Chapter 29 Gerontology

Societal Bias Older adults stereotyped Discrimination because of age Older adults viewed as sick, frail, powerless, sexless, burdensome Today’s older adults living longer Good nutrition, regular exercise, stress reduction, yearly physical exams, no smoking, new technology (See Critical Thinking box)

Facts About Aging Aging progressive, universal, slow process No diseases specific to aging Interest, personal and financial resources, family structure, genetics, attitude play part in how one ages [FIGURE 29-1]

Facts About Aging Lifestyle a factor Smoking Misuse of chemicals such as alcohol or drugs Type of diet Lack of exercise Greater variability among older people than younger groups All older ages not alike

Physiological Changes Not all individuals age the same Body produces smaller amounts of various hormones and other chemicals Every body system undergoes changes both physiological and psychological

Physiological Changes Senses Vision Pupil size diminishes Lens may become cloudy Cornea thickens Increased sensitivity to glare Cataracts, glaucoma, macular degeneration common

Physiological Changes Senses Hearing Hearing loss not uncommon May be thought to be mentally weak or senile Presbycusis is normal hearing loss in elderly

Physiological Changes Senses: taste and smell Diminishes and makes food less appealing Taste buds decrease in size Detecting odors becomes difficult and impaired Lessens desire for food Inability to smell smoke or gas and dangerous fumes [FIGURE 29-3]

Physiological Changes Integumentary system Aging skin more fragile Sunlight exposure major cause of wrinkled skin, “liver spots,” leathery looking skin Hypothermia and hyperthermia serious problems Hair loses color and becomes thinner Development of skin cancer

Physiological Changes Nervous system Brain shrinks in size Some memory loss or delay in memory can be expected Transient ischemic attacks (TIAs) can cause sudden loss of memory and confusion Problems with balance, temperature regulation, diminished pain sensation, insomnia can occur

Physiological Changes Musculoskeletal system Muscle strength decreases; results in loss of mobility Less flexibility and joints can stiffen Loss of height and stooped appearance can result Arthritis and osteoporosis not unusual Older adults can suffer fractured bones more easily

Physiological Changes Respiratory system Breathing capacity diminishes Rib and chest muscles become smaller and less efficient Lungs lose their elasticity Older people prone to pneumonia

Physiological Changes Cardiovascular system Heart disease and blood vessel disorder major causes of death Arteriosclerosis: blood vessels lose elasticity, become narrower, build up with plaque, arteries harden Myocardium loses some ability to pump effectively Hypertension direct result of these factors Congestive heart failure Myocardial infarction

Physiological Changes Gastrointestinal system Stomach secretions and peristalsis slow Pernicious anemia can occur Malnourishment not uncommon Poor eating habits, poor nutrition, over- or undereating can lead to dental problems

Physiological Changes Gastrointestinal system Poor dental hygiene leads to gum disease and loss of teeth; makes chewing food difficult Sometimes cardiac problems occur from gum disease

Physiological Changes Urinary system Kidneys can decrease in size resulting in less urine production and output Cardiovascular arteriosclerosis: blood flow to kidney less Levels of medication may increase to dangerous level Bladder walls become more inelastic

Physiological Changes Urinary system Ability to empty bladder completely difficult Residual urine remains in bladder; microorganisms can cause infection Cystitis: infection and inflammation of bladder Urinary incontinence: uncontrollable loss of urine

Physiological Changes Reproductive system Women experience menopause at about age 55 Men continue to produce sperm after 50 years of age Testosterone levels diminish (andropause) May lead to benign hypertrophy of the prostate Aging men and women can maintain sexual desires

Prevention of Complications Older people at risk for complications as result of body systems undergoing change Accidents due to impaired vision or inability to hear Malnutrition and anemia can develop due to poor nutrition Older adults have diminished sensitivity and lack ability to feel pain Heat and cold applications can injure the aging

Prevention of Complications Older people at risk for complications as result of body systems undergoing change Impaired nervous system function may lead to loss of balance, disorientation, confusion Due to osteoporosis, bones easily fracture Respiratory tract infections not unusual Urinary infections more common

Prevention of Complications Older people at risk for complications as result of body systems undergoing change Circulatory problems common Vaginitis more common Enlargement of prostate makes urination difficult Consult provider regarding alternative substances or engaging in alternative therapy

Psychological Changes Great variation in psychological functioning of older adults Psychosocial history, race, sex, environmental aspects (education, support system, social class) Dementia affects memory, personality, cognitive functioning Alzheimer’s disease form of dementia

Psychological Changes Other forms of dementia: People who have had stroke Parkinson’s disease Syphilis Huntington’s disease Depression in older adults can occur

The Medical Assistant and the Geriatric Patient Older adults may experience many factors coupled with physiologic changes and are special challenge to medical assistant Empathize with patient’s situation Do not talk to older people as if they were children Speak slowly, clearly, and have eye contact

The Medical Assistant and the Geriatric Patient Memory-impaired older adults Geriatric care poses challenges when attempting to communicate Follow techniques that can be effective in improving verbal communication

The Medical Assistant and the Geriatric Patient Visually impaired older adults Need to know you are present Do not approach individual until you make your presence known Hearing-impaired older adults Follow techniques that will be beneficial and facilitate communication and understanding

The Medical Assistant and the Geriatric Patient Elder abuse Physical, emotional, verbal abuse, neglect All states have elder abuse laws Required to report abuse Signs and symptoms of mistreatment or abuse Carefully document in patient’s chart or EMR

Healthy and Successful Aging Older adults enjoying longer, healthier lives Increase in number of gerontologists Awareness and involvement with health care Improved nutrition Regular exercise New medications Advancing medical technology