The Aging Adult

KEY CONCEPTS

Biologic, psychosocial, and environmental factors influence the aging process. Adults from 40 to 65 years of age are considered middle adults, while anyone older than 65 years is an older adult. Middle-aged adults who practice preventive health practices often have improved quality and quantity of life. Chronic diseases in middle-aged adults can have a major effect on self-concept and may precipitate changes in life structure. Adjustments associated with the middle adult years may include changes in employment, changes in spousal relationships, and increased caregiver responsibilities. Life expectancy for men is 76 years of age and for women is 81 years of age. Eighty percent of older adults suffer from at least one chronic illness. Pain is often experienced by older adults but is not a normal consequence of aging. Older adults use more health care than any other age group. Prolonged social isolation has been associated with declining health and higher mortality rates. The complicated medical regimens typical of care for older adults are a challenge for them and require careful attention and diligence. Falls are the most common cause of injury and hospital admissions for older adults. Most often it is family members who are responsible for elder abuse or maltreatment. A medical or surgical event can trigger a sequence of adverse events in a frail older adult that is referred to as cascade iatrogenesis. The focus of nursing care for older adults is to assist them to function as independently as possible and to support their individual strengths.

Which of the following statements accurately describe the role of the middle adult? (Select all that apply.) a. A task of the middle adult is to guide the next generation. b. A task of the middle adult is to prepare for separation from family and friends. c. One role of the middle adult is to adjust to the needs of aging parents. d. According to Levinson, middle adults may choose either to continue an established lifestyle or reorganize their life in a period of midlife transition. e. Gould viewed the middle years as a time when adults look inward and accept their life span as having definite boundaries. f. Persons in the middle adult years must adjust to decreased personal freedom and economic instability.

a. A task of the middle adult is to guide the next generation. c. One role of the middle adult is to adjust to the needs of aging parents. d. According to Levinson, middle adults may choose either to continue an established lifestyle or reorganize their life in a period of midlife transition. e. Gould viewed the middle years as a time when adults look inward and accept their life span as having definite boundaries.

According to Havighurst, which of the following is a developmental task of older adulthood? a. Adjusting to declining physical strength and health b. Moving from one's own home to the home of others c. Learning to live by oneself after losing a spouse d. Establishing oneself in the community

a. Adjusting to declining physical strength and health

Which of the following aging theories assumes that healthy aging is related to the ability of the older adult to continue similar patterns of behavior that existed in young to middle adulthood? a. Identity-continuity theory b. Disengagement theory c. Activity theory d. Life review theory

a. Identity-continuity theory

Which of the following statements concerning the physical condition of older adults are accurate? (Select all that apply.) a. In older adults, all organs undergo some degree of decline in overall functioning. b. Body functions that require integrated activity of several organ systems are affected the most in older adults. c. Most older adults experience severe limita- tions in activities. d. Statistically, one out of every five older adults suffers from at least one chronic illness. e. An older adult who lives alone is at greatest risk for loss of independence. f. An older adult's ability to adapt determines whether he/she is ill or healthy.

a. In older adults, all organs undergo some degree of decline in overall functioning. b. Body functions that require integrated activity of several organ systems are affected the most in older adults. e. An older adult who lives alone is at greatest risk for loss of independence. f. An older adult's ability to adapt determines whether he/she is ill or healthy.

Which of the following accurately describe conditions found in older adulthood? (Select all that apply.) a. Sundowning syndrome is a condition in which an older adult habitually becomes confused, restless, and agitated after dark. b. Delirium is a permanent state of confusion occurring in older adulthood. c. Depression is a prolonged or extreme state of sadness occurring in many older adults. d. As many as 50% of adults 65 years and older experience an episode of delirium during a hospitalization. e. Polypharmacy is a term that is used to describe the habit of older adults to use many pharmacies to obtain their prescription drugs. f. A significant percentage of older adults limit their activities because of fear of falling that might result in serious health consequences.

a. Sundowning syndrome is a condition in which an older adult habitually becomes confused, restless, and agitated after dark. c. Depression is a prolonged or extreme state of sadness occurring in many older adults. f. A significant percentage of older adults limit their activities because of fear of falling that might result in serious health consequences.

Which of the following is a developmental task of the middle adult? a. Selecting a life partner b. Establishing and guiding the next generation c. Establishing a social network d. Forming a personal philosophical and ethical structure

b. Establishing and guiding the next generation

Which of the following nursing actions would help maintain safety in the older adult? a. Treat each patient as a unique individual. b. Orient the patient to new surroundings. c. Encourage independence. d. Provide planned rest and activity times.

b. Orient the patient to new surroundings.

Which of the following statements about the older adult is accurate? a. Old age begins at age 65. b. Personality is not changed by chronologic aging. c. Most older adults are ill and institutionalized. d. Intelligence declines with age.

b. Personality is not changed by chronologic aging.

As defined by Erickson, in what stage of human development is the older adult? a. Intimacy versus isolation b. Identity versus role diffusion c. Ego-integrity versus despair d. Generativity versus stagnation

c. Ego-integrity versus despair

Which of the following are considered to be normal physical changes in the middle adult? (Select all that apply.) a. Skin moisture increases. b. Hormone production increases. c. Hearing acuity diminishes. d. Cognitive ability diminishes. e. Cardiac output begins to decrease. f. There is a loss of calcium from bones.

c. Hearing acuity diminishes. e. Cardiac output begins to decrease. f. There is a loss of calcium from bones.

Which of the following accurately describes the behavior of the middle adult? a. Believes in establishment of self but fears being pulled back into the family b. Usually substitutes new roles for old roles and perhaps continues formal roles in a new context c. Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community d. Looks forward but also looks back and begins to reflect on his/her life

c. Looks inward, accepts life span as having definite boundaries, and has special interest in spouse, friends, and community

Which of the following facts regarding Alzheimer's disease (AD) are accurate? (Select all that apply.) a. AD accounts for about one third of the cases of dementia in the United States. b. AD primarily affects young to middle adults. c. Scientists estimate that more than 5 million people have AD. d. The number of people with AD doubles every 20 years. e. AD affects brain cells and is characterized by patchy areas of the brain that degenerate. f. AD is a progressively serious but not a life- threatening disease.

c. Scientists estimate that more than 5 million people have AD. d. The number of people with AD doubles every 20 years. e. AD affects brain cells and is characterized by patchy areas of the brain that degenerate.

Which of the following adult developmental theorists viewed the middle years as a time when adults increase their feelings of self- satisfaction, value their spouse as a companion, and become more concerned with health? a. Erickson b. Levinson c. Piaget d. Gould

d. Gould

Based on an understanding of the cognitive changes that normally occur with aging, what would you expect a newly hospitalized older adult to do? a. Talk rapidly but be confused b. Withdraw from strangers c. Interrupt with frequent questions d. Take longer to respond and react

d. Take longer to respond and react