Common Health Problems of Older Adults Chapter 3 Common Health Problems of Older Adults

Subgroups of Late Adulthood Young old—ages 65 to 74 years Middle old—ages 75 to 84 years Old old—ages 85 to 99 years Elite old—ages 100 years and older

Common Health Issues and Concerns Nutrition Mobility Stress and loss Safety Drug use and misuse Mental health/behavioral health Elder neglect and abuse

Nutrition Causes of older adult malnutrition: Inflation, reduced income, and lack of transportation Inappropriate or unbalanced foods Trouble carrying heavy bags or packages Loneliness Diminished sense of taste and smell Tooth loss and poorly fitting dentures

Mobility

Benefits of Regular Exercise Decreased risk for falls Increased mobility Increased sleep Reduced or maintained weight Improved well-being and self-esteem Fewer depression symptoms Improved longevity Reduced risk for DM and CAD

Frequent Sources of Stress Rapid environmental changes Changes in lifestyle Acute or chronic illness Loss of significant others Financial hardships Relocation stress syndrome

Accidents Fallophobia—a fear of falling, which causes one to avoid leaving home Factors that increase accident likelihood: Presbyopia Reduced sense of touch Decreased reaction time Peripheral neuropathy Arthritis

Fall Prevention and Safety Home modification Exercise Tai chi

Driving Safety Motor vehicle accidents are the most common cause of injury-related death in the young-old population, those between 65 and 74 years of age. Adult driver safety: Attend driving refresher classes. Avoid high-risk driving conditions. Be aware of prescription side effects.

Drug Use and Misuse Polypharmacy May not be able to tolerate standard dosage of drugs Physiologic changes from aging can affect absorption, distribution, metabolism, and excretion of drugs from the body “Start low and go slow” policy

Self-Administration of Drugs

Mental Health/Behavioral Health Clinically competent—person is legally competent and can make clinical decisions Decisional capacity—individual’s ability to identify problems, recognize options, make decisions, and provide the rationale supporting the decisions

Depression Mood disorder that can have cognitive, affective, and physical manifestations Primary depression Secondary or situational depression Geriatric Depression Scale used for assessment Treatment generally includes drug therapy and psychotherapy

Geriatric Depression Scale

Dementia Syndrome that involves a slowly progressive cognitive decline, sometimes referred to as chronic confusion Global impairment of intellectual function that is generally chronic and progressive Alzheimer’s disease

Delirium Acute state of confusion Usually short-term and reversible within 3 weeks or less Often seen among older adults in a setting with which they are unfamiliar Can include physical manifestations of change

Elder Neglect and Abuse Neglect—failure to provide basic needs Physical abuse—use of physical force that results in bodily injury Financial abuse—mismanagement or misuse of property or resources Emotional abuse—intentional use of threats, humiliation, intimidation, and isolation

Health Care Issues in Hospitals Sleep disorders Problems with eating and feeding Incontinence Confusion Falling Skin breakdown

Restraints Reduction of use in nursing homes and hospitals Chemical restraints Physical restraints used when chemical restraints and warnings fail