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Geriatric Care

Geriatric Care

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Geriatric Care

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  1. Geriatric Care JAMES VALLEY VOCATIONAL TECHNICAL CENTER

  2. MYTHS • Elderly people are incompetent and incapable of making decisions or handling their own affairs. • Most elderly live in nursing homes • All elderly people live in poverty

  3. Older people are lonely and unhappy • Elderly do not want to work • “Old Age” begins a 65 • Retirement ends your active life

  4. Physical Changes of Aging • Most physical changes that occur with aging are gradual and take place over a long period of time. In addition, the rate and degree of change varies among individuals.

  5. Factors such as disease can increase the speed and degree of the changes. Lifestyle, nutrition, economic status, and social environment can also have effects. • If an individual can recognize the changes as a/an normal part of aging, the individual can usually learn to adapt to & cope with change

  6. Integumentary SystemChanges • Production of new skin cells decreases • Oil and Sweat glands become less active • Circulation decreases

  7. Hair losses color, and hair loss occurs • Skin becomes less elastic & dry • Itching is common • Dark yellow or brown colored spots appear • Senile lentigines (liver spots)

  8. Fatty tissue layer of skin diminishes • Lines and wrinkles appear • Nails become thick, tough, and brittle • Increased sensitivity to temperature

  9. Care of Skin • Use mild soap • Bath oils or lanolin lotion • Bath or Shower once or twice a week • Brush Hair daily

  10. Shampoo as often as needed for cleanliness and comfort • Care for sore or injuries immediately • Socks, sweaters, lap blankets, and layers of clothing will help alleviate the feeling of coldness

  11. Because of the need for oxygen and nutrients the elderly may experience: • Weakness • Dizziness • Numbness in hands & feet • Rapid heart beat

  12. Circulatory System Care • With circulatory changes: • Avoid strenuous exercise or over exertion • Periods of rest • Moderate exercise, according to individual’s tolerance

  13. Prevent the formation of a blood clot (thrombus) • Support stockings, anti-embolism hose • DO NOT wear garters or tight bands around legs\ • If confined to bed • ROM

  14. High Blood Pressure = • Diet low in salt • Decrease fat intake • Exercise as recommended by physician

  15. Respiratory Changes • Respiratory muscles become weaker • Rib cage more rigid • Alveoli thinner & less elastic which decreases exchange of gases - emphysema

  16. Bronchioles lose elasticity • Changes in larynx lead to higher pitched & weaker voice • Chronic diseases may decrease the efficiency of the respiratory system even more severely

  17. Changes may cause the elderly to experience: • Dyspnea • Breathing increases in rate • Difficulty coughing up secretions • Increases susceptibility to infections such as a cold or pneumonia

  18. Respiratory Care • Alternate activity with periods of rest • Proper body alignment & positioning • Sleep in semi-fowlers position • Use 2 or 3 pillows

  19. Avoid polluted air • Breath deeply & cough frequently • May need continuous oxygen therapy

  20. Nervous System Changes • Blood flow to brain decreases & there is a progressive loss of brain cells - - Interferes with • Thinking - Reacting • Interpreting - Remembering

  21. Senses of taste, smell, vision, & hearing are diminished • Nerve endings less sensitive • Decreased ability to respond to pain and other stimuli • Decrease in taste& smell frequently affects appetite

  22. Changes in vision • Problems reading small print • Seeing objects at a distance • Decrease in peripheral vision • Decrease in night vision • Increased sensitivity to glare • Cataracts • Glaucoma

  23. Changes in hearing • Hearing loss usually gradual • Person may speak louder than usual • Ask for words to be repeated • Not hear high frequency sounds • May not hear well in crowded places

  24. Decreased sensation to pain & other stimuli = more susceptible • Burns • Frostbite • Cuts • Fractures • Muscle strain and other injuries

  25. Digestive Changes • Fewer digestive juices and enzymes produced • Muscle action becomes slower & peristalsis decreases • Teeth are lost • Liver function decreases

  26. Dysphagiais frequent complaint • Less saliva • Slower gag reflex • Loss of teeth • Poor fitting dentures • Slower digestion of food • indigestion

  27. Decrease peristalsis • Increase flatulence (gas) • Constipation • Decrease sensation of taste • Poor appetite • Poor diet

  28. Digestive Care • Good oral hygiene • Repair or replace damaged teeth • Relaxed eating atmosphere • High-fiber high-protein foods with different tastes and textures • Seasoning to improve taste • Increased fluid intake

  29. Urinary Changes • Kidneys decrease in size & become less efficient • Bladder becomes less efficient • May not hold as much • May not empty completely • incontinence

  30. Urinary Care • Increase fluid intake • Decrease before bedtime • Regular trips to bathroom • Easy to remove clothing • Absorbent pads

  31. Endocrine Changes • Increased production of some hormones and decreased of others • Immune system less effective • BMR decreases • Intolerance to glucose

  32. Endocrine Care • Proper exercise • Adequate rest • Medical care for illness • Balanced diet • Healthy lifestyle

  33. Reproductive System Changes • Decrease of estrogen / progesterone in female • Thinning of vaginal wall • Decrease vaginal secretions • Inflammation of vagina common

  34. Weakness in supporting tissue: • Uterus sags downward (Uterine prolapse) • Breasts sag when fat redistributed • Decrease in Testosterone • Slow production of sperm • Response to sexual stimuli slower • Testes smaller less firm

  35. Male and Female • Sexual desire may or may not decrease • Advantages of sex in elderly • Improves muscle tone & circulation • Pain from arthritis seems to decrease

  36. Reproductive Care • Understand physical and psychological sexual needs of the elderly • Allow married couples to be in the same room • Give privacy to consenting elderly

  37. Psychocosocial Changes • Some individual cope with psychosocial changes, and others experience extreme frustration and mental distress

  38. Fears of a sick person: • Death • Chronic illness • Loss of function • Pain

  39. Dealing with fears created by an illness: • Listening • Patience • Understanding • Provide support

  40. Confusion and Disorientation • Six signs: • Talking incoherently • Not knowing their name • Not recognizing others • Wandering aimlessly • Lacking awareness of time or place

  41. Displaying hostile and combative behavior • Hallucinating • Regressing in behavior • Paying less attention to personal hygiene • Inability to respond to simple commands or instructions

  42. Causes of temporary confusion / disorientation • Stress and/or depression • Use of alcohol or chemicals • Kidney disease • Respiratory disease • Liver disease • Medication

  43. Diseases: • CVA • Arteriosclerosis • Atherosclerosis • Cause TIA’s ministrokes which result in temporary periods of diminished blood flow to the brain.

  44. Dementia • Loss of mental ability characterized by a decrease in intellectual ability, loss of memory, impaired judgement, personality change, and disorientation

  45. Acute dementia • When the symptoms are caused by temporary reason: • High fever, dehydration, hypoxia • Chronic dementia • When symptoms are caused by permanent, irreversible damage to brain cells

  46. Alzheimer’s Disease • Form of dementia that causes progressive changes in brain cells

  47. Early Stages: • Memory loss • Mood & personality changes • Depression • Poor judgment • Confusion regarding time & place • Inability to plan and follow through with ADLs

  48. Middle Stages: • Nigh time restlessness • Mood swings increase • Personal hygiene ignored • Weight fluctuates • Paranoia & hallucinations • Full time supervision needed

  49. Late Stages: • Total disorientation • Incoherent • Unable to communicate with words • Loses control of bladder & bowel functions

  50. Develops seizures • Loses weight despite eating a balanced diet • Becomes totally dependent • Lapses into a coma • Dies