1. 5-31-05 Aging & Sensory Function Vision Hearing Balance Touch Taste, smell Content for this module provided by The John A. Hartford Foundation, Institute for Geriatric Nursing, Online Gerontological Nursing Certification Review Course http://www.nyu.edu/education/nursing/hartford.institute/course/ Support for this project provided to School of Nursing, University of Washington by the John A. Hartford Foundation, Geriatric Nursing Education Grant and Nursing School Geriatric Investment Program Grant.

2. 5-31-05 Aging & Changes to the Eyes Anatomical changes  eyelid elasticity (ectropian, entropian) Conjunctiva become thinner & yellow with increased risk of infection Pingueculae (fat pads under conjunctiva) may develop Lacrimal gland & ducts loose fatty tissue & quantity of tears decreases Photo provided by the Administration on Aging at http://www.aoa.gov/press/multimed/photos/2002/01_Jan/images_aging/photo_images_aging.asp

3. 5-31-05 Aging & Changes to the Eyes Anatomical changes (continued) Eyeballs sit deeper in sockets Cornea flattens and iris fades  connective tissue may cause sclerosis of sphincter muscles Pupils become smaller, sclera becomes thick, rigid Photo provided by the Administration on Aging at http://www.aoa.gov/press/multimed/photos/2002/01_Jan/images_aging/photo_images_aging.asp

4. 5-31-05 Aging & Changes to the Eyes Anatomical changes (continued) Vitreous humor can degenerate & also detach from retina Cones in retina deteriorate Lenses thicken & lose transparency, decreasing passage of light to retina 1 in 3 persons experiences cataracts

5. 5-31-05 Aging & Changes to the Eyes Physiological changes Presbyopia (  ability to adjust near/far vision)  visual acuity (especially near vision) & narrowing of visual field Difficulty gazing upward & maintaining convergence, adapting to lighting changes

6. 5-31-05 Aging & Changes to the Eyes Physiological changes (continued) Impairment of color discrimination Dullness, dryness of eyes Dry, irritated cornea r/t  tear secretion

7. 5-31-05 Aging & Changes to the Ears Anatomical changes Gradual buildup & hardening of cerumen in ear canal Possible atrophy of the organ of Corti & the auditory nerve Thickening of tympanic membrane (ear drum)

8. 5-31-05 Aging & Changes to the Ears Physiological changes  tone discrimination Presbycusis: difficulty hearing high frequency sounds (  hearing acuity)  ability to discern consonants  equilibrium due to vestibular changes

9. 5-31-05 Aging & Changes to the Ears Hearing loss is NOT a normal part of aging process Hearing loss requires further evaluation for proper treatment conductive loss sensory loss mixed

10. 5-31-05 Aging & Changes to the Ears Signs & symptoms of hearing loss  volume on television or radio Tilting head toward person speaking Cupping hand around one ear Watching speaker’s lips Speaking loudly Not responding when spoken to

11. 5-31-05 Aging & Changes in Balance  balance - caused by a combination of factors  sensory input Slowing of motor responses Musculoskeletal limitations Increased postural sway

12. 5-31-05 Aging & Changes in Balance Functional changes May not present in healthy older adults Deprivation in more than one system is likely to lower balance threshold (i.e., vision & proprioception input) Challenging conditions lower balance threshold climbing up & down steps, curbs getting in & out of bathtub

13. 5-31-05 Aging & Changes in Taste, Smell Alterations in oral mucosa & tongue, & pathologic state of nasal cavity  # of cells, damage to cells,  neurotransmitters

14. 5-31-05 Aging & Changes in Taste, Smell Olfactory losses in healthy adults normal aging process medications viral infections, long-term exposure to toxic fumes head trauma Taste losses disease states of nervous & endocrine systems nutritional & upper respiratory conditions viral infections medications

15. 5-31-05 Aging & Changes in Taste, Smell Functional changes  in sensitivity to airborne chemical stimuli  in recognition of odors Many foods taste bitter or lack taste - potential  in food intake  risk for noxious chemicals & poisonings (e.g., may fail to detect odor of smoke or leaking gas)  risk for impaired nutritional & immune status

16. 5-31-05 Aging & Changes in Touch  sensitivity to light touch  spacial acuity thresholds  two-point discrimination  tactile vibratory thresholds  warm-cold difference thresholds  risk for injury, especially in affected limbs

17. 5-31-05 Aging & Changes in Touch Common disorders affecting tactile information Cerebrovascular accident (CVA) Peripheral vascular disease (PVD) Diabetic neuropathy

18. 5-31-05 Aging & Sensory Changes Nursing considerations Proper screening & intervention are critical: assess impact on ADLs & IADLs ensure appropriate provision & usage of assistive devices

19. 5-31-05 Aging & Sensory Changes Nursing considerations  sight & hearing can lead to:  communication depression social isolation loss of self-esteem loss of independence (i.e., can’t drive) safety concerns