CHAPTER 1&2: OVERVIEW OF PHYSICAL CHANGES IN AGING AND
COMMON GERIATRICS COMPLAIN
CARE IN OLDER ADULT
BS Nursing 3-1 | PROF. C. Garcia, RN | SEM 1 2022
DEFINITION OF TERMS
AGING: a normal process of time related
changes that occur throughout the life.
OLD AGE: a normal part of human
development.
STAGES IN HUMAN DEVELOPMENT
 INFANCY: 0-12
 TODDLER: 1-2
 EARLY CHILDHOOD: 3-5
 MIDDLE LATE CHILDHOOD: 6-11
 ADOLESCENCE: 12-19
 EARLY ADULTHOOD: 20-40
 MIDDLE AGE ADULTHOOD: 41-64
 LATE ADULTHOOD/OLDER AGE: 65
GEATRICS: branch of health science that
concerned with the study and treatment of
problems & disease associated with aging.
GERONTOLOGY: study of the aging person
& the effect on older person.
OLDER PERSON: the last major segment
with the life system. begins: age of 65 to 70
and up.
GOVERNMENT POLICIES RELATED TO OLDER
PEOPLE
The Philippine Government has enacted laws
that cater to the needs and provides
privileges and benefits to the older persons.
 Republic Act 10. 344 or the
Accessibility Law of 1982 provides for
the minimum requirements and standards
to make buildings, facilities, and utilities
for public use accessible to persons with
disability, including older persons who are
confined to wheelchairs and those who
have difficulty in walking or climbing
stairs, among others.
 Republic Act No. 7876 entitled, “An
Act Establishing a Senior Citizens
Center in all Cities and Municipalities
of the Philippines and Appropriating
Funds Therefore” provides for the
establishment of Senior Citizen Centers to
cater to older persons’ socialization and
interaction needs as well as to serve as a
venue for the conduct of other meaningful
activities. The DSWD in coordination with
other government agencies, NGO’s, and
people’s organizations shall provide the
necessary technical assistance in the form
of social and recreational services, health
and personal care services, livelihood
services and volunteer resource services.
 Republic Act No. 8425 provides for the
institutionalization and enhancement of
the social reform agenda by creating the
National Anti-Poverty Commission (NAPC).
Through its multi-dimensional and cross
sectoral approach, NAPC provides a
mechanism for older persons to
participate in policy formulation and
decision-making on matters concerning
poverty alleviations.
 Republic Act No. 10155, known as
“The General Appropriation Act of
2012,” under Section 218 mandates that
all government agencies and
instrumentalities should allocate one
percent of their total agency budget to
programs and projects for older persons
and persons with disabilities.
 Republic Act No. 9994, known as
“Expanded Senior Citizens Act of
2010,” an act granting additional benefits
and privileges to senior citizens, further
amending Republic Act No. 7432 and
otherwise known as, “an act to maximize
the contribution of senior citizens to
nation building, grant benefits and special
privileges and for other purposes.” (Senior
Citizen Act of 1992, Act No. 7432)
PRESIDENTIAL PROCLAMATIONS AND
EXECUTIVE ORDERS
 CHAPTER 1&2: OVERVIEW OF PHYSICAL CHANGES IN AGING AND
COMMON GERIATRICS COMPLAIN
CARE IN OLDER ADULT
BS Nursing 3-1 | PROF. C. Garcia, RN | SEM 1 2022
 Presidential Proclamation No. 470, Series
of 1994, declaring the first week of October of
every year as “Elderly Filipino Week.”
 Presidential Proclamation No. 1048, Series
of 1999, declaring a “Nationwide
Observance in the Philippines of the
International Year of Older Persons.”
 Executive Order No. 105, Series of 2003,
approved and directed the implementation of
the programs providing for group homes and
foster homes for neglected, abandoned,
abused, detached, and poor older people and
people with disabilities.
THE PHILIPPINE PLAN OF ACTION FOR SENIOR
CITIZENS (2011-2016)
 This plan aims to ensure giving priority to
community-based approaches which are
gender-responsive, with effective
leadership and meaningful participation of
senior citizens in decision-making process,
both in the context of family and
community.
 Health and Care
o The Department of Social Welfare
Development (DSWD) has issued
Administrative Order No. 4 Series of
2010, “Guidelines on the Home Care
Support Services for Senior Citizens,”
establishing community-based health
care services for older people.
o The RA 9994 provides health care
services for poor older people such as
free medical services on government
hospitals, discounted services on
private hospitals and clinics, free
vaccines, discounted medicines, and
mandatory PhilHealth coverage.
 Social Pension
o Under the RA 9994, the Philippine
Government provides a social pension
of PHP 500 per month to poor older
people aged 77 and over who are not
yet receiving any government or
private pension. The Department of
Social Welfare and Development is the
lead agency tasked with identifying
and reviewing social pension
beneficiaries.
 Senior Citizens
o Refer to the resident citizens of the
Philippines at least 60 years old,
including those who have retired from
government offices and private
enterprises and have a yearly income
of not more than 60,000, subject to
review by NEDA every three years. As
privileges for the Senior Citizens.
GOALS IN THE CARE OF THE AGING
PERSON
 Maintain health function
 Detect disease at an early stage
 Prevent deterioration of an existing
condition
ASSESSMENT
 Wrinkles
 Tissue Sag
 Pouches under eyes
HAIR
 Gray hair in most adult by age 50
 Gradually loss of hair (not all)
PATHOLOGICAL CHANGES
 Barrel chest
 Diminished cough reflex
 Loss of alveolar gas exchange
 Diminished visual cavity (presbyopia)
 Diminished total brain weight
 Diminished amount of neurotransmitter
 Decrease short term of memory
 Decreased in height 1-4 inches
o Resulting from narrowing of the intra
vertebral disk.
 Decreased bone density
CHAPTER 1&2: OVERVIEW OF PHYSICAL CHANGES IN AGING AND
COMMON GERIATRICS COMPLAIN
CARE IN OLDER ADULT
BS Nursing 3-1 | PROF. C. Garcia, RN | SEM 1 2022

o Due to increased risk of absorption  Loss of 12-24 hours

which exceeds the rate of bone  Loss of erection may take only a few
replenishment. COGNITIVE
 Diminished muscular activity  Increasingly forgetful
 Sensory acuity  Decrease sensory acuity
 Impaired balance/coordination PSYCHOSOCIAL
REPRODUCTIVE SYSTEM  Self-sufficiency
CHANGES IN THE PHASES OF o Reflect on life accomplishment, events,
INTERCOURSE IN AGING experiences
EXCITEMENT o Few significant relationship
 Delay in production of vaginal secretions o Some with withdrawal (isolation)
& lubrication HEALTH
PLATEAU  Risk for injuries due to;
 Reproduction in vaginal length, width, and o Muscle weakness
expansion o Change in balance
 Decrease uterine elevation o Gait abnormalities
 Labia majora flaccid & do not elevate &
o Slowed reaction time
flattened against perineum
o Use of medication
 Labia minora do not undergo sex color
o Change in vision, hearing, smells
(change from pink to burgundy)
o Chronic medical condition e.g.
 Clinical size decrease after 60 years of age
parkinsons disease
o Orgasm: slower than in younger age
ISSUES & CONCERN IN OLDER PERSON
o Resolution: occurs more rapidly
1. Social Issues
CHANGES IN THE PHASE OF
 Modification of lifestyle
INTERCOURSE IN AGING MALE
 Decreased power
EXCITEMENT
 Retirement
 Slower increment in excitement
 Social isolation
 Sex flushed less in duration & intensity
2. Psychological Issues
 Diminished involuntary spasm
 Increasing forgetful
 Increase time to obtain erection
 Re-appraise the past
 Lessened testicular elevation & scrotal sac
 Self-concern
vaso-congestion in erection
 Powerlessness
PLATEAU
o Perception that one’s own action will not
 Longer duration
significantly affect an outcome. A
 Increase in penile diameter due to pre-
perceive lack of control over a current
ejaculating fluid
situation or immediate happening.
ORGASM
 Hopelessness
 Shorter duration
o The subjective state in which an
 Fewer contraction in expulsion of serum
individual sees limited or no alternatives
bodies
RESOLUTION
CHAPTER 1&2: OVERVIEW OF PHYSICAL CHANGES IN AGING AND
COMMON GERIATRICS COMPLAIN
CARE IN OLDER ADULT
BS Nursing 3-1 | PROF. C. Garcia, RN | SEM 1 2022

or personal choice available & cannot  Chronic Obstructive Pulmonary Disease

mobilize energy on own behalf.  Heart Disease
 Depression  Cataract
o A state of low mood & aversion to  Orthopedic Impairment
activity that can affect a person’s  Cancer
thoughts, behavior, feelings & physical  Diabetes
well being  Stroke
 Suicidal attempt DIAGNOSTIC TEST USED FOR EARLY
3. Ethical Issues DETECTION OF PROBLEM/ILLNESS
 Decision-making capacity  ECG (ELECTROCARDIOGRAM): to detect
 Advance Derivatives subtle heart abnormalities.
o A written document used to plan & then  CHEST X-RAY: to check any changes in
communicate choices for medical large blood vessel & bony structures of
treatment when can no longer speak for the chest, heart size, presence of TB, lung
themselves because of terminal illness cancer etc.
or permanent loss of consciousness.  PULMONARY FUNCTION TEST: to rule out
 Will (living will) chronic bronchitis & emphysema.
o An act whereby a person is permitted  TONOMETER TEST: to measure
with formalities of law to control, to intraocular pressure to glaucoma.
contain degree the disposition of a state  BLOOD GLUCOSE TEST: to detect
to take effect after his death. diabetes mellitus.
4. Hazard/Accident Issues  PAPANICULAOU TEST: to detect cancer of
CAUSES OF SOCIAL ISSUES & the cervix
PSYCHOLOGICAL PROBLEMS IN OLDER  BLOOD URINE TEST
PERSON  HEARING & VISION TEST: check sensory
1. Loneliness due to losing a spouse & long deprivation.
term friend COMMON GERIATRICS COMPLAIN
2. Taking care of an ill spouse  Shortness of Breath
3. Difficulty with independently managing  Chest Pain
regular activities of living  Altered Mental Status
4. Adjusting & accepting challenges of aging  Abdominal Pain
5. Coping with ongoing medical problems  Dizziness or Weakness
6. Increase number of daily medications  Fever
7. Feeling isolated & less important as older  Trauma
children are engaged in their own lives  Pain
8. Sense of inadequacy from inability to work  Falls
9. Lack of routine activities  Nausea, Vomiting and Diarrhea
MAJOR CHRONIC CONDITION IN  Insomnia
OLDER ADULTS ALTERED MENTAL STATUS
 Arthritis  It’s not normal.
 Hypertension o Vascular
CHAPTER 1&2: OVERVIEW OF PHYSICAL CHANGES IN AGING AND
COMMON GERIATRICS COMPLAIN
CARE IN OLDER ADULT
BS Nursing 3-1 | PROF. C. Garcia, RN | SEM 1 2022

o Inflammation  Could be an indication of Myocardial

o Toxins Infarction
o Trauma  May cause dehydration
o Tumors INSOMIA
o Autoimmune  Usually chronic as 50% of older adults
 Patient complain of difficulty failing
o Metabolic
asleep, frequent nocturnal or early
o Infection
morning awakening, or not feeling rested
o Narcotics
after sleep.
o Systemic
 Most of those affected last of 2 years.
o Congenital  Prevalence is higher in women who are
o Degenerative divorced or widowed.
ABDOMINAL PAIN  Consequence if not address earlier.
 Among the most frustrating assessment GERIATRIC HEALTH ASSESSMENT
for the EMT.  Health history
 One half of patients with abdominal pain  Physical assessment
will require hospital admission. One third  Functional assessment
will need surgical intervention.  Mental status assessment
DIZZINESS OR WEAKNESS  Assessment of social support
 CAUSES:  Environmental & safety assessment
o Cardiac problems  Comprehensive assessment
o Inner ear problems Fluids
o Hypotension Aeration
o Hypertension Nutrition
FEVER Communication
 The body’s immune response to combat Activity
infection decrease. Pain
TRAUMA Elimination
 Can be more debilitating in an older Socialization and Social
patient than a younger patient. GENERAL PRINCIPLES OF GERIATRIC
PAIN CARE
 Many older patients live with pain on a 1. Consider individuality
daily basis. 2. Be patient, kind and sympathetic
 Activities are modified because of pain. 3. Encourage independence
 Weather can exacerbate the pain. 4. Assist elderly to achieve emotional
 EMS may have been called because of an stability
increase in their pain. 5. Stimulate mental acuity and sensory input
FALLS and physical activity
NAUSEA, VOMITING AND DIARRHEA 6. Make elderly stay in home interesting &
 Has an underlying cause lively
7. Provide diversion/occupational therapy
CHAPTER 1&2: OVERVIEW OF PHYSICAL CHANGES IN AGING AND
COMMON GERIATRICS COMPLAIN
CARE IN OLDER ADULT
BS Nursing 3-1 | PROF. C. Garcia, RN | SEM 1 2022

8. Maintain privacy
9. Handle them gently
10. Make them comfortable
11. Encourage them to maintain body
hygiene
12. Assist them to take care of visual,
auditory and dental aid
13. Protect from injuries
14. Ensure adequate nutrition
15. Facilitate elimination
16. Encourage them to do active range of
motion exercise
17. Help elderly to establish good sleep
pattern
18. Caution elderly about the use of drugs
19. Have them physically examined annually
and whenever needed
20. Observe any psycho physiological
changes