2. By Mrs/ Hamdia Mohammed

3. Assessment older adult client Learning Objectives: 1- Identify the categories of the aging population. 2- list the general physical changes occur for aging client. 3- describe the physical changes occur for each body system.

4. Assessment older adult client The categories of the aging population:  Young-old: 65 to 75 years.  Old: 75 to 85 years.  Old-old: 85 to 100 years.  Elite old; over 100 years.

5. Assessment of integumentary system Physical changesRationale Increased skin dryness.Decrease in sebaceous gland activity and tissue fluid. Increased skin pallor.Decreased vascularity. Increased skin fragility.Reduced thickness and vascularity of the dermis; loss of subcutaneous fat. Progressive wrinkling and sagging of the skin. Loss of skin elasticity, increased dryness, and decreased subcutaneous fat.

6. Assessment of integumentary system Physical changesRationale Brown “age spots” on exposed body parts (e.g., face, hands, arms). Clustering of melanocytes (pigment- producing cells). Decreased perspiration.Reduced number and function of sweat glands. Thinning and graying of scalp, pubic, and axillary hair. Progressive loss of pigment cells from the hair bulbs. Slower nail growth and increased thickening with ridges. Increased calcium deposition.

7. Assessment of neuromuscular system Physical changesRationale Decreased speed and power of skeletal muscle contractions. Decrease in muscle fibers. Slowed reaction time.Diminished conduction speed of nerve fibers and decreased muscle tone. Loss of height (stature).Atrophy of intervertebral discs. Osteoporosis.Bone demineralization. Joint stiffness.Deterioration of joint cartilage.

8. Assessment older adult client Physical changesRationale Impaired balance.Decreased muscle reaction time and coordination. Sensory/perceptual: Loss of visual acuity.Degeneration leading to lens opacity (cataracts), thickening, inelasticity (presbyopia). Increased sensitivity to glare and decreased ability to adjust to darkness. Changes in the ciliary muscles; rigid pupil sphincter; decrease pupil size.

9. Assessment older adult client Physical changesRationale Partial or complete glossy white circle around the periphery of the cornea. Fatty deposits. Progressive loss of hearing. Changes in the structures and nerve tissues in the inner ear; thickening of the eardrum. Decreased sense of taste, especially the sweet sensations at the tip of the tongue. Decreased number of taste buds in the tongue because of tongue atrophy.

10. Assessment older adult client Physical changesRationale Decreased sense of smell. Atrophy of the olfactory bulb at the base of the brain. Increased threshold for sensations of pain, touch, and temperature. Possible nerve conduction and neuron changes. Pulmonary: Decreased ability to expel foreign or accumulated matter Decreased elasticity and ciliary activity

11. Assessment of respiratory system

12. Assessment of cardiovascular system Physical changesRationale Reduced cardiac output, particularly during increased activity or unusual demands; may result in shortness of breath on exertion and pooling of in the extremities Increased rigidity and thickness of heart valves; decreased contractile strength Reduced elasticity and increased rigidity of arteries Increased calcium deposits in the muscular layer

13. Assessment of cardiovascular system Increase in diastolic and systolic blood pressure Inelasticity of systemic arteries and increased peripheral resistance Orthostatic hypotension Reduced sensitivity of the blood pressure-regulating baroreceptors Gastrointestinal: Delayed swallowing time Alterations in swallowing mechanism Increased tendency for indigestion Gradual decrease in digestive enzymes, reduction in gastric pH, and slower absorption rate

14. Assessment older adult client Increased tendency for constipation Decreased muscle tone of the intestines; decreased peristalsis Urinary system: Reducing filtering ability of the kidney and impaired renal function Decreased number of functioning nephrons and arteriosclerotic changes in blood flow Less effective concentration of urine Decreased tubular function Urinary urgency and urinary frequency Enlarged prostate gland in men, weakened muscles supporting the bladder or weakness of the urinary sphincter in women

15. Assessment older adult client Tendency for a nocturnal frequency and retention of residual urine Decreased bladder capacity and tone Genitals: Prostate enlargement in men Exact mechanism is unclear; possible endocrine changes. Multiple changes in women (shrinkage and atrophy of the vulva, cervix, uterus, fallopian tubes, and ovaries; reduction in secretions; and changes in vaginal flora). Diminished secretion of female hormones and more alkaline vaginal pH

16. Assessment older adult client