1. Chapter 14 Advanced Old Age and Geriatrics Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

2. Objectives 1. Explain the concept of geriatrics. 2. Discuss the anticipated future increase in the advanced old-age population as related to the development of geriatrics as a specialty. 3. State four normal physiological changes that occur in the geriatric adult. 4. List the major developmental tasks of the geriatric adult. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 2

3. Objectives (cont.) 5. Name three psychological changes or challenges that occur in the geriatric adult. 6. Discuss three specific psychosocial problems associated with aging. 7. List four specific health-promoting activities for the geriatric adult. 8. Discuss the role of diet, exercise, and stress management in achieving the goals of Healthy People 2020 in relation to the older adult. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 3

4. Objectives (cont.) 9. Discuss the sexuality needs of the geriatric adult. 10. Discuss six health-maintenance requirements for adults who are in advanced old age. 11. Discuss various modifications of the environment necessary for the geriatric adult. 12. State four factors to consider when helping to select a nursing home for placement. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 4

5. Objectives (cont.) 13. Discuss alternatives to nursing-home care. 14. Define activities of daily living. 15. Discuss principles of elder care and the role of the health-care worker. 16. Discuss the teaching needs of the geriatric adult. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 5

6. Key Terms  activities of daily living (ADLs)  ageism  Alzheimer's disease  apoptosis  atrophy  biological clock  disengagement  elder abuse  free radical  geriatrics  immune theory  osteoporosis  senescence  wear-and-tear theory Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 6

7. Definition  Senescence  Young-old: 65 to 75  Old: 76 to 84  Old-old: 85 to 99  Elite-old: 100 and older Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 7

8. Geriatrics  Biological, psychological, physiological, and sociological aspects of aging  Goal is to maximize the ability to function and to live independently and to shorten the period of illness and disability Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 8

9. Theories Of The Aging Process  Cellular Changes  Free Radicals  Biological Clock (Programmed Cell Death)  Wear-and-Tear Theory  Immune Theory Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 9

10. Physiological Changes  Bones and cartilage  Blood vessels  Lungs  Kidneys and bladder  Metabolism  Digestion  Teeth  Skin  Eyes  Ears  Nervous system Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 10

11. Critical Thinking Question 1  What modifications in methods of health teaching should be made to take into consideration the physiological changes of the aged adult? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 11

12. Sexuality  Specific changes in sexual responses occur  Continue to have sexual feelings  Cosmetic surgery  Aging without protest Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 12

13. Sexual Responses in the Aging Woman  Menopause does not decrease sexual response  May experience dryness in the vaginal mucosa, hot flashes, and other assorted hormone-related body changes Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 13

14. Sexual Responses in the Aging Man  Testosterone production decreases between the ages of 40 and 60  Decrease in the size and firmness of the penis and reduced production, motility, and lifespan of sperm  Male climacteric Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 14

15. The Impact of Illness on Sexuality  Cancer of the prostate  Heart attack  Hospitalization Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 15

16. Critical Thinking Question 2  Why are the sexual needs of the aged adult often not included in care plans and health care programs? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 16

17. Psychological Changes  Negative self-image may affect his or her ability to function  The aging process is a gradual one that provides time for coping and adaptation to physical changes  Role adjustments require adaptation and acceptance Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 17

18. Developmental Tasks  Immortality versus extinction  Adjusting to retirement  Adjusting to and accepting the frailties of aging and the accompanying changes in physical appearance and lifestyles Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 18

19. Physical Exercise  “Use it or lose it”  Regular exercise promotes mental and physical health  Walking, jogging, or swimming are appropriate Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 19

20. Critical Thinking Question 3  Regular health checkups and screenings are recommended for aged adults. What can be done to increase access to preventive health care for a population that may have decreased income, reduced availability of transportation, lack of family support, or other challenges? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 20

21. Healthy People 2020 Goals  Occupational Activities  Nutrition  Prevention Of Illness  Mental Health  Environmental Controls  Elder Abuse  Polypharmacy And Medication Errors  Placement Alternatives Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 21

22. Critical Thinking Question 4  Should businesses make an effort to contact their retirees 6 months to 1 year after retirement? If so, what should be the responsibility of the business if depression is identified in the retiree? Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 22

23. Role Of The Health-Care Worker  Minor changes in the environment can enhance their ability to function  Important to observe family interaction Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. 23