chapter 10

© 2009 Delmar, Cengage Learning

Chapter 10

Geriatric Care


10:1 Myths on Aging

• Aging for everyone begins at at birth and

ends at death

• Gerontology: scientific study of aging and

the problems of the old

• Geriatric care: care of the elderly

• Health care worker must distinguish fact

from myth


Myths and Facts

• Myth: most elderly individuals are cared

for in institutions (nursing homes), or

long-term care facilities

• Fact: most older people are living at

home, with family, or in retirement

communities or facilities

(continues)


Myths and Facts(continued)

• Myth: all elderly people live in poverty

• Fact: less than 10 percent of people over

65 are living at poverty level

• Myth: the older generation are unhappy

and lonely

• Fact: many elderly individuals socialize

by being involved in charity or volunteer

work(continues)



• Myth: anyone over 65 is old

• Fact: many elderly are active and

productive into their 80s and beyond

• Myth: elderly people are not able to

manage their finances

• Fact: older people have lots of

experience and knowledge

(continues)



• Myth: elderly individuals do not want to

work; their goal is to retire

• Fact: there are many elderly who prefer

to work into their 70s and 80s

• Myth: retired people are bored and have

nothing to do with their lives

• Fact: retirees are busy with hobbies,

church, family, and community


Summary

• There are many myths about aging

• Needs of elderly individuals vary

• Even though only 5% of the elderly live in

long-term care facilities, this still means

that 3 million people will be in these

facilities by the year 2020

• Recognizing normal changes allows the

individual to adapt and cope


10:2 Physical Changes of Aging

• Physical changes are a normal part of

the aging process

• Rate and degree of change varies

• Usually related to a decreased function

of body systems


Integumentary System

• Production of new skin cells decreases

• Sebaceous (oil) and sudoriferous (sweat)

glands become less active

• Circulation to skin decreases

• Hair loses color; hair loss may occur

• Methods to adapt and cope with changes

• Measures to slow or decrease changes


Musculoskeletal System

• Muscles lose their tone, volume, strength

• Osteoporosis

• Arthritis

• Coping with changes


• Providing a safe environment


Circulatory System

• Heart muscle becomes less efficient at

pushing blood into the arteries

• Blood vessels narrow and become less

elastic

• Blood flow may decrease to brain and

other vital organs

• Methods used to adapt and cope with

changes


Respiratory System

• Respiratory muscles become weaker

• Rib cage becomes more rigid

• Bronchioles lose elasticity

• Changes in larynx affect voice

• Methods to cope with changes



Nervous System

• Progressive loss of brain cells

• Senses diminish

• Nerve endings are less sensitive

• Methods to adapt and cope



Digestive System

• Fewer digestive juices and enzymes are

produced

• Muscle action becomes slower;

peristalsis decreases

• Teeth are lost

• Liver function is reduced

• Methods that are used to adapt and cope

with changes


Urinary System

• Kidneys decrease in size; not as efficient

at producing urine

• Decreased circulation to kidneys

• Bladder function weakens

• Methods to adapt and cope with

ongoing changes



Endocrine System

• Increased production of hormones

• Decreased production of hormones



Reproductive System

• Female: vaginal walls thin and secretions

decrease; uterus can drop; breasts sag

• Male: sperm decreases; sexual stimuli is

slower; ejaculation takes longer; testes

become smaller; seminal fluid becomes

thinner and less is produced

• Measures to cope with changes


Summary

• Aging causes physical changes in all

body systems; rate and degree vary

• Adapting and coping means fuller

enjoyment of life

• Health care workers need to assess

individuals’ needs

• Tolerance, patience, and empathy are

essential


10:3 Psychosocial Changes of

Aging

• Elderly individuals also experience

psychological and social changes

• Some cope well, while others experience

extreme frustration and mental distress

• Health care workers must be aware of

this and assess changes and stresses


Work and Retirement

• Most adults spend a large portion of their

days working

• Retirement is often viewed as an end to

the working years

• Many enjoy retirement

• Some feel a major sense of loss


Social Relationships

• Change occurs throughout life

• In elderly individuals, it may occur

more rapidly

• Some elderly people adjust to changes

• Some elderly people cannot cope


Living Environments

• Changes in living environments create

psychosocial changes

• Many elderly people prefer to stay in

their own homes

• Some individuals leave their home by

choice

• Moving to a long-term care facility often

creates stress


Independence

• Most individuals want to be independent

and self-sufficient

• Elderly people learn that independence

can be threatened with age

• Factors that can lead to decreased

independence include physical disability,

illness, and decreased mental ability

(continues)


Independence(continued)

• Individuals may need assistance, but the

health care worker needs to allow the

elderly maximum independence and

personal choice


Disease and Disability

• Elderly people are more prone to disease

and disability

• Diseases sometimes cause permanent

disabilities

• When functioning is affected,

psychological stress is experienced

• Sick people often have fear of death,

illness, loss of function, and pain


Summary

• Psychosocial changes can be a major

source of stress

• As changes occur, individuals must learn

to accommodate the changes and

function in new situations

• With support, understanding, and

patience, workers can assist individuals

as they learn to adapt


10:4 Confusion and Disorientation

in the Elderly

• Most remain mentally alert until death

• Signs of confusion or disorientation

• It is sometimes a temporary condition

• Disease and/or damage to the brain


Dementia

• Term used to describe a loss of mental

ability

• Characteristics include decrease in

intellectual ability, loss of memory, and

personality change

• Acute dementia

• Chronic dementia


Alzheimer’s Disease

• One form of dementia

• Causes progressive changes in the brain

cells

• Lack of neurotransmitter

• Frequently occurs in 60s, but can occur

as young as 40 years of age

• Cause is unknown

(continues)


Alzheimer’s Disease(continued)

• Terminal incurable brain disease; usually

lasting 3–10 years

• Early stage

• Middle stage

• Terminal stage


Caring for the Confused or

Disoriented Patient

• Provide safe and secure environment

• Follow the same routine

• Follow “reality orientation” guidelines


Summary

• Caring for a confused or disoriented

individual can be frustrating and even

frightening at times

• Perform continual assessments

• Design program to maximize function

• Practice patience, consistency, and

sincere caring


10:5 Meeting the Needs of the

Elderly

• Geriatric care can be challenging but

rewarding

• Elderly people have the same needs as

others

• Cultural needs

• Religious needs

• Freedom from abuse

• Respect patient’s rights


Summary

• Needs of the elderly do not vary that

much from needs of others

• Sensitive to individual cultural and

religious differences

• Important to respect and follow all of the

patient’s rights

• Must ensure that the patient is free from

abuse

chapter 10

Education

elderly people

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cengage learning2myths

cengage learning5myths

cengage learning3myths

cengage learning6summary

cengage learning4myths

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