly and accumulate with time.
• ST

  ERROR THEORY - proposes that aging is the result of the accumulation of errors in deoxyribonucleic acid and ribonucleic acid synthesis. The accumulation of errors over time eventually leads to failure of cellular activity and the changes we associate with aging.

  
  

  Ex: Environmental agents like radiation causing chromosomal abnormalities.

  
  

  *** Hayflick (1996) does not support this theory, all aged cells do not have errant proteins nor are all cells found with errant proteins
• FREE RADICAL THEORY Postulates that as fats, proteins and carbohydrates oxidize, they create what are called free radicals, which attach to other molecules and damage them.

  
  

  ▪ Cell damage causes mitochondrial deterioration due to oxidants causing loss of cell energy & decrease metabolism

  
  

  Harman (1994) suggests strategies to assist in delaying the mitochondrial decay:

  
  

  ✓ decrease calories to lower weight

  ✓ Maintain a diet high in nutrients

  ✓ Use antioxidants

  ✓ Minimize accumulation of metals in the body that can triggers free radical reactions
• WEAR and TEAR THEORY Described as “wornout”

  
  

  ▪ Aging is caused by the accumulation of repeated and random injury and overuse of cells, tissues, organs ands andystems

  
  

  Aged cells have lost the ability to counteract mechanical, inflammatory, and other injuries due to their senescence (Aigner, Rose, Martin, &Buckwalter, 2004).
• CONNECTIVE TISSUE THEORY also referred to as cross-link theory, and it proposes that, over time, biochemical processes create connections between structures not normally connected.

  
  

  Elastin dries up and cracks with age. Hence, skin with less elastin (as with the older adult) tends to be dried and wrinkled

  
  

  Over time, due to decreased extracellular fluid, numerous deposits of sodium, chloride, and calcium build up in the cardiovascular system. (No clinical application studies were Found to support this theory)
• NONSTOCHASTICTHEORIES suggest that aging is genetically programmed for the specific life span of an organism and includes senescence or aging of the entire organism
• PROGRAMMED THEORY Each cell is born with a limited number of replications

  
  

  When they are done, the cell dies and the organisms does as well Increased cell apoptosis rates do cause organ dysfunction, and this is hypothesized to be the underlying basis of the pathophysiology of multiple organ dysfunction (MODS) (Papathanassoglou,Moynihan, & Ackerman, 2000).
• GENE/BIOLOGICAL CLOCKTHEORY Each cell, or entire organism has a genetically programmed aging code that is stored in the organism’s DNA. It is thought that biological rhythms lose some rhythmicity with aging

  
  

  By restricting calories there is a decreased need for insulin exposure,which consequently decreases growth factor exposure. Both insulin and growth factor are related to mammals’ genetically determined clock controlling life span, (Haq, 2003)
• NEUROENDOCRINETHEORYdescribes a change in hormone secretion, such as with the releasing hormones of the hypothalamus and the stimulating hormones of the pituitary gland, which manage the thyroid, parathyroid, and adrenal glands, and how they influence the aging process
• Estrogen decreases thinning of bones, whenwomen age less estrogen

  
  

  as one ages there is a loss of neuroendocrine transmitter function that is related to the cessation of reproductive cycles

  
  

  with physiological aging and also with certain psychiatric disorders there is increased activation of the hypothalamus pituitary-adrenal axis, which causes increased plasma cortisol levels. The increased cortisol levels can be linked with several diseases
• IMMUNOLOGICAL /AUTOIMMUNE THEORY proposed 40 years ago and says that the normal aging process of humans and animals is related to faulty immunological function(Effros, 2004).
• Decreased immune function in the elderly.

  
  

  Thymus gland shrinks in size and ability to function

  
  

  Loss of T-cell differentiation so that the body incorrectly perceives old, irregular cells as foreign bodies and attacks them

  
  

  An increase in certain autoantibodies such as rheumatoid factor and a loss of interleukins causing auto immune diseases.
• ACTIVITY THEORY - Remaining occupied and involvedis necessary to a satisfying late-life
• 2. DISENGAGEMENT THEORY - Gradual withdrawal from society and relationships serves to maintain social equilibrium and promote internal reflection.
• 3. SUBCULTURE THEORY - The elderly prefer to segregate from society in an aging subculture sharing loss of status and societal negativity regarding the aged. Health and mobility are key determinants of social status.
• 4. CONTINUITY THEORY - Personality influences roles and life satisfaction and remains consistent throughout life. Past coping patterns recur as older adults adjust to physical, financial, and social decline and contemplate death. Identifying with one’s age group, finding a residence compatible with one’s limitations, and learning new roles post retirement are major tasks.
• 5. AGE STRATIFICATION THEORY - Society is stratified by age groups that are the basis for acquiring resources, roles, influenced by their historical context and share similar experiences, beliefs, attitudes, and expectations of life course transitions
• 6. PERSON-ENVIRONMENT FIT - Function is affected by ego strength, mobility, health, cognition, sensory perception, and the environment. Competency changes one’s ability to adapt to environmental demand
• 7. GEROTRANSCENDENCE - The elderly transform from a materialistic/rational perspective toward oneness with the universe. Successful transformation includes an outward focus, accepting impending death, substantive relationships, intergenerational connectedness, and unity with the universe
• 1. HUMAN NEEDS THEORY - Five basic needs motivate human behavior in a lifelong process toward need fulfillment.Although Maslow does not specifically address old age, it is clear that physical, economic, social, and environmental constrain can impede need fulfillment of older adults
  2. Jones and Miesen (1992) used Maslow’s hierarchy to present anursing care model for working with aged persons with specificneeds in an attempt to relate all patient needs to universal needs
• 2. THEORY OF INDIVIDUALISM - Jung (1960) proposes alifespan view of personality development rather thanattainment of basic needs. Personality consists of an egoand personal and collective unconsciousness that views lifefrom a personal or external perspective. Older adults searchfor life meaning and adapt to functional and social lossesAs individuals age, Jung proposes that elders engage in an “innersearch” to critique their beliefs and accomplishments. According toJung, successful aging means acceptance of the past and anability to cope with functional decline and loss of significant others
• Personality develops in eight sequential stages with corresponding life tasks
• The eighth phase is integrity versus despair
• Characterized by evaluating life accomplishments
• Struggles include letting go, accepting care, detachment, and physical and mental decline
• In a recent study of frail elderly men and women by Neumann (2000)
• Used Erikson's theoretical framework
• Participants were asked to discuss their perceptions about the meaning of their lives
• Older adults expressing higher levels of meaning and energy described a sense of connectedness, self-worth, love, and respect
• These aspects were absent among participants who felt unfulfilled
• 4. LIFE-COURSE/LIFESPAN DEVELOPMENT - Life stages are predictable and structured by roles, relationships, values, and goals. Persons adapt to changing roles and relationships. Successful adaptation to life change may necessitate revising beliefs in order to be consistent with societal expectations. Individuals must adapt to changed roles and relationships that occur throughout life, such as getting married, finishing school, completing military service, getting a job, and retiring (Cunningham& Brookbank, 1988)
• Selective Optimization with Compensation (SOC) is a theory that explains how individuals cope with aging losses through activity/role selection, optimization, and compensation
• As individuals age and face limitations, they become more selective in activities and roles
• Individuals choose activities and roles that are most satisfying (optimization)
• Individuals adapt by seeking alternatives when functional limits prevent them from sustaining former roles or activities
• Retirement quality for women is associated with good health, a continuous career, earlier retirement, and a good postretirement income
• For men, retirement quality is impacted by good health, an enjoyable career, low work role prominence, preretirement planning, and retiring voluntarily