Older adult (over 65 years old) - Extremely -Slowed reaction time

aged -Loss of height

Frail elderly- describe a individual who has -Osteoporosis
significant physiologic and functional
-Joint stiffness
impairment of whatever age
-Impaired balance
Categorization of age population
Young old- 65 to 75 years old Sensory/Perceptual
-Loss of visual acuity
Old- 75 to 85 years old
-Partial or complete glossy white circle
Old-old - 85 to 100 years old around the periphery of the cornea
Elite old- over 100 years old -Progressive loss of hearing
-Decreased sense of taste
Common biologic theories in aging -Decreased sense of smell
-Ear and tear theories -Increased threshold to pain, temperature
-endocrine theory and touch
-Degeneration leading to lens opacity
Free-radical theory
-Fatty deposits
Genetic theories
-Changes in structure of the nerve tissues in
Cross- linking theories the inner ear
Immune theories -Tongue atrophy
-Atrophy of olfactory bulb
Physical changes -Possible nerve conduction changes
Integumentary
-Increased skin dryness Pulmonary
-Increased skin pallor -Decreased ability to expel foreign body
-Increased skin fragility -Decreased lung expansion, less effective
-Progressive wrinkling of the skin exhalation
-Brown spot -Difficult, short, heavy, rapid breathing
following intense exercise
-Decreased perspiration
-Decreased elasticity and ciliary activity
-Thinning and graying of the hair -Weakened thoracic muscle
-Slower nail growth -Diminished delivery and diffusion of oxygen
-Decrease in sebaceous gland activity and to the tissues
tissue fluid
-Decreased vascularity
-Reduced thickness and vascularity of the
dermis -Reduced cardiac output and stroke volume
particularly during increased activity
-Loss of skin elasticity
-Clustering of melanocytes -Reduced elasticity and increased rigidity of
-Reduced number and function of sweat arteries
glands -Increase BP
-Progressive loss of pigments
-Increased calcium deposition -Orthostatic hypotension
-Increased rigidity and thickness of the heart
valves
Neuromuscular
-Decreased speed and power of skeletal -Increased calcium deposits in the muscular
muscle layer
-Inelasticity of systemic arteries
-Reduced sensitivity to baroreceptors
Gastrointestinal
-Delayed swallowing time
-Increased tendency for constipation
-Increased tendency for indigestion
-Alterations in swallowing mechanisms
-Gradual decrease in digestive enzymes
-Decreased muscle tone of the intestines
and peristalsis
Urinary
-Reduced filtering ability of the kidneys and
-impaired renal function
-Less effective concentration of urine
-Urinary urgency and frequency
-Tendency for nocturnal frequency and
retention of residual urine
-Decreased number of functioning nephrons
-Decreased tubular function
-Enlarged prostate gland in men, weakened
muscle supporting the bladder
-Decrease bladder capacity and tone
Genitals
-Prostate enlargement
-Multiple changes in women - shrinkage
and atrophy of the reproductive system
-Possible endocrine changes
-Diminished secretion of female hormones
and more alkaline vaginal pH
Developmental task of Older Adult
65-75 years
-Adjusting to decreasing physical strength
-Adjusting to retirement and lower and fixed
income
-Adjusting to death of friends, spouse,
parents
-Adjusting to new relationships with adult
children
-Adjusting to leisure time
-Adjusting to slower physical and cognitive
responses
-Keeping active and involved
-Making satisfying living arrangements as
aging progresses
Psychosocial Development
-Disengagement theory – aging involves
mutual withdrawal between the older person
and others in the elderly person’s
environment
-Activity theory – the best way is to stay
active physically and mentally
-Continuity theory – people maintain values,
habits, and behavior in old age
-Ego integrity vs., despair
-People who attain ego integrity view life
with a sense of wholeness and derive
satisfaction from past accomplishments
-View death as an acceptable completion of
life
-Assignment: Review theories by Peck
Retirement
-Can be a time when recreational activities
deferred for a long time can be pursued
-People who attempt to suddenly refocus
and enrich life at retirement usually have
difficulty
-Economic change
Relocation
-Difficult and stressful
-Assisted living
-Adult day care
-Adult foster care and group homes
Maintaining independence and self
esteem
-To maintain older adults self respect,
nurses and family members need to
encourage them to do as much as possible
for themselves, provided that safety is
maintained
-It can be difficult for elderly to recognize the
differences when they were young and the
present situation
-Recognize their decision making abilities
Facing death and grieving
-Experience feelings of loss, emptiness and
loneliness
-Feelings of guilt and inadequacy can arise
-A person who has meaningful relationship,
friendship, security, ongoing interests in the
community, private hobbies can cope more
easily -Tooth decay
-Peripheral arterial disease
Cognitive Development Developmental Assessment Guidelines
-A difference in speed than in ability Physical Development
-Maintains intelligence judgment, problem -Adjust to physiologic changes
solving, creativity, and other well practiced -Adapt lifestyle to diminishing energy and
cognitive skills ability
-Retrieval of information from long term -Maintain vital sign (especially blood
memory may be slower pressure) within normal range for age and
-Increase forgetfulness in short term sex
memory
Psychosocial Development
-Manage retirement years in a satisfying
Spiritual Development manner
-Understand ideas missed previously -Participate in social and leisure activities
-Takes on new meaning for the elderly who -Have a social network of friends and
may find comfort, solace and affirmation in support persons
religious activities -View life as worthwhile
-Have high self esteem
Health Problems -Gain support from value system and
*Leading causes of death among 65 years spiritual philosophy
and above -Accept and adjust tot significant others
-Heart disease
-Cerebrovascular disease Development in Activities of Daily Living
-Pneumonia -Exhibit healthy practices in nutrition,
-COPD exercise, recreation, sleep patterns, and
-Cancer personal habits
*Accidents –falls,vehicular accidents -Have the ability to care for self or to secure
*Chronic disabling disease appropriate help with activities of daily living
*Drug Use and Misuse -Have satisfactory living arrangement and
*Alcoholism income to meet changing needs
*Dementia
*Elder Abuse Health Promotion Guidelines
Health test and screening
Dementia -Same with middle aged adult
-A slow insidious process that results in
progressive loss of cognitive function Safety
-Characterized by changes in memory, -Home safety measures to prevent falls, fire,
judgment, language, calculation, abstract burns, scalds, and electrocution
reasoning and problem solving ability and -Motor vehicle safety reinforcement,
by impulsive behavior, stupor, confusion especially when driving at night
and disorientation -Precautions to prevent pedestrian
-Most common is Alzheimer”s disease accidents
-Cause is unknown Nutrition and exercise
Health care professionals should be alert -Importance of a well-balanced diet with
for the following signs fewer calories to accommodate lower
-Depression
metabolic rate and decreased physical
-Risks factors for suicide
-Abnormal bereavement activity
-Changes in cognitive function -Importance of sufficient amounts of Vitamin
-Medications that increase risk of falls D and calcium to prevent osteoporosis
-Signs of abuse and neglect -Nutrition and exercise factors that may lead
-Skin lesions to cardiovascular disease
-Regular program of moderate exercise to
maintain joint mobility, muscle tone and
bone calcification
Elimination
-Importance of adequate roughage in the
diet
-At least 6 glasses of fluid daily
-Exercise
Social Interactions
-Encouraging intellectual and recreational
pursuits
-Encouraging personal relationships that
promote discussion of feelings, concerns
and fear
-Availability of social community centers and
programs for seniors