2. QUALITY CARE FOR THE GERONTOLOGICAL POPULATION Linda Hansen Ferris State University

3. OBJECTIVES The learner will : exhibit knowledge of how the aging population uses the health care system by stating two facts related to health care use identify three anatomical and physiological changes that occur during the normal aging process state two wellness diagnoses of the aging population. identify two theories of aging identify five assessment tools available to evaluate the aging population state 2 characteristics for optimal care of the aging population state how increased knowledge can help to prevent poor outcomes in the aging population

4. Population Statistics The Elderly population is the fastest growing population in the United States By the year 2030, 20% of the population will be over the age of sixty-five The largest population growth will be in the age group over 85 Barba, B. & Fay, V. 2009

6. Health Care Service Statistics 10.5 visits per year compared to 6.4 visits 85% of all home cares 90% of ECF population Use 48% of nation’s top health resources 60% of hospital admissions Barba, B. & Fay, V. 2009

7. HEALTH CHANGES IN THE ELDERLY POPULATION

8. Physical and Anatomical Changes Cardiovascular changes Arterial wall thickening Heart valve damage Smith, C. and Cotter, V. 2008

9. Physical and Anatomical Changes Continued Musculoskeletal changes Mobility impairment Decreased muscle mass – replaced with fat Risk of falls Smith, C. and Cotter, V. 2008

10. Physical and Anatomical Changes Continued

11. Pulmonary system changes Drier mucous membranes Decreased cough reflex or weakened cough Decreased chest muscle strength Smith, C. and Cotter, V. 2008 Physical and Anatomical Changes Continued

12. Renal and genito-urinary system changes Decreased bladder elasticity Prostate enlargement Decreased creatinine clearance night time voids Smith, C. and Cotter, V. (2008)

13. Physical and Anatomical Changes Continued Oropharyngeal and GI system changes Decreased gastric motility Decreased absorption Smith, C. and Cotter, V. (2008)

14. Physical and Anatomical Changes continued Nervous system and cognition changes Decreased sensitivity to temperature Nervous system diseases Slower response times Sensory changes Smith, C. and Cotter, V. (2008)

15. Sensory Changes Touhy states, “… sensory organs are our windows on the world.” Two sensory organs that impact the elderly are vision and hearing. (Ebersole, Hess, Touhy, Jett, and Luggen, 2008, p. 338).

16. Hearing Loss The two major types of hearing loss Conductive (abnormalities of the ear) Sensor-neural (presbycusis) related to aging Factors that affect hearing loss genetics noise exposure medical conditions medications stress Ebersole et al., 2008

17. Visual Changes Pathological changes in the eye can lead to poorer vision, even blindness decreased visual acuity decreased color discrimination can take longer to adapt to changes in light and darkness increased sensitivity to glare longer time to focus Boyce, 2003

18. Wellness Nursing Diagnoses Adapting to retirement Adjustment to physiological changes Participating in satisfying activities Developing a pattern for daily life Satisfaction with past and present life as lived Stolte, K. 1996