Geriatric Care

1
Chapter 10

• Geriatric Care

2
Myths on Aging

• Aging 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

3
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)
4
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)
5
Myths and Facts(continued)

• 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)
6
Myths and Facts(continued)

• 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

7
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

8
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

9
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

10
Musculoskeletal System

• Muscles lose their tone, volume, strength
• Osteoporosis
• Arthritis
• Coping with changes
• Measures to slow or decrease changes
• Providing a safe environment

11
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

12
Respiratory System

• Respiratory muscles become weaker
• Rib cage becomes more rigid
• Bronchioles lose elasticity
• Changes in larynx affect voice
• Methods to cope with changes
• Measures to slow or decrease changes

13
Nervous System

• Progressive loss of brain cells
• Senses diminish
• Nerve endings are less sensitive
• Methods to adapt and cope
• Measures to slow or decrease changes

14
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

15
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
• Measures to slow or decrease changes

16
Endocrine System

• Increased production of hormones
• Decreased production of hormones
• Measures to slow or decrease changes

17
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

18
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

19
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

20
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

21
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

22
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

23
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)
24
Independence(continued)

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

25
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

26
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

27
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

28
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

29
Alzheimers 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)
30
Alzheimers Disease(continued)

• Terminal incurable brain disease usually lasting
  310 years
• Early stage
• Middle stage
• Terminal stage

31
Caring for the Confused or Disoriented Patient

• Provide safe and secure environment
• Follow the same routine
• Follow reality orientation guidelines

32
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

33
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 patients rights

34
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
  patients rights
• Must ensure that the patient is free from abuse