Chapter 17 Caring for Older Adults People live longer than ever before. Chronic illness is common in older persons. Disability often results Most older persons have at least one disability. Most older people live in a family setting. Some live alone or with friends Some live in nursing centres The need for nursing centre care increases with aging. Slide 2 Late adulthood involves these age ranges: Young-old between 65 and 74 years of age Old between 75 and 84 years of age Old-old 85 years of age and older Gerontology is the study of the aging process. Geriatrics is the care of aging people. Aging is normal. Normal changes occur in body structure and function. Psychological and social changes also occur. Slide 3 1
Psychological and Social Changes Physical reminders of aging can threaten selfesteem and independence. Social roles change. How people cope with aging depends on: Health status Life experiences Finances Education Social support systems Slide 4 Psychological and Social Changes (Cont d) Retirement is a reward for a life-time of work. It usually means reduced income. Social relationships change throughout life. Children may become caregivers. Death of a partner is common. Slide 5 Physical Changes These happen to everyone. The rate and degree of change vary with each person. Quality of life does not have to decline. Slide 6 2
The integumentary system: The skin loses its elasticity, strength, and fatty tissue layer. Secretions from oil and sweat glands decrease. Blood vessels decrease in number. Brown spots appear on the skin. Loss of the skin s fatty tissue layer makes the person more sensitive to cold. Dry skin causes itching and skin is easily damaged. Slide 7 The integumentary system (cont d): Nails become thick and tough. Feet usually have poor circulation. The skin has fewer nerve endings. White or grey hair is common. Hair loss occurs in men. Hair thins on men and women. Facial hair may occur in women. Hair is drier from decrease in scalp oils. Skin disorders increase with age. Slide 8 The musculoskeletal system: Muscle cells decrease in number. Muscles atrophy and decrease in strength. Bones lose minerals, especially calcium. Bones lose strength, become brittle, and break easily. Vertebrae shorten. Joints become stiff and painful. Mobility decreases. Activity, exercise, and diet help prevent bone loss and loss of muscle strength. Slide 9 3
The nervous system: Nerve cells are lost. Nerve conduction and reflexes slow. Blood flow to the brain is reduced. Changes occur in brain cells. Sleep patterns change. Touch and sensitivity to pain and pressure are reduced. Sensing heat and cold are reduced. Taste and smell dull. Slide 10 Changes occur in the eye: Eyelids thin and wrinkle. Tear secretion is less. The pupil becomes smaller and responds less to light. Clear vision is reduced. The lens of the eye yellows. Older persons become more farsighted (presbyopia). Changes occur in the ear: Changes occur in the auditory nerve. Eardrums atrophy. Wax secretion decreases. Wax becomes harder and thicker. Slide 11 The circulatory system The heart muscle weakens. Arteries narrow and are less elastic. Sometimes circulatory changes are severe. Rest is needed during the day. Over-exertion is avoided. The respiratory system Respiratory muscles weaken. Lung tissue becomes less elastic. The person may lack strength to cough and clear the airway of secretions. Slide 12 4
The digestive system Salivary glands produce less saliva. Dysphagia is a risk. Sense of taste and smell become duller. Secretion of digestive juices decreases. Loss of teeth and ill-fitting dentures cause chewing problems. Peristalsis decreases. Fewer calories are needed. Slide 13 The urinary system Kidney function decreases. The kidneys atrophy. Blood flow to the kidneys is reduced. The ureters, bladder, and urethra lose tone and elasticity. Bladder muscles weaken. Bladder size decreases. In men, the prostate gland enlarges. Urinary tract infections are risks. Slide 14 The reproductive system In men, the hormone testosterone decreases. Affects strength, sperm production, and reproductive tissues An erection takes longer. The phase between erection and orgasm is longer. Orgasm is less forceful than when younger. Erections are lost quickly. The time between erections is longer. Slide 15 5
The reproductive system (cont d) Menopause occurs in women. Menstruation stops. Woman can no longer have children. Female hormones (estrogen and progesterone) decrease. The uterus, vagina, and genitalia atrophy. Vaginal walls thin and there is vaginal dryness. Arousal takes longer. Orgasm is less intense. The pre-excitement state returns more quickly. Slide 16 6