1. Chapter 92 Gerontology: The Aging Adult

2. Gerontology Gerontology
The study of the effects of normal aging and age- related diseases
Geriatrics
The branch of medicine concerned with the problems and illnesses of aging and their treatment
Gerontological nursing
Geriatric nursing

3. Activities of Daily Living
ADLs
Most older adults are active and healthy and able to perform typical activities of daily living (ADLs).
IADLs
As the individual ages, there is an increasing difficulty in the ability to perform more complex tasks such as household maintenance or managing money, which are referred to as instrumental activities of daily living (IADLs).

4. Common Changes in Aging
Decreased functioning of organs, reaction time, tactile sensations, and decreased capacity for recovery from wounds, injury, or illness
Changes in visual and auditory acuity
Unsteady gait, decreased sense of balance, and stiff joints
Increased emotional, socioeconomic, and physical losses
Combinations of chronic illnesses, poor dietary habits, and lack of exercise

5. Effects of Aging on Body Systems
Integumentary system
Musculoskeletal system
Nervous system
Eyes, ears, and other senses
Cardiovascular system
Respiratory system
Gastrointestinal system
Urinary system
Endocrine system
Immune system
Female reproductive system
Male reproductive system

6. Care Settings for Older Adults
Factors determining the choice of residence include:
Time frame of recovery from chronic or acute illness or the combination of both
The person’s ability to provide for physical, financial, and emotional self-care needs
Physical, financial, and emotional support from family and friends
Access to healthcare and rehabilitation services, including availability and transportation
Need for protection and supervision

7. Care Settings for Older Adults (cont’d)
Home care
Senior centers
Retirement complexes
Long-term care options
Assisted-living facility
Rehabilitative care facility
Long-term care facility (LTC)
Subacute care facility

8. Question Is the following statement true or false?
LTC facilities have all the required onsite services similar to an acute-care facility.

9. Answer
False
LTC facilities generally do not have some of the onsite services that can be found in an acute-care facility.
Services such as occupational therapy, physical therapy, rehabilitation, and hospice may be available and used according to each resident’s individual needs. Other services are brought into the facility, as needed, or the resident may be transported to the location of the service.

10. Nutritional Needs
Understanding the nutritional status of the older adult
Special considerations
Teeth and chewing
Swallowing difficulties
Medications and supplements
Water
Supplementing oral intake

11. Medication Administration
Changes in aging as related to medication administration
Decreased sense of thirst, dry oral mucosa, total body fluid volume or percentage
Decreased muscle tissue, increased percentage of fatty tissue
Decreased general circulation; circulation to colon, vagina, liver, and kidneys; fewer functioning nephrons
Decreased stomach acids and other digestive fluids
Confusion, forgetfulness

12. Personal Hygiene Needs
Skin care
Oral hygiene
Hair care
Nail and foot care
Shaving
Clothing

13. Question Is the following statement true or false?
Nurses should encourage older people with dentures to check the condition of their gums regularly.

14. Answer
True
A nurse must encourage older people with dentures to check the condition of their gums regularly. Irritation can result from poorly fitting dentures. Cancer of the mouth sometimes occurs and may go undetected.

15. Elimination Needs Constipation Bladder or bowel incontinence
Difficulty in voiding

16. Question Is the following statement true or false?
Impaction in an elderly client is not likely to become serious.

17. Answer
False
Impaction in an elderly client can become very serious. Impaction can cause infarction of the bowels, which leads to death of intestinal tissue, and soon the client becomes critically ill.
Death is not uncommon due to an unrecognized sequence of events:
constipation impaction infarction = death

18. Mental Health Concerns in Older Clients
Anxiety
Depression
Substance abuse

19. Emotional and Psychological Support
Measures for emotional and psychological support
Remotivation techniques
Recreation
Cognitive function
Social life and activities
Pet therapy
Religious support
Use of volunteers

20. Communication Visual impairment Presbyopia Sjögren’s syndrome
Hearing loss
Presbycusis
Speech impairment
Aphasia

21. Safety Loss of proprioception Safety devices
Restraints (client safety devices)

22. Physical Activity and Exercise
Walking is the single most highly recommended exercise for older adults.
Benefits of exercise
Cardiovascular system
Musculoskeletal system
Nervous system
Kyphosis

23. Sexuality
The older adult generally maintains the ability and desire to engage in sexual activity.
Encourage clients to discuss with their healthcare provider the impact of health conditions on sexual activity.

24. Elder Abuse Emotional, physical, and sexual abuse
Financial exploitation
Neglect

25. Elder Abuse (cont’d) Risk factors
Minimal respite to caregiver(s) of elderly, frequent or no visits to healthcare personnel
History of unexplained injuries, untreated conditions or wounds, inability or lack of interest in self-care
Malnutrition or weight loss, inappropriate medication administration, substance abuse of senior or caregiver
Depression, withdrawal, fearfulness, accumulated loss, nontypical spending or donating money

26. Question Is the following statement true or false?
Older adults often fail to report abuse.

27. Answer
True
Older adults often fail to report abuse, as witnesses are often difficult to obtain and many older victims often fear retaliation.
The most common elder abusers are caregivers, which include adult children, other relatives, spouses, service providers, friends or neighbors, grandchildren, and siblings.

28. End of Presentation