Chapter 30 Sensory Deficits

Importance of Good Sensory Function Protection from harm Protection from falls from unseen obstacles Ability to hear alarms and warnings Recognition of hazardous substances by taste recognition Ability to detect the odor of smoke or gas Avoidance of skin breakdown

Factors Contributing to Sensory Problems of Elders Alterations during the aging process Excessive use and abuse of certain medications The disease processes that affect all age groups Sensory deficits Increased vulnerability to accidents Social isolation Declining physical function

Facilitating Optimal Vision Functioning Routine eye examinations by an ophthalmologist Prompt evaluation of symptoms: –Burning or pain in the eye –Blurred or double vision –Redness of the conjunctiva –Spots –Headaches

Nutrients Beneficial to Vision Zinc Selenium Vitamin C Vitamin A Vitamin E Riboflavin Ginkgo biloba Flavonoid

Preventing Hearing Loss Prompt and complete treatment of ear infections Prevention of trauma to the ear Removal of cerumen or particles Protection from exposure to loud noises Regular audiometric examinations

Cataracts No associated discomfort or pain Vision is distorted, night vision is decreased, and objects appear blurred. Eventually lens opacity and vision loss are complete. Nuclear sclerosis develops. Surgery to remove lens is only cure.

Measures for Living with Visual Impairment from Cataracts Wear sunglasses in sunlight. Place sheer curtains over windows. Place furniture away from bright light. Use several soft lights instead of a single bright light source. Place items within the visual field of the unaffected eye.

Characteristics Associated with Glaucoma Increased size of the lens Iritis Allergy Endocrine imbalance Emotional instability Family history of this disorder

Cause and Symptoms of Acute Glaucoma (Closed-Angle) Cause –Rapid increase in intraocular pressure Symptoms –Severe eye pain –Headache –Nausea –Vomiting

Symptoms of Chronic Glaucoma (Open- Angle) Tired feeling in eyes Headaches Misty vision Seeing halos around lights

Preventing Additional Damage Due to Glaucoma Avoid any situation or activity that increases IOP. Instill miotics into the eye. Use administration technique called tear duct occlusion. Avoid administration of mydriatics, stimulants, and agents that elevate the blood pressure. Schedule periodic evaluations by an ophthalmologist.

Causes of Macular Degeneration Involves damage or breakdown of the macula –Loss of central vision Most common form is involutional macular degeneration –Associated with the aging process Other causes –Injury –Infection –Exudative macular degeneration

Detached Retina Cause –Forward displacement of retina from normal position Symptoms –Perception of spots moving across eye –Blurred vision –Flashes of light –Feeling of coating over eye

Measures Prescribed for Detached Retina Bed rest Use of bilateral eye patches Surgery –Electrodiathermy –Cryosurgery –Scleral buckling and photocoagulation

Causes of Corneal Ulcers Inflammation of the cornea, accompanied by a loss of substance due to: –Febrile states –Irritation –Dietary deficiencies –Lowered resistance –Cerebrovascular accident

Symptoms of Corneal Ulcers Bloodshot appearance Increased lacrimation Pain and photophobia

Treatment of Corneal Ulcers Seek early treatment for irritations –Treat the underlying causes Cycloplegics Sedatives Antibiotics Heat Wearing sunglasses Corneal transplants

Causes of Hearing Deficits Exposure to noise Certain drugs Certain diseases Psychogenic factors Vascular problems, viral infections, and presbycusis Otosclerosis Dermatoses, furunculosis, and cerumen impaction

Measures to Promote Communication Talking into the less impaired ear. Facing the individual when talking. Using visual speech. Allowing the person to lip read. Using a stethoscope to amplify sounds. Using flash cards, work lists, and similar aids and devices.

Other Sensory Deficits Taste Pain reception Olfaction Tactile sensation

Compensating for Sensory Deficits Provide sensory stimulation –Variety of colors and flavors in diet –Aromatherapy –Wind chimes –Different colors and textures in environment

Source Eliopoulos, C. (2005). Gerontological Nursing, (6 th ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN ).