© 2009 Delmar, Cengage Learning Chapter 10 Geriatric Care.

© 2009 Delmar, Cengage Learning

Chapter 10

Geriatric Care


10:1 Myths on Aging

• Aging for everyone begins at 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

• 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

(continues)


Myths and Facts(continued)

• Myth: all elderly people live in poverty

• Fact: 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

(continues)



• Myth: anyone over 65 is old

• Fact: many elderly are active and productive into their 80s and beyond

• Myth: elderly people are not able to manage their finances

• Fact: older people have lots of experience and knowledge

(continues)



• 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

• There are many myths about aging

• Needs of elderly individuals vary

• Even 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


10:2 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


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


Musculoskeletal System

• Muscles lose their tone, volume, strength

• Osteoporosis

• Arthritis

• Coping with changes


• Providing a safe environment


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 used to adapt and cope with changes


Respiratory System

• Respiratory muscles become weaker

• Rib cage becomes more rigid

• Bronchioles lose elasticity

• Changes in larynx affect voice

• Methods to cope with changes



Nervous System

• Progressive loss of brain cells

• Senses diminish

• Nerve endings are less sensitive

• Methods to adapt and cope



Digestive System

• Fewer digestive juices and enzymes are produced

• Muscle action becomes slower; peristalsis decreases

• Teeth are lost

• Liver function is reduced

• Methods that are used to adapt and cope with changes


Urinary System

• Kidneys decrease in size; not as efficient at producing urine

• Decreased circulation to kidneys

• Bladder function weakens

• Methods to adapt and cope with ongoing changes



Endocrine System

• Increased production of hormones

• Decreased production of hormones



Reproductive System

• 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

• 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


10:3 Psychosocial Changes of Aging

• 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 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


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


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

• Moving to a long-term care facility often creates stress


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

(continues)


Independence(continued)

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


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, illness, loss of function, and pain


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, workers can assist individuals as they learn to adapt


10:4 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


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


Alzheimer’s Disease

• One form of dementia

• Causes progressive changes in the brain cells

• Lack of neurotransmitter

• Frequently occurs in 60s, but can occur as young as 40 years of age

• Cause is unknown

(continues)


Alzheimer’s Disease(continued)

• Terminal incurable brain disease; usually lasting 3–10 years

• Early stage

• Middle stage

• Terminal stage


Caring for the Confused or Disoriented Patient

• Provide safe and secure environment

• Follow the same routine

• Follow “reality orientation” guidelines


Summary

• Caring for a confused or disoriented individual can be frustrating and even frightening at times

• Perform continual assessments

• Design program to maximize function

• Practice patience, consistency, and sincere caring


10:5 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


Summary

• Needs of the elderly do not vary that much from needs of others

• Sensitive 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

© 2009 Delmar, Cengage Learning Chapter 10 Geriatric Care.

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