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Sensory Deprivation and Loss
Catherine McClendon, RN MSN
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Sensory Deprivation
Definition
Absence of stimuli in environment
Inability to interpret existing stimuli
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Sensory Deprivation
Leads to:
Boredom
ConfusionIrritability
Disorientation
Anxiety
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Sensory Deprivation
Prevention
Color
Pictures
Textures
Smells
Sounds
Interpret environment
Change scene often
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Cataracts
Clouding of normally clear, transparent
lens.
Leading cause of blindness in the world-
per WHO.
www.sabateseye.com
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Cataracts
Causes
Aging
Congenital
Trauma
Long term corticosteroid use
Diabetes
Radiation Exposure---SUN!
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Cataracts
Pathophysiology
No clearly understood
Physical changes in suspension of lens
Chemical changes in lens protein
Occurs bilaterally, but at the same rate
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Cataracts
Signs/Symptoms
Decreased visual acuityGlare sensitivity
Poor night vision
Pupil may appear gray or pearly white
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Cataracts
Diagnosis by eye exam.Snellen visual acuity test
Ophthalmoscopy
Slit-lamp biomicroscopic exam
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Cataracts
Treatment
No non-surgical treatment cures cataracts.
Determine extent to which it hinders ADLs.
Corrective glasses and magnifying glass
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Cataracts
Types of Surgery
Intracapsular
Remove entire lens
Not used much anymore
Extracapsular
98% done this way
Remove anterior capsule and lens
Leave posterior capsule
Place plastic lens
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Cataracts
Complications
Corneal damageGlaucoma
Hemorrhage
IOL malposition
Secondary lens develop
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Cataracts
Post Operative Care
May read and watch TV
NO bending forward at the waist
Kneel or squat to pick up objects
Sleep with protective shield
Sleep on back
Wear glasses during day
Sunglasses outside
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Cataracts
Post Operative Care, cont.
Avoid: rubbing eyes, straining to have BM,
soap in eyes, lifting over 15 pounds, driving,
coughing, sneezing, vomitingMedications: Steroids, antibiotics, given locally.
REPORT: pain, headache, ocular redness,
swelling, drainage, discharge, changes invisual acuity (dots or floaters).
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Glaucoma
Visual field loss from damage to optic nerve fromhigh intraocular pressure generally.
Leading cause of blindness in US.
Asymptomatic until extensive and irreversible
damage done.
www.sabateseye.com
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Glaucoma
More prevalent in elder
Occurs most often in diabetics, AfricanAmericans, those with family history, andthose with history of eye trauma or eyesurgery.
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Glaucoma
Classification
Open Angle
Angle Closure
Primary
Secondary
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Glaucoma
Diagnosis
Assess ocular history, medicationsOphthalmic exam
Tonometry
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Glaucoma
Symptoms
Loss of peripheral vision
Halo vision
Blurred vision
Ocular pain with increases in IOP
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Glaucoma
Medications
Beta Blockers
Timolol
Betagen
Betoptic
Cholinergics
Pilocarpine
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Glaucoma
Surgery
IridectomyTrabeculoplasty
Done with laser if possible
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Glaucoma
Post Operative Care
No straining, lifting, or bending for 1 week
No driving for at least 1 week
Patch 24 hours a day
No water in eye
Antibiotic drops
Corticosteroid drops
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Glaucoma
Patient Education
Strict, lifelong adherence to medicationsKeep eyes clean
No rubbing
Non-allergic cosmetics
Continuous follow up with physician
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Hearing Loss
Consequences
Speech discrimination lost
Social isolation
Lower performance on mental exams
Depression
Boredom
Safety issuesCant test reality-leads to paranoia
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Hearing Loss
Characteristics
Often gradual and difficult to recognize
Denial is common
Blamed on acoustics or others mumbling
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Hearing Loss
Conductive-decreased or absenttransmission of sound from external
auditory canal to and through the middleear.
Causes
Impacted cerumen
Loss of elasticity of tympanic membrane
Bone rigidity-otosclerosis
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Hearing Loss
Sensorineural-gradual hearing loss inelder. Presbycusis in elder. Damage tothe inner ear, auditory nerve, brainstemand/or cortical-auditory pathways.
Causes
Noise damage
Aging
Drug toxicity (ototoxicity)
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Hearing Loss
Management
Prevention in the first place!
Health problems can go untreated due to hearing loss.
Make whatever accommodations are neededSign language
Think about it: You are elderly and ill. You are in a
strange place having strangers do strange things to yourbody. The room is darkened and they are wearingmasks. You cant hear or understand what they are
saying. Would you feel comfortable?
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Hearing Aids
Body worn
Eyeglasses
Behind the ear
Intra-auricular
In the canal
Completely in the canal
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Hearing Aids
Issues
Cost
Dexterity needed
Tiresome
Adjustment to fit
Old types intensify all noise
Batteries neededDigital technology
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Hearing Aids
Care
Acquisition of hearing aids
Hearing Guide Dogs
