PERUBAHAN BIO,SPIRITUAL DAN

KULTURAL YANG LAZIM TERJADI PADA

PROSES MENUA
BY:
Suwanti,S.Kep.Ns.,MNS
 Out line

BIOLOGICAL CHANGES
SPIRITUAL CHANGES
CULTURAL CHANGES
BIOLOGICAL CHANGES
Normal Changes of Aging (Wallace,2008)
 Cardiovascular system
 Respiratory system
 Integumentary system
 Gastrointestinal system
 Urinary system
 Musculoskeletal system
 Sexuality/reproductive system
 Changes in the senses
 Neurological changes
 System Normal Aging Changes
Cardiovascular a. Heart becomes larger & occupies a greater amount of
space within the chest
b. Reduction in the amount of functional muscle mass of
heart.
c. Decreased in the amount of functional muscle mass of
heart.
d. More adventitious S4 heart sounds
e. Premature contractions & arrhytmias.
f. Blood flow is slower
g. Low diastolic pressure
h. Increase pulse pressure

Peripheral vascular a. Increase in the peripheral vascular resistance (blood has

system a hard time returning to the heart & lungs).
b. Valve in the veins don’t function effectively & form(non-
pathological)edema.
Respiratory a. Decreased vital respiratory capacity
b. Lungs loss elasticity
c. Loss of water&calcium in bones causes the thoracic cage
to stiffen.
d. Decreased amount of cilia lining system
e. Decreased cough reflex
Integumentary a. Skin becomes thinner & more fragile.
b. Skin is dry & loses elasticity (wrinkles)
c. Sweat gland lessen, which leads to less perspiration
d. Subcutaneaous fat and musculer layers begin to diminish; less
padding, more easyly bruised.
e. Dryness
f. Skin tears
g. Fingernaills and toenails become thick and brittle
h. Hair become dry, fine, and thin.
i. Facial hair on women
j. Decreased body hair on men and women.
Gastrointestinal a. Inflamed gums
b. Periodontal disease
c. Sensitive teeth
d. Tooth loss
e. Decreased of peristalsis of esophagus
f. Decreased gut motility, gastric acid
production,and absorption of nutrient
g. Difficulty evaluating wastes (constipation)
h. Involuntary leakage of liquid stool (fecal
incontinence)

Urinary a. Kidneys experience a loss of nephrons

and glomeruli
b. Bladder tone and volume capacity
decrease
c. Incontinence (not a normal change, but
occurs in response)
Musculoscelet a. Decrease in total mass and bone mass
al b. Muscle unit that combine to form muscle groups
diminish

Sexual/ a. Decrease in testoteron in men,and

reproductive estrogen,progesterone,androgen in women.
b. Men: increased length of time needed for erection and
ejaculation
c. Women:
1) Follicullar depletion in the ovaries
2) Natural breast tissues is replaced by fatty tissue.
3) Labia shrinks
4) dectreasess in vaginal secretion and shortening and of the
vagina.
5) strength of orgasmic contraction diminishes, and orgasmic
phase is decreased.
Senses a. Eyes: Visual acuity declines
Ability of pupil to constrict in response to
stimuli decreases.
Peripheral vision declines
Lens of the eye often becomes yellow
Arcus senilus
a. Ear:Increased of hard cerumen
b. Taste&smell: 30% of taste buds diminishes.
Neurological a. Total brain weight decreases.
b. Shift in the propotionof gray matter to white
matter
c. Loss of neuron
d. Increase in the number of senile plaques
e. Blood flow to the cerebrum decreases.
 SPIRITUAL CHANGES (Azizah,2011)
 Agama dan kepercayaan lansia makin berintegrasi dalam
kehidupannya (Nugroho,2006;Maslow, 1976; Stuart &
Sundeen, 1998 dalam Azizah, 2011).
 Lansia makin teratur dan mature dalam kehidupan
keagamaannya. Hal ini dapat terlihat dalam berfikir dan
bertindak sehari-hari (Murray & Zenther dalam
Nugroho,2000).
 Sikap terhadap kematian. Hal ini menunjukkan bahwa lansia
cenderung tidak terlalu takut terhadap konsep realitas
kematian. Lansia merasakan/sadar akan kematian (Sense of
awareness of mortality).
Continued..
 Harapan memungkinkan individu dengan keimanan
spiritual/religius untuk bersiap menghadapi krisis kehilangan
dalam hidup sampai kematian.
 Perkembangan spiritual pada usia 70 tahun menurut Fowler
(1978), universalizing, perkembangan yang dicapai pada
tingkat ini adalah berfikir dan bertindak dg cara memberi
contoh ,cara mencintai dan keadilan.
 CULTURAL CHANGES (TSNIPH,2008)

Familial support and care giving among generations typically

run in both directions. Older people often provide care for a
variety of others (spouses, older parents, children,
grandchildren, and nonfamily members), while families, and
especially adult children, are the primary source of support
and care for their older relatives. Most older people today
have children, and many have grandchildren and living
siblings. However, in countries with very
low birth rates, future generations will have few if any
siblings.The global trend toward having fewer children
assures that there will be less potential care and support for
older people from their families in the future.
 Cultural aspects Significant cultural differences in
many aspects of ageing appear, for example, in cross-
cultural gerontology studies. These differences appear in
the attitudes towards ageing and old people, in the
cultural-moral visions of relationships among persons, families and
states; in the roles of beliefs, spirituality and religion regarding
health and disease; in perceptions of health, and in cultural norms
and perceptions regarding the benefits of different behavior and
health practice. In addition, the differences are reflected in
people’s hopes and expectations about how they want and are able
to live, how they want to die, how they work their way through
life, how and when they learn, and how they comprehend and feel
about the reality of ageing and old age. These differences create
important challenges for health promotion in ageing.
 Consistent with cultural theories of ageing, many studies
have shown how important it is that health promotion program
and interventions are in agreement with the target group’s
cultural norms, perceptions and self awareness.Significant cultural
differences exist between ethnic and cultural minority groups but
also between social classes, between metropolitan areas, and
between rural and urban areas. Contextual factors may either help
or hinder health promotion, in ‘troublesome’ or ‘better’
neighbourhoods: community differences in what is termed social
capital. The scales used in research to examine for example
depression may yield different results due to cross-cultural
differences in the concept of depression.
 Similarly, the understanding and practice of exercise
for physical fitness seems to vary greatly between
older adults in different countries. Additional
knowledge is required about cross20 cultural differences as
well as cross-cultural universals, to prevent stereotypes and
promote health promotion.
 REFERENCES
Azizah, Lilik Ma’rifatul.2011. KeperawatannLanjut Usia.Graha
Ilmu,Yogyakarta
Nugroho.2000.Keperawatan Gerontik.EGC.Jakarta
Nugroho, Wahyudi.2008.Keperawatan Gerontik dan Geriatrik,
edisi 3, EGC, Indonesia
The Swedish National Institute of Public Health.2008.Healthy
Aging, A Challange in Europe
Wallace,Meredith.2008.Essential of Gerontological Nursing.
Springer Publishing Company,New York.