Unit 9 Geriatric Care. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2 9:1 Myths...

Unit 9 Geriatric Care

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

9:1 Myths on Aging

Aging begins at birth and ends at death Gerontology: scientific study of aging and

the problems of the old Geriatric care: care of the elderly Health care worker must distinguish fact

from myth


Myths

Most elderly individuals are cared for in institutions or long-term care facilities

Anyone over a certain set age (such as 65) is old

Elderly people are incompetent and not capable of making decisions or handling their own affairs


Myths (continued)

All elderly people live in poverty Older people are unhappy and lonely Elderly individuals do not want to work,

their goal is to retire, and prior to retirement, they lose interest in work

Retired people are bored and have nothing to do with their lives


Summary

There are many myths about aging Health care workers must recognize

problems that do exist Needs of elderly individuals vary Even though only 5% of the elderly live

in long-term care facilities, this still means 2 million people will be in these facilities by 2008


9:2 Physical Changesof Aging

Physical changes are a normal part of the aging process

Rate and degree of change varies Usually related to a decreased function of

body systems Recognizing normal changes allows the

individual to adapt and cope


Integumentary System

Production of new skin cells decreases Sebaceous (oil) and sudoriferous (sweat)

glands become less active Circulation to skin decreases Hair loses color; hair loss may occur Methods to adapt and cope with changes Measures to slow or decrease changes


Musculoskeletal System

Muscles lose tone, volume, and strength Osteoporosis Arthritis Methods to adapt and cope with changes Measures to slow or decrease changes Providing a safe environment


Circulatory System

Heart muscle becomes less efficient at pushing blood into the arteries

Blood vessels narrow and become less elastic

Blood flow may decrease to brain and other vital organs

Methods to adapt and cope with changes Measures to slow or decrease changes


Respiratory System

Respiratory muscles become weaker Rib cage becomes more rigid Bronchioles lose elasticity Changes in larynx affect voice Methods to adapt and cope with changes Measures to slow or decrease changes


Nervous System

Progressive loss of brain cells Senses diminish Nerve endings are less sensitive Methods to adapt and cope with changes Measures to slow or decrease changes


Digestive System

Fewer digestive juices and enzymes are produced

Muscle action becomes slower; peristalsis decreases

Teeth are lost Liver function is reduced Methods to adapt and cope with changes Measures to slow or decrease changes


Urinary System

Kidneys decrease in size; are less efficient Decreased circulation to kidneys Decreased number of nephrons Bladder function weakens Methods to adapt and cope with changes Measures to slow or decrease changes


Endocrine System

Increased production of some hormones Decreased production of some hormones Methods to adapt and cope with changes Measures to slow or decrease changes


Reproductive System

Female: vaginal walls thin and secretions decrease; decreased support of uterus; breasts sag when fat is redistributed

Male: production of sperm decreases; response to sexual stimuli is slower; ejaculation takes longer; testes become smaller and less firm; seminal fluid becomes thinner and less is produced

Methods to adapt and cope with changes


Summary

Aging causes many physical changes in all body systems; rate and degree vary

All experience some degree of change Adapting and coping means fuller

enjoyment of life within physical limitations Health care workers need to assess

individuals’ needs and assist with coping Tolerance, patience, and empathy

are essential


9:3 Psychosocial Changes of Aging

Elderly individuals also experience psychological and social changes

Some cope and others experience extreme frustration and mental distress

Health care workers must be aware of this and assess changes and stresses


Work and Retirement

Most adults spend a large portion of their days working

Retirement is often viewed as an end to the working years

Many enjoy retirement Some feel a major sense of loss


Social Relationships

Change occurs throughout life In elderly individuals, it may occur

more rapidly Some elderly people adjust to changes Some elderly people cannot cope with

changes


Living Environments

Changes in living environments create psychosocial changes

Many elderly people prefer to stay in their own homes

Some individuals leave their home by choice

Some are forced to move from their home Moving to a long-term care facility often

creates stress


Independence

Most individuals want to be independent and self-sufficient

Elderly people learn that independence can be threatened with age

Factors that can lead to decreased independence include physical disability, illness, and decreased mental ability


Independence (continued)

Individuals may need assistance, but allow maximum independence and personal choice


Disease and Disability

Elderly people are more prone to disease and disability

Diseases sometimes cause permanent disabilities

When functioning is affected, psychological stress is experienced

Sick people often have fear of death, chronic illness, loss of function, and pain


Summary

Psychosocial changes can be a major source of stress

As changes occur, individuals must learn to accommodate the changes and function in new situations

With support, understanding, and patience, health care workers can assist individuals as they learn to adapt


9:4 Confusion and Disorientation in the Elderly

Most remain mentally alert until death Signs of confusion or disorientation It is sometimes a temporary condition Disease and/or damage to the brain can

result in chronic confusion or disorientation


Dementia

Term used to describe a loss of mental ability

Characteristics include decrease in intellectual ability, loss of memory, and personality change

Acute dementia Chronic dementia


Alzheimer’s Disease

One form of dementia Causes progressive changes in brain cells Lack of neurotransmitter Frequently occurs in 60s, but can occur as

young as 40 years of age Cause is unknown


Alzheimer’s Disease(continued)

Terminal incurable brain disease; usually lasting 3-10 years

Early stage Middle stage Terminal stage


Caring for the Confused or Disoriented Patient

Provide safe and secure environment Follow the same routine Follow “reality orientation” guidelines


Summary

Caring for a confused or disoriented individual can be frustrating and even frightening

Perform continual assessments Design program to maximize function Practice patience, consistency, and

sincere caring


9:5 Meeting the Needs of the Elderly

Geriatric care can be challenging but rewarding

Elderly people have the same needs as others

Cultural needs Religious needs Freedom from abuse Respect patient’s rights


Summary

Needs of the elderly do not vary that much from needs of others

Must respect cultural and religious differences

Must respect and follow patient’s rights Must ensure that the patient is free

from abuse

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