1. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 10 Chapter 10 The Older Person

2. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  People live longer than ever before.  Most older persons have at least one disability.  Disabilities increase and become more severe with aging.  Most older people live in a family setting. Slide 2

3. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Growth and Development  Throughout life, people grow and develop.  Growth and development occur in a sequence, order, and pattern.  Certain skills must be completed during each stage.  A stage cannot be skipped.  Each stage is the basis for the next stage.  Late adulthood involves these age ranges:  Young-old: between 65 and 74 years of age  Old: between 75 and 84 years of age  Old-old: 85 years of age and older Slide 3

4. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Gerontology is the study of the aging process.  Geriatrics is the care of aging people.  Aging is normal.  There are many myths about aging and older persons.  A myth is a widely believed story that is not true. Slide 4

5. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Psychological and Social Changes  How people cope with aging depends on:  Health status  Life experiences  Finances  Education  Social support systems  Retirement  Retirement is a reward for a lifetime of work.  Work helps meet love, belonging, and self-esteem needs.  Retirement usually means reduced income. Slide 5

6. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Social relationships  Social relationships change throughout life.  Most older people have regular contact with children, grandchildren, family, and friends.  Some older persons are lonely.  Children as caregivers  Some children care for older parents.  Parents and children change roles.  Death of a partner  Women usually live longer than men.  When death occurs, the loss is crushing. The person loses a lover, friend, companion, and confidant. The person loses a lover, friend, companion, and confidant. Slide 6

7. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Physical Changes  Physical changes occur with aging.  Energy level and body efficiency decline.  The changes occur over many years.  The rate and degree of change vary with each person.  Quality of life does not have to decline. Slide 7

8. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The integumentary system  The skin loses its elasticity, strength, and fatty tissue layer.  Secretions from oil and sweat glands decrease.  Blood vessels decrease in number.  Brown spots appear on the skin.  Loss of the skin’s fatty tissue layer makes the person more sensitive to cold.  Dry skin is easily damaged and causes itching. Slide 8

9. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Nails become thick and tough.  The skin has fewer nerve endings.  Older persons often complain of cold feet.  White or gray hair is common.  Hair loss occurs in men.  Hair is drier from decreases in scalp oils.  Skin disorders increase with age. Slide 9

10. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The musculoskeletal system  Muscle cells decrease in number.  Muscles atrophy (shrink).  Muscles decrease in strength.  Bones lose minerals, especially calcium.  Bones lose strength.  Bones become brittle and break easily.  Activity, exercise, and diet help prevent bone loss and loss of muscle strength. Slide 10

11. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The nervous system  Nerve cells are lost.  Nerve conduction and reflexes are slow.  Responses are slower.  Blood flow to the brain is reduced.  There is loss of brain cells over time and reduced blood flow to the brain. This affects personality and mental function. This affects personality and mental function. Memory is shorter. Memory is shorter. Forgetfulness increases. Forgetfulness increases. Responses slow. Responses slow. Confusion, dizziness, and fatigue may occur. Confusion, dizziness, and fatigue may occur. Slide 11

12. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Many older people are mentally active and involved in current events.  They show fewer personality and mental changes.  Sleep patterns change.  The senses  Touch and sensitivity to pain and pressure and heat and cold are reduced.  Taste and smell dull.  There are changes in the eye.  Changes occur in the ear. Slide 12

13. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The circulatory system  The heart muscle weakens. It pumps blood with less force. It pumps blood with less force.  Arteries narrow and are less elastic. Poor circulation occurs in many body parts. Poor circulation occurs in many body parts.  When circulatory changes are severe: Rest is needed during the day. Rest is needed during the day. Overexertion is avoided. Overexertion is avoided. Personal care items and other needed items are kept nearby. Personal care items and other needed items are kept nearby. Slide 13

14. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The respiratory system  Respiratory muscles weaken.  Lung tissue becomes less elastic.  Dyspnea may occur with activity.  The person may lack strength to cough and clear the airway of secretions.  Respiratory infections and diseases may develop.  The person should be as active as possible. Slide 14

15. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The digestive system  Salivary glands produce less saliva. This can cause dysphagia (difficulty swallowing). This can cause dysphagia (difficulty swallowing).  Secretion of digestive juices decreases.  Loss of teeth and ill-fitting dentures can cause chewing problems.  Peristalsis decreases.  Flatulence and constipation can occur.  These measures can help: Avoid dry, fried, and fatty foods. Avoid dry, fried, and fatty foods. Eat high fiber foods. Eat high fiber foods. Eat foods that provide soft bulk. Eat foods that provide soft bulk. Slide 15

16. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  The urinary system  Kidney function decreases.  The kidneys shrink (atrophy).  Blood flow to the kidneys is reduced.  The ureters, bladder, and urethra lose tone and elasticity.  Bladder muscles weaken.  Bladder size decreases.  Urinary tract infections are risks. Slide 16

17. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc.  Changes in the reproductive organs occur in men.  The hormone testosterone decreases.  Changes affect strength, sperm production, and reproductive tissues.  Changes in the reproductive organs occur in women.  Menopause is when menstruation stops and the woman can no longer have children.  Female hormones (estrogen and progesterone) decrease. Slide 17

18. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Housing Options for Older People  Living with family  Adult day-care centers  Elder Cottage Housing  Apartments, accessory dwelling units (ADU)  Residential hotels  Congregate housing  Senior citizen housing  Home-sharing  Assisted living  Board and care homes  Adult foster care  Continuing care retirement communities (CCRCs)  Nursing centers Slide 18

19. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Environmental Requirements  The person’s care equipment is clean and properly stored.  Bed linens are clean and in good condition.  There are clean towels and wash cloths for each person.  The person has closet space with reachable shelves.  Lighting, temperature, and sound levels are comfortable and adequate.  Hand rails, assistive devices, and other surfaces are in good repair.  Care equipment is used following the manufacturer’s instructions.  Safety measures are practiced. Slide 19

20. Copyright © 2011, 2007, 2003, 1999 by Mosby, Inc., an affiliate of Elsevier Inc. Quality of Life  Moving to a nursing center can cause feelings of loneliness and isolation.  Some people are trying to cope with many losses.  These measures can help the person feel good about his or her appearance:  Help residents with grooming.  Help them dress in clothes of their choice.  Make sure dentures, eyeglasses, and hearing aids are in place.  Respect the person’s wishes for privacy. Slide 20