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Geriatric Care. JAMES VALLEY VOCATIONAL TECHNICAL CENTER. MYTHS. Elderly people are incompetent and incapable of making decisions or handling their own affairs. Most elderly live in nursing homes All elderly people live in poverty. Older people are lonely and unhappy
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Geriatric Care JAMES VALLEY VOCATIONAL TECHNICAL CENTER
MYTHS • Elderly people are incompetent and incapable of making decisions or handling their own affairs. • Most elderly live in nursing homes • All elderly people live in poverty
Older people are lonely and unhappy • Elderly do not want to work • “Old Age” begins a 65 • Retirement ends your active life
Physical Changes of Aging • Most physical changes that occur with aging are gradual and take place over a long period of time. In addition, the rate and degree of change varies among individuals.
Factors such as disease can increase the speed and degree of the changes. Lifestyle, nutrition, economic status, and social environment can also have effects. • If an individual can recognize the changes as a/an normal part of aging, the individual can usually learn to adapt to & cope with change
Integumentary SystemChanges • Production of new skin cells decreases • Oil and Sweat glands become less active • Circulation decreases
Hair losses color, and hair loss occurs • Skin becomes less elastic & dry • Itching is common • Dark yellow or brown colored spots appear • Senile lentigines (liver spots)
Fatty tissue layer of skin diminishes • Lines and wrinkles appear • Nails become thick, tough, and brittle • Increased sensitivity to temperature
Care of Skin • Use mild soap • Bath oils or lanolin lotion • Bath or Shower once or twice a week • Brush Hair daily
Shampoo as often as needed for cleanliness and comfort • Care for sore or injuries immediately • Socks, sweaters, lap blankets, and layers of clothing will help alleviate the feeling of coldness
Circulatory System Changes • Loss of pacemaker cells: -Slightly slower heart rate/abnormal rhythms • Heart muscle becomes more rigid -HR and cardiac output diminished
Circulatory System Changes • Decreased parasympathetic system: -HR more prone to increase • Decreased baroreceptors that monitor the blood pressure • Increased dizziness
Circulatory System Changes • Decreased elasticity of blood vessels -Increased blood pressure • Thicker capillary walls • Decreased nutrient/waste exchange
Because of the need for oxygen and nutrients the elderly may experience: • Weakness • Dizziness • Numbness in hands & feet • Rapid heart beat
Circulatory System Care • With circulatory changes: • Avoid strenuous exercise or over exertion • Periods of rest • Moderate exercise, according to individual’s tolerance
Prevent the formation of a blood clot (thrombus) • Support stockings, anti-embolism hose • DO NOT wear garters or tight bands around legs\ • If confined to bed • Range Of Motion exercises
High Blood Pressure = • Diet low in salt • Decrease fat intake • Exercise as recommended by physician
Respiratory Changes • Respiratory muscles become weaker • Rib cage more rigid • Alveoli thinner & less elastic which decreases exchange of gases - emphysema
Bronchioles lose elasticity • Changes in larynx lead to higher pitched & weaker voice • Chronic diseases may decrease the efficiency of the respiratory system even more severely
Changes may cause the elderly to experience: • Dyspnea • Breathing increases in rate • Difficulty coughing up secretions • Increases susceptibility to infections such as a cold or pneumonia
Respiratory Care • Alternate activity with periods of rest • Proper body alignment & positioning • Sleep in semi-fowlers position • Use 2 or 3 pillows
Avoid polluted air • Breath deeply & cough frequently • May need continuous oxygen therapy: tanks vs. concentrators
Nervous System Changes • Blood flow to brain decreases & there is a progressive loss of brain cells - - Interferes with • Thinking - Reacting • Interpreting - Remembering
Senses of taste, smell, vision, & hearing are diminished • Nerve endings less sensitive • Decreased ability to respond to pain and other stimuli • Decrease in taste& smell frequently affects appetite
Changes in vision • Problems reading small print • Seeing objects at a distance • Decrease in peripheral vision • Decrease in night vision • Increased sensitivity to glare • Cataracts • Glaucoma
Changes in hearing • Hearing loss usually gradual • Person may speak louder than usual • Ask for words to be repeated • Not able to hear high frequency sounds • May not hear well in crowded places
Decreased sensation to pain & other stimuli = more susceptible • Burns • Frostbite • Cuts • Fractures • Muscle strain and other injuries
Nervous System Care • Mental and physical exercise can help your brain stay sharp. Mental exercises include: • Reading • Doing crossword puzzles • Stimulating conversation • Physical exercise promotes blood flow to your brain. It also helps reduce loss of brain cells.
Nervous System Care • Glasses • Hearing Aids • Minimize crowds….less background noise • Speak slower and facing the individual • Medications and gum disease may influence sense of taste…
Digestive Changes • Fewer digestive juices and enzymes produced • Muscle action becomes slower & peristalsis decreases • Teeth are lost • Liver function decreases
Dysphagiais frequent complaint • Less saliva • Slower gag reflex • Loss of teeth • Poor fitting dentures • Slower digestion of food • indigestion
Decrease peristalsis • Increase flatulence (gas) • Constipation • Decrease sensation of taste • Poor appetite • Poor diet
Digestive Care • Good oral hygiene • Repair or replace damaged teeth • Relaxed eating atmosphere • High-fiber high-protein foods with different tastes and textures • Seasoning to improve taste • Increased fluid intake
Urinary Changes • Kidneys decrease in size & become less efficient • Bladder becomes less efficient • May not hold as much • May not empty completely • Incontinence
Urinary Care • Increase fluid intake • Decrease before bedtime • Regular trips to bathroom • Easy to remove clothing • Absorbent pads
Endocrine Changes • Increased production of some hormones and decreased of others- Estrogen (in women), Testosterone (in men), Growth hormone, Melatonin • Immune system less effective • BMR decreases • Intolerance to glucose
Endocrine Care • Proper exercise • Adequate rest • Medical care for illness • Balanced diet • Healthy lifestyle
Reproductive System Changes • Decrease of estrogen / progesterone in female • Thinning of vaginal wall • Decrease vaginal secretions • Inflammation of vagina common
Weakness in supporting tissue: • Uterus sags downward (Uterine prolapse) • Breasts sag when fat redistributed • Decrease in Testosterone • Slow production of sperm • Response to sexual stimuli slower • Testes smaller less firm
Male and Female • Sexual desire may or may not decrease • Advantages of sex in elderly • Improves muscle tone & circulation • Pain from arthritis seems to decrease
Reproductive Care • Understand physical and psychological sexual needs of the elderly • Allow married couples to be in the same room • Give privacy to consenting elderly
Psychocosocial Changes • Some individuals cope with psychosocial changes, and others experience extreme frustration and mental distress
Fears of a sick person: • Death • Chronic illness • Loss of function • Pain
Dealing with fears created by an illness: • Listening • Patience • Understanding • Provide support
Confusion and Disorientation • Six signs: • Talking incoherently • Not knowing their name • Not recognizing others • Wandering aimlessly • Lacking awareness of time or place
Displaying hostile and combative behavior • Hallucinating • Regressing in behavior • Paying less attention to personal hygiene • Inability to respond to simple commands or instructions
Causes of temporary confusion / disorientation • Stress and/or depression • Use of alcohol or chemicals • Kidney disease • Respiratory disease • Liver disease • Medication