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Theory of Aging Paper

Kaitlyn R. Ludwig

Saint Francis Medical Center College of Nursing

Theory of Aging Paper

My client G.B. is a 78-year-old retired female who is my maternal grandmother. Prior to

retirement she worked at Country Companies in Bloomington Illinois in the accounting

department. The purpose of this paper is to connect the Activity Theory to my client.

Client Background

Client has a medical history of high blood pressure, hypothyroidism, arthritis, acid reflux,

insomnia, fibromyalgia, chronic back pain and high cholesterol. G.B. has a past medical history

of breast cancer in the left breast as well as cataracts in both eyes. Client has a past surgical

history of cataract removal in both eyes, a lumpectomy in the left breast and a double knee

replacement. Clients social history includes going to meet friends 2-3 times a week going to

lunch with friends as well as grocery shopping with a group of friends. Client states they have no

allergies.

Medications include: Hydrochlorothiazide, 12.5mg tablets, 1 tab by mouth daily, diuretic,

indicated for high blood pressure. Lisinopril, 20 mg tablets, take one tab by mouth daily, ACE

Inhibitor, indicated for high blood pressure. Omeprazole, 40 mg capsules, take one capsule by

mouth daily, Proton pump inhibitor, indicated for acid reflux. Gabapentin, 300 mg capsules, take

1 capsule by mouth twice a day, GABA analogue, indicated for fibromyalgia. Levothyroxine,

0.088mg tab, take 1 tab by mouth daily, thyroid hormone, indicated for hypothyroidism.

Simvastatin, 40 mg ab, take 1 tablet by mouth every evening, HMG-CoA inhibitor, indicated for

high cholesterol. Tramadol/APAP 37.5 mg/325mg tabs, take 2 abs by mouth every 4 hours as

needed for pain, oral analgesic, indicated for chronic back pain. Her chief complaint is that she is

bored from being stuck home due to COVID-19 as well as her back pain. Due to not being able

to get into the doctor it is harder for her to get ahold of her doctor to get her medication
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prescription to the pharmacy. Due to the medication being a narcotic she has to have a

prescription every time she fills it.

Functional Assessment

I completed a functional assessment on the client. One assessing her ADL’s and the other

assessing her IADLS. The first assessment tool to assess her ADL’s was Barthel’s Index, the

Barthel Scale is an ordinal scale used to measure performance in activities of daily living. Ten

variables describing ADL and mobility are scored, a higher number being a reflection of greater

ability to function independently following hospital discharge (Physiopedia, 2019). Barthel Index

includes feeding, bathing, grooming, dressing, bowel and bladder control, toilet use, transfers,

mobility and stairs. On this scale you receive a max of 15 points for each category, if she is

independent, 5-10 points depending on how much help they require and 0 points if they are

unable to complete that task. The maximum score is 100 meaning that the person is totally

independent. My client received independent in all categories with a score of 100 points. She

received this score because she is able to complete all the tasks on that list without help.

The second assessment tool used on my client was Lawton’s Instrumental Activities of

Daily Living. This scale was developed to assess more complex activities necessary for

functioning in community settings (e.g., shopping, cooking, managing finances). The capacity to

handle these complex functions normally is lost before basic “activities of daily living”.

Therefore, assessing IADLS may identify incipient decline in older adults who are otherwise

capable and healthy (American Psychological Association, 2017). This assessment contains

eight items that are rated with a summary score of 0-8. My client had a score of 8 meaning that

she is high functioning according to the assessment.

My client was not deficient in either of the two functional assessments. According to both

of them she is independent. She manages all of her own care, besides asking me to help her do

things that she cannot do because she is not tall enough or because I can do things such as climb

up a ladder to cut down limbs without as much of a risk of falling and hurting myself severely.

Theory. The activity theory was first proposed by Robert J. Havighurst. This theory was

originally conceived as a response to the recently published disengagement theory of aging. The

theory states that individuals need to remain active to age successfully. Activity is necessary to

maintain life satisfaction and positive self-concept. This theory sees activity as necessary to

maintain a person’s life satisfaction and positive self-concept.

By remaining active, the older person stays engaged and gains satisfaction with aging.

The theory is based on three assumptions: it is better to be active than inactive; It is better to be

happy than unhappy; an older individual is the best judge of his or her own success in achieving

the first two assumptions. Within the context of this theory, activity may be viewed broadly as

physical or intellectual. Therefore, even with illness or advancing age, the older person can

remain “active: and achieve a sense of life satisfaction. (Meiner, S., & Yeager, J.J., 2019)

The activity theory of aging proposes that older adults are happiest when they stay active

and maintain social interactions. These activities help the elderly to replace lost life roles after

retirement and therefore resist the social pressures that limit an older person’s world. The theory

assumes a positive relationship between activity and life satisfaction.

Activity Theory. There was a study conducted that evaluated the impact of participation

in discretionary activities on life satisfaction, social isolation, and loneliness, using data from a

longitudinal study of older adults. The study showed that older adults who participated in 8

weeks of discretionary activities reported greater life satisfaction and lower levels of social
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isolation compared with non-participants (Winstead, V., et al, 2014). This study and theory apply

to my client. My client showed on both assessment tools that she is completely independent and

completes all of her own work. In the interview with my client I asked numerous questions

regarding the amount of acidity she gets per day.

On a typical day my grandmother will wake up take a bath by herself, get dressed and

make breakfast. Depending on the day she will either go to Bloomington to meet her friends for

lunch or go with her friends to go grocery shopping. On the days that she is not doing that she

will work outside in her yard or in her house doing housework. Such as pulling weeds, mowing,

planting flowers outside. While inside she works on dusting, vacuuming, or doing laundry. While

I have been home on spring break my grandmother has been helping me with painting and fixing

holes in my wall so that I could re paint and re do my room.

My grandmother follows all three of the presumptions of this theory. She meets the first

one just by staying active. The first presumption states it is better to be active than inactive. My

grandmother is very active, and I believe that her staying active and independent most of her life

that she has helped in her own health. For being 78 my grandmother does not have many health

issues. Her high B/P and high cholesterol can be accounted to diet and the choice not to work on

losing weight. The second presumption is it is better be happy than unhappy.

My grandmother demonstrates this by her choice of lifestyle, being outside and staying

busy is what keeps my grandmother happy. He favorite time of the year is spring and summer

because she is able to be outside. This is an example of practical application of sociologic aging

theory. Older adults are continuing to be active, engaging or disengaging as they wish, and

remaining valued members of society.

Health Promotion. Due to my patient’s medical history of high blood pressure and high

cholesterol my recommendation would be a healthier diet as well as implementing more

exercise. Eating variety of foods from all food groups can help supply the nutrients a person

needs as they age. To help with the high cholesterol eating foods with more fiber can help lower

cholesterol levels by 10% as well as cutting out sugary foods and beverages. Another part of the

diet that is very important is limiting the intake of red meat, dairy products made with whole

milk, and limiting fried food. Knowing your fats such as fats that raise LDL cholesterol and

which ones don’t is key in lowering your risk of heart disease. (American Heart Association,

2017).

Becoming more physically active will lower both cholesterol and high blood pressure.

For my client as she is older, just adding a small walk every day would help lower cholesterol

and her blood pressure. By adding other physical activity besides housework and yard work she

is bettering her health and allowing her body to lose weight. Which is also very beneficial to her

health as it will lower her bad cholesterol and help with her high blood pressure (American Heart

Association, 2017).

The activity theory of aging is one of the most important theories regarding elderly

people in my opinion. Not only is staying active good for their physical health, there are many

conducted studies that physical activity is good for your mental health as well. If my client were

to implement the recommended changes that I have made she could live an even happier and

healthier lifestyle than she already is now. The study that I referred to in a previous paragraph

showed that elderly that participated in social and physical activity reported greater life

satisfaction. If more programs were available to the elderly, we could improve a lot more peoples

lives.
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References

Barthel Index. (2019). Retrieved from https://www.physio-pedia.com/Barthel_Index

Cromwell, D. (2003). The performance of instrumental activities of daily living scale in screening

for cognitive impairment in elderly community residents. Journal of Clinical

Epidemiology, 56(2), 131–137. doi: 10.1016/s0895-4356(02)00599-1

Graf, C. (2008). The Lawton Instrumental Activities of Daily Living Scale. AJN, American Journal

of Nursing, 108(4), 52–62. doi: 10.1097/01.naj.0000314810.46029.74

Instrumental Activities of Daily Living Scale. (2017). Retrieved from

https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/daily-

activities

Meiner, S., & Yeager, J. J. (2019). Gerontologic nursing. St. Louis, MO: Elsevier.

Prevention and Treatment of High Cholesterol (Hyperlipidemia). (2017). Retrieved from

https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-

hyperlipidemia

Shah, S., Vanclay, F., & Cooper, B. (1989). Improving the sensitivity of the Barthel Index for stroke

rehabilitation. Journal of Clinical Epidemiology, 42(8), 703–709. doi: 10.1016/0895-

4356(89)90065-6

Winstead, V., Yost, E. A., Cotten, S. R., Berkowsky, R. W., & Anderson, W. A. (2014). The Impact

of Activity Interventions on the Well-Being of Older Adults in Continuing Care

Communities. Journal of Applied Gerontology, 33(7), 888–911. doi:

10.1177/0733464814537701
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Appendix A

Lawton Instrumental Activities of Daily Living. Scale assesses a person’s ability to

perform tasks such as using a telephone, doing laundry, and handling finances. Measuring eight

domains, it can be administered in 10 to 15 minutes. The scale may provide an early warning of

functional decline or signal the need for further assessment (Journal of Clinical Epidemiology).

This functional assessment is made up of eight parts: Ability to use telephone, shopping,

food preparation, housekeeping, laundry, mode of transportation, responsibility for own

medications and the ability to handle finances. The client is rated on a scale of either one or zero,

one is given to the patient who can act independently or needs minimum help for that task. A

zero is given when they are incapable of completing that task (American Journal of Nursing).

Appendix B

Barthel Index. Scale assesses a person’s ability to perform tasks such as feeding, dressing,

and bathing. Measuring in 10 domains. The scale provides a clear view on how capable a person

is in taking care of themselves. The client is rated on a scale of either 15, 10, 5 or 0. Depending

on the domain the scale for that domain may be 10, 5 and 0. Such as dressing: independent gets a

+10, Needs help gets +5 and unable receives a 0. Highest score is 100.