Geriatric Care

MYTHS
Elderly people are incompetent
and incapable of making decisions
or handling their own affairs.
Most elderly live in nursing homes
All elderly people live in poverty

 Older people are lonely and

unhappy
Elderly do not want to work
Old Age begins a 65
Retirement ends your active life

Physical Changes of Aging

Most physical changes that
occur with aging are gradual and
take place over a long period of
time. In addition, the rate and
degree of change varies among
individuals.

 Factors such as disease can increase

the speed and degree of the changes.
Lifestyle, nutrition, economic status,
and social environment can also have
effects.
If an individual can recognize the
changes as a/an normal part of aging,
the individual can usually learn to
adapt to & cope with change

Integumentary
System
Changes

Production of new skin cells

decreases
Oil and Sweat glands
become less active
Circulation decreases

 Hair losses color, and hair loss

occurs
Skin becomes less elastic & dry
Itching is common
Dark yellow or brown colored
spots appear
Senile lentigines (liver
spots)

 Fatty tissue layer of skin

diminishes
Lines and wrinkles appear
Nails become thick, tough, and
brittle
Increased sensitivity to
temperature

Care of Skin
Use mild soap
Bath oils or lanolin lotion
Bath or Shower once or twice a
week
Brush Hair daily

 Shampoo as often as needed for

cleanliness and comfort
Care for sore or injuries
immediately
Socks, sweaters, lap blankets,
and layers of clothing will help
alleviate the feeling of coldness

 Because of the need for oxygen

and nutrients the elderly may
experience:
Weakness
Dizziness
Numbness in hands & feet
Rapid heart beat

Circulatory System
Care
With circulatory changes:
Avoid strenuous exercise or over
exertion
Periods of rest
Moderate exercise, according to
individuals tolerance

 Prevent the formation of a

blood clot (thrombus)
Support stockings, antiembolism hose
DO NOT wear garters or tight
bands around legs\
If confined to bed
ROM

 High Blood Pressure =

Diet low in salt
Decrease fat intake
Exercise as recommended by
physician

Respiratory
Changes

Respiratory muscles become

weaker
Rib cage more rigid
Alveoli thinner & less elastic
which decreases exchange of
gases - emphysema

 Bronchioles lose elasticity

Changes in larynx lead to
higher pitched & weaker voice
Chronic diseases may decrease
the efficiency of the respiratory
system even more severely

 Changes may cause the elderly

to experience:
Dyspnea
Breathing increases in rate
Difficulty coughing up secretions
Increases susceptibility to
infections such as a cold or
pneumonia

Respiratory Care
Alternate activity with periods
of rest
Proper body alignment &
positioning
Sleep in semi-fowlers position
Use 2 or 3 pillows

 Avoid polluted air

Breath deeply & cough
frequently
May need continuous oxygen
therapy

Nervous System
Changes
Blood flow to brain decreases
& there is a progressive loss of
brain cells - - Interferes with
Thinking
Interpreting

- Reacting
- Remembering

 Senses of taste, smell, vision, &

hearing are diminished
Nerve endings less sensitive
Decreased ability to respond to
pain and other stimuli

Decrease in taste& smell

frequently affects appetite

 Changes in vision
Problems reading small print
Seeing objects at a distance
Decrease in peripheral vision
Decrease in night vision
Increased sensitivity to glare
Cataracts
Glaucoma

 Changes in hearing
Hearing loss usually gradual
Person may speak louder than
usual
Ask for words to be repeated
Not hear high frequency sounds
May not hear well in crowded
places

 Decreased sensation to pain &

other stimuli = more susceptible
Burns
Frostbite
Cuts
Fractures
Muscle strain and other injuries

Digestive Changes
Fewer digestive juices and
enzymes produced
Muscle action becomes slower
& peristalsis decreases
Teeth are lost
Liver function decreases

 Dysphagia is

frequent complaint

Less saliva
Slower gag reflex
Loss of teeth
Poor fitting dentures

Slower digestion of food

indigestion

 Decrease peristalsis
Increase flatulence (gas)
Constipation

Decrease sensation of taste

Poor appetite
Poor diet

Digestive Care
Good oral hygiene
Repair or replace damaged teeth
Relaxed eating atmosphere
High-fiber high-protein foods with
different tastes and textures
Seasoning to improve taste
Increased fluid intake

Urinary Changes
Kidneys decrease in size &
become less efficient
Bladder becomes less efficient
May not hold as much
May not empty completely
incontinence

Urinary Care
Increase fluid intake
Decrease before bedtime

Regular trips to bathroom

Easy to remove clothing
Absorbent pads

Endocrine Changes
Increased production of some
hormones and decreased of
others
Immune system less effective
BMR decreases
Intolerance to glucose

Endocrine Care
Proper exercise
Adequate rest
Medical care for illness
Balanced diet
Healthy lifestyle

Reproductive
System Changes
Decrease of estrogen /
progesterone in female
Thinning of vaginal wall
Decrease vaginal secretions
Inflammation of vagina common

Weakness in supporting tissue:

Uterus sags downward
(Uterine prolapse)

Breasts sag when fat redistributed

Decrease in Testosterone
Slow production of sperm
Response to sexual stimuli slower
Testes smaller less firm

 Male and Female

Sexual desire may or may not
decrease

Advantages of sex in elderly

Improves muscle tone &
circulation
Pain from arthritis seems to
decrease

Reproductive Care
Understand physical and
psychological sexual needs of
the elderly
Allow married couples to be in
the same room
Give privacy to consenting
elderly

Psychocosocial
Changes
Some individual cope with
psychosocial changes, and
others experience extreme
frustration and mental distress

 Fears of a sick person:

Death
Chronic illness
Loss of function
Pain

 Dealing with fears created by

an illness:
Listening
Patience
Understanding
Provide support

Confusion and
Disorientation
Six signs:
Talking incoherently
Not knowing their name
Not recognizing others
Wandering aimlessly
Lacking awareness of time or place

Displaying hostile and

combative behavior
Hallucinating
Regressing in behavior
Paying less attention to
personal hygiene
Inability to respond to simple
commands or instructions

 Causes of temporary
confusion / disorientation
Stress and/or depression
Use of alcohol or chemicals
Kidney disease
Respiratory disease
Liver disease
Medication

 Diseases:
CVA
Arteriosclerosis
Atherosclerosis
Cause TIAs ministrokes which
result in temporary periods of
diminished blood flow to the brain.

 Dementia
Loss of mental ability
characterized by a decrease in
intellectual ability, loss of
memory, impaired judgement,
personality change, and
disorientation

 Acute dementia
When the symptoms are caused
by temporary reason:
High fever, dehydration, hypoxia

Chronic dementia
When symptoms are caused by
permanent, irreversible damage to
brain cells

Alzheimers Disease
Form of dementia that causes
progressive changes in brain
cells

Early Stages:
Memory loss
Mood & personality changes
Depression
Poor judgment
Confusion regarding time & place
Inability to plan and follow
through with ADLs

Middle Stages:
Nigh time restlessness
Mood swings increase
Personal hygiene ignored
Weight fluctuates
Paranoia & hallucinations
Full time supervision needed

Late Stages:
Total disorientation
Incoherent
Unable to communicate with
words
Loses control of bladder &
bowel functions

 Develops seizures
Loses weight despite eating a
balanced diet
Becomes totally dependent
Lapses into a coma
Dies

 Certain aspects of care

should be followed with any
confused or disorientated
individual. Provide a/an safe
and secure environment,
follow the same routine, keep
activities simple and last for
short periods of time.

Avoid loud noises, crowded

rooms, and excessive
commotion. Promote
awareness of person, time, and
place by providing reality
orientation (RO)

Reality Orientation:
Address person by name preferred
Avoid: sweetie, baby, honey
State your name, correct elderly if
calls you by the wrong name
Make reference to day, time, place
Use clocks, calendars, bulletin bd.

 Keep individual oriented to day

night cycles:
Regular clothes during the day
Open curtains during the day]
Close curtains at night
Pajamas at night

 Speak slowly, clearly / ask clear

& simple questions
Never rush or hurry the
individual
Repeat instructions patiently,
allow time for ind. to reaspond
Encourage conversations about
familiar things or current events

 Encourage use of tv, radio

without overstimulating them
Be sure ind. uses sensory aids
Keep familiar objects in view
Avoid moving furniture &
belongings
Do not agree with incorrect
statements

 Do not hesitate to touch

communicate with person
Avoid arguments
Encourage independence and
self help whenever possible

Meeting the Elderly

Needs
Culture: the values, beliefs,
ideas, customs, and
characteristics that are passed
from one generation to the next.

 Areas affected by an
individuals culture:
Language
Food habits
Dress
Work
Leisure activities
Health care

 The spiritual beliefs and

practices of an individual is
called their religion. It is
important to accept an
individuals belief without bias,
and that health care workers not
force their own religious beliefs
on the ind. being cared for.

 Respect and Consideratin of a

persons religious beliefs
Proper treatment of religious
articles
Allow person to practice religion
Honor request for special food
Provide privacy during clergy
visits

 Abuse
Physical
Verbal
Psychological
Sexual

 Report any abuse observed to

proper agency
Reasons elderly do not report
abuse
Feel they deserve the abuse
Want to protect abuser