1. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 8 The Older Person

2. Slide 2 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  People live longer than ever before.  Most older persons have at least one disability. Disabilities increase and become more severe with aging. Disabilities increase and become more severe with aging.  Most older people live in a family setting.

3. Slide 3 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  GROWTH AND DEVELOPMENT  Throughout life, people grow and develop.  Growth and development occur in a sequence, order, and pattern. Certain skills must be completed during each stage. Certain skills must be completed during each stage. A stage cannot be skipped. A stage cannot be skipped. Each stage is the basis for the next stage. Each stage is the basis for the next stage.  Late adulthood involves these age ranges: Young-old—between 65 and 74 years of age Young-old—between 65 and 74 years of age Old—between 75 and 84 years of age Old—between 75 and 84 years of age Old-old—85 years of age and older Old-old—85 years of age and older

4. Slide 4 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Gerontology is the study of the aging process.  Geriatrics is the care of aging people.  Aging is normal.  There are many myths about aging and older persons. A myth is a widely believed story that is not true. A myth is a widely believed story that is not true.

5. Slide 5 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  PSYCHOLOGICAL AND SOCIAL CHANGES  How people cope with aging depends on: Health status Health status Life experiences Life experiences Finances Finances Education Education Social support systems Social support systems  Retirement Retirement is a reward for a lifetime of work. Retirement is a reward for a lifetime of work. Work helps meet love, belonging, and self-esteem needs. Work helps meet love, belonging, and self-esteem needs. Retirement usually means reduced income. Retirement usually means reduced income.

6. Slide 6 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Social relationships Social relationships change throughout life. Social relationships change throughout life. Most older people have regular contact with children, grandchildren, family, and friends. Most older people have regular contact with children, grandchildren, family, and friends. Some older persons are lonely. Some older persons are lonely.  Children as caregivers Some children care for older parents. Some children care for older parents. Parents and children change roles. Parents and children change roles.  Death of a partner Women usually live longer than men. Women usually live longer than men. When death occurs, the loss is crushing. When death occurs, the loss is crushing.  The person loses a lover, friend, companion, and confidant.

7. Slide 7 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  PHYSICAL CHANGES  Physical changes occur with aging. Energy level and body efficiency decline. Energy level and body efficiency decline.  The changes occur over many years. The rate and degree of change vary with each person. The rate and degree of change vary with each person. Quality of life does not have to decline. Quality of life does not have to decline.

8. Slide 8 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The integumentary system The skin loses its elasticity, strength, and fatty tissue layer. The skin loses its elasticity, strength, and fatty tissue layer. Secretions from oil and sweat glands decrease. Secretions from oil and sweat glands decrease. Blood vessels decrease in number. Blood vessels decrease in number. Brown spots appear on the skin. Brown spots appear on the skin. Loss of the skin’s fatty tissue layer makes the person more sensitive to cold. Loss of the skin’s fatty tissue layer makes the person more sensitive to cold. Dry skin is easily damaged and causes itching. Dry skin is easily damaged and causes itching.

9. Slide 9 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Nails become thick and tough. Nails become thick and tough. The skin has fewer nerve endings. The skin has fewer nerve endings. Older persons often complain of cold feet. Older persons often complain of cold feet. White or gray hair is common. White or gray hair is common. Hair loss occurs in men. Hair loss occurs in men. Hair is drier from decreases in scalp oils. Hair is drier from decreases in scalp oils. Skin disorders increase with age. Skin disorders increase with age.

10. Slide 10 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The musculoskeletal system Muscle cells decrease in number. Muscle cells decrease in number. Muscles atrophy (shrink). Muscles atrophy (shrink). Muscles decrease in strength. Muscles decrease in strength. Bones lose minerals, especially calcium. Bones lose minerals, especially calcium. Bones lose strength. Bones lose strength. Bones become brittle and break easily. Bones become brittle and break easily. Activity, exercise, and diet help prevent bone loss and loss of muscle strength. Activity, exercise, and diet help prevent bone loss and loss of muscle strength.

11. Slide 11 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The nervous system Nerve cells are lost. Nerve cells are lost. Nerve conduction and reflexes are slow. Nerve conduction and reflexes are slow. Responses are slower. Responses are slower. Blood flow to the brain is reduced. Blood flow to the brain is reduced. There is loss of brain cells over time and reduced blood flow to the brain. There is loss of brain cells over time and reduced blood flow to the brain.  This affects personality and mental function.  Memory is shorter.  Forgetfulness increases.  Responses slow.  Confusion, dizziness, and fatigue may occur.

12. Slide 12 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Many older people are mentally active and involved in current events. Many older people are mentally active and involved in current events.  They show fewer personality and mental changes. Sleep patterns change. Sleep patterns change. The senses The senses  Touch and sensitivity to pain and pressure and heat and cold are reduced.  Taste and smell dull.  There are changes in the eye.  Changes occur in the ear.

13. Slide 13 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The circulatory system The heart muscle weakens. The heart muscle weakens.  It pumps blood with less force. Arteries narrow and are less elastic. Arteries narrow and are less elastic.  Poor circulation occurs in many body parts. When circulatory changes are severe: When circulatory changes are severe:  Rest is needed during the day.  Over-exertion is avoided.  Personal care items and other needed items are kept nearby.

14. Slide 14 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The respiratory system Respiratory muscles weaken. Respiratory muscles weaken. Lung tissue becomes less elastic. Lung tissue becomes less elastic. Dyspnea may occur with activity. Dyspnea may occur with activity. The person may lack strength to cough and clear the airway of secretions. The person may lack strength to cough and clear the airway of secretions. Respiratory infections and diseases may develop. Respiratory infections and diseases may develop. The person should be as active as possible. The person should be as active as possible.

15. Slide 15 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The digestive system Salivary glands produce less saliva. Salivary glands produce less saliva.  This can cause dysphagia. Secretion of digestive juices decreases. Secretion of digestive juices decreases. Loss of teeth and ill-fitting dentures can cause chewing problems. Loss of teeth and ill-fitting dentures can cause chewing problems. Peristalsis decreases. Peristalsis decreases. Flatulence and constipation can occur. Flatulence and constipation can occur. These measures can help: These measures can help:  Avoid dry, fried, and fatty foods.  Eat high fiber foods.  Eat foods that provide soft bulk.

16. Slide 16 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  The urinary system Kidney function decreases. Kidney function decreases. The kidneys shrink (atrophy). The kidneys shrink (atrophy). Blood flow to the kidneys is reduced. Blood flow to the kidneys is reduced. The ureters, bladder, and urethra lose tone and elasticity. The ureters, bladder, and urethra lose tone and elasticity. Bladder muscles weaken. Bladder muscles weaken. Bladder size decreases. Bladder size decreases. Urinary tract infections are risks. Urinary tract infections are risks.

17. Slide 17 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Changes in the reproductive organs occur in men. The hormone testosterone decreases. The hormone testosterone decreases. Changes affect strength, sperm production, and reproductive tissues. Changes affect strength, sperm production, and reproductive tissues.  Changes in the reproductive organs occur in women. Menopause is when menstruation stops and the woman can no longer have children. Menopause is when menstruation stops and the woman can no longer have children. Female hormones (estrogen and progesterone) decrease. Female hormones (estrogen and progesterone) decrease.

18. Slide 18 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  HOUSING OPTIONS FOR OLDER PEOPLE  Living with family Adult day-care centers Adult day-care centers  Apartments  Residential hotels  Congregate housing Senior citizen housing Senior citizen housing  Homesharing  Assisted living  Board and care homes  Adult foster care  Continuing care retirement communities (CCRCs)  Nursing centers

19. Slide 19 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  QUALITY OF LIFE  Moving to a nursing center can cause feelings of loneliness and isolation.  Some people are trying to cope with many losses.  These measures can help the person feel good about his or her appearance: Help residents with grooming. Help residents with grooming. Help them dress in clothes of their choice. Help them dress in clothes of their choice. Make sure dentures, eyeglasses, and hearing aids are in place. Make sure dentures, eyeglasses, and hearing aids are in place.  Respect the person’s wishes for privacy.