Chapter 10Chapter 10Geriatric Care

Myths on AgingMyths on AgingAging for everyone 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

Myths and Facts Myths and Facts Myth: most elderly individuals are

cared for in institutions (nursing homes), or long-term care facilities

Fact: most older people are living at home, with family, or in retirement communities or facilities

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Myths and FactsMyths and Facts((continuedcontinued))

Myth: all elderly people live in povertyFact: less than 10 percent of people

over 65 are living at poverty level

Myth: the older generation are unhappy and lonely

Fact: many elderly individuals socialize by being involved in charity or volunteer work

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Myths and FactsMyths and Facts((continuedcontinued))

Myth: anyone over 65 is old Fact: many elderly are active and

productive into their 80s and beyondMyth: elderly people are not able to

manage their financesFact: older people have lots of

experience and knowledge

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Myths and FactsMyths and Facts((continuedcontinued))

Myth: elderly individuals do not want to work; their goal is to retire

Fact: there are many elderly who prefer to work into their 70s and 80s

Myth: retired people are bored and have nothing to do with their lives

Fact: retirees are busy with hobbies, church, family, and community

Summary Summary There are many myths about agingNeeds of elderly individuals varyEven though only 5% of the elderly

live in long-term care facilities, this still means that 3 million people will be in these facilities by the year 2020

Recognizing normal changes allows the individual to adapt and cope

Physical Changes of AgingPhysical Changes of AgingPhysical changes are a normal part

of the aging processRate and degree of change variesUsually related to a decreased

function of body systems

Integumentary SystemIntegumentary System

Production of new skin cells decreasesSebaceous (oil) and sudoriferous

(sweat) glands become less activeCirculation to skin decreasesHair loses color; hair loss may occurMethods to adapt and cope with

changesMeasures to slow or decrease changes

Musculoskeletal SystemMusculoskeletal SystemMuscles lose their tone, volume,

strengthOsteoporosisArthritisCoping with changesMeasures to slow or decrease

changesProviding a safe environment

Circulatory SystemCirculatory 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 used to adapt and cope with changes

Respiratory SystemRespiratory System

Respiratory muscles become weakerRib cage becomes more rigidBronchioles lose elasticityChanges in larynx affect voiceMethods to cope with changesMeasures to slow or decrease

changes

Nervous SystemNervous SystemProgressive loss of

brain cellsSenses diminishNerve endings are less

sensitiveMethods to adapt and

copeMeasures to slow or

decrease changes

Digestive SystemDigestive System

Fewer digestive juices and enzymes are produced

Muscle action becomes slower; peristalsis decreases

Teeth are lostLiver function is reducedMethods that are used to adapt and

cope with changes

Urinary SystemUrinary System

Kidneys decrease in size; not as efficient at producing urine

Decreased circulation to kidneysBladder function weakensMethods to adapt and cope with

ongoing changesMeasures to slow or decrease changes

Endocrine SystemEndocrine SystemIncreased production of

hormonesDecreased production of

hormonesMeasures to slow or decrease

changes

Reproductive Reproductive SystemSystem

Female: vaginal walls thin and secretions decrease; uterus can drop; breasts sag

Male: sperm decreases; sexual stimuli is slower; ejaculation takes longer; testes become smaller; seminal fluid becomes thinner and less is produced

Measures to cope with changes

Summary Summary

Aging causes physical changes in all body systems; rate and degree vary

Adapting and coping means fuller enjoyment of life

Health care workers need to assess individuals’ needs

Tolerance, patience, and empathy are essential

Psychosocial Changes of Psychosocial Changes of AgingAging

Elderly individuals also experience psychological and social changes

Some cope well, while others experience extreme frustration and mental distress

Health care workers must be aware of this and assess changes and stresses

Work and RetirementWork and RetirementMost adults spend a large portion

of their days workingRetirement is often viewed as an

end to the working yearsMany enjoy retirementSome feel a major sense of loss

Social RelationshipsSocial Relationships

Change occurs throughout lifeIn elderly individuals, it may occur

more rapidlySome elderly people adjust to

changesSome elderly people cannot cope

Living EnvironmentsLiving EnvironmentsChanges in living environments

create psychosocial changesMany elderly people prefer to stay

in their own homesSome individuals leave their home

by choiceMoving to a long-term care facility

often creates stress

IndependenceIndependence

Most individuals want to be independent

and self-sufficientElderly people learn that independence

can be threatened with ageFactors that can lead to decreased

independence include physical disability, illness, and decreased mental ability

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IndependenceIndependence((continuedcontinued))

Individuals may need assistance, but the health care worker needs to allow the elderly maximum independence and personal choice

Disease and DisabilityDisease and DisabilityElderly 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, illness, loss of function, and pain

SummarySummaryPsychosocial changes can be a

major source of stressAs changes occur, individuals

must learn to accommodate the changes and function in new situations

With support, understanding, and patience, workers can assist individuals as they learn to adapt

Confusion and Disorientation Confusion and Disorientation

in the Elderlyin the ElderlyMost remain mentally alert until

deathSigns of confusion or

disorientationIt is sometimes a temporary

conditionDisease and/or damage to the

brain

Dementia Dementia Term used to describe a loss of

mental abilityCharacteristics include decrease

in intellectual ability, loss of memory, and personality change

Acute dementiaChronic dementia

Alzheimer’s DiseaseAlzheimer’s DiseaseOne form of dementiaCauses progressive changes in the

brain cellsLack of neurotransmitterFrequently occurs in 60s, but can

occur as young as 40 years of ageCause is unknown

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Alzheimer’s DiseaseAlzheimer’s Disease((continuedcontinued))

Terminal incurable brain disease; usually lasting 3–10 years

Early stageMiddle stageTerminal stage

Caring for the Confused or Caring for the Confused or Disoriented PatientDisoriented Patient

Provide safe and secure environment

Follow the same routineFollow “reality orientation”

guidelines

SummarySummaryCaring for a confused or

disoriented individual can be frustrating and even frightening at times

Perform continual assessmentsDesign program to maximize

functionPractice patience, consistency, and

sincere caring

Meeting the Needs of the Meeting the Needs of the ElderlyElderlyGeriatric care can be challenging

but rewardingElderly people have the same

needs as othersCultural needsReligious needsFreedom from abuseRespect patient’s rights

Summary Summary Needs of the elderly do not vary

that much from needs of othersSensitive to individual cultural

and religious differences

Important to respect and follow all of the patient’s rights

Must ensure that the patient is free from abuse