Physical Changes in Aging Affecting Various Systems Health Promotion Strategies

INTEGUMENTARY SYSTEM  Limit solar exposure to 10-15 minutes daily for

CHANGES: vitamin D (use protective clothing and
 Decreased collagen & subcutaneous fat, sunscreen at least 30 SPF)
interstitial fluid, muscle tone, glandular activity,  dress appropriately for temperature;
sensory receptors resulting in decreased  maintain a safe indoor temperature;
protection against trauma and sun exposure,  take shower rather than hot tub
and temperature extremes;  bath if possible;
 Diminished secretion of natural oils and  lubricate skin with lotions that contain
perspiration; petroleum or mineral oil
 Capillary fragility
IMPLICATIONS & RECOMMENDATIONS
SUBJECTIVE AND OBJECTIVE FINDINGS 1. The skin of older person is much more
 Thin, wrinkled, and dry skin; susceptible to injury even from minor bumps to
 Complaints of injuries, bruises, and sunburn; scrapes.
 Complaints of intolerance to heat; 2. Complaints of pruritus are common.
 Bone structure is prominent 3. Pressure sores are likely to develop of older
people are immobilized for any length of time
OTHER CHANGES 4. One must be very gentle in handling and
Hair holding onto them
 Decreased melanocytes 5. Make sure certain objects which might cause
 Decreased hair follicle density injury aren't sticking out in their environment
Melanocytes – causes skin coloration; helps in UV 6. Use soaps and bathing products which keep skin
radiation smooth use lotions as needed and protective
garments when in the sun
Nails 7. They should be kept in appropriately warm
 Hypo/hyperplasia of nail matrix clothing
 Decreased blood supply to nails
 Longitudinal/long ridges TEACHING GUIDE: ESSENTIALS FOR PATIENT AND
Foot care is important. FAMILY EDUCATION
1. Avoid overexposure to the sun by applying
Eyes sunscreen, wearing clothing with sleeves and
 Decreased orbital fat wearing wide brimmed hat.
 Decreased elasticity of lids 2. Consider staying indoors during peak sun times
Sunken eyes is common in older people. of the day
Entropion – eyelids are inward 3. Avoid excessive bathing (All east once a day /
Ectropion – eyelids are outward every other day)
Arcus senilis – grayish/white/yellow around the cornea 4. Avoid applying drying agents such as alcohol
and deodorant soap to the skin
1. Flattening of the dermo-epidermal junction 5. Inspect skin every month or daily for those at
2. Reduced collagen and elastin risk of skin breakdown
3. Decreased subcutaneous fats 6. Report any lesion that fails to heal.
4. Decreased sebaceous gland activity. 7. Report any change in the mole or any change in
5. Atrophy of the eccrine and apocrine gland size, shape or color of existing lesion.
6. Lentigo senilis 8. Avoid use of OTC preparation to treat calluses
7. Diminished blood supply or ingrown toenails.
8. Decreased cellular repair 9. Cut nails straight across even with tops of the
9. Decreased elasticity fingers and toes.
10. Capillary Fragility
11. Diminished awareness to pain, touch,
temperature and peripheral vibration
MUSCULOSKELETAL SYSTEMS
Changes:
1. Loss of bone density;
2. loss of muscle strength and size;
3. degenerated joint cartilage
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Height loss;
2. prone to fractures;
3. kyphosis;
4. back pain;
5. loss of strength, flexibility, and
6. endurance;
7. Joint pain
Health Promotion Strategies
1. Exercise regularly;
2. Eat a high-calcium diet;
3. Limit phosphorus intake;
4. Take calcium and vitamin D
5. supplements as prescribed
RESPIRATORY SYSTEM
Changes
1. Increase in residual lung volume;
2. Decrease in muscle strength, endurance, and
vital capacity;
3. Decreased gas exchange and diffusing capacity;
4. Difficulty coughing up secretions
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Fatigue and breathlessness with sustained
activity,
2. Decreased respiratory excursion and chest/lung
expansion with less effective exhalation;
3. Difficulty coughing up secretions
Health Promotion Strategies
1. Exercise regularly
2. Avoid smoking
3. Take adequate fluids to liquefy secretions
4. Receive yearly influenza immunization and
pneumonia vaccine at 65 years of age;
5. Avoid exposure to upper respiratory tract
infections
CARDIOVASCULAR SYSTEM
Changes
1. Decreased cardiac output
2. Diminished ability to respond to stress
3. Heart rate and stroke volume do not increase
with maximum demand
4. Slower heart recovery rate
5. Increased blood pressure
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Complaints of fatigue with increased activity
2. Increased heart rate recovery time
3. Optimal blood pressure <120/80 mm
- BP
Prehypertension
>120-139/80-89 mmHg
Hypertension
>140/90 mmHg
Health Promotion Strategies
1. Exercise regularly
2. Pace activities
3. Avoid smoking
4. Eat a low-fat, low-salt diet;
5. Participate in stress-reduction activities;
6. Check blood pressure regularly;
7. Medication compliance;
8. Weight control
GASTROINTESTINAL SYSTEM
Changes:
1. Decreased sense of thirst, smell and
2. Decreased salivation
3. Difficulty swallowing foo
4. Delayed esophageal and gastric emptying;
5. Reduced gastrointestinal motility
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Risk of dehydration, electrolyte imbalances, and
poor nutritional intake;
2. Complaints of dry mouth;
3. Complaints of fullness, heartburn and
indigestion; constipation, flatulence, and
abdominal discomfort
Health Promotion Strategies
1. Use ice chips, mouthwash; brush, floss, and
massage gums daily;
2. Receive regular dental care;
3. Eat small, frequent meals;
4. Sit up and avoid heavy activity after eating;
5. limit antacids;
6. Eat a high-fiber, low-fat diet;
7. Limit laxatives; toilet regularly; drink adequate
fluids
GENITOURINARY SYSTEM
Changes
1. Male: Benign prostatic hyperplasia
2. Female: Relaxed perineal muscles, detrusor
instability (urge incontinence), urethral
dysfunction (stress urinary incontinence)
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Urinary retention;
2. Irritative voiding symptoms including frequency,
feeling of incomplete bladder emptying,
multiple nighttime voiding
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Urgency/frequency syndrome, decreased
"warning time,” drops of urine lost with cough,
laugh, position change
Health Promotion Strategies
Male:
1. Limit drinking in evening (eg, caffeinated
beverages, alcohol);
2. do not wait (no fluid beyond 9PM) long periods
between voiding and empty bladder all the way
when passing urine.
Creed’s Maneuver
- Duoton ang pus-on
Female:
1. Wear easily manipulated clothing;
2. Drink adequate fluids;
3. Avoid bladder irritants (eg. caffeinated
beverages, alcohol, artificial sweeteners);
4. Pelvic floor muscle exercises, preferably learned
via biofeedback; consider urologic workup
REPRODUCTIVE SYSTEM
Changes
Female:
1. Vaginal narrowing and decreased elasticity;
2. Decreased vaginal secretions
Male:
1. Less firm testes and decreased sperm
production
Male and Female:
1. Slower sexual response
SUBJECTIVE AND OBJECTIVE FINDINGS
Female:
1. Painful intercourse;
2. Vaginal bleeding following intercourse;
3. Vaginal itching and irritation
4. Delayed orgasm
Male:
1. Delayed erection and achievement of orgasm
Health Promotion Strategies
1. May require vaginal estrogen replacement;
2. Gynecology/urology follow-up; use a lubricant
with sexual intercourse
NERVOUS SYSTEM
Changes
1. Reduced speed in nerve conduction; increased
confusion with physical illness and loss of
environmental cues; reduced cerebral
circulation falls (becomes faint, loses balance)
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Slower to respond and react; learning takes
longer; becomes confused with hospital
admission; faintness; frequent falls
Health Promotion Strategies
1. Pace teaching;
2. With hospitalization, encourage visitors
3. Enhance sensory stimulation; with sudden
confusion, look for cause
4. Encourage slow rising from a resting position
SPECIAL SENSES
Changes
Vision:
1. Diminished ability to focus on close objects;
(tend to put objects away of eyes
2. Inability tolerate Glare;
3. Difficulty adjusting to changes of light intensity
4. Decreased ability to distinguish colors
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Holds objects far away from face;
2. Complains of glare;
3. Poor night vision
4. Confuses colors
CHANGES
Hearing:
1. Decreased ability to hear high frequency
sounds;
2. Tympanic membrane thinning and loss of
resiliency
SUBJECTIVE AND OBJECTIVE FINDINGS
1. Gives inappropriate responses;
2. Asks people to repeat words;
3. Strains forward to hear
CHANGES
Taste and smell:
1. Decreased ability to taste and smell

SUBJECTIVE AND OBJECTIVE FINDINGS

1. Uses excessive sugar and salt
2. Uses herbs and spice

Health Promotion Strategies

1. Wear eyeglasses, use sunglasses outdoors;
2. avoid abrupt changes from dark to light;
3. use adequate indoor lighting with area lights
and nightlights
4. use large-print books (big font size)
5. Use magnifier for reading
6. Avoid night driving
7. Use contrasting colors for color coding;
8. Avoid glare of shiny surfaces and direct sunlight

Health Teaching Strategies

Hearing:
1. Recommend a hearing examination;
2. Reduce background noise;
3. Face person;
4. Enunciate clearly;
5. Speak with a low-pitched voice
6. Use nonverbal cues

Taste
1. Encourage use of lemon, spices, herbs
2. Recommend smoking cessation