Geriatric considerations - Psychosocial: Nursing

Geriatrics is the branch of medicine that deals with the physiology and psychology of aging, as well as the diagnosis and treatment of diseases affecting older clients. Now, as a person ages, they go through psychosocial development, which refers to how the client's personal needs fit with the needs of the society. This occurs through a life-long series of events with multifactorial influences like personality, thinking, and behavior. Two psychiatrists and psychologists who were involved in studying psychosocial development are Carl Jung and Erik Erikson.

Okay, now one particular theory of Carl Jung is called individualism, which describes the process by which a person develops into a unique individual by balancing their orientation between the external world and their own subjective, inner experiences. According to Jung, individuals age successfully when they accept the past, adapt to physical decline, and accept their life’s accomplishments as well as its limitations.

Now, Erikson constructed a theory called the psychosocial theory of development, which describes development in eight life stages. Typically, an individual needs to fulfill a particular task in one stage to move to the next one. The eighth and final life stage in Erikson’s theory occurs in clients who are 65 years or older, and it is called integrity vs. despair. Integrity is when older clients review their lives with satisfaction, even in the presence of inevitable mistakes, whereas despair occurs when older clients regret missed opportunities in life. Finally, psychosocial development is closely related to decisions regarding the end of life.

Now, psychosocial development can influence quality of life, or QOL for short, which can be health-related or environmental. Health-related QOL includes a client’s physical, mental, emotional, and social functioning, and their impact on quality of life. These can include mobility, independence in bathing and dressing, sensory acuity, in addition to mood and absence or presence of pain. On the other hand, environmental QOL involves the effect of the client’s environment influencing quality of life. These can include economic resources, housing, air and water quality, and community stability, as well as access to arts and entertainment, capacity to form friendships and appreciate nature, and finding satisfaction in spiritual or religious life.

Now, these two types of QOL are so related that one may affect the other, and vice versa. For example, cognitive impairment associated with dementia can typically affect both health-related and environmental quality of life.

Finally, during the end of life period, older clients typically think about the meaning of illness, spiritual uncertainty, loss and grief, as well as fear of increasing dependency on others, uncertainty and fear about the future, and worries about loved ones.