Aging & Sensory Function Vision Hearing Balance Touch Taste, smell Content for this module provided by The John A. Hartford Foundation, Institute for Geriatric Nursing, Online Gerontological Nursing Certification Review Course Support for this project provided to School of Nursing, University of Washington by the John A. Hartford Foundation, Geriatric Nursing Education Grant and Nursing School Geriatric Investment Program Grant.

Aging & Changes to the Eyes Anatomical changes  eyelid elasticity (ectropian, entropian) Conjunctiva become thinner & yellow with increased risk of infection Pingueculae (fat pads under conjunctiva) may develop Lacrimal gland & ducts loose fatty tissue & quantity of tears decreases Photo provided by the Administration on Aging at

Aging & Changes to the Eyes Anatomical changes (continued) Eyeballs sit deeper in sockets Cornea flattens and iris fades  connective tissue may cause sclerosis of sphincter muscles Pupils become smaller, sclera becomes thick, rigid Photo provided by the Administration on Aging at

Aging & Changes to the Eyes Anatomical changes (continued) Vitreous humor can degenerate & also detach from retina Cones in retina deteriorate Lenses thicken & lose transparency, decreasing passage of light to retina 1 in 3 persons experiences cataracts

Aging & Changes to the Eyes Physiological changes Presbyopia (  ability to adjust near/far vision)  visual acuity (especially near vision) & narrowing of visual field Difficulty gazing upward & maintaining convergence, adapting to lighting changes

Aging & Changes to the Eyes Physiological changes (continued) Impairment of color discrimination Dullness, dryness of eyes Dry, irritated cornea r/t  tear secretion

Aging & Changes to the Ears Anatomical changes Gradual buildup & hardening of cerumen in ear canal Possible atrophy of the organ of Corti & the auditory nerve Thickening of tympanic membrane (ear drum)

Aging & Changes to the Ears Physiological changes  tone discrimination Presbycusis: difficulty hearing high frequency sounds (  hearing acuity)  ability to discern consonants  equilibrium due to vestibular changes

Aging & Changes to the Ears Hearing loss is NOT a normal part of aging process Hearing loss requires further evaluation for proper treatment conductive loss sensory loss mixed

Aging & Changes to the Ears Signs & symptoms of hearing loss  volume on television or radio Tilting head toward person speaking Cupping hand around one ear Watching speaker’s lips Speaking loudly Not responding when spoken to

Aging & Changes in Balance  balance - caused by a combination of factors  sensory input Slowing of motor responses Musculoskeletal limitations Increased postural sway

Aging & Changes in Balance Functional changes May not present in healthy older adults Deprivation in more than one system is likely to lower balance threshold (i.e., vision & proprioception input) Challenging conditions lower balance threshold climbing up & down steps, curbs getting in & out of bathtub

Aging & Changes in Taste, Smell Alterations in oral mucosa & tongue, & pathologic state of nasal cavity  # of cells, damage to cells,  neurotransmitters

Aging & Changes in Taste, Smell Olfactory losses in healthy adults normal aging process medications viral infections, long-term exposure to toxic fumes head trauma Taste losses disease states of nervous & endocrine systems nutritional & upper respiratory conditions viral infections medications

Aging & Changes in Taste, Smell Functional changes  in sensitivity to airborne chemical stimuli  in recognition of odors Many foods taste bitter or lack taste - potential  in food intake  risk for noxious chemicals & poisonings (e.g., may fail to detect odor of smoke or leaking gas)  risk for impaired nutritional & immune status

Aging & Changes in Touch  sensitivity to light touch  spacial acuity thresholds  two-point discrimination  tactile vibratory thresholds  warm-cold difference thresholds  risk for injury, especially in affected limbs

Aging & Changes in Touch Common disorders affecting tactile information Cerebrovascular accident (CVA) Peripheral vascular disease (PVD) Diabetic neuropathy

Aging & Sensory Changes Nursing considerations Proper screening & intervention are critical: assess impact on ADLs & IADLs ensure appropriate provision & usage of assistive devices

Aging & Sensory Changes Nursing considerations  sight & hearing can lead to:  communication depression social isolation loss of self-esteem loss of independence (i.e., can’t drive) safety concerns