1. Unit 9 Geriatric Care

2. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2 9:1 Myths on Aging  Aging begins at birth and ends at death  Gerontology: scientific study of aging and the problems of the old  Geriatric care: care of the elderly  Health care worker must distinguish fact from myth

3. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.3 Myths  Most elderly individuals are cared for in institutions or long-term care facilities  Anyone over a certain set age (such as 65) is old  Elderly people are incompetent and not capable of making decisions or handling their own affairs

4. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.4 Myths (continued)  All elderly people live in poverty  Older people are unhappy and lonely  Elderly individuals do not want to work, their goal is to retire, and prior to retirement, they lose interest in work  Retired people are bored and have nothing to do with their lives

5. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.5 Summary  There are many myths about aging  Health care workers must recognize problems that do exist  Needs of elderly individuals vary  Even though only 5% of the elderly live in long-term care facilities, this still means 2 million people will be in these facilities by 2008

6. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.6 9:2 Physical Changes of Aging  Physical changes are a normal part of the aging process  Rate and degree of change varies  Usually related to a decreased function of body systems  Recognizing normal changes allows the individual to adapt and cope

7. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.7 Integumentary System  Production of new skin cells decreases  Sebaceous (oil) and sudoriferous (sweat) glands become less active  Circulation to skin decreases  Hair loses color; hair loss may occur  Methods to adapt and cope with changes  Measures to slow or decrease changes

8. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.8 Musculoskeletal System  Muscles lose tone, volume, and strength  Osteoporosis  Arthritis  Methods to adapt and cope with changes  Measures to slow or decrease changes  Providing a safe environment

9. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.9 Circulatory System  Heart muscle becomes less efficient at pushing blood into the arteries  Blood vessels narrow and become less elastic  Blood flow may decrease to brain and other vital organs  Methods to adapt and cope with changes  Measures to slow or decrease changes

10. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.10 Respiratory System  Respiratory muscles become weaker  Rib cage becomes more rigid  Bronchioles lose elasticity  Changes in larynx affect voice  Methods to adapt and cope with changes  Measures to slow or decrease changes

11. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.11 Nervous System  Progressive loss of brain cells  Senses diminish  Nerve endings are less sensitive  Methods to adapt and cope with changes  Measures to slow or decrease changes

12. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.12 Digestive System  Fewer digestive juices and enzymes are produced  Muscle action becomes slower; peristalsis decreases  Teeth are lost  Liver function is reduced  Methods to adapt and cope with changes  Measures to slow or decrease changes

13. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.13 Urinary System  Kidneys decrease in size; are less efficient  Decreased circulation to kidneys  Decreased number of nephrons  Bladder function weakens  Methods to adapt and cope with changes  Measures to slow or decrease changes

14. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.14 Endocrine System  Increased production of some hormones  Decreased production of some hormones  Methods to adapt and cope with changes  Measures to slow or decrease changes

15. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.15 Reproductive System  Female: vaginal walls thin and secretions decrease; decreased support of uterus; breasts sag when fat is redistributed  Male: production of sperm decreases; response to sexual stimuli is slower; ejaculation takes longer; testes become smaller and less firm; seminal fluid becomes thinner and less is produced  Methods to adapt and cope with changes

16. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.16 Summary  Aging causes many physical changes in all body systems; rate and degree vary  All experience some degree of change  Adapting and coping means fuller enjoyment of life within physical limitations  Health care workers need to assess individuals’ needs and assist with coping  Tolerance, patience, and empathy are essential

17. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.17 9:3 Psychosocial Changes of Aging  Elderly individuals also experience psychological and social changes  Some cope and others experience extreme frustration and mental distress  Health care workers must be aware of this and assess changes and stresses

18. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.18 Work and Retirement  Most adults spend a large portion of their days working  Retirement is often viewed as an end to the working years  Many enjoy retirement  Some feel a major sense of loss

19. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.19 Social Relationships  Change occurs throughout life  In elderly individuals, it may occur more rapidly  Some elderly people adjust to changes  Some elderly people cannot cope with changes

20. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.20 Living Environments  Changes in living environments create psychosocial changes  Many elderly people prefer to stay in their own homes  Some individuals leave their home by choice  Some are forced to move from their home  Moving to a long-term care facility often creates stress

21. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.21 Independence  Most individuals want to be independent and self-sufficient  Elderly people learn that independence can be threatened with age  Factors that can lead to decreased independence include physical disability, illness, and decreased mental ability

22. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.22 Independence (continued)  Individuals may need assistance, but allow maximum independence and personal choice

23. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.23 Disease and Disability  Elderly people are more prone to disease and disability  Diseases sometimes cause permanent disabilities  When functioning is affected, psychological stress is experienced  Sick people often have fear of death, chronic illness, loss of function, and pain

24. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.24 Summary  Psychosocial changes can be a major source of stress  As changes occur, individuals must learn to accommodate the changes and function in new situations  With support, understanding, and patience, health care workers can assist individuals as they learn to adapt

25. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.25 9:4 Confusion and Disorientation in the Elderly  Most remain mentally alert until death  Signs of confusion or disorientation  It is sometimes a temporary condition  Disease and/or damage to the brain can result in chronic confusion or disorientation

26. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.26 Dementia  Term used to describe a loss of mental ability  Characteristics include decrease in intellectual ability, loss of memory, and personality change  Acute dementia  Chronic dementia

27. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.27 Alzheimer’s Disease  One form of dementia  Causes progressive changes in brain cells  Lack of neurotransmitter  Frequently occurs in 60s, but can occur as young as 40 years of age  Cause is unknown

28. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.28 Alzheimer’s Disease (continued)  Terminal incurable brain disease; usually lasting 3-10 years  Early stage  Middle stage  Terminal stage

29. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.29 Caring for the Confused or Disoriented Patient  Provide safe and secure environment  Follow the same routine  Follow “reality orientation” guidelines

30. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.30 Summary  Caring for a confused or disoriented individual can be frustrating and even frightening  Perform continual assessments  Design program to maximize function  Practice patience, consistency, and sincere caring

31. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.31 9:5 Meeting the Needs of the Elderly  Geriatric care can be challenging but rewarding  Elderly people have the same needs as others  Cultural needs  Religious needs  Freedom from abuse  Respect patient’s rights

32. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.32 Summary  Needs of the elderly do not vary that much from needs of others  Must respect cultural and religious differences  Must respect and follow patient’s rights  Must ensure that the patient is free from abuse