1. Chapter 29
Gerontology

2. Societal Bias Older adults stereotyped Discrimination because of age
Older adults viewed as sick, frail, powerless, sexless, burdensome
Today’s older adults living longer
Good nutrition, regular exercise, stress reduction, yearly physical exams, no smoking, new technology
(See Critical Thinking box)

3. Facts About Aging Aging progressive, universal, slow process
No diseases specific to aging
Interest, personal and financial resources, family structure, genetics, attitude play part in how one ages
[FIGURE 29-1]

4. Facts About Aging Lifestyle a factor
Smoking
Misuse of chemicals such as alcohol or drugs
Type of diet
Lack of exercise
Greater variability among older people than younger groups
All older ages not alike

5. Physiological Changes
Not all individuals age the same
Body produces smaller amounts of various hormones and other chemicals
Every body system undergoes changes both physiological and psychological

6. Physiological Changes
Senses
Vision
Pupil size diminishes
Lens may become cloudy
Cornea thickens
Increased sensitivity to glare
Cataracts, glaucoma, macular degeneration common

7. Physiological Changes
Senses
Hearing
Hearing loss not uncommon
May be thought to be mentally weak or senile
Presbycusis is normal hearing loss in elderly

8. Physiological Changes
Senses: taste and smell
Diminishes and makes food less appealing
Taste buds decrease in size
Detecting odors becomes difficult and impaired
Lessens desire for food
Inability to smell smoke or gas and dangerous fumes
[FIGURE 29-3]

9. Physiological Changes
Integumentary system
Aging skin more fragile
Sunlight exposure major cause of wrinkled skin, “liver spots,” leathery looking skin
Hypothermia and hyperthermia serious problems
Hair loses color and becomes thinner
Development of skin cancer

10. Physiological Changes
Nervous system
Brain shrinks in size
Some memory loss or delay in memory can be expected
Transient ischemic attacks (TIAs) can cause sudden loss of memory and confusion
Problems with balance, temperature regulation, diminished pain sensation, insomnia can occur

11. Physiological Changes
Musculoskeletal system
Muscle strength decreases; results in loss of mobility
Less flexibility and joints can stiffen
Loss of height and stooped appearance can result
Arthritis and osteoporosis not unusual
Older adults can suffer fractured bones more easily

12. Physiological Changes
Respiratory system
Breathing capacity diminishes
Rib and chest muscles become smaller and less efficient
Lungs lose their elasticity
Older people prone to pneumonia

13. Physiological Changes
Cardiovascular system
Heart disease and blood vessel disorder major causes of death
Arteriosclerosis: blood vessels lose elasticity, become narrower, build up with plaque, arteries harden
Myocardium loses some ability to pump effectively
Hypertension direct result of these factors
Congestive heart failure
Myocardial infarction

14. Physiological Changes
Gastrointestinal system
Stomach secretions and peristalsis slow
Pernicious anemia can occur
Malnourishment not uncommon
Poor eating habits, poor nutrition, over- or undereating can lead to dental problems

15. Physiological Changes
Gastrointestinal system
Poor dental hygiene leads to gum disease and loss of teeth; makes chewing food difficult
Sometimes cardiac problems occur from gum disease

16. Physiological Changes
Urinary system
Kidneys can decrease in size resulting in less urine production and output
Cardiovascular arteriosclerosis: blood flow to kidney less
Levels of medication may increase to dangerous level
Bladder walls become more inelastic

17. Physiological Changes
Urinary system
Ability to empty bladder completely difficult
Residual urine remains in bladder; microorganisms can cause infection
Cystitis: infection and inflammation of bladder
Urinary incontinence: uncontrollable loss of urine

18. Physiological Changes
Reproductive system
Women experience menopause at about age 55
Men continue to produce sperm after 50 years of age
Testosterone levels diminish (andropause)
May lead to benign hypertrophy of the prostate
Aging men and women can maintain sexual desires

19. Prevention of Complications
Older people at risk for complications as result of body systems undergoing change
Accidents due to impaired vision or inability to hear
Malnutrition and anemia can develop due to poor nutrition
Older adults have diminished sensitivity and lack ability to feel pain
Heat and cold applications can injure the aging

20. Prevention of Complications
Older people at risk for complications as result of body systems undergoing change
Impaired nervous system function may lead to loss of balance, disorientation, confusion
Due to osteoporosis, bones easily fracture
Respiratory tract infections not unusual
Urinary infections more common

21. Prevention of Complications
Older people at risk for complications as result of body systems undergoing change
Circulatory problems common
Vaginitis more common
Enlargement of prostate makes urination difficult
Consult provider regarding alternative substances or engaging in alternative therapy

22. Psychological Changes
Great variation in psychological functioning of older adults
Psychosocial history, race, sex, environmental aspects (education, support system, social class)
Dementia affects memory, personality, cognitive functioning
Alzheimer’s disease form of dementia

23. Psychological Changes
Other forms of dementia:
People who have had stroke
Parkinson’s disease
Syphilis
Huntington’s disease
Depression in older adults can occur

24. The Medical Assistant and the Geriatric Patient
Older adults may experience many factors coupled with physiologic changes and are special challenge to medical assistant
Empathize with patient’s situation
Do not talk to older people as if they were children
Speak slowly, clearly, and have eye contact

25. The Medical Assistant and the Geriatric Patient
Memory-impaired older adults
Geriatric care poses challenges when attempting to communicate
Follow techniques that can be effective in improving verbal communication

26. The Medical Assistant and the Geriatric Patient
Visually impaired older adults
Need to know you are present
Do not approach individual until you make your presence known
Hearing-impaired older adults
Follow techniques that will be beneficial and facilitate communication and understanding

27. The Medical Assistant and the Geriatric Patient
Elder abuse
Physical, emotional, verbal abuse, neglect
All states have elder abuse laws
Required to report abuse
Signs and symptoms of mistreatment or abuse
Carefully document in patient’s chart or EMR

28. Healthy and Successful Aging
Older adults enjoying longer, healthier lives
Increase in number of gerontologists
Awareness and involvement with health care
Improved nutrition
Regular exercise
New medications
Advancing medical technology